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Global Health Watch 2005–2006 was first published by Zed Books Ltd, 7 Cynthia Street, London n1 9jf, uk and Room 400, 175 Fifth Avenue, New York, ny 10010, usa in 2005 www.zedbooks.co.uk in association with: People’s Health Movement: c/o Community Health Cell, #367 ‘Srinivasa Nilaya’, Jakkasandra 1 Main, 1 Block, Koramangala, Bangalore–560 034, India Medact, The Grayston Centre, 28 Charles Square, London n1 6ht, uk Global Equity Gauge Alliance: c/o Health Systems Trust, 401 Maritime House, Salmon Grove, Victoria Embankment, Durban 4001, South Africa www.ghwatch.org Copyright © People’s Health Movement, GEGA, Medact, 2005 The rights of the editor and contributors to be identified as the authors of this work have been asserted by them in accordance with the Copyright, Designs and Patents Act, 1988. Cover photo credits: Thailand drought (Kittprempool/UNEP/Still Pictures); India, Mumbai, slum with highrise buildings in the background (Ron Giling/Still Pictures); USA, California, motorway juntion (NRSC/Still Pictures); China, Hong Kong, the city at night (JP Sylvestre/Still Pictures); Mali near Segou, healthcare in the Niger River area – village clinic (Jan Banning/Panos Pictures); India, Calcutta, examining sick child at a hospital for the poor (Neil Cooper/Panos Pictures). Cover designed by Andrew Corbett Set in Arnhem and Futura Bold by Ewan Smith, London Index: ed.emery@britishlibrary.net Printed and bound in Malta by Gutenberg Press Distributed in the usa exclusively by Palgrave Macmillan, a division of St Martin’s Press, llc, 175 Fifth Avenue, New York, ny 10010. A catalogue record for this book is available from the British Library. us cip data are available from the Library of Congress. All rights reserved isbn 1 84277 568 5 hb isbn 1 84277 569 3 pb
Contents Boxes, figures and tables | vi Illustrations | ix Acknowledgements | xi Foreword | xvii Introduction 1 Part A | Health and globalization 9 a1 Health for all in the ‘borderless world’? 11 Part B | Health care services and systems 53 b1 Health care systems and approaches to health care 55 b2 Medicines 100 b3 The global health worker crisis 119 b4 Sexual and reproductive health 134 b5 Gene technology 147 Part C | Health of vulnerable groups 161 c1 Indigenous peoples 163 c2 Disabled people 179 Part D | The wider health context 191 d1 Climate change 193 d2 Water 207 d3 Food 225 d4 Education 239 d5 War 253 Part E | Holding to account: global institutions, transnational corporations and rich countries 267 e1 World Health Organization 269 e2 UNICEF 293 e3 The World Bank and the International Monetary Fund 299 e4 Big business 307 e5 Aid 322 e6 Debt relief 332 e7 Essential health research 339 Part F | Conclusions 351 Index | 361
Page 1 and 2: About this book Today’s global he
Page 3: Global Health Watch 2005-2006 An al
Page 7 and 8: C2.1 The facts about disability 180
Page 9 and 10: Illustrations 1 Medicine cannot dea
Page 11 and 12: Acknowledgements The following indi
Page 13 and 14: London School of Hygiene and Tropic
Page 15 and 16: Victoria, Canada; Centre for Health
Page 17 and 18: Foreword New reports on different a
Page 19 and 20: Introduction Origins The Global Hea
Page 21 and 22: Child malnutrition, death and disab
Page 23 and 24: Human rights and responsibilities A
Page 25 and 26: impacting on health. The Watch hope
Page 27: part a | Health and globalization T
Page 30 and 31: Health and globalization | A1 and h
Page 32 and 33: Health and globalization | A1 in 20
Page 34 and 35: Health and globalization | A1 is gl
Page 36 and 37: Health and globalization | A1 peopl
Page 38 and 39: Health and globalization | A1 numbe
Page 40 and 41: Health and globalization | A1 and p
Page 42 and 43: Health and globalization | A1 econo
Page 44 and 45: Health and globalization | A1 Box A
Page 46 and 47: Health and globalization | A1 half
Page 48 and 49: Health and globalization | A1 appro
Page 50 and 51: table a1 Key health concerns with W
Page 52 and 53: Health and globalization | A1 Healt
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Health and globalization | A1 merci
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Health and globalization | A1 thems
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Health and globalization | A1 Even
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Health and globalization | A1 • A
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Health and globalization | A1 non-v
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Health and globalization | A1 27-28
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Health and globalization | A1 Jenki
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Health and globalization | A1 Satte
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Health and globalization | A1 WHO (
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and regulatory authorities mandated
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Health care systems | B1 4) selecti
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Health care systems | B1 • And si
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Health care systems | B1 • declin
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Health care systems | B1 user charg
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Health care systems | B1 focus on t
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Health care systems | B1 for health
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Health care systems | B1 their cont
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Health care systems | B1 health car
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Health care systems | B1 ing servic
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Health care systems | B1 Box B1.7 G
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Health care systems | B1 many of th
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Health care systems | B1 the lack o
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Macro-economic factors Impoverished
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Health care systems | B1 HALE 2000
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Health care systems | B1 But improv
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Health care systems | B1 high-incom
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Health care systems | B1 Structural
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Health care systems | B1 the high t
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Health care systems | B1 and histor
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Health care systems | B1 norms (Loe
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Health care systems | B1 Foster M,
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Health care systems | B1 Toole M et
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B2 | Medicines Introduction Essenti
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Health care systems | B2 of new med
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Health care systems | B2 chapter re
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Health care systems | B2 the fourth
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Health care systems | B2 agenda thr
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Health care systems | B2 nonetheles
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Health care systems | B2 decision o
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Health care systems | B2 for the an
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Health care systems | B2 expenditur
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Health care systems | B2 Medawar C
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Health care systems | B3 between he
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Severe shortage Low density Moderat
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Health care systems | B3 sector and
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Health care systems | B3 to the US,
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Health care systems | B3 500 400 30
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Health care systems | B3 have been
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Health care systems | B3 to underta
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B4 | Sexual and reproductive health
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Health care systems | B4 10 Policy-
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Health care systems | B4 women and
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Health care systems | B4 of funding
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Health care systems | B4 debate on
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Health care systems | B4 the sexual
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Health care systems | B4 perspectiv
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Health care systems | B5 genome res
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Health care systems | B5 drugs base
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Health care systems | B5 Complete f
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Health care systems | B5 when a tes
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Health care systems | B5 are allowi
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Health care systems | B5 of life sc
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part c | Health of vulnerable group
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Health of vulnerable groups | C1 me
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Health of vulnerable groups | C1 pr
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Health of vulnerable groups | C1 Th
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Health of vulnerable groups | C1 Ca
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Health of vulnerable groups | C1 Bo
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Page 194 and 195:
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Health of vulnerable groups | C1 Pa
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Health of vulnerable groups | C2 DP
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Page 204 and 205:
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Health of vulnerable groups | C2 di
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part d | The wider health context T
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D1 | Climate change Introduction En
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increasing quantities are now causi
Page 215 and 216:
development, local availability foo
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14 Droughts threaten the food secur
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Protocol can meet their targets by
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15 Transport and travel are major d
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• Redesign trade rules. Governmen
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D2 | Water Access to enough clean w
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water consumption worldwide. Each p
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table d2.1 Top corporate players in
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16 Protesting against the privatiza
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Box D2.3 Regulating private water c
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The private sector overestimates th
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Box D2.7 US citizens told to boil t
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to water. Worse still, it does this
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References Barlow M, Clarke T (2002
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D3 | Food Undernutrition is by far
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Functional and Productive Capacity
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table d3.1 Corporate control of US
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keting and processing means that sm
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average Indian family of four reduc
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Bank’s US$ 93.5 million loan to C
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Avery N, Drake M, Lang T (1993). Cr
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D4 | Education Some 135 million chi
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ledge about health-care practices a
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2005, and on present trends about 4
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Box D4.3 Programmes that aim to emp
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• per capita public spending fall
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unable to recruit 9000 badly needed
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Gordon D et al. (2003). The distrib
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D5 | War War has an enormous and tr
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19 Chechnya destroyed. War has wide
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initiated a ‘war on terrorism’.
Page 277 and 278:
an explosive force equivalent to ab
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the risk of their misuse and divers
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Box D5.3 An agenda for peace The Ha
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Machel G (1996). Impact of Armed Co
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part e | Holding to account: global
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E1 | World Health Organization The
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The sources consulted worldwide in
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Box E1.1 Milestones in WHO history
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aised by his attempts to revitalize
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• stronger internal focus on perf
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21 WHO - up in the clouds? Reaction
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in favour of so-called ‘vertical
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to speak openly, while bullying and
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velop a unified, purposeful health
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to medicines, and the mobilizing ro
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Recommendations WHO’s core purpos
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doctors, and more people with exper
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E2 | UNICEF In 2005, Carol Bellamy,
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In sum, for almost a decade, childr
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prompted a global debate on how to
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E3 | The World Bank and the Interna
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22 World Bank: the centre of world
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approach to conditionality is being
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tal policies should explicitly refe
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E4 | Big business This chapter deal
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23 The Marlboro Man was described b
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dedicated funding [Articles 5.6 and
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grass roots in building government
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24 A pack of Cerelac cereal food pu
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USAID has also funded work on breas
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(from whatever its source, and howe
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These trends in taxation are underp
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Norway Denmark Netherlands Luxembou
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Global aid trends - allocation Wher
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weapons, vehicles and military trai
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table e5.1 Value (in £) of new DFI
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OECD (2005). Development Co-operati
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25 Breaking the chains of debt: pro
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Box E6.1 Zambia: inflation or death
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have met the Fund’s conditions, a
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E7 | Essential health research Rese
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Developing national health research
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for African Medical Editors (Certai
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Neither the consultations leading u
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Box E7.4 Asking the social-politica
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• global architecture for health
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part f | Conclusions Global Health
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current debt relief mechanism - the
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agreement, and taking health and he
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ity of the now-developed countries
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tion and water are experiencing sim
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