From poverty to power - Oxfam-Québec

FROM POVERTY TO POWERTherefore when donors lost interest and their funding for vaccineprogrammes decreased, there was a collapse of many vaccinationprogrammes and a falling vaccination rate in the following years.Currently, private philanthropy and government-led public–privatepartnerships (PPPs) are reinvigorating vaccination programmes, buttheir sustainability requires massive and long-term investment inpublic health services, something that many donors have yet to accept.People with less political clout, such as those living in remotelocations, urban slums, and border areas, as well as indigenous groupsand displaced populations, are most likely to miss out on vaccination– an indicator of their lack of access to other essential health services.An estimated 2.1 million people around the world died in 2002 ofdiseases preventable by widely used vaccines. This toll included 1.4million children under the age of five. 73On top of continuing epidemics of preventable diseases such aschest infections, malaria, and TB, and of treatable ones such as AIDS,the wealthier developing countries now also face a rise of ‘first world’ailments such as heart disease, diabetes, and cancer, creating a ‘tripleburden’ of old, new, and chronic disease that threatens to overwhelmunderfunded health services. More than half of the world’s new casesof diabetes are in India and China. Half of global cancer deaths are indeveloping countries, including (due to late diagnosis and lack oftreatment) 95 per cent of deaths from cervical cancer. 74 Since theseafflictions usually strike wealthier urban populations who enjoygreater political clout, providing treatment for them may drainresources away from tackling the health risks facing poor people,through preventive strategies and long-term investments in healthsystems.An additional global problem is the extraordinarily unequalgeographic distribution of health spending and health workers. TheAmericas, with 10 per cent of the global burden of disease, have 37 percent of the world’s health workers and absorb more than 50 per cent ofthe world’s health financing. Africa, on the other hand, has 24 per centof the disease burden but only 3 per cent of health workers, andcommands less than 1 per cent of world health expenditure.Moreover, Africa’s attempts to increase provision are constantlyundermined by the exodus of its nurses and doctors in search of240