When economic agenda governs public health, you get clichs instead of solutions
a 'commission on social determinants of health', set up by the World Health Organization took four years to tell us that the poor cannot expect to live 100 years as they live in the poorest physical condition and have no access to healthcare! Equity in healthcare isn't a new idea by any means. This report is eerily similar to the recommendations doled out 30 years ago by the International Conference on Primary Health Care at Alma-Ata. The current voluminous diagnosis by a 19-member team is only the latest in a series, and the prescription to the disease of global ill health remains an academic exercise only. The prescription calls for universal employment, and improved environment to cure the disease, as if the medicines and the political economy that creates the disease are mutually exclusive. The report also remains silent on how to fix the holes in current health policies of various nations.
The recommendation that health inequity can be bridged if all national and international policies are sensitive to health needs fails to digest the fact that the economic system in place creates the inequity in society in the first place. Ideally, a public health campaign should aim to stop people from using tobacco products completely. Instead, the campaigns pussyfoot the message, wrapping them in politically correct language of 'raising awareness' as governments cannot give up the revenue from the industry. Similarly, a patent regime on drugs is promoted at the behest of the World Trade Organization, although it is well known that this would hike the cost of drugs and healthcare. Even if we discount the revolutionary approach of closing inequity, there are hundreds of tools that may give poor communities confidence in basic health. These solutions are only good practices that come absolutely free, and can be applied and monitored by the community itself. But that does not happen as state policies always introduce substitutes prompted by healthcare, food and drug industries. Inability to pay for these products and services push people into the dark cycle of ill health. Governments are torn between the demands of promoting industry and promoting healthcare among the most vulnerable. who's commission would have done its job if it had addressed this conflict of interest. It did not. Another opportunity lost.
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