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What's the best way to improve developing world health?
Written by: Peter Apps
It may be the high profile disasters like earthquakes, tsunamis and the Californian fires that steal headlines but death tolls from disease and ill-health in the developing world dwarf the few dozen, hundred or even thousand killed by sudden catastrophes. Reducing that toll was one of the main aims of the Millennium Development Goals, which sets targets for reducing poverty and mortality. Some estimates show that countries need to spend $35-$40 a person to meet those targets. But poor states such as Liberia are having to manage with closer to five dollars. Aid agency Merlin recently held a conference on the best way to meet the Millennium health goals, based on their work in Liberia. You can read their report here. The US-based Public Library of Science posed the question "which single intervention would do most to improve the health of those living on less than one dollar a day?" to a range of development and medical experts as well slum dwellers. There was an interesting array of answers. Some suggested medicated bed nets to reduce malaria, others direct cash transfers to the poor to buy health services, safe water supplies, a hypothetical AIDS vaccine, educating women, ensuring free trade or promoting vaccination. "Ensure two square meals a day," suggests Mushtaque Chowdhury, director of the research and evaluation commission of the Bangladesh Rural Advancement Committee. "I believe for the poorest food is the most effective first intervention for health improvement." Ugandan television reporter Rosebell Kagumire suggests educating women is key. "An educated woman will know what a child needs to eat for nutritional purposes, and their income level is mostly higher than that of illiterate mothers," he says. Others are more political, calling for free trade to enhance household incomes in poor countries or even outright revolution to bring in governments with greater commitment to uplifting the poor. Liberian health minister Walter Gwenigale says he knows what would make a real difference in his country -- and it is the one thing Western donors will not fund. He told Reuters that what he really wanted was outside funding so he could pay doctors enough not to quit and go overseas -- and hopefully to tempt back medical staff who fled during the war and are now earning better money in other countries. It is a problem that some experts and aid groups feel will get worse if the European Union introduces its "blue card" scheme to encourage skilled migration, which could also drain trained medical staff and nurses from poor countries. "I think it's quite hypocritical," World Vision UK health adviser Rebecca Cooper told me. "It doesn't make sense to keep increasing the aid budget year-on-year and say we want to help if we are doing this."
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4 responses to “What's the best way to improve developing world health?”
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Peter Apps covered business, politics, disaster, disease, agriculture and occasional crime stories for Reuters in southern Africa before being reposted to Sri Lanka just in time for a new outbreak of civil war. A minibus crash on assignment in September 2006 broke his neck and left him quadriplegic. Nine months to the day after the crash, he was released from hospital in a wheelchair and returned to work for AlertNet in London, scheming his return to field reporting.
31 Oct 2007 08:48:23 GMT
I had hoped to read a miraculous recipe, some innovative idea. Nothing yet. Perhaps the problem has to be stated differently: health can not be isolated from education, housing, food security, employment, micro-finance, literacy... Poverty has to be tackled as a whole - with its many components - and governments of poor countries have to be the main protagonists of their own development. They have to be the core signatories of their own Millennium Development Goals. Goals that are realistic and that they assume full ownership, responsibility and accountability for. With the strong support, participation and even monitoring by the rest of the world - the rich countries and international organizations - within the frame of a world alliance.
01 Nov 2007 09:07:19 GMT
As things are, the human biosphere is a terribly dysfunctional set of systems.
It seems obvious that no single intervention could ever turn things around for those currently "living on less than a dollar a day". What would bring about most improvement to health in the short term would be adequate safe water supplies, and an adequate basic diet for all. In the longer term it would be safety, security and education - but the latter would need to be both adequate and relevant - a distant dream. What we seek to reduce is suffering - but then, that's what life is, isn't it? And despite the fact that life is fragile and easily extinguished, human population figures do still keep multiplying, globally. It seems to me that we actually need smaller human populations - kinder, wiser ones, with a more equitable distribution of resources all round. Then we'd all be healthier. Utopia? Probably.05 Nov 2007 09:08:55 GMT
Social health insurance. We know what has worked for many other developing countries and developed countries as well. Just look at the few developing countries with acceptable to "healthy" health indicators e.g Costa Rica, Cuba. The evidence are there for those (policy makers) who "care" to open an eye to see them and easily understand them. But it requires a bit of: courage from governments with political will to put the policies on paper and allocate resources accordingly; solidarity from society as a whole to accept that some resources and risk pooling to take place; professionalism from civil servants (health workforce) to implement policies in decent ways and learn to be accountable at every level... The rest is history and I hope to witness it in my lifetime!
05 Nov 2007 09:10:20 GMT
Miss Maureen, If you think we "need smaller human populations" then why don't you volunteer to be the first to go? If you really believe your statement you will end up supporting inaction when action is needed to keep alive the malnourished children on streets an in slums. Please don't believe what you said about smaller populations.