It’s becoming alarmingly clear who is paying the highest price for the global financial crisis – and it’s not Wall Street, writes Daniel Tarantola, Professor of Health and Human Rights at the University of New South Wales.
The United Nations estimates 55 to 90 million more people will be plunged into poverty this year alone by the continuing economic downturn, while at the same time the escalating food crisis has pushed world hunger through the one billion mark.
Last month the UN conceded its Millennium Development Goals for 2015 – the ambitious blueprint set by world leaders in 2000 to make the world a fairer, better place – are now in jeopardy.
We’re not just looking at a short term disaster in the third world, but at a long term health crisis: the forces of poverty, globalisation, climate change and pandemics are compounding to threaten health as never before.
This comes at a time when we’ve never had such a wealth of medical knowledge and technology. We can restore sight with a patient’s own stem cells and we’ve achieved a more than 50 per cent cure rate for cancer – but in much of the world, especially in our region, the right to good health is becoming a distant dream.
Being poor makes people sick – and, often, being sick makes people poor. Health care services are being pushed out of the reach of many as free market economic reforms lead to a shift from centralised public health systems to private health care.
Asia now has the highest level of out of pocket expenditure on health care and the highest number of households driven into poverty by the costs of sickness – even if the most sophisticated medical facility is just next door.
The conditions of impoverishment themselves, such as poor sanitation, a lack of adequate food and shelter, substandard education and forced migration, also lead to ill health.
Just as the 19th Century industrial revolution saw millions of people moving into squalid slums and factories, so 21st Century globalisation – even though it has lifted 600 million people out of poverty in Asia since 1990 – is making many people more vulnerable to ill health in squalid slums or from exposure to new toxic threats.
Mass people movements due to the financial crisis are of growing concern. Asian workers in the Middle East who are losing their jobs are returning to their homes in Vietnam or the Philippines, often without employment opportunities or access to an adequate level of accommodation and food.
What happens when the next pandemic strikes the cramped, unsanitary slums in which many of these workers are finding themselves? Or when their numbers are boosted by thousands forced from their homes by the next weather catastrophe wrought by climate change?
The 21st Century economy is affecting health in other ways, too. New multilateral or bilateral trade agreements are imposing stricter controls on drugs – while they are ensuring better quality, they are also restricting people’s access to cheaper generic medicine.
The food market is also under patent protection which is making food more expensive across the region and leading to an increase of counterfeited products which themselves can jeopardise health, such as contaminated milk products from China.
Ironically, globalisation has also exposed people in the third world to a host of Western health concerns, such as obesity, cardiovascular disease, cancer and depression. Globally, traffic accidents are increasing and tobacco-related deaths will outnumber those from HIV/AIDS this century.
All of these crises compound people’s vulnerabilities to ill health, but they have traditionally been considered in isolation.
Health and development are inextricably linked. We need to understand how they intersect and build bridges between our responses to these multiple crises so they can be addressed in a more meaningful way.
A human rights-based approach is the most promising. Everyone has a right to the highest attainable standard of health – and also the right to the basic determinants of health such as clean water and food, shelter, health services and equality.
It is only by addressing people’s most basic needs, and recognising these as fundamental rights, that we can bring the extraordinary potential of modern medicine to everyone in a globalised world.
Daniel Tarantola is Professor of Health and Human Rights at the University of New South Wales (UNSW). Professor Tarantola was formerly a senior advisor to the World Health Organisation, where he supervised the team responsible for eradicating small pox worldwide. He has held senior positions with the Harvard School of Public Health and played a key role in the creation of Medicins Sans Frontieres. Professor Tarantola is Chair of UNSW’s Initiative for Health and Human Rights, which is organising Asia’s first international conference on health, rights and development to be held in Vietnam in October.
