It strikes me that the global economic meltdown is creating one of those “is the glass half full or half empty?” moments. Governments are talking up the need for public spending, investment and infrastructure development as part of efforts to kickstart economies. As Fran Baum and colleagues point out in Crikey today, it’s a critical time for those working for a more equitable distribution of health, whether within individual countries or more globally. Their ability to influence governments will depend on their ability to transform a public debate about economics into a much broader discussion. Is this likely? I’d like to believe so, but must confess that I’m probably more of a “glass half empty” type of gal on this one…
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The comments from Fran and co are right on the button! But the issue is not just about the poor in developing countries but the poor (and their health) in general. At a global level we need not to reform the World Bank, WTO and IMF but abandon them. They are not what Keynes envisaged would come out of the Bretton Woods Agreement. The voting in these is all too skewed towards the rich West and if the West cannot get its way there, it then retreats to the G7 and G8. What we need is the voice of the people as world citizens not to sort out this mess but to provide the values on which to sort out this mess. As Stiglitz – but only after he left his very senior position at the World Bank – has stated ’If the issue of [improving] access to AIDS drugs were put to a vote, in either developed or developing countries, the overwhelming majority would never support the position of the pharmaceutical companies.’ There is a gap between what informed citizens of the world want and what global institutions deliver. There seems also to be a gap between the values of a nation’s citizens and what is then provided by way of health care and public health.