Poverty and the Continuing Global Health Crisis

vails, poverty, the curse of the majority of the world's population was and to successful health reforms, contributing to this day to the global health crisis that the.
Table of contents

If the rich countries are struggling on this issue, for poorer countries, it is even harder:. Throughout Africa, the privatization of health care has reduced access to necessary services. The introduction of market principles into health care delivery has transformed health care from a public service to a private commodity. The outcome has been the denial of access to the poor, who cannot afford to pay for private care For example … user fees have actually succeeded in driving the poor away from health care [while] the promotion of insurance schemes as a means to defray the costs of private health care … is inherently flawed in the African context.

When infectious diseases constitute the greatest challenge to health in Africa, public health services are essential. Private health care cannot make the necessary interventions at the community level … is less effective at prevention, and is less able to cope with epidemic situations. The privatization of health care in Africa has created a two-tier system which reinforces economic and social inequalities….

Despite these devastating consequences, the World Bank and IMF have continued to push for the privatization of public health services. A blanket avoidance of user fees may not always be advisable. Where appropriate , user fees may encourage accountable health practice. Foreign donors and the Bangladeshi government gave Dr. Zaf money, but he also charged his poor patients modest fees to expand services further.

He found that even the poor were willing to pay for good service [and fees can be] a way to increase accountability for delivering health services. Maternal mortality in the area covered by [the center] is one fourth of the national average. So, although full privatization still seems inappropriate, the example from a part of Bangladesh suggests that there may be numerous and innovative ways to address different types of issues. Furthermore, poverty has contributed to the phenomena of brain drain whereby the poor countries educate some of their population to key jobs such as in medical areas and other professions only to find that some rich countries try to attract them away.

Developed world is robbing African countries of health staff. Some countries are left with just doctors each with large areas without any health workers of any kind. A shocking one third of practicing doctors in UK are from overseas , for example, as the BBC reports. Some of the ideological underpinnings that drive Structural Adjustment have long-continued.

For example, the Bretton Woods Project organization summarizes the finding from a recent evaluation of World Bank health work that was damming in its conclusions, while the Bank carries on pushing the same policies:. It rated projects according to how well they met stated objectives, regardless of how good those objectives were. Highly satisfactory outcomes were almost unheard of, and only about two-thirds of projects had moderately satisfactory outcomes or better. Projects in Africa were particularly weak , with only 27 per cent achieving satisfactory outcomes.

Overall only 29 per cent of freestanding HIV projects had satisfactory outcomes, falling to 18 per cent in Africa. Repeating a consistent criticism of past reports, the IEG found that monitoring and evaluation remains weak while evaluation is almost nonexistent. Only 27 per cent of projects had substantial or high monitoring and evaluation structures.

This has led to irrelevant objectives, inappropriate project designs, unrealistic targets, inability to measure the effectiveness of interventions. Sub-Saharan Africa had the most projects but an abysmal satisfactory rating of 25 per cent and points to an unwillingness to adapt existing projects based on lessons learned. Importantly, the article continues, the review admits that Bank management did not commit enough resources to implement the new strategy until more than one year after it had been finalized. Indeed, as the article notes, the Bank, despite these criticisms and criticism for many, many years is pushing for further privatization in health, education and water.

Structural Adjustment has therefore been a major cause of poverty, and as a result, a cause of many health issues around the world. Multinational pharmaceutical companies neglect the diseases of the tropics, not because the science is impossible but because there is, in the cold economics of the drugs companies, no market. There is, of course, a market in the sense that there is a need: But there is no market in the sense that, unlike Viagra, medicines for leishmaniasis are needed by poor people in poor countries.

Pharmaceutical companies judge that they would not get sufficient return on research investment, so why, they ask, should we bother? In the corporate headquarters of major drug companies, the public relations posters display the image they like to present: For many years, the large pharmaceutical companies and their lobby groups have come under sharp criticism for intensely lobbying rich country governments to protect their interests around the world through things like enforcement of strict patents laws on medicines, allowing companies to monopolize their products, charging high prices for medicines that people around the world depend on.

For the large companies, they feel their investment into research and development would suffer if other companies then simply copy what they produce. Yet, a lot of the base science and research that the large companies have benefited from has been publicly funded—through university programs, government subsidized research, and other health programs.

Privatizing such profits may be acceptable to a certain degree. He points out that many of the anti-retroviral drugs used to treat HIV and AIDS today stem from the government-funded cancer drug research of the s. The rights to government-created innovations were sold to pharmaceutical companies at low prices … guaranteeing companies like Bristol-Myers Squibb huge returns on investment. Some of the plants patented for their medicinal purposes do not even belong to the rich countries where most of the big pharmaceutical companies are based; they come from the developing world, where they have been used for centuries, but patented without their knowledge.

Just as controversial [as patenting living organisms], or even more so, are patents and patent applications relating to plants that have traditionally been used for medicinal and other purposes e. Many medicines are derived from or based on biochemical compounds originating from plants and biodiversity in the tropical and sub-tropical countries.

Much of the knowledge of the use of plants for medical purposes resides with indigenous peoples and local communities. Scientists and companies from developed countries have been charged with biopiracy when they appropriate the plants or their compounds from the forests as well as the traditional knowledge of the community healers, since patents are often applied for the materials and the knowledge.

From a purely economic perspective, the idea of patents is to spur innovation, but with pharmaceuticals, it is not just about economics. Drummond Rennie, from the Journal of the American Medical Association , noted in a television documentary that.

Pharmaceuticals, they are a commodity. But they are not just a commodity. And that gives them altogether a deeper significance. Indeed, I believe that they often forget it completely. However, critics are pointing out that as well as saving lives, they are also taking lives from the poor, especially in the developing world, where, through rich country governments, they have lobbied for policies that will help ensure that their patents are recognized in most countries, thus extending those monopolies on their drugs. Writer and broadcaster, John Madeley, summarizes a number of concerns raised over the years:.

Making use of advertising that is inexpensive in comparison to what they pay in industrialized countries, the drug TNCs [Transnational Corporations] use the most persuasive, not to say unethical, methods to persuade the poor to buy their wares. Extravagant claims are made that would be outlawed in the Western countries.

A survey, in the Annals of Internal Medicine found that 62 per cent of the pharmaceutical advertisements in medical journals were either grossly misleading or downright inaccurate. A vivid case is that of South Africa and cheaper generic drugs. In fact, there was no violation. As problematic as the WTO rules have been in this area, there was provision in the rules allowing generic drugs to be created for emergency situations and public, non-commercial use. While public outrage managed to get such a move backed down, the underlying concerns from the big pharmaceutical companies have remained, and in various ways since, they have pressured the United States and other rich, industrialized nations to prevent other countries from doing similar things.

You can understand why the big companies are in fear. Poor countries realized they might have more affordable means to deal with a massive health crisis that afflicts them the most; and the large multinationals saw their monopoly prices severely threatened, and, exposed.

CIPLA, for example, offered this low-cost price for their AIDS drug at a loss for itself , because it said it made profits from other drugs, and this was something that was more than about profit and loss. Their patent laws were tightened up in early , to come into line with WTO laws, thus making cheaper alternatives less easy to produce. However, as Wired also noted, this introduces a number of issues, such as:. Brazil too has found itself under pressure from the United States for producing cheaper generics.

When its currency devalued in , the case of Brazil also highlighted another issue: Even though the dollar may be relatively weak currently, other rich countries where pharmaceuticals may be purchased from have currently got currencies that are stronger than the dollar.

Author and Page information

Currencies of course fluctuate. The point is then, that the fluctuation makes it harder for poorer countries to forecast how much the drugs may cost. They, and any other country would be dependent upon price negotiations with the pharmaceutical companies, too. Noting that drugs bring billions to big pharmaceutical companies, and hopes to people, they asked, how far would drugs companies go to get their drugs approved and the prices they want? As the documentary said in their introduction, the implications are alarming and if their power remains unchecked, many more people will soon will be dying for drugs.

In Canada, it was revealed how a drug company attempted to silence a leading academic who had doubts about their drug. In South Korea, it followed the attempts of desperately ill patients to make a leading drug company sell them the drugs they need to save their lives at an affordable price.

The child died while the documentary crew filmed the desperate smuggling. On the controversial high pricing for drugs, the documentary noted, Big pharma generally defends high prices for new drugs … to cover costs for researching and developing new drugs. But in fact, most new drugs launched are just slight variations of existing medicines.

So called Me Toos. Me Too drugs; the tenth headache pills; the 15th Viagra.

It’s Time to Bring Global Health Home

There are currently eight drugs in development at the moment for erectile dysfunction. Do we need 8 more drugs for erectile dysfunction? Markets for pharmaceutical companies are not just about finding people to target, but people with money. In another example of how power was used, the documentary noted what happened in Thailand in They also wanted to make a generic AIDS drug. The Thai trade representative was very frightened and they stopped making the generic drugs.

S Secretary of Commerce threatened the South Korean Minister of Health in a similar way, but despite those threats, he continued campaigning for cheaper drug prices. He was later sacked. How do companies have such power over entire countries? Jamie Love, also interviewed in this documentary, suggested an answer:. Its because they not only can threaten not to make medicines available, but they can credibly threaten that the U.

Your whole economy will suffer. These, and other examples presented in the documentary were not isolated cases. Hard-fought changes to WTO rules that would have allowed poorer nations easier access to generic drugs was agreed to by virtually every member country in the world, but was resisted by the U. Side Note For more information on this aspect, see the Dying for Drugs link above.

These complex issues are alive today, as the latest Avian flu concerns confirm. The Third World Network raises the issue again of the role of patents in restricting access to badly needed medicines , in this case, Tamiflu, recommended by health officials to reduce the severity of this feared flu. Smith from the Institute for Economic Democracy noted a long time ago, it is of course, a cruel world:. Few have challenged or even recognized the unfair tax upon the unfortunate created by vastly overpriced products and services.

There is a consistent pattern; the greater the need, the greater the overcharge. Though the need of those with physical disabilities is great, they have limited power to defend themselves. The first efforts to develop mechanical aids for people with physical problems were undoubtedly undertaken with noble intentions. Typically no profit was involved and much labor and time was donated as generous people tried to help the unfortunate. However, those who knew the value of these aids when monopolized claimed patent rights, and those with disabilities now must pay those monopolists.

Witness the hearing aids… Each is only a tiny amplifier, yet costs ten to twenty times as much as a radio, which is hundreds of times larger and much more complicated. Due to what many believe is reasons of bad publicity, many large pharmaceutical companies have given away AIDS and other drugs at cheaper prices and even donated large sums of money to global initiatives. However, less discussed are the many fundamental issues that affect poor countries: Many of these issues go to the heart of the World Trade Organization WTO and the global rules made at this organization to accommodate world trade.

However, critics for many years have said that the WTO is overly influenced by the rich countries, who are far more able to wield their economic and political influences to get what is best for them, often at the expense of the developing world. Created in , medicines were included in its patent rules. Some of its rules had come under severe criticism from activists and developing countries. Concerns included that TRIPS allowed monopolization of life-saving drugs for 20 years, risking price increases, and even stifling innovation.

Poor countries cannot afford to wait 20 years to enjoy the benefits of important drugs. Joseph Stiglitz, mentioned earlier, explained in an editorial in the prestigious British Medical Journal that.

Intellectual property differs from other property—restricting its use is inefficient as it costs nothing for another person to use it. Intellectual property rights, however, enable one person or company to have exclusive control of the use of a particular piece of knowledge, thereby creating monopoly power. Monopolies distort the economy. Restricting the use of medical knowledge not only affects economic efficiency, but also life itself. We tolerate such restrictions in the belief that they might spur innovation, balancing costs against benefits.

But the costs of restrictions can outweigh the benefits. It is hard to see how the patent issued by the US government for the healing properties of turmeric, which had been known for hundreds of years, stimulated research. Had the patent been enforced in India, poor people who wanted to use this compound would have had to pay royalties to the United States. These rights were intended to reduce access to generic medicines and they succeeded. As generic medicines cost a fraction of their brand name counterparts, billions could no longer afford the drugs they needed.

Developing countries paid a high price for this agreement. But what have they received in return? Drug companies spend more on advertising and marketing than on research, more on research on lifestyle drugs than on life saving drugs, and almost nothing on diseases that affect developing countries only. This is not surprising.

Global Health and the Global Economic Crisis

Poor people cannot afford drugs, and drug companies make investments that yield the highest returns. During the WTO meeting in Doha, Qatar, , the overall outcome was not seen as favorable for the poor. However, one area where there was some success was in health issues.

Slightly strengthened WTO TRIPS rules meant governments that could not afford branded drugs would be able to take measures to protect health a bit more easily by creating cheaper generics themselves, through compulsory licensing. WTO patent rules still allow 20 years of exclusive rights to make the drugs. Hence, the price is set by the company, leaving governments and patients little room to negotiate—unless a government threatens to overturn the patent with a compulsory license. Such a mechanism authorizes a producer other than the patent holder to produce the product though the patent-holder does get some royalty to recognize their contribution.

Parallel importing is another potentially powerful mechanism available to poor countries. Effectively, it allows a nation to shop around for the best price for the same drug, which may be sold in many countries at different prices. Compulsory licensing and parallel importing in particular, parallel importing of generic drugs are very effective tools to get prices down for developing countries.

For example, the above-mentioned documentary noted that a drug in question had been offered in Brazil at dramatically reduced cost by Novartis themselves because of the threat that generic versions would have posed. In the Europe Union EU , parallel importing has been practiced for a while, though it is only on brand drugs and only amongst EU member states, so the benefits to patients of reduced prices appear more questionable. Side Note For more information on this, see for example: EU pharmaceutical parallel trade—benefits to patients?

However, compulsory licensing laws in TRIPS imply that generics are only to be used for domestic purposes, not for export, and so parallel importing—which has been strongly resisted by the US and the pharmaceutical multinationals—was not part of the agreement. In reality, this means that given most poor countries do not have a sophisticated domestic pharmaceutical industry and thus would not have the ability to make their own generics, they would likely have to purchase the more expensive branded drugs. At the next major WTO meeting, in Cancun, Mexico in September , the developing countries managed to get another small win.

But parallel importing may still prove difficult:. Developing countries successfully stopped the US and the pharmaceutical lobby from excluding many important diseases of the third world from the deal, which is an important achievement. However no matter how desperate the health need, a poor country without the capacity to produce a needed drug—which is virtually all of them—will have to ask another government to suspend the relevant patent and license a local company to produce and export it.

Few countries, if any, will be prepared to help other countries in this way, as it would provoke retaliation by the US, which fiercely defends the commercial interests of the drug companies. What is more the agreement is wrapped in so much red tape and uncertainty that in practice it will be very difficult to use.

The bottom line is that many poor countries will still have to pay the high price for patented medicines or most probably, doing without. While praised by some richer countries as meeting poorer countries concerns, poorer countries and NGOs criticized it codifying a difficult-to-work waiver, which no one has used yet and thus is unproven.

In addition, as noted further above however, the US has sought to undermine the agreement made at Doha. Oxfam, a prominent NGO, has been highly critical of the practices of big pharmaceutical companies, arguing that, The U. Trade Representative is pursuing standards of patent protection which go far beyond WTO patent rules, and it is doing so regardless of the devastating impact that this could have on … developing countries. The industry has an interest in strong patent protections, which limit generic competition and therefore protect its market share and profits.

The cheapest generic versions of new patented drugs are being blocked from developing-country markets by U. During the two years since Doha, the U. The USA does this in a number of ways. It provides biased technical assistance in countries such as Uganda and Nigeria, which benefits its own industry by increasing drug prices and limiting the availability of generics, but reducing access.

It uses bilateral and regional free trade agreements to ratchet up patent protection in developing countries. It has recently concluded free trade agreements with Chile and Singapore and is using the high intellectual property standards in the latter as a model for negotiations on the FTAA Free Trade Area of the Americas … and with Central American, Southern African, and other countries. And lastly, the U.

The Costa Rican Pharmaceutical Industry estimates that the implementation of such TRIPS-plus patent rules would mean an increase in the cost of medicines of up to per cent, because these rules would seriously restrict competition from generics. These agreements, Khor wrote, are creating new barriers to access to medicines, as they forbid the developing countries from policies which the WTO allows that promote generic medicines.

To add to the sour French-US political relations, There was a diplomatic uproar when the French President Jacques Chirac accused the US of blackmailing developing countries to give up measures to obtain life-saving drugs through these bilateral trade deals. A worrying development, seen at the G8 summit , though hardly reported in the mainstream media, is the attempt to shift discussion of intellectual property rights away from the WTO, to the OECD.

While there are many issues and concerns already with the WTO process, it is at least a somewhat global forum.

Site not found · GitHub Pages

The OECD is like the rich countries club and so this tactic of course is political. If it succeeds, it will further limit global dialogue, undermining any notion of a global level of participation and democracy which is already poor. Since around , a number of global initiatives have been set up to deal with various global health crises. To their credit, the big pharmaceutical companies have been actively involved in them, too. Mega-rich individuals, such as Bill Gates, have also shown incredible charity by donating hundreds of millions of dollars to these initiatives.

Some of the donations from people like Bill Gates are not without their criticisms for other motives, however. In a crisis, this vulnerability becomes more acute. As a Financial Times editorial put it:. Almost unnoticed behind the economic crisis, a combination of lower growth, rising unemployment and falling remittances together with persistently high food prices has pushed the number of chronically hungry above 1 [billion] for the first time. This food crisis specifically originated with sharp increases in the price of major food grain prices.

The United Nations has estimated that such food price increases—along with the immediate effects of higher energy prices and the financial crisis—are responsible for pushing more than million people back into poverty and ill health.

On this page:

As in the global financial, food, and energy markets, there is now a shift toward privatization in which health—like food or oil—becomes a commodity that can be bought and sold by the few while the majority is increasingly deprived. Power lies with an emerging new hybrid of public and private health care institutions that are increasingly governed by the forces of the world market. The trends described in the previous section have massively distorted the practice of medicine and its research agenda globally, leading us to reflect on the quest for health and what the role of medicine is in achieving this goal.

AN UNSTABLE WORLD

Achievement of health, so defined, requires attention to the social determinants of disease 6 , 34 and a lifelong supportive environment that includes good prenatal care, safe childbirth, a nurturing childhood, adequate education, prevention of avoidable diseases, and opportunities to flourish physically, socially, and intellectually.

Health services in this context should provide access to affordable, effective health care, with recognition of the limits of medicine, particularly at the end of long lives or irremediable prolonged suffering, when at best only marginal benefits can be achieved. Corrective attention is also required to the opportunity costs of the excessive pursuit of profit in medicine, which gives precedence to vast expenditure on some aspects of clinical care that offer minimal improvement in health or may even cause greater suffering over more effective forms of treatment that could be more widely applied.

Health, illness, and medicine go beyond individuals and their families to involve and affect whole societies, their institutions, and their global interconnections and ramifications. By its nature, the right to basic health care is a collective right—not an individual or exclusionary right, as is the right to private property, or the private ownership of a commodity.

Social solidarity in health care implies that governments should provide basic public goods not only as a matter of economic and social efficiency but also as a public duty to their citizens. Because a long history of discrimination against the poor in the United States who are predominantly Black and Hispanic lies behind the reluctance to subsidize the health of the poor, Krugman proposed that universal health care coverage should be at the center of a new, progressive US administration's agenda.

We contemplate 3 potential scenarios for health care to help envisage and thus potentially shape future health care strategies. The first is an increasingly unequal market-governed future in which inequalities in income and health are accentuated, and new advances are applied predominantly for the benefit of the wealthy. This scenario, which is regrettably the most likely as a continuation of neoliberalism , would be associated with a continued erosion of publicly supported health care systems, even in wealthy countries.

The second scenario would be a system of neoliberal market governance with some additional redistribution that would result in significant improvement in health for many people, but with residual wide disparities still affecting billions. The third possibility, which we support, is redistribution based on creative new thinking and action within a paradigm of health and social development that could couple economic growth to redistribution of resources and fairer access to effective health care.

On the basis of existing data on global economics, we believe that there are adequate resources to achieve immediate short-term improvements in global health. A tax of 0. Substantial improvements in global health could therefore be achieved in the short term, although such improvement will be contingent on a significant redistribution of global economic resources. In time, new resources could be mobilized for thoroughly justified and ambitious global health goals—provided that social and political forces can confront the misallocation, waste, and distorted preferences currently characterizing a consumption-driven, energy-intensive, and wasteful neoliberal economic system premised on support for the affluent.

Although governments are now paying more attention to tax evasion and the offshore world because of the looming fiscal pressures caused by the global economic crisis, their efforts need to go further. By rectifying tax evasion, eliminating transfer-pricing systems used by corporations, and abolishing offshore tax havens, governments could generate enormous new resources for funding social and health provisions. All of these endeavors to achieve basic reforms of the international tax regime 59 should be combined with efforts to fundamentally reform global economic governance, including much stricter prudential regulation of banks to prevent a repeat of past reckless practices.

These material questions highlight the need for a more intense focus on basic human needs if we wish to define a civilized world as one characterized by policies and activities capable of sustaining the advancement of decent human lives for all. More socially accountable and democratic institutions are needed, and these institutions should be linked to capacity-building for self-sufficiency while promoting local sustainability within an increasingly interdependent world.

We suggest several steps to broaden our discourses, which in turn would help develop policies that could have a practical effect. The dominant ethics discourse of our time has been focused on the ethics of interpersonal relationships e. This discourse must now be extended to include the ethics of how institutions e. Similarly, concern for human rights should include consideration of the social, economic, and cultural rights required for more people to have the opportunity to achieve their human potential.

These policies would include the promotion of socially sustainable economic recovery and social cohesion, new financing mechanisms for health to provide more equitable distribution of benefits, and macroeconomic stabilization that could provide greater social protection for the poor. A political economy analysis reveals the opportunity costs of such choices—the possible alternative uses forgone in the decision to spend the funds in this way.

Many of these funds could have been spent on job retraining, health care, accessible education, and affordable housing. Moreover, such social expenditures have far more favorable effects on macroeconomic stabilization because they raise aggregate demand in greater measure than do outlays on financial bailouts—because poorer people spend more of their income than the wealthy. This additional spending is needed to reverse the economic slump and to mitigate rising unemployment.

Economic arguments for the general socialization of risk were made by Keynes, in his analysis of the Great Depression of the s, as a means to stabilize and legitimate capitalism. These arguments became a staple of mainstream economic thinking between and , the era before neoliberal capitalism. Engagement in critique and popular education is needed to counteract the tenacity of a paradigm based on the assumption that continuous economic growth for some, driven by the profit motive, provides necessary and sufficient conditions to protect privileged ways of life.

There is a need to develop policies for education and culture to help emancipate creative potentials in new ways. Specifically, knowledge and media systems should promote widespread understanding of how inequality and ill health result from economic governance and geopolitical arrangements that extract resources from the poor and maintain economic growth and profit for the privileged at the expense of others in the short term and of all in the longer term.

New mindsets would imply significant changes—not only in the field of economics but also across the social and natural sciences—to produce a more integrated and forward-looking understanding to promote sustainability and justice. The dysfunctional global economic system we have described is geared primarily to the pursuit of profit at the expense of human flourishing and human rights. Thomas Pogge's innovative Health Impact Fund project, designed to facilitate the development of drugs that have the maximum potential for saving lives, is an example of how such trends could feasibly be reversed on the basis of a new compact between private and public interests, because it would still reward pharmaceutical companies.

Global Health Overview

Beyond specific initiatives, the challenges enumerated here call for the development of imaginative international strategic alliances using varied expertise from many academic disciplines and the mobilization of political will within multiple spheres of influence—in the public and private sectors—to force change on unresponsive leaders and the military, economic, and social power that they seek to protect. This moral challenge for the 21st century requires many centers of political action to produce and implement a new perspective on political economy, civic life, human flourishing, and health care.

To achieve this goal requires a change in cultural ethos to facilitate the extensive multidisciplinary research needed to show the path ahead. Such enlightenment could enable us to 1 be served by the market system rather than us serving the market 84 and 2 deal constructively with upstream causes of poor health. The challenge of funding and undertaking this research is of the order of magnitude of researching and developing an HIV vaccine. We hope that this brief review will stimulate the discussion, debate, and commitment to research of sufficient depth, breadth, and intensity to achieve ambitious global health goals.

National Center for Biotechnology Information , U. Am J Public Health. Correspondence should be sent to Solomon R. Reprints can be ordered at http: Contributors All the authors contributed equally to conceptualizing and writing this article. Accepted July 26, This article has been cited by other articles in PMC. Abstract Although the resources and knowledge for achieving improved global health exist, a new, critical paradigm on health as an aspect of human development, human security, and human rights is needed.

As a Financial Times editorial put it: Extension of the Ethical Discourse The dominant ethics discourse of our time has been focused on the ethics of interpersonal relationships e. Broadening Concern for Human Rights Similarly, concern for human rights should include consideration of the social, economic, and cultural rights required for more people to have the opportunity to achieve their human potential.

Immediate Social and Economic Policy Responses These policies would include the promotion of socially sustainable economic recovery and social cohesion, new financing mechanisms for health to provide more equitable distribution of benefits, and macroeconomic stabilization that could provide greater social protection for the poor. Medium-Term Social and Economic Policies for a Healthier Society These policies would include initiatives to Revise the tax base in a more macro-economically efficient way while ensuring that the future distribution of tax burdens is equitable and sustainable;.

Develop comprehensive measures to ensure that the economy is regulated effectively and prudently e. Develop policies to revitalize public and collective services such as public health systems, as well as infrastructure for public transportation, public information, and communications systems;. Deal with demographic shifts e. Rethink policies to change the destructive logic of affluent lifestyles and thus minimize overconsumption, waste, and bad especially meat-based affluent diets and to promote healthier ways of living, while preserving toleration and diversity of social choices.

Changing Mindsets for Potentially Enduring Long-Term Benefit Engagement in critique and popular education is needed to counteract the tenacity of a paradigm based on the assumption that continuous economic growth for some, driven by the profit motive, provides necessary and sufficient conditions to protect privileged ways of life. Acknowledgments We thank the anonymous reviewers and the editor for helpful comments and suggestions. Global disparities in health and human rights. University of California Press; Amnesty International The G8: Accessed January 8, Neoliberalism, Globalization and Inequalities: Consequences for Health and Quality of Life.

Social Determinants of Health. World Health Organization; Accessed April 28, Ethics and infectious disease. The global burden of chronic diseases: Accessed November 21, International Comparison Program database. Accessed January 30, The world cup of diplomacy. Toronto Globe and Mail. Accessed July 17, What's behind the financial market crisis? Mises Daily , Ludwig von Mises Institute. The Myth of the Rational Market: Globalization and Its Discontents.

The Conscience of a Liberal. The Economics of Innocent Fraud: Truth for Our Time. Finance, production and panopticism. A physician's view of Freidson's analysis. J Health Polit Policy Law. The American health care system: N Engl J Med. The Ethical Poverty Line: Organisation for Economic Co-Operation and Development; Impact of the global financial and economic crisis on health: The consequences of bad economics. Accessed November 25, Broader measure of US unemployment stands at GEO 4, Environment for Development. Farrar, Strauss and Giroux; Preparing for the next pandemic.

Stonington S, Holmes SM. Social medicine in the 21st century. In support of a broad model of public health: The political economy of health and development. Textbook of International Health. Oxford University Press; Powers M, Faden R. The G8 and Global Health. Neumayer E, de Soysa I. Trade openness, foreign direct investment and child labour. Gerring J, Thacker SC. Do neoliberal economic policies kill or save lives?

Human rights in the biotechnology era.