BOOK
Global Health Watch 4
(2014)
Additional Information
Book Details
Abstract
Global Health Watch, now in its fourth edition, is widely perceived as the definitive voice for an alternative discourse on health and healthcare. It covers a range of issues that currently impact on health, including the present political and economic architecture in a fast-changing and globalized world; a political assessment of the drive towards Universal Health Coverage; broader determinants of health, such as gender-based violence and access to water; stories of struggles, actions and change; and a scrutiny of a range of global institutions and processes. It integrates rigorous analysis, alternative proposals and stories of struggle and change to present a compelling case for a radical transformation of the way we approach actions and policies on health.
The Global Health Watch is a broad collaboration of public health experts, non-governmental organizations, civil society activists, community groups, health workers and academics. It was initiated by the People’s Health Movement, Global Equity Gauge Alliance and Medact as a platform of resistance to the neoliberal dominance in health.
'Global Health Watch 4 challenges us to look at health and health care from a critical perspective, providing a bridge between big, global questions and independent local issues. It not only 'watches' what is unfolding before our eyes but also offers inspiration and strategies for changing what we do not like. Essential reading for the movers and shakers in health policy the world over.'
Gill Walt, professor emeritus at the London School of Hygiene and Tropical Medicine
'I highly recommend this fourth edition for anyone concerned about the future of equitable global health. It adds value to its predecessor editions through penetrating critiques of current issues such as the debate on universal health coverage. The analyses of various crises are also balanced by encouraging stories, including the 'living well' movement in Bolivia.'
Vic Neufeld, Special Advisor, Canadian Coalition for Global Health Research
'We live in an era of stark contrasts in the prospects for health and development for much of the World's population. Although great advances in our knowledge of effective prevention and treatment have been achieved in recent decades, the fruits of this knowledge have been shared inequitably. Global Health Watch provides an invaluable independent analysis of these challenges and suggests constructive ways to address them. It should be required reading for students of global health and their teachers.'
Professor Sir Andy Haines, London School of Hygiene and Tropical Medecine
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Front cover | ||
| Praise for Previous Editions | i | ||
| Title | iii | ||
| Copyright | iv | ||
| Contents | v | ||
| Boxes, Tables and Figures | vii | ||
| Images | x | ||
| Acknowledgements | xiii | ||
| Introduction | 1 | ||
| The Global Political and Economic Architecture | 1 | ||
| Health Systems: Current Issues and Debates | 2 | ||
| Beyond Healthcare | 4 | ||
| Watching | 5 | ||
| Resistance, Actions and Change | 6 | ||
| Towards a Shared Narrative for Change | 7 | ||
| Section A: The Global Political and Economic Architecture | 9 | ||
| A1: The Health Crises of Neoliberal Globalization | 11 | ||
| Introduction | 11 | ||
| From Neoliberalism 1.0 to Neoliberalism 3.0: An Abbreviated History | 12 | ||
| Modelling Health Costs | 24 | ||
| Towards a Progressive Public Health Agenda | 26 | ||
| Where Should Health Activists Start? | 37 | ||
| Note | 38 | ||
| References | 38 | ||
| A2: Fiscal Policies in Europe in the Wake of the Economic Crisis: Implications for Health | 43 | ||
| Genesis of the Economic Crisis in Europe | 43 | ||
| Influence of Policies in Germany | 44 | ||
| Crisis in the US and Its Aftermath | 45 | ||
| Greece and Spain: Acute Manifestations of the Crisis | 46 | ||
| Social Consequences | 48 | ||
| Greece: The Face of the Health Crisis in Europe | 49 | ||
| Manifestations of the Crisis on Healthcare in Different Parts of Europe | 52 | ||
| Solidarity in the Midst of a Crisis | 54 | ||
| Notes | 55 | ||
| References | 55 | ||
| A3: Social Struggle, Progressive Governments, and Health in Latin America | 59 | ||
| Social Changes and the Health Sector | 60 | ||
| Advances Towards Universal Public Health Systems | 62 | ||
| Countries Where Neoliberal Reforms Dominate | 64 | ||
| Conclusions | 66 | ||
| References | 67 | ||
| A4: After the Arab Spring | 68 | ||
| Neoliberal Policies and the Decline of the Welfare State | 68 | ||
| Praise from the IMF | 70 | ||
| Change and Continuity | 71 | ||
| Rebuilding the Neoliberal Agenda | 72 | ||
| Conclusions | 73 | ||
| Note | 74 | ||
| References | 74 | ||
| Section B: Health Systems: Current Issues and Debates | 75 | ||
| B1: The Current Discourse On Universal Health Coverage (UHC) | 77 | ||
| The Ideological Foundations of UHC | 79 | ||
| The Ambiguities of UHC\r | 82 | ||
| Where is the Evidence? | 83 | ||
| Public Systems Efficiencies | 85 | ||
| UHC in Advanced Capitalist Countries | 86 | ||
| UHC in Low- and Middle-Income Countries | 88 | ||
| Conclusions | 92 | ||
| Notes | 92 | ||
| References | 93 | ||
| B2: The National Health Service (NHS): Prey to Neoliberal Lust for Markets | 95 | ||
| The NHS as It Was Conceived\r | 95 | ||
| Thatcher and the Attack on the NHS\r | 96 | ||
| The Health and Social Care Act (HSCA) and the New ‘National Healthcare Market’ \r | 102 | ||
| The Failure of Democracy to Save the NHS | 102 | ||
| The Moral of the Story of the NHS | 105 | ||
| The Challenge for Health Professionals | 106 | ||
| References | 107 | ||
| B3: Reform of the Mexican Healthcare System: The Untold Story\r | 108 | ||
| The Mexican Health System | 108 | ||
| Reforms to Promote a Clear Agenda | 109 | ||
| Health Insurance: The Fashionable ‘Success Story’ | 110 | ||
| An Uncertain Future | 112 | ||
| Notes | 112 | ||
| References | 112 | ||
| B4: Brazil: The Rocky Road to a Universal Healthcare System\r | 114 | ||
| The Health System in Brazil | 114 | ||
| Challenges and Limitations of SUS | 117 | ||
| Looking Ahead | 118 | ||
| References | 118 | ||
| B5: South Africa: Building or Destroying Health Systems?\r | 120 | ||
| Proposed Reforms | 120 | ||
| Obstacles Posed by Treasury Policy | 122 | ||
| Private Sector Challenges | 122 | ||
| Strategic ‘Purchasing’ of Care? | 123 | ||
| Notes | 125 | ||
| References | 126 | ||
| B6: The Right to Health in Tunisia\r | 127 | ||
| Social Security in the Pre-Independence Period | 127 | ||
| Provision of Free Healthcare After Independence | 128 | ||
| Authoritarian Rule and Crisis | 129 | ||
| Structural Adjustment Programmes and the Erosion of the Right to Health | 130 | ||
| Neoliberal Policies and Healthcare for Those Who Can Afford It | 131 | ||
| The Right to Health in the Aftermath of the ‘Freedom and Dignity Revolution’\r | 132 | ||
| Conclusion | 133 | ||
| Notes | 133 | ||
| References | 133 | ||
| B7: The Revival of Community Health Workers in National Health Systems\r | 134 | ||
| Introduction | 134 | ||
| Programa de Agentes Comunitários de Saúde in Brazil | 137 | ||
| South Africa: Still Seeking a Clear Role for CHWs | 138 | ||
| India’s ‘ASHA’ Programme | 139 | ||
| Behvarz in Iran: Linchpin of Primary Healthcare | 141 | ||
| Conclusion | 142 | ||
| Notes | 144 | ||
| References | 144 | ||
| B8: The Crisis of Maternal and Reproductive Health\r | 147 | ||
| Global Progress in Reducing Maternal Mortality Rates, 1990–2010 | 147 | ||
| Why Pregnancy Kills Women in Africa | 148 | ||
| Interventions That Could Make a Difference | 154 | ||
| Conclusion | 155 | ||
| References | 156 | ||
| B9: The Global Health Workforce Crisis\r | 158 | ||
| The ‘Big Picture’ Challenges for Human Resources for Health\r | 158 | ||
| Flawed Analysis and Proposals | 159 | ||
| WHO’s Global Code of Practice: Fatally Deficient\r | 161 | ||
| Who Is a Health Worker? | 161 | ||
| Steps Forward in Mitigating the Crisis | 162 | ||
| Scaling Up Transformative Education | 163 | ||
| Conclusion | 165 | ||
| References | 166 | ||
| B10: The Politics and Landscape of Medical Devices in a Global Market\r | 167 | ||
| Medical Device Innovation, Safety and Regulation | 169 | ||
| Access and Organization | 171 | ||
| The Politics of Medical Technology and Global Health | 173 | ||
| Conclusion | 175 | ||
| References | 175 | ||
| Section C: Beyond Healthcare\r | 177 | ||
| C1: Social Protection: Reimagining Development\r | 179 | ||
| History of the Debate on ‘Development’ | 179 | ||
| Poverty Reduction and Social Development | 182 | ||
| Universal Social Protection | 183 | ||
| Conclusion | 185 | ||
| References | 186 | ||
| C2: Non-Communicable Diseases: Is Big Business Hijacking the Debate?\r | 188 | ||
| Evidence as a Marketing Tool | 188 | ||
| A Fresh Look at Mortality and ‘Burden of Disease’ Data\r | 189 | ||
| What Does the GBD Data Show? | 192 | ||
| A Critical Look at the GBD | 194 | ||
| Promoting NCDs as a Profit-Making Arena | 195 | ||
| Conclusions | 196 | ||
| Notes | 197 | ||
| References | 197 | ||
| C3: Nutrition and Food Sovereignty\r | 198 | ||
| Erosion of Food Sovereignty and Impact on Nutritional Status in India | 199 | ||
| Factors Responsible for the Erosion of Food Sovereignty | 201 | ||
| Food Support Schemes | 204 | ||
| Challenges to Food Sovereignty and the Risks to Human Health in the Pacific Islands | 205 | ||
| Effect on Farmers of Changing Patterns of Production | 205 | ||
| Food Prices, Food Accessibility and Food Culture | 206 | ||
| Erosion of Policy Space | 208 | ||
| Conclusion | 209 | ||
| Acknowledgements | 209 | ||
| Notes | 209 | ||
| References | 210 | ||
| C4: Breaking Free from Gender-Based Violence\r | 213 | ||
| Recognition of Gender-Based Violence as a Human Rights and Public Health Issue | 213 | ||
| Gender-Based Violence: How Prevalent Is It?\r | 215 | ||
| Consequences for Human Rights and Health | 216 | ||
| Health System Response to Gender-Based Violence | 216 | ||
| The Way Ahead | 218 | ||
| Note | 218 | ||
| C5: Talking Shit: Is Community Led Total Sanitation Empowering or Divisive?\r | 220 | ||
| Distinctive Features of CLTS | 221 | ||
| How Sustainable Is CLTS? | 222 | ||
| A Rights-Based Analysis of CLTS | 224 | ||
| Who Takes Responsibility? | 225 | ||
| Power Dynamics of CLTS | 225 | ||
| Conclusion | 227 | ||
| References | 227 | ||
| C6: Extractive Industries and Health\r | 229 | ||
| Impact of Extractive Industries on Health | 230 | ||
| Social Environment and Health | 233 | ||
| Economic Benefits: Questioning Claims | 234 | ||
| Canada: A ‘Safe Haven’ for Mining Companies | 236 | ||
| Conclusions: Mining Justice and Better Health are Possible | 241 | ||
| Note | 242 | ||
| References | 242 | ||
| Section D: Watching | 245 | ||
| D1: WHO Reform: For What Purpose? | 247 | ||
| Background to Reforms in WHO | 248 | ||
| Evaluation of the Reforms | 249 | ||
| Global Health Governance: A Sub-Domain of Global Economic Governance\r | 250 | ||
| The Features and Capabilities of the ‘WHO We Need’ | 255 | ||
| Scorecard for the Current Reform Programme | 263 | ||
| An Advocacy Programme for Civil Society: ‘Save WHO!’ | 264 | ||
| Notes | 265 | ||
| References | 265 | ||
| D2: A New ‘Business Model’ for NGOs? | 267 | ||
| Introduction | 267 | ||
| Conceptual and Definitional Ambiguity | 269 | ||
| Numbers and Scope | 269 | ||
| Implications for Governance and Health Systems | 272 | ||
| Two Vignettes of NGO-Led ‘Interventions’ | 273 | ||
| Risk of Co-Option | 275 | ||
| In Lieu of a Conclusion | 276 | ||
| Notes | 277 | ||
| References | 277 | ||
| D3: Private Sector Influence on Public Health Policy | 279 | ||
| The Gates Foundation | 279 | ||
| The Global Fund | 281 | ||
| The GAVI Alliance | 282 | ||
| The Role of Mckinsey and Co. in the Privatization of the NHS | 284 | ||
| The Tax Avoidance Industry | 285 | ||
| Conclusion | 285 | ||
| Notes | 286 | ||
| References | 286 | ||
| D4 : The TRIPS Agreement: Two Decades of Failed Promises | 288 | ||
| TRIPS Flexibilities: Do They Work? | 288 | ||
| Free Trade Agreements: Going Beyond TRIPS | 292 | ||
| Using the Bogey of ‘Counterfeit’ to Criminalize Generic Drugs | 295 | ||
| Voluntary Licences and Differential Pricing | 296 | ||
| International Investment Agreements | 296 | ||
| The Way Forward | 297 | ||
| Notes | 298 | ||
| References | 298 | ||
| D5: Cholera Epidemic in Haiti\r | 300 | ||
| Haiti: A History of Occupation | 300 | ||
| Structural Adjustment Programmes and UN Presence | 301 | ||
| The Earthquake and Its Aftermath | 303 | ||
| Two Tales and an Epidemic | 305 | ||
| The Response from the International Community | 305 | ||
| Conclusion | 306 | ||
| References | 307 | ||
| D6: The International Finance Corporation’s ‘Health in Africa’ Initiative\r | 309 | ||
| IFC’s Track Record in Health | 310 | ||
| Poor Progress on Health in Africa Investments | 311 | ||
| High-Cost, Low-Impact Investments | 313 | ||
| Turning a Blind Eye to Measuring Impact | 313 | ||
| Unaccountable and Opaque: Use of Financial Intermediaries | 315 | ||
| The World Bank’s Response to Health in Africa’s Mid-Term Evaluation | 315 | ||
| Conclusion | 316 | ||
| Notes | 316 | ||
| References | 316 | ||
| D7: The Ethical Cost of Offshoring Clinical Trials | 319 | ||
| Offshoring: At What Price? | 319 | ||
| Lack of Transparency and Accountability | 322 | ||
| Case Studies: Deficient Regulatory Environments | 323 | ||
| Conclusion | 328 | ||
| Notes | 328 | ||
| References | 328 | ||
| Section E: Resistance, Actions and Change\r | 331 | ||
| E1: Reframing Health in Bolivia Around the Concept of ‘Living Well’ | 333 | ||
| Background | 333 | ||
| Living Well | 335 | ||
| Structural Changes in the Health Sector: ‘Mobilized for the Right to Health and Life’ for Living Well | 338 | ||
| Conclusion | 339 | ||
| Notes | 340 | ||
| References | 340 | ||
| E2: Social Change in El Salvador and the Health Sector | 341 | ||
| Historical Backdrop\r | 341 | ||
| The Struggle Against Military Dictatorship\r | 341 | ||
| The Health System in El Salvador\r | 342 | ||
| The New Government and Health Reform | 343 | ||
| The Reform Process | 345 | ||
| Evidence of Success | 346 | ||
| Obstacles and Constraints | 347 | ||
| Notes | 347 | ||
| References | 348 | ||
| E3: Venezuela: The Impact on Health of Social Change | 349 | ||
| New Vision of Health in the 1999 Constitution | 349 | ||
| Transforming Health: Mission Barrio Adentro | 349 | ||
| Developing a Health Workforce and Social Participation | 352 | ||
| The Results are Evident | 352 | ||
| The Struggle Ahead | 354 | ||
| References | 354 | ||
| E4: Colombia: Social Struggles against the Commodification of Health | 356 | ||
| Law 100 and Its Impact on the Right to Health | 356 | ||
| Collective Social Action for the Right to Health | 358 | ||
| Looking Forward | 360 | ||
| Note | 360 | ||
| References | 360 | ||
| E5: Peru: Social Movement against Neoliberal Reforms | 361 | ||
| Introduction | 361 | ||
| Key Numbers and the Failure of Universal Health Insurance | 361 | ||
| Resistance against the Reforms | 362 | ||
| Forging an Inclusive Social Movement | 364 | ||
| Notes | 366 | ||
| References | 366 | ||
| E6: Struggles for Health in Europe\r | 368 | ||
| National Mobilisations in Different Countries | 368 | ||
| Transnational Solidarity and Mobilization | 377 | ||
| The Movement against ‘Unnecessary Imposed Mega Projects’ | 377 | ||
| Struggles against Extractive Industries | 378 | ||
| The Struggle against the Transatlantic Trade and Investment Partnership (TTIP) | 378 | ||
| Note | 380 | ||
| References | 380 | ||
| E7: The Struggle against a Destructive Mining Project in Greece | 382 | ||
| Background | 382 | ||
| Impacts | 382 | ||
| Genesis of a Popular Struggle | 383 | ||
| Notes | 387 | ||
| References | 387 | ||
| E8: The Right to Food Campaign in India\r | 388 | ||
| Judicial Pressure and Popular Mobilization | 388 | ||
| National Legislation on Food Security | 390 | ||
| A Minimalist Approach to Food Security | 391 | ||
| Building Solidarity across Different Movements | 392 | ||
| Notes | 394 | ||
| References | 394 | ||
| E9: Aboriginal Community-Controlled Health Services in Australia\r | 395 | ||
| Development of Aboriginal Community-Controlled Health Services (ACCHS) | 395 | ||
| Flag-Bearer of Comprehensive Primary Health Care\r | 396 | ||
| The Struggle to Be Part of the ‘Mainstream’ Health System | 397 | ||
| Welfare Colonialism | 398 | ||
| Improvements in Health Outcomes | 399 | ||
| New Challenges | 401 | ||
| References | 401 | ||
| Contributors | 403 | ||
| Index | 405 | ||
| Back Cover | Back cover |