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Why investing in health is a challenge under the current global economic system

Linda Mans

This summer I took up IHP’s suggestion and read Paul Mason’s ‘PostCapitalism: a Guide to Our Future’. That triggered my interest in Ilias Alami’s ‘On the terrorism of money and national policy-making in emerging capitalist economies’. My “summer of Marxism” provided me with a few clues on why investing in health and the health workforce is a ‘Grand Challenge’ of sorts (to borrow a term from an arch-capitalist). That shouldn’t stop us from advocating for it, though, even if the term is still an understatement, I’m afraid.

Since investing in health and the health workforce is the talk of the day in the global health community, and the need to restructure the global economic order for health equity reasons follows suit (well, at least in the eyes of many, though perhaps not the ones with most power in the global health architecture), it was with this lens that I read Paul Mason’s book ‘PostCapitalism: a Guide to Our Future’. Mason loves the Wikipedia project; I’d like to refer you to one of its pages for a nice summary of the book and encourage you to read the whole book to know why Mason loves Wiki and how he views this late stage of capitalism.

 

The second semester of 2018 will feature some interesting conferences for the global health community. One of them is the Global Conference on Primary Health Care in Astana, Kazakhstan. In the run-up to that conference, the Geneva Global Health Hub (G2H2) organised a civil society workshop earlier this year. ‘Health is not only a matter of human rights, but also of justice. Governments who are not making provision for decent health care are denying justice to their people. The Alma Ata declaration recognised the need to restructure the global economic order to address inequalities and enable countries to generate resources for decent health care and tackle the root causes of poor health’, is an excerpt of that workshop’s consultation statement.

 

Why is restructuring the global economic order necessary to achieve decent health care for all, including a proper health workforce? With his book, Mason shares his study on capitalism as a whole system – social, economic, demographic, cultural, ideological – and what is needed to make a developed society function through markets and private ownership. I was particularly interested in Mason’s description of the state’s (key) role in neoliberalism: ‘The neoliberal system cannot exist without constant, active intervention by the state to promote marketization, privatization and the interests of finance. It typically deregulates finance, forces government to outsource services and allows public healthcare, education and transport to become shoddy, driving people to privatise services.’

 

How does this system work and who has a say in it, I was pondering? Is ‘governance for health being held captive by private foundations and corporations’? How does it affect governments’ intentions to invest in health? And which actors within governments make certain decisions that either improve health for all or make public healthcare ‘shoddy’? At the big conferences we usually meet ministers or deputy ministers of health, or people that work at the ministry of health, most often accompanied by people working at the ministries of foreign affairs. But if it is, rather, about ‘the interests of finance’, as Mason indicates, are they then the right target group of our advocacy?

 

This is an excerpt from Linda Mans’ blog on International Health Policies. To find out why economic literacy for all is so important, read her full blog here.

 

Read more about our work on health worker mobility and the Health Systems Advocacy Partnership

 

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