Robert Fogel on Improving Health Care – Developing Nations

This a continuation of yesterday's post about Robert Fogel's views on improving global health care as found in The Escape From Hunger and Premature Death, 1700-2100. Europe, America, and the Third World. Today's segment concerns health care in developing nations. Any emphasis is mine.

Finally, any consideration of how to reduce health inequality must involve a reconsideration of America’s obligation to increase its contribution to the international campaign to bring vaccines and other products to children and adults whose lives can be saved if there the international will to do so. The lack of access to such products in the poorest 50 or so countries is the most glaring instance of inequality in the global health system and a lingering threat the health of those rich countries.

The large advances in life expectancy in China and other emerging economies shoe that it is not necessary to wait for the industrialization to be completed before making major advances in health and longevity. Modern methods of sanitation and other public health programs can be introduced at a modest cost. Cleaning up the water supply, improving the distribution of basic nutrients, draining swamps and otherwise disrupting vectors of disease, and improving waste disposal can be achieve quickly and cheaply, as had been demonstrated by China, Indonesia, and Malaysia. OECD nations can help speed up the process in countries still lagging behind by training public health officials, by helping to supply vital nutrients to pregnant mothers and infants, and by helping to supply antibiotics and other vital drugs and vaccines.

A particularly urgent issue is posed by the worldwide pandemic of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). Although death rates from AIDS have recently declined in the United States and other OECD nations, AIDS is ravaging Africa. Of the 3 million individuals worldwide who died of AIDS in 2000, more than 2 million lived in sub-Saharan Africa. Although rates of infection are still relatively low in India and China, they are at risk of a rapid escalation in the spread of the infection. Public campaigns to inform the populations of these countries of the threat of this disease, of means of reducing the odds of infection, and of available treatment for those already infected ware urgently needed. OECD and international agencies can provide money and skilled personnel to confront AIDS and other deadly infectious diseases, and to help provide vaccines and other drug therapies to those who need them. One important way to help is by increasing the R&D budgets of the OECD nations for diseases that afflict the poor countries of the world. It is not only morality but also self-interest that argues for these measures. Epidemics in the Third World can spread to OECD nations.

The current concern with making the distribution of health care more equal reflects both the large increase of global per capita income during the twentieth century and the great strides in biomedical technology. To poor people, adequate food takes precedence over seeing a doctor. As the people in OECD nations escaped poverty, they demanded more and more health care. The same pattern is now apparent in many Third World countries. The increasing share of global income spent on health care expenditures is not a calamity; it is a sign of the remarkable social and economic progress of our age. (106-107)

There you have it. What do you think?