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Date: Tue, 21 Mar 1995 00:27:06 -0500
Sender: Pan-Africa Discussion List <AFRICA-L@VTVM1.CC.VT.EDU> From: Nyanchama Matunda <matunda@GAUL.CSD.UWO.CA>
Subject: HEALTH: Social Summit Fails to Treat Global Health Crisis (fwd)

From: Inter Press Service Harare <>
Subject: HEALTH: Social Summit Fails to Treat Global Health Crisis

Social Summit Fails to Treat Global Health Crisis

By Kalinga Seneviratne

COPENHAGEN, Mar 20 (IPS) - The recently-concluded World Summit on Social Development may have called for access to primary health care for all by the year 2000, but it failed to diagnose the root causes of the global health crisis, non-governmental organisations (NGOS) say.

They say the Summit sidestepped discussion of the deterioration in health care policies worldwide, which they trace to ill-advised policies for developing countries and structural adjustment programmes (SAPs) that forced governments to cut back on health budgets to meet macroeconomic targets.

At an NGO Forum meeting, David Werner of the U.S.-based HealthRights group said these trends in global health tend to undermine the 1978 Alma Ata Declaration, which says the pursuit of health is inseparable from the struggle for a fairer, more caring society.

NGOs say health policies around the world are under assault by the World Bank's SAPs, which Werner says are the Bank's attempts to enter the health policy area with conditionalities.

United Nations agencies are also casting a critical eye at saps. The U.N. Children's Fund (UNICEF) issued a report at the Social Summit seeking the reexamination of SAPs.

Anwarul Chowdhury, secretary of UNICEF's executive board, said: ''They may say you have to bring in financial discipline to address economic problems. But if it seriously brings down living standards of common people, then the discipline is not beneficial.''

''It's like saying the operation was successful but the patient died. We would like it (SAP) reexamined to ensure that social sectors are not affected,'' he pointed out.

''There can be no social development or sustained economic growth without health,'' WHO director general Hiroshi Nakajima said in his statement at the Summit. ''We must look beyond short- term policies which provide minimal safety nets only, or we run the risk of helping poverty become institutionalised.''

Another WHO official said saps and its health priorities are causing untold suffering and deepening poverty in developing countries.

''When we talk about privatisation, let's realise that health is different. It cannot be bought and sold at commercial rates,'' said Dr. Aleya Hammad, WHO special representative for health policies, at a seminar attended by World Bank officials.

Health is a human rights issue ''whether or not it contributes to economic development'', she pointed out.

David de Ferranti, director of the World Bank's Population, Health and Nutrition programme, said real progress has been made by countries that seriously tried to restructure their economies.

He said the Bank invests more than 5 billion dollars a year in basic services,''more than twice what goes to economic reforms.''

But the University of Ottawa's Michel Chossudovsky said SAPs have forced countries to cut spending on health and education so much that internal economies have virtually collapsed.

SAPs have forced fuel price hikes, causing economic crises that not only paralyse public health systems but hurt nutrition, availability of drugs and marketing of produce, he added.

''The World Bank's solution is social safety nets, structural adjustment with a human face,'' he said, adding that safety nets were the official platform of the Social Summit.

But SAPs are ''designed to manage poverty at minimal cost to the creditors'', Chossudovsky argued.

''It means you reduce commitment to universal programmes, because the bank believes it is more equitable and efficient to target vulnerable groups, the poor, and the universal funding of health is only benefiting the rich,'' he said.

The hidden agenda is to disengage ministries of health and reallocate money to debt servicing, he warned. Bank officials argued that the Bank does not create economic crisis through SAPs, but that SAPs were introduced precisely because countries are in already deep economic crisis.

NGO delegates from Zimbabwe, the Philippines, Mexico and Nicaragua also described SAPs' ill effects in their countries.

David Sanders, director of the public health programme at South Africa's University of the Western Cape, said the decline in real wages, removal of food subsidies and fees and levies imposed on schools under SAPs have pushed down health standards in Zimbabwe.

Filipino health worker Luz Bartolome said poor health services are forcing midwives and nurses to give instructions only for partial treatment. People are dying from simple accidents and curable diseases, she added.

In Nicaragua, a report by the Centre for Information and Advisory Services for Health said only 42 per cent of the populace had access to health services in 1977, when the Sandinistas came to power. This rose to 83 per cent in 1990, but by 1993 only 55 per cent of new health equipment was working.

Said Manuel Palacios of Nicaragua: ''Now children are dying. They don't eat enough food, don't go to school. After years of World Bank programmes we see them as against us. They have made women into prostitutes to buy food for their children.''