Not only medical professionals but also many development experts argue that, like education, health care for all is a goal worth working towards. There are a number of concrete measures, each of which moves the world’s population to better health. The Millennium Development Goals, adopted at the Millennium Summit in Sept 2000, call for major improvement in the health of the poor. The delegates recognized the importance of improving the health and longevity of the poor as an end in itself, but also as a means to achieving the other development goals relating to poverty reduction. For example, immunization programs dramatically reduce infant mortality as do provision of oral re-hydration therapy (ORT) to the under five year olds who suffer from chronic diarrhea. While there is no “quick fix” for the health problems of the world, it is possible to reverse many of the trends mentioned above that pose such a significant threat to world health. In this section we will explore both what is already being done to address threats to global health and also focus on some of the ambitious proposals designed to bring adequate health care to all.

Worldwide access to reproductive health care would be a giant step towards population stabilization. Not only would it reduce the ratio of population to health care infrastructure but it would also significantly reduce migration. The capacity to control family size permits women to safeguard their chosen children’s’ health by focusing on their improved hygiene and diet rather than their survival. Stabilizing population movement, especially from rural to urban areas will also slow the spread of diseases like HIV-AIDS associated with transient groups such as sex workers and truck drivers. Most importantly, reproductive health services are by their very nature preventive and reassert the importance of public health and primary health care as opposed to private, curative approaches.

Does the narrowing of the rich-poor gap lead to improved health or is it the other way around? In fact, both are probably true. It certainly makes sense that affordable treatment and access to tools of prevention like immunization and family planning contribute to a more economically productive population. Strong healthy industrial and agricultural workers and students certainly work with greater attention and efficiency. People with a stable income will be able to afford adequate health care. Experts in international anti-poverty strategies often link improved health care for the poor with education at all age and ability levels as a key ingredient in reducing or even eliminating poverty. The Global Campaign Against HIV-AIDS gives equal emphasis to community education and drug treatment.

On a more global level, reduction of the crushing national debts of the poorest nations of the world is essential; these countries can then budget for basic health services. Jeffrey Sachs, Chair of The Commission on Macroeconomics & Health recommends the creation of a Close to Client (CTC) system in which the local health post is given higher budgetary priority than hospitals and expensive medical facilities. The effectiveness of such programs hinges on the efficiency and accountability of both local and national governments in which civil society plays the key role. Good governance guarantees that local primary health care as well as massive immunization programs like those currently supported by the Bill &
Melinda Gates Foundation are effectively and equitably administered.

Rapid communication and the widespread use of the Internet have led to the growth of consciousness that good health is indeed a human right. In the World Health Organization’s 50th anniversary statement they reaffirmed the right of all people to have adequate health care. Human Rights Watch and Amnesty International have also pledged to expand their advocacy programs to economic, cultural, and social rights, recognizing that, without good health, freedom of speech is almost a luxury. At the beginning of the 21st century, the Global Fund to Fight AIDS, TB, and Malaria has underscored this commitment by targeting these three diseases, which affect the most under-served populations of the world.

Indeed, recent court decisions in South Africa allowing the manufacture of a generic antiretroviral AIDS drug suggest a shift in legal attitude towards the rights of the poor to affordable drugs.

Given the urgency of the worldwide environmental crisis, it’s tempting to give precedence to programs that address pollution and global warming. But the interrelatedness of all global problems reminds us that we can’t focus on CO2 emissions without also looking at the habits of the truck drivers who are prime carriers of the HIV virus. Prevention is as important in the environmental arena as in the transmission of disease. Most nations of the world have signed the Kyoto Protocol, agreeing to reduce carbon emissions significantly before the end of the first decade of this century. By reducing global warming we will also narrow the range of the malaria-carrying anopheles mosquito, just as more predictable weather patterns will eventually moderate the impact of cholera.

Food and water security are obviously key links in the chain of health care for all. We continue to make impressive strides in the production of food but not always in its equitable distribution. We must encourage sustainable organic agriculture at the local level, while resisting the pressures to grow cash crops and overuse technology. There are impressive examples in both the developing and developed world of the application of appropriate technology to food production. Emphasis on a more balanced diet and better use of available land for the production of food grains instead of cattle feed will make a tremendous difference in international food security. A reliable water source at the village level transforms the lives of all its inhabitants; organizations like OXFAM and United Nations Development Program are promoting relatively inexpensive small-scale projects. They lead directly to not only a changed attitude about what’s possible, but to the mobilization of civil society. The village health post is the next step.

Health For All: We Can Make a Difference

All of the above measures are components of what we can call a global wellness program. Many of these steps are preventive in nature and are not that expensive, even on a global scale. Immunization against smallpox and other campaigns in the past against diseases have been tremendously effective. We can continue to achieve the same successes but it will require a basic shift in attitude as we recognize the increased interconnectedness of humanity and realize that ill health and the resulting instability anywhere in the world can affect us all. Only by reaffirming the importance of public health will we be able to achieve these goals. Preventive and holistic healthcare clearly the foundation stones for global wellness.

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