[Ip-health] (Fwd) 20 million unnecessary deaths/year: can privatisation fix this?

Patrick Bond pbond at mail.ngo.za
Sun Mar 16 11:24:35 PDT 2014


The Lancet, Volume 383, Issue 9921 
<http://www.thelancet.com/journals/lancet/issue/vol383no9921/PIIS0140-6736%2814%29X6075-7>, 
Page 949, 15 March 2014
doi:10.1016/S0140-6736(14)60473-6<http://www.thelancet.com/popup?fileName=cite-using-doi>Cite 
or Link Using DOI <http://www.thelancet.com/popup?fileName=cite-using-doi>
Copyright © 2014 Elsevier Ltd All rights reserved.


  Investing in health

David Chiriboga 
<http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=David+Chiriboga> 
a 
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960473-6/fulltext#aff1>Email 
Address <mailto:dechiriboga at gmail.com>, Paulo Buss 
<http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=Paulo+Buss> 
b 
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960473-6/fulltext#aff2>, 
Anne-Emanuelle Birn 
<http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=Anne-Emanuelle+Birn> 
c 
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960473-6/fulltext#aff3>, 
Juan Garay 
<http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=Juan+Garay> 
d 
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960473-6/fulltext#aff4>, 
Carles Muntaner 
<http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=Carles+Muntaner> 
e 
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960473-6/fulltext#aff5>, 
Laura Nervi 
<http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=Laura+Nervi> 
f 
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960473-6/fulltext#aff6>, 
on behalf of 42 signatories

As public health professionals devoted to global health equity, we would 
like to express our deep concern with the /The Lancet/ Commission 
/Global health 2035: a world converging within a generation/ (Dec 7, p 
1898),1 
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960473-6/fulltext#bib1> 
a re-run of the 1993 World Development Report, whose policies 
contributed to the shrinkage of government institutions and massive 
privatisation and fragmentation of health-care systems, effectively 
decreasing coverage and accessibility.2 
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960473-6/fulltext#bib2>, 
3 
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960473-6/fulltext#bib3>
/The Lancet/ Commission on Investing in Health comprised mostly of 
individuals affiliated with or funded by international financial 
institutions, corporations, public---private partnerships, bilateral 
donor agencies, and their philanthropic and academic partners, mostly 
from high-income countries, presents a biased perspective reminiscent of 
failed neoliberal prescriptions rooted in the reinvention of formulas by 
co-opting terms like universal health care and access. The 
recommendations are based on the principle of return on investment, not 
on health equity, while creating a double standard: one for the rich and 
another for the rest of us. Any policy for the poor is by definition a 
poor policy.
/
The Lancet/ Commission's recommendations do not represent the global 
health community and are fundamentally flawed by neglecting the 
principle of the right to health. The report analyses Millennium 
Development Goals progress without reference to stagnant levels of 
health inequity: 20 million deaths each year, more than a third of all 
deaths, are avoidable and caused by socio-economic injustice---a number 
and a proportion that have not changed for the past 40 years.4 
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960473-6/fulltext#bib4> 
Every individual, organisation, or government working to promote heath 
equity and WHO's objective of enjoyment by all peoples of the best 
attainable level of health should be on their guard.
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We declare that we have no competing interests.


    References

1 
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960473-6/fulltext#back-bib1> 
Jamison DT, Summers LH, Alleyne G, et al. Global health 2035: a world 
converging within a generation. Lancet 2013; 382: 1898-1955. Full Text 
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2813%2962105-4/fulltext>| 
PDF(2940KB) 
<http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673613621054.pdf?id=aaaUhAUEhFP6h7YJy8ltu> 
| CrossRef 
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2813%2962105-4/fulltext>| 
PubMed 
<http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=Search&term=Lancet[Jour]+AND+382[Volume]+AND+1898[page]>
2 
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960473-6/fulltext#back-bib2> 
Laurell AC, Arellano OL. Market commodities and poor relief: the World 
Bank proposal for Health. Int J Health Serv 1996; 26: 1-18. CrossRef 
<http://dx.doi.org/10.2190/PBX9-N89E-4QFE-046V>| PubMed 
<http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=Search&term=Int%20J%20Health%20Serv[Jour]+AND+26[Volume]+AND+1[page]>
3 
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960473-6/fulltext#back-bib3> 
Lister J. Globalization and health systems change. WHO Commission on 
Social detetminants of Health. University of Ottawa, 2008. 
http://www.globalhealthequity.ca/webfm_send/14. (accessed March 1, 2014).
4 
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960473-6/fulltext#back-bib4> 
Garay J, Harris L, Beam M, Zompi S. Global inequity death toll: 
targeting global health equity and estimating the burden of inequity. 
141st American Public Health Association Annual Meeting; Boston, MA, 
USA; Nov 2---6, 2013. Abstr 291133.
a 
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960473-6/fulltext#back-aff1>Hospital 
de Zumbahua, Zumbahua, Cotopaxi, Ecuador
b 
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960473-6/fulltext#back-aff2>Oswaldo 
Cruz Foundation's Center for Global Health, Rio de Janeiro, Brazil
c 
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960473-6/fulltext#back-aff3>Dalla 
Lana School of Public Health, Centre for Critical Development Studies, 
University of Toronto, ON, Canada
d 
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960473-6/fulltext#back-aff4>Andalusian 
School of Public Health, Granada, Spain
e 
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960473-6/fulltext#back-aff5>Bloomberg 
Faculty of Nursing, Department of Psychiatry and Dalla Lana School of 
Public Health, University of Toronto, Toronto, ON, Canada
f 
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960473-6/fulltext#back-aff6>Human 
Ecology Institute, Concepcion, Chile

SIGNED:

David Chiriboga, MD, MPH (au)
Former Pro-Tempore President of the Council of Health Ministers of 
UNASUR (Unión de Naciones Suramericanas)
and former Minister of Health of Ecuador

Paulo Buss, MD, MPH (au)
Director of the Oswaldo Cruz Foundation's Center for Global Health, Full 
Member of the National Academy of Health, Brazil

Anne-Emanuelle Birn, MA, ScD (au)
Professor, Dalla Lana School of Public Health, Centre for Critical 
Development Studies University of Toronto, Canada

Juan Garay, MD, MPH, MSc (au)
Professor of Global Health, Andalusian School of Public Health, Granada, 
Spain

Carles Muntaner, MD, PhD
Professor
Bloomberg Faculty of Nursing Dept of Psychiatry and Dalla Lana School of 
Public Health University of Toronto, Canada

Laura Nervi, PhD, MPH, MSSc
Senior Researcher
Human Ecology Institute
Concepción, Chile

María Cristina Alvarez Degregori, MD, MSSc, MSc
Expert Global Health
International Organization for Equity in Global Health and Social 
Justice- AIxESS, Barcelona, Spain

Carlos M. Artundo, MD, Psych, MSc
Director
Andalusian School of Public Health-EASP
Granada, Spain

Joan Benach, MD, MPH, PhD
Director Health Inequalities Research Group, Employment Conditions 
Network (GREDS-EMCONET)
Universitat Pompeu Fabra,
Barcelona, Spain

Patrick Bond, PhD
Senior Professor
University of KwaZulu-Natal School of Built Environment and Development 
Studies
South Africa

Pedro Brito, MD, MPH
Professor, Faculty of Public Health and Health Administration
Cayetano Heredia University
Lima, Perú

Xochtil Castañeda, MSc
Director of Health Initiative of the Americas
University of California, Berkeley, USA

Meei-shia Chen, MPH, PhD
Distinguished Professor
Department of Public Health
College of Medicine, National Cheng Kung University
Taiwan

Anna Cirera Viladot, MD, MPH
Expert Global Health
International Organization for Equity in Global Health and Social 
Justice - AIxESS
Barcelona, Spain

Ms. Nicoletta Dentico
President
Italian Global Health Watch-OISG
Italy

Mr. Daniele Dionisio, MD
Head Research Project Geopolitics, Public Health and Access to Medicines 
(GESPAM)
Member, European Parliament Working Group on Innovation, Access to 
Medicines and Poverty-Related Diseases, Italy

Oscar Feo, MD, MPH
Former Executive Secretary of the Andean Health Organization
Alternate Coordinator of ALAMES
Professor of the University of Carabobo, Venezuela

Sergio Galan , MD, MPH
Head of Health Sector Unit
Spanish Agency for International Development
Spain

Eva Harris, PhD
Director, Center for Global Public Health
Professor, Division of Infectious Diseases & Vaccinology, School of 
Public Health
University of California, Berkeley, USA

Ida Hellander, MD
Director of Policy and Programs
Physicians for a National Health Program
Chicago, IL, USA

David U. Himmelstein, M.D.
City University of New York School of Public Health
New York, USA

Celia Iriart, PhD, MPH
Associate Professor
Associate Director Public Health Program
School of Medicine, Health Sciences Center
University of New Mexico-UNM, USA

MiRa Lee, MD
Doctors for Humanism, Busan
Republic of (South) Korea.

Luis Andrés López-Fernández, MD, MPH
Senior Lecturer
Andalusian School of Public Health-EASP
Granada, Spain

Miguel Machuca, MD, MPH
Independent Scholar
El Salvador and Panama

Juan Ignacio Martínez Millán, MD, MPH
Senior Lecturer
Andalusian School of Public Health-EASP
Granada, Spain

Paloma Menendez, MD, MPH
Expert Occupational Health
International Organization for Equity in Global Health and Social 
Justice- AIxESS
Barcelona, Spain

Juan Jose Mercader Casas, MD, MPH
Senior Lecturer
Andalusian School of Public Health-EASP
Granada, Spain

Joan Muela Ribera, PhD, MSc
Senior Researcher
PASS-International
Universitat Rovira i Virgili, Cataluña, Spain

José Ignacio Oleaga Usategui, MD, MPH
Coordinator, Global Health Area
Andalusian School of Public Health-EASP
Granada, Spain

Victor Penchaszadeh, MD, MPH
Professor, Department of Health Sciences
National University of La Matanza, Buenos Aires, Argentina.

Ted Schrecker, MA
Professor of Global Health Policy
School of Medicine, Pharmacy and Health
Wolfson Research Institute
Queen's Campus, Durham University, UK

Eduardo Siqueira MD, ScD
Associate Professor
College of Public and Community Service (CPCS)
The Mauricio Gastón Institute for Latino Community Development and 
Public Policy
University of Massachusetts-UMass, Boston, USA

Angelo Stefanini MD, MPH
Director, Centre for International Health
Dept. of Medical and Surgical Sciences
University of Bologna, Italy

Mario Testa, MD, MPH
Professor
Department of Community Health
National University of Lanus, Buenos Aires, Argentina

Fabiano Tonaco Borges, PhD, MPH
Assistant Professor
Institute of Public Health
Federal University of Mato Grosso, Brazil

Jean-Pierre Unger, MD, PhD
Senior Lecturer Institute of Tropical Medicine, Antwerp
Honorary Senior Research Fellow, Queen Mary
University of London, UK

Josep Vargas, PhD
Senior Public Health Officer
UNHCR N'Djamena, Chad

Juan Carlos Verdugo Urrejola, MD
Executive Director
Inclusive Health Institute-ISIS
Guatemala

Gastão Wagner S Campos, MD, PhD
Full Professor Collective Health
School of Medicine University of Campinas
San Pablo, Brazil

Howard Waitzkin, MD, PhD, FACP
Distinguished Professor Emeritus, Sociology
Clinical Professor of Medicine
University of New Mexico, USA

Steffie Woolhandler, M.D., M.P.H.
City University of New York School of Public Health
New York, USA

The views and opinions expressed in this letter are those of the authors 
and do not necessarily reflect the official policy or position of the 
institutions with which the authors are affiliated.



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