The whole period of 19th century was characterized by colonialization
of Latin American, African,
and Asian
subcontinents, while the early 20th century saw the epochal changes
through two world wars. These wars led to the shift of military might from
Europe to the United States of America. As a result, Europe had to struggle
with the politico – economic restructuring with change in power dynamics. The
United States of America (USA) was also pulled into this European affair. This
engagement in a decisive role to end the war led the USA undoubtedly becoming a new superpower
in global political leadership and principal advocate for neoliberalism in global
affairs. This essay explains the dynamic relationship between population
health and development with some examples of its advantage and disadvantage.
First, let us explore and try to understand the advantage
in considering population health and development together. Although there was
continuous shift in understanding the relationship between development and
health in academia and developmental sector, all the discourses were heavily
influenced by ideological divide that exist between socialism and capitalism.
In the midst of these changes, the
movement of comprehensive Primary Health Care (CPHC) lead to the Alma Ata Declaration by the World Health Assembly
(WHA) in 1978. This CPHC movement brought an overwhelming shift in
the thought process dealing with health of the community and its link with
socio – economic development. One of the key principle that was enshrined in
the declaration was that health is basic human right (Basilico, Weigel, Motgi,
Jacob, & Keshavjee, 2013).
The Alma Ata declaration also recognized that the investment in health
strengthen the local health infrastructure and improve access to essential
health care services with community participation. This meant that health was treated as an end, while socio – economic
development was the
means to address the challenge of poverty and disease in the community through
community participation. One of the legacies of such though process that
started with CPHV movement today would be Millennium Developmental Goals (MDG)
which have now streamlined as sustainable developmental goals (SDG).
Although the CPHC movement brought enthusiasm in health
and developmental sector, it was short lived with the rising influence of neoliberalism, which considered health as commodity
to be bought and paid in contrast to health being basic human right. However,
on positive side, the world witnessed the birth of numerous international
institutions like the United
Nations (UN), the World
Bank (WB), the International
Monetary Fund (IMF), the World
Health Organization (WHO), UNICEF (for children’s safety and health) and
several rich governments funded overseas development agencies like USAID.
Majority of these organizations were harbinger of colonial legacies like the Pan American Health Organization
(PAHO). All of these new organizations were also headquartered in Europe and few in the USA became the powerhouse for providing
policy direction on the subject of development and health across the world.
With complex bureaucratic processes (Kleinman, 2010) and its ramifications within the organizations, the
discourse on population health and socio economic development in low income
countries were influenced by rapid changes in the socio political and economic
landscape of the world. There was also parallel rise in independence movements
all across Africa and Asia. All previous colonial states like India were
exercising their self-determination rights for freedom and sovereignty.
However, there political and economic situation was very fragile in
post-colonial period. (Basilico et al., 2013) Sadly, all key international developmental organizations
like World Bank, IMF, UNICEF and other bilateral donors were dictated favoring
neoliberal ideas and principles against the basic needs of the population in
low income countries. All these organizations also used this international platform
as means to exercise their political and economic interests. This meant that
all those countries in Africa or Asia, who received huge development loans from
WB and IMF, were heavily influenced in the framing of their national policy and
its implementation. All of these practices were clearly against the spirit of
Alma Ata Declaration. The outcome of these neo liberal ideas and principles dictated
the development and health related policies, resulting into failure or poor
performance of health care delivery in targeted countries in the long run. (Basilico et al., 2013)
In summary, the start of debate in considering the role of population health in
the socio economic development brought serious discourse among world leaders,
policy makers, planners,
and funders. As a result of this discourse, there is a serious academic and
policy interest in the relationship of poverty and diseases and socio economic
development in low-income
countries. Also, we
need to acknowledge that there is always the push and pull between different
socio – political ideologies, which play important role in dictating the course
of population health in a community through their influence on the policies and
its implementation.
Reference:
Basilico, M., Weigel, J., Motgi, A., Jacob,
B., & Keshavjee, S. (2013). Health for All? Competing Theories and
Geopolitics. In Reimagining Global Health: An Introduction (pp. 74–110).
Kleinman, A. (2010). Four social theories for global health. Lancet,
375(9725), 1518–1519. http://doi.org/10.1016/S0140-6736(10)60646-0
