The champagne glass of world poverty
BMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7189.0 (Published 10 April 1999) Cite this as: BMJ 1999;318:0All rapid responses
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Like you I am convinced that repayment of debt by the poorest
countries in the world is a major cause of poverty and ill health. I am
enthusiastic about us doing everything in our power to put an end to this
vicious circle. I am sure public demonstration does help by raising
awareness and could possibly influence those who have the power to
initiate a change of importance. I do wonder however whether we are doing
enough. After joining hands, perhaps we should reach for our cheque books!
We could start a charity with the sole aim of repaying what the poorest
nations owe to the UK. I am sure that if we make a start others will
follow both locally and internationally.
Yours Sincerely,
A. Hossenbocus, MD FRCP
Consultant Physician & Gastroenterologist
Competing interests: No competing interests
EDITOR - I am very pleased that the BMA is a part of Jubilee 2000
Coalition, and to note the support for it in the BMJ. I have been reading
with great interest the series of articles on the World Bank and world
health. It seems to me that cancellation of Third World debt is one of the
few worthwhile ways that have been suggested to celebrate the Millenium,
and by far the most important in global terms.
With reference to "Editor's Choice" in the BMJ dated 10 April 1999,
it should be noted that there will be a Jubilee 2000 Scottish Link of the
Global Chain Reaction for the cancellation of Third World Debt in
Edinburgh on Saturday, 12 June at 1.00 pm, surrounding Edinburgh Castle.
Perhaps you could bring this to the attention of your readers, some
of whom may find this a more convenient venue to attend.
E Sheila Merchant
Consultant in Family Planning and Reproductive Health Care
Ayrshire and Arran Community Health Care Trust
Aurshire Central Hospital
Irvine
Ayrshire, Scotland
Competing interests: No competing interests
In the same report the world bank calculated the health expenditures
in various parts of the world.
In the established markets on average 1 802 USD per capita per year are
spent on health.
In the rest of the world this figure is around 60 USD per capita per year.
Just imagine what would happen to your hospital if the number of staff and
beds were reduced by a factor 30 !!
Honey, I shrunk the hospital.
In addition to that the burden caused by disease is 3 times greater in the
developing world as measured by the DALY, developed by Murray ea.
Health for all by the year 2015 implies not only a redistribution in
income, but also a change in resource allocation.
Competing interests: No competing interests
The editor is right to draw attention to the importance of popular
protest. It has helped to push the debt issue to the top of the
international agenda.
We need to continue to pile on the pressure in advance of the next G8
Summit to make sure that the leaders of the world's most powerful nations
turn their promises of debt reduction into reality.
It is anticipated that tens of thousands of people will come to the
next human chain events in Edinburgh (Saturday 12 June) and London (Sunday
13 June). We are expecting hundreds of doctors, students and other health
professionals to come to both events. The London chain will have a special
"health section" organised by Medact, and will be preceeded by a public
meeting on debt and health.
Get in touch with me via the Medact office (medact@gn.apc.org or 0171
272 2020) if you want to know more about plans for the day.
Mike Rowson
Medact*
*Medact is a health professionals organisation which lobbies and
campaigns on global health issues
Competing interests: No competing interests
It was in a very special moment that the article "The champagne glass
of world poverty" reached me. I had just came out of a class on Public
Health where the theme developed by the professor was "The definition of
health". It was an interesting class in that the professor demonstrated
how the students' view of what health meant was individualist and
egocentric. I realize now that "health" is a matter of social, economical,
political, and historical circunstances--not just "biological"
circunstances.
Leaving in a poor country like Brazil, it is reassuring to know that our
friends in the Northern Hemisphere are willing to contribute to the
improvement of health parameters in the Third World. Surely, the drainage
of money from South America, Africa, and Asia to New York, Tokio, Paris,
London, Berlin, etc has little impact on the welfare of the First World's
population, but it represents an irreperable loss for those who do not
know if money will be enough for eating until the end of the month.
Jubilee 2000 is a chance for all indebted poor countries to start
eliminating social discrepancies that cause many of the health problems
faced by the Third World. However, this will not be enough. In order to
improve the Health of Third World countries, there needs to be: (1)
persuasion aiming at convincing public authorities to face their duties as
a commitment to the citizens and not as a way of making money;
(2)persuasion with the objective of implementing actions to reduce the
social innequities of poor countries.
Jubilee 2000 faces a terrible dilema. In the event of creditors canceling
the Third World debt, there is a risk concerning the aptness of our
governors to transform social gains into individual benefits. This must
not be understood as a discouragement for Jubilee 2000, but just as a
suggestion of what to do if this wonderful undertaking succeeds.
Yours sincerely,
Ivan Salzo
PS. In addition to being a technical assistant at "Instituto de
Medicina Fetal e Genética Humana" (Institute of Fetal Medicine and Human
Genetics), I am an undergraduate student of Biological Sciences at
University of Sao Paulo (Sao Paulo State, Brazil)
Competing interests: No competing interests
Banking on human rights?
While the world is given the sad and wastefully criminal war
firecrackers, and the TV manipulates world opinion (whether this is on
Irak, Kosovo or some other targetted places by the eye of the US, done by
NATO -its new "covered agent"- or directly, it does not matter)we move no
further in bettering the world from the worst plague: the debt. Your
article is interesting in putting things in simple terms. How much would
it costs to rid the entire world of it is not a big deal, financially
speaking... But when countries like Brazil were robbed of over US$103
billion in just a few weeks, making banks their best profit ever, we have
to denounce the shame and cynical approaches promoted by the globalization
process. There is no attempt to improve human rights. Particularly when
the balkanization comes from old cold war goals, and it could have been
avoided. We seem powerless in front of big brother´s frantic attempts to
control every place in the world. Packaging it as human rights has not
made it any better.
The 1998 World Bank Report shows the following targets:
* reduce by half the proportion of people living in extreme poverty by
2015;
* achieve universal primary education in all countries by 2015;
* achieve gender equality in primary and secondary education by 2005;
* reduce infant and child mortality by two thirds, and maternal deaths by
three quarters, by 2015;
* provide universal access to reproductive health services by 2015; and
* reverse current global and national loss of environmental resources by
2015
They are certainly fine... but... it does not address why things
continue to get worse! Just look at debt repayment facts and you will see
why. Children can´t continue to wait!
My only comment is: how come they do not target the debt as an urgent
step that can be done with in little time? The fate of people is not a
technical problem: it is political. But the Bank seems to act like just a
big Bank...
Competing interests: No competing interests