Lecture outline Oct 17
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- How we frame an issue is structurally and historically conditioned
- Many countries have not been able to break out of structural constraints imposed on them
- Importance of understanding history: looking at modernization, dependency theory
- Amartya Sen- rethink development as more than just economic growth, focus on individual freedoms
- Civil society organization
- Philanthropic organization- trying to play the part of a development actor, changing the landscape of
Health and development
- How health can be better understood from the perspective of capability?
- Our understanding today is colored by our understanding of the past
- Relationship between development and health?
- Health is a messy concept!
- What is health? Student definitions: Physical and medical well-being, lack of disease, holistic being:
Common conceptions - Definition of health as lack of disease is parallel to the definition of poverty as lack of wealth fallacies.
These definitions have policy implications
- How the definition of health has changed over time?
- What are the social determinants of health? We think of things as separate.
- Drug targets specific condition, provides solution to problem although a condition can be a result of a
complex set of factors
- Looking at the social context, the political and economic environment and their role in the population’s
health and individuals
Health is not simply a medical but also a social and human rights issue
- Corporations are playing a part as development actors
- Coca cola as a global brand that has an ability to reach almost every part of the world.
- The Global Fund- public private partnerships (many organizations participate in it): contribute a lot of
money towards finding cures for wide spread diseases in Africa
- Enlisting Coca Cola because it has access to almost every part of the world. They have the networks,
people, computer networks, good inventory tracking systems.
What are the positive/negative things about the Global Funds collaboration with Coke? Coke
distributing medicine when distributing their product
- Coke goes only to places where they can sell their products
- Box of medicine, needles – how does it get to the people if there is no medical personnel? Assumption
that getting the medicine there will fix the problem, but what about the infrastructure of administering
- Technical solution: trying to solve a wrong problem - Coke has been taking over so many local companies in East Africa. It is able to come in and use the
local water supply when people have to pay more for the water because it is privatized.
- White/Green washing exercises to make Coke look good as a corporation!
- Coke contributes to a lot of diseases due to the sugary nature of its products
Subtle ways though which health and development are being debated
- Difficult to dissect
- People in rich countries live dramatically longer, healthier lives than people in poorer countries. Is this
true? The World Bank would say it is. Generally true, although you can live longer, but not be healthier.
This is a broad generalization. In countries like Nepal people have really long life-spans.
- If the sentence is true, then wealth generation will be key to health as is the eradication of disease
- Policies that promote wealth creation will lead to healthy and happy populations: What about the
- In the US, medicine is not socialized. If you are not insured, you have to pay out of your own pocket. In
contrast, Canada, there is a one payer, distributive system. They system in Canada is not perfect, but it is
much different form the one in the US.
- Cost of health care in the US has led to the development of a huge insurance industry. The US has one
of the highest expenditures for health.
- Obama wants to make more of a socialized system
- The US is very polarized in terms of the health care
- Mitt Romney believes that generating wealth is the solution to all problems, although his belief doesn’t
have empirical evidence.
- Free market- right price will somehow be generated by the invisible hand of the free market. How World Health Organization defines health?
- What kind of an organization is it? It is a multilateral organization formed in 1946
- Some of the key issues following WWII were food security, infectious diseases
- WHO was meant to coordinate efforts to deal with disasters, crises, setting guidelines and providing
- “Health is a state of complete physical mental and social well-being and not merely the absence of
disease or infirmity” (WHO). This understanding has not been as publicized and popularized. Idealized
definition? It is not easily operationalized
- Operationalizing the definition of health has always been the key, which is part of why the WHO
definition of health has been out of the public eye for such a long time
- WHO has lost its leadership role. Organizations such as the Gates Foundation have a lot more funds.
WHO’s ability to drive agendas has diminished. Did it become too big as an organization? Too many
layers making it difficult to make decisio