Key Readings Relevant to The
Politics of Health
Compiled by the International People's Health Council,
and HealthWrights
Note: This is a short list, mainly of books and magazines,
most of which are accessibly written and should be fairly
easy to find. With few exceptions, it does not include
articles from journals. We recognize that this list is
very incomplete, but have tried to limit it to key writings,
mainly for the concerned student or lay reader. Some of
the writings are published recently, others are older,
but still represent some of the best, most relevant writings
in their field. HealthWrights and the International People's
Health Council are ongoingly developing more complete
lists, and would appreciate suggestions of new and important
materials. So as you come across such materials, please
keep us informed. Send
e-mail to HealthWrights
See also the Papers by David
Werner and Newsletters
from the Sierra Madre on this website.
PRIMARY HEALTH CARE and DETERMINANTS OF HEALTH:
Werner, David; Sanders, David with Jason
Weston, Steve Babb and Bill Rodriguez.
Questioning the Solution:
The Politics of Primary Health
Care and Child Survival.
HealthWrights, 1997. Questioning the
Solution analyzes why 13 million children die every
year from preventable causes, and challenges conventional
Primary Health Care and Child Survival Strategies. Too often,
health and development planners try to use technological
fixes rather than confront the social and economic inequities
that perpetuate poverty, poor health, and high child mortality.
As a case study, the authors show how marketing Oral Rehydration
Therapy as a commercial product, rather than encouraging
self-reliance, has turned this potentially life-saving technology
into yet another way of exploiting and further impoverishing
the poor. Macdonald, John. Primary Health Care:
Medicine In Its Place. University of
Bristol, UK. 1993. Available through Kumarian
Press, 630 Oakwood Ave., Suite 119, West Hartford, CT
06110-1529, USA. Traces the development of Primary Health
Care since its inception at Alma Ata in 1978 to the present,
providing strong arguments for the rationale of PHC. Emphasizes
the need for equity and strong community participation.
Navarro, V. "A Critique of the Ideological
and Political Position of the Brandt Report and the Alma
Ata Declaration." International Journal
of Health Services. Vol. 14, No. 2 (1984): pp 159-172.
Social Science and Medicine. "The
Debate on Selective or Comprehensive Primary Health Care."
Vol 26, No 9 (1988): pp 877-878. Introduction
to and historical background of the debate. Editors question
whether there is really a fundamental conceptual conflict
between SPHC and CPHC. They assert that donors should support
nations to develop national health systems based on primary
health care. Several good papers by key critics.
Werner, David and Bower, Bill. Helping
Health Workers Learn. A people-centered
guide to teaching community health workers. Intended for
those who feel that their first allegiance lies with working
and poor people. Discusses (and simplifies) the awareness-raising
methodologies developed by Paulo Freire.
Halstead, SB, Walsh, Julia A, and Warren,
Kenneth S, eds. Good Health at Low Cost. New
York: The Rockefeller Foundation. 1985. An important study
investigating why certain countries--China, Kerala state
in India, Sri Lanka and Costa Rica--have attained widespread
good health despite low GNP per capita.
Daly, Herman. For the Common Good: Redirecting
the Economy toward Community, the Environment, and a Sustainable
Future. Boston: Beacon
Press, 1989. Daly, a former World Bank economist who
left in disgust, argues for an eco-economic model
of development based on equilibrium , not growth, with full
cost pricing that builds in human and environmental
costs.
UNICEF The State of the World's Children.
Oxford, England: Oxford University Press.
Annually updated progress ln Child Survival. Has useful
statistics and graphs on health, education and economic
indicators in most of the world's countries with year by
year comparisons. Clearly presented.
McKeown, Thomas. The Role of Medicine:
Dream, Mirage or Nemesis? Oxford,
UK. Basil Blackwell Publisher. 1979. A superb review of
how medical interventions had relatively little to do with
public health improvements in Europe and the US between
1800 and 1950. Challenges myths about the contribution of
biomedicine.
Sanders, David. The Struggle for Health.
Hampshire, UK: Macmillan Education. 1985.
A perceptive overview of the causes of widespread poor health
and early death in situations of underdevelopment. It demonstrates
clearly that far-reaching improvements in health depend
more on social factors than on biomedical advances.
Ehrenreich, J. ed. The Cultural Crisis
in Modern Medicine. Monthly Review
Press. 1978. This book is a collection of writings by 14
authors divided into 3 parts: The Social Functions of Medicine,
The Historical and contemporary Roots and Devastating Impact
of Medical Sexism, and the Use of the Art of Healing in
Promoting and Maintaining Imperialism.
Kent, George. The Politics of Children's
Survival. New York. Praeger. 1991.
This book provides a clear, trenchant analysis of how "structural
violence" impacts the lives and mortality of children in
the Third World. Kent makes a strong case for equity-oriented
development and strategies that empower the poor.
Werner, David. The Life and Death of
Primary Health Care, or, The McDonaldization of Alma Ata.
1993. Available from HealthWrights,
964 Hamilton Ave, Palo Alto, CA 94301, USA. Talk given to
Medical Aid for the Third World. Reprinted in Third
World Resurgence (see below). Gives a cogent history
of the 3 major attacks on PHC since Alma Ata: Selective
Primary Health Care, User Financing and Cost-Recovery Schemes,
and the World Bank's Investing In Health report.
DEVELOPMENT AND SOCIAL CHANGE: ISSUES THAT
AFFECT HEALTH
Isbister, John. Promises Not Kept: The
Betrayal of Social Change in the Third World. West
Hartford, Connecticut: Kumarian
Press 1991. Reveals how world leaders rose to power
on promises for social progress and how they blatantly broke
those promises. Packed with hard-hitting facts, the book
gives a chronology on how poverty evolved.
UNDP
Human Development Index. Provides
important, useful data on distribution of wealth and resources
within and between countries, along with social indicators
(rather than merely economic ones) of a population's progress
and well-being. Presents a more honest (people friendly)
description and analysis of global trends than does the
World Bank's World Development Report.
Watkins, Kevin. The Oxfam Poverty Report.
Oxfam Publishing, BEBC Distribution,
PO Box 1496, Parkstone, Poole, Dorst BH123YD, UK. 1995.
A comprehensive analysis of the state of poverty in the
world today, this well documented book identifies the structural
forces that deny people their basic economic and social
rights. It outlines some of the wider policy and institutional
reforms needed to create an enabling environment in which
people can take self-determined action to reduce poverty.
Magazines (monthly):
Third World Resurgence. Published
by Third
World Network, 228 Macalister Road, 10400 Penang, Malaysia.
Perhaps the best periodical critique and analysis from the
Third World on development, environmental, and health issues.
Aims at "fair distribution of world resources and forms
of development which are ecologically sustainable and fulfill
human needs." If you subscribe to just one Third World periodical,
consider this one.
The
New Internationalist. Subscriptions:
PO Box 79, Hertford, SG14 1AQ, UK. "Exists to report on
issues of world poverty and inequality; to focus attention
on the unjust relationship between the powerful and the
powerless in both rich and poor nations " Each issue focuses
on a different theme relevant to development and basic needs.
Quality varies, but many issues carry important debate on
"the radical changes needed within and between nations if
the basic needs of all are to be met."
GLOBAL POWER STRUCTURES, FINANCIAL INSTITUTIONS
AND TRANSNATIONAL CORPORATIONS THAT IMPACT HEALTH
World Bank. World Development Report,
1993. Investing in Health. Oxford,
UK. Oxford U. Press. 1993. This is the position paper for
the World Bank's take-over of Third World health policy
planning. It calls for more equitable and efficient health
systems. But stripped of its Good Samaritan face lift, it
is a rehash of the conservative strategies that have derailed
Comprehensive Primary Health Care, but with the added shackles
of structural adjustment, including privatization of public
services and user-financed cost-recovery. A masterpiece
of disinformation, this market-friendly version Selective
Primary Health Care has ominous implications. By tying its
new policy to loans, the Bank can impose it on countries
that can least afford it. In sum, the Report promotes the
same top-down development paradigm that has perpetuated
poverty, foreign debt, and the devastating impact of structural
adjustment policies.
Critical Reactions to the World Bank's World
Development Report 1993: Investing in Health:
- Various papers assembled in 1993 by
Health Action International--Europe. Address: Jacob
van Lennepkade 334T, 1053 NJ Amsterdam, The Netherlands.
This is a packet of extremely important analysis and
criticism, including responses from Save the Children
Fund (UK), Tony Klouda on behalf of the PHC-NGO group
(IPPF, UK) and an article by Dorothy Logie and Jessica
Woodroffe from the British Medical Journal, July 3,
1993.
- Legge, David. "Investing in the Shaping of World Health
Policy," Prepared for the AIDAB, NCEPH
and PHA workshop (Canberra, Australia, Aug. 31, 1993).
Long, in depth review of Investing in Health.
(Available from HealthWrights)
- Epprecht, Marc. "The World Bank, Health, and Africa,"
Z
Magazine, Nov. 1993, p. 31-38. Lengthy in-depth
review of harm caused by World Bank health plan in Africa.
Danaher, Kevin, editor. Fifty Years is
Enough: the case against the World Bank and International
Monetary Fund. South
End Press, Boston MA, USA, 1994. A revealing collection
of essays, country studies, and statements by marginalized
groups of the reversals in social progress and deepening
of poverty caused by structural adjustment and other lop-sided
development policies pushed by these powerful financial
institutions.
Meeker-Lowry, Susan, Investing in the
Common Good.1995. New
Society Publishers, PO Box 734, Montpelier, VT 05601,
USA. Alternative development strategy which calls strongly
for equity and participatory democratic process. Critical
of the top-down, status-quo preserving strategy of the World
Bank's Investing in Health report.
Tan, Michael. Dying for Drugs: Pill Power
and Politics in the Philippines. Published
by Health
Action Information Network (HAIN), 1156 PO Box 1665,
Central Post Office, Quezon City, Philippines. 1988. One
of the best books from the Third World exposing the exploits
and abuses and double standards of the multinational drug
companies. HAIN also puts out an excellent bulletin, Health
Alert, which looks at many health related issues, Philippine
and international, from a pro-people perspective.
Chetley, Andrew and Allain, Annelies. Protecting
Infant Health: A health worker's guide to the International
code of Marketing of Breastmilk Substitutes. Published
by International
Baby Food Action Network (IBFAN) PO Box 19, 10700 Penang,
Malaysia. 1993 (revised). An excellent well-illustrated
booklet for awareness raising in community groups.
Korten, David. When Corporations Rule
the World. Kumarian
Press, 630 Oakwood Ave. Suite 119, West Hartford, CT
06110-1592, USA. 1995. "A searing indictment of an unjust
international world order" together with a very rational
alternative strategy for "People Centered Development" (the
title of his first major book). Korten is the founder of
the People-Centered Development Forum, based in New York
City.
Magazine (monthly):
Multinational
Monitor. Subscriptions: PO Box
19405, Washington DC 20036, USA. Excellent, balanced, well
documented articles that expose the unscrupulous actions
of transnational corporations, their influence on national
and global politics, and their violations of international
codes. Some articles are directly related to health concerns;
almost all are at least indirectly related.
