The world ’s population is projected to grow to 8 million people
by 2030, with the majority of growth in the less developed countries
of the South. What should our imperatives be in the North (the ‘‘developed
world ’’) to make the world a better and healthier place for
all of us to live?
This is a fundamental question that has been under discussion and will
continue during the summit of the group of eight (G8) industrialized
nations this summer. UK Prime Minister Tony Blair recently suggested
our common plight in a domestic address:‘‘For each of us,
one of the most important things in life is our own and our family’s
health. ’’If this is indeed heralded as a goal for domestic
spending, it could be transposed into thinking of policies for the G8,
where the United Kingdom also has a leadership position.
There is significant discussion in policy circles to alleviate debt
from the North to help the South. Consider the potential of helping
hundreds of millions of the world’s most destitute who unknowingly
are servicing a debt with their current economic system. For example,
some African governments spend triple the amount on debt service annually
as they do on health care. Even with such hopeful future goals to alleviate
debt, there continues to be investment and incurred debt from the World
Bank and the International Monetary Fund (IMF). These organizations
contribute billions of dollars to development programs in the South.
In fact, the World Bank is the world ’s largest external funder
of health, committing more than $1 billion annually in new loans to
improve health nutrition and population in the South.The North has attempted
to add billions in potential additional funds to the development coffers,
with strong support from Europeans to reach a target of 0.7% of gross
domestic product (GDP) by 2015.
Given the great development challenges the world faces, some suggest
across-the-board debt relief. In the case of Tsunami stricken states,
however, this was a short-term solution as those who would select such
an offer might lose credit by gaining such relief. The best long-term
way forward is not to deal with more debt, but instead to develop ways
for development of sound economies and societies.
One recent solution has been suggested:Sell some of the IMF ’s
gold reserves (the reserves have a market value of $43 billion), thereby
translating the hard medal to hard actions to help people.Such an approach
would not require new funds from the North and could be used for the
long-term capacity development and infrastructure necessary to build
and sustain health in the future.
There also are other opportunities for long-term sustainable models
integrating public health into trade mechanisms, yet these are limited.
Nonetheless, given the success of the Framework Convention on Tobacco
Control, the first treaty negotiated by the World Health Organization
(WHO) in its history,there are new proposals under negotiation for the
World Trade Organization ’s (WTO’s) General Agreement in Trade
in Services (GATS) and the Regional Free Trade Area of the Americas
(FTAA). These initiatives present a wide range of health issues, including
services, facilities, professional licensing, water and sanitation,
and tobacco and alcohol distribution.
These are just some examples that provide an opportunity to extend
the scope of health with ongoing integrative communication on the global
agenda. However, there is limited attention to these areas in the realm
of public health and communication,hence the introduction of such a
dialogue in this journal.
Those of us dedicated to serving the health interests of people globally
should take note of this trend and examine ways to engage in ethical
support to encourage advances as investment in health has the best return,
building toward a true wealth. Health could be addressed with trade
reform that eliminates certain subsidies and market access limitations.
Simple macroeconomic trade measures may be a step forward while concomitantly
addressing investment in health, environment, and related areas of global
concern.
Our challenges in health are great,with global trade often principally
viewed epidemiologically as a vector for infectious disease. The scope
of global health requires networks, understanding and action in research,
surveillance, advocacy,
education, and policy so that the important long-term development for
quality life —health —innovates in the twenty-first century
to make us and our future generations proud of our attempt to make the
world a better place.
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Scott C. Ratzan MD, MPA, MA is Editor-in-Chief of the Journal
of Health Communication: International Perspectives. He also is
Vice President, Government Affairs, Europe for Johnson & Johnson
with academic appointments at George Washington University School of
Public Health, Tufts University School of Medicine, Yale University
School of Medicine, The College of Europe, and University of Cambridge.
