The diseases are in the developing South, but the money and the patents are locked in the post-industrial North. The world's poor are in a free fall.
As governments of the develo ing world retreat from their welfare responsibilities and hive off public health functions to the private sector on advisement from international high finance, are we to begin depending on the charity and munificence of the multinational tycoons? When CNN founder and media magnate Ted Turner announced a billion dollars for humanitarian projects of the United Nations, everyone ooohed and aaahed without calling to account the many billions that are being wrested away from the social sector by governments of the developed and developing world. Bill Gates, richest man in the world over in Seattle, then went one up on Turner and everyone else by endowing the largest philanthropic organisation ever, the Bill and Melinda Gates Foundation. Last year, outperforming the US government on this front, he donated USD 300 million to charitable causes, primarily aimed at 'reversing' the health crisis among the world's poor. This fund targets global threats such as malaria, tuberculosis and AIDS, and Gates' giving adds up to more than 25 percent of the total support given by the West towards health in the developing countries. What is the crisis in the globalised economy that governments both down here and out there, turn away so offensively from their public health commitments, leaving the field free for philanthropy and private benevolence—but most importantly to the rapacious market?
Since 1978, by the United Nations' reckoning, the number of countries that are 'least developed' has shot up from 28 to 48. This means that one country per year has slipped down the development ranking during the last two 'development decades'. The assets of the three richest people in the world are more than the GNP of the 48 least developed countries, and the three richest officers of Gates' Microsoft have more assets (upwards $140 billion) than the combined GNP of the 43 least developed countries. Meanwhile, health care eludes the poor who constitute 50 percent of the population of the least developed 46 poorest countries. About two billion people in the world live on less than a (US) dollar a day, and more than 800 million people have total lack of access to any form of basic health care. Nearly three billion do not have access to safe drinking water and appropriate sanitation.
The contributions by Turner and Gates underline the increasingly important role wealthy private individuals and philanthropists are playing in international development, but the fundamental question has not been asked with any sense of urgency—should private forces, however benevolent, be even permitted to draw up and drive the international health agenda, as is beginning to happen? Can donations and whimsical price reductions of patented drugs, so-called private-state partnerships and corporate-community welfare programmes ever be viable, sustainable substitutes to the long-term responsibility of the state to protect, promote and ensure the right to health care? In the process of privatisation, not only of public health programmes, but also of public health funding, are organisations which have led in the past, such as the World Health Organisation (WHO) being further sidelined?