In the headlong rush to embrace market-friendly solutions, our governments are letting go of their responsibilities for public health. The Health for All slogan is but an embarrassing reminder of idealistic days long past.
The Man in Black on the flight to Dhaka could have been a photographer on his way to cover the People's Health Assembly. After all, this meeting on globalisation, poverty and health had attracted worldwide attention and the international press. As it turned out, the gentleman was an architect from Bangalore carrying designs for the Dhaka branch of the Madras-based Apollo Hospital chain, which has plans to nurse the Bangladeshi elite back to good health. Even as all over South Asia the well-to-do are beginning to access the best in medical care via the medium of organisations such as Apollo, the divide between the medical haves and public health have-nots, has begun to expand rapidly.
That, indeed, was going to be the main subject of concern for the participants from 93 countries congregated at the village of Savar near Dhaka in the first week of December. The People's Health Assembly was the culmination of a year-long international campaign against international economic policies which have inflated prices, increased unemployment, and heightened job insecurity and economic equality between and within nations. These processes have reduced the availability of food, social services and health care for the poor, and the immediate repercussions have been felt in the medical fitness of people, and their susceptibility to disease.
The choice of Bangladesh as the site for the conference was appropriate, for its story has been one of a step forward and two back when it comes to public health. Once famous as an inspirational David among Goliaths, thumbing its nose at the pharmaceutical giants and going the way it thought was right in drug policy, Bangladesh has come back to the fold of developing countries who do as they are told. In the not-too-distant past, during the regime of Hussain Mohammad Ershad, the community-based organisation, Gonoshasthaya Kendra, had helped formulate a national drug policy that resisted the pressures of multinationals and thwarted the dumping of inappropriate and dangerous drugs. A set of limited medicines of known efficacy was popularised, and the country became the toast of the public health fraternity worldwide.