The whole period of 19th century was colonialization of Latin American, African and Asia subcontinents, while the early 20th century saw the epochal changes through two world wars. These wars led to the shift of military might from Europe to the United States of America. As a result, Europe had to struggle with the politico – economic restructuring with change in power dynamics. The United States of America (USA) was also pulled into this European affair. This engagement in a decisive role to end the war led the USA undoubtedly a new superpower in global political leadership and principal advocate for neoliberalism in global affairs. This essay explains the dynamic relationship between population health and development with some examples of its advantage and disadvantage.
First, let us explore and try to understand the advantage in considering population health and development together. Although there was continuous shift in understanding the relationship between development and health in academia and developmental sector, all the discourses were heavily influenced by ideological divide that exist between socialism and capitalism. In the midst of these changes, movement of comprehensive Primary Health Care (CPHC) lead to Alma Ata Declaration by World Health Assembly (WHA) in 1978. TisCPHC movement brought overwhelming shift in the thought process dealing with health of the community and its link with socio – economic development. One of the key principle that was enshrined in the declaration was that health is basic human right (Basilico, Weigel, Motgi, Jacob, & Keshavjee, 2013) The Alma Ata declaration also recognized that the investment in health strengthen the local health infrastructure and improve access to essential health care services with community participation. This meant that health as an endwhile socio – economic development means to address the challenge of poverty and disease in the community through community participation. One of the legacies of such though process that started with CPHV movement today would be Millennium Developmental Goals (MDG) which have now streamlined as sustainable developmental goals (SDG).
Although the CPHC movement brought enthusiasm in health and developmental sector, it was short lived with therising influence of neoliberalism, which considered health as commodity to be bought and paid in contrast to health being basic human right. However, on positive side, the world witnessed the birth of numerous international institutions likeUnited Nations (UN), World Bank (WB), International Monetary Fund (IMF), World Health Organization (WHO), UNICEF (for children’s safety and health) and several rich governments funded overseas development agencies like USAID. Majority of these organizations were harbinger of colonial legacies like Pan American Health Organization (PAHO). All of these new organizations were also headquartered in Europe andfew in USA became the powerhouse for providing policy direction on the subject of development and health across the world. With complex bureaucratic processes (Kleinman, 2010) and its ramifications within the organizations, the discourse on population health and socio economic development in low income countries were influenced by rapid changes in the socio political and economic landscape of the world. There was also parallel rise in independence movements all across Africa and Asia. All previous colonial states like India were exercising their self-determination rights for freedom and sovereignty. However, there political and economic situation was very fragile in post-colonial period. (Basilico et al., 2013) Sadly, all key international developmental organizations like World Bank, IMF, UNICEF and other bilateral donors were dictated favoring neoliberal ideas and principles against the basic needs of the population in low income countries. All these organizations also used this international platform as means to exercise their political and economic interests. This meant that all those countries in Africa or Asia, who received huge development loans from WB and IMF, were heavily influenced in the framing of their national policy and its implementation. All of these practices were clearly against the spirit of Alma Ata Declaration. The outcome of these neo liberal ideas and principles dictated the development and health related policies, resulting into failure or poor performance of health care delivery in targeted countries in the long run. (Basilico et al., 2013)
In summary, the start of debate inconsidering the role of population health in the socio economic development brought serious discourse among world leaders, policy makers, planners and funders. As a result of this discourse, there is a serious academic and policy interest in the relationship of poverty and diseases and socio economic development in countr. Also, we need to acknowledge that there is always the push and pull between different socio – political ideologies, which play important role in dictating the course of population health in a community through their influence on the policies and its implementation.
Basilico, M., Weigel, J., Motgi, A., Jacob, B., & Keshavjee, S. (2013). Health for All? Competing Theories and Geopolitics. In Reimagining Global Health: An Introduction (pp. 74–110).
Kleinman, A. (2010). Four social theories for global health. Lancet, 375(9725), 1518–1519. http://doi.org/10.1016/S0140-6736(10)60646-0