Rapid Responses to:
|
|
Rapid Responses: Rapid Responses published:
-
![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
Ignorance isn't always bliss
- Hugh van't Hoff (14 September 2007)
-
Ideological anti-capitalism in the WHO and among public health administrators blocks further progress in alleviating international poverty and improving health
- Bruce G Charlton (16 September 2007)
-
Equality of Opportunities and Leveling the Playing Fields is Pro-Development and Generation of Wealth
- Fabio Ferri-de-Barros (9 April 2008)
|
|
|||
|
Hugh van't Hoff, GP and educationalist May Lane Surgery, Dursley, glos GL11 4JN
Send response to journal:
|
Dear Dr Maryon-Davies, Whilst I agree with the bulk of your editorial and with the aspirations of the Crisp Report, I am struck by the global absence of a debate about health literacy in this area. By which I don't mean keeping things simple. Patients (users) in all countries have a right to information about health. This is enshrined in the WHO constitution of 1946 (see below). If we are to share our knowledge we need to share a common language. Up to now advocates of health literacy have suggested we remove technical language - a sort of dumbing down. My proposal is that we give up our hold on medical information and make it available to all from primary school on - admittedly there would have to be a massive effort by govt, medics and educationalists to re-package the information but in principle it's worth looking at (and, as yet, no-one apart from me is calling for this change). By doing this we would be educating children about the social, political, geographic and 'medical' (infectious, degenrative etc) causes and we would be altering presently dry subject areas like history, geography and statistics. Not only this, we would be emancipating kids to make their own decisions and possibly helping with the down-turn in interest in pure sciences in the developed nations. I have started an educational pilot programme along these lines in my local secondary school and will soon start direct patient education in my surgery (focussing on 'frequent flyers'). The aim with both is for the client to understand the processes involved in illness and by doing so reach a more rounded view about their problem and be better able to own their condition and take more responsibility for it. This doesn't mean we are trying to teach them that the doctor is always right - more that the science on which we make decisions is valid if sometimes poorly used. The project is called the Facts 4 Life Project. Please see www.facts4life.org and go to files (top menu) for more information. Yours, Hugh van't Hoff GP and educationalist cc letter BMJ (rapid response) CONSTITUTION OF THE WORLD HEALTH ORGANIZATION The Constitution was adopted by the International Health Conference held in New York from 19 June to 22 July 1946, signed on 22 July 1946 by the representatives of 61 States Excerpts: THE STATES Parties to this Constitution declare, in conformity with the Charter of the United Nations, that the following principles are basic to the happiness, harmonious relations and security of all peoples: Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Informed opinion and active co-operation on the part of the public are of the utmost importance in the improvement of the health of the people. CHAPTER II - FUNCTIONS Article 2 In order to achieve its objective, the functions of the Organization
shall:
Competing interests: None declared |
|||
|
|
|||
|
Bruce G Charlton, Editor-in-Chief, Medical Hypotheses Newcastle University, NE1 7RU, UK
Send response to journal:
|
Maryon-Davis's BMJ editorial egregiously embodies the doctrinaire anti-capitalism characteristic of public health administrators including the World Health Organization. This bias leads to stunning mis- representations of reality, and currently stands as a major obstacle to improving world health. The past couple of decades have seen the largest-scale reduction of poverty in the history of the planet [1]. This unprecedented progress is mainly due to the progressive adoption of capitalism by the vast populations of China, India and other Asian nations: China alone is "lifting a million people a month out of poverty." [2]. Yet Maryon-Davis seems not to have noticed this. The poorest parts of the world are the least capitalist. Some nations in Sub-Saharan Africa are going backwards. In Malawi the standard of living (daily calorie consumption) is perhaps the lowest that has ever existed in human history. This is a consequence of medical advances which allow population to increase even during chronic famine [3]. Poverty is bad for health; and wealth is the only thing that can cure poverty [4]. And China and India demonstrate that capitalist wealth creation is effective, while the more ‘socialist’ and redistributive WHO strategy (focusing on 'health equity') has a poor track record. The entrenched ideology of anti-modernization among international public health professionals stands in the path of further progress; both at home and abroad. What the sick and poor of the world need is more capitalism, more industrialization and more globalization. 1. The Economist. Understanding global inequality. www.economist.com. Mar 11th 2004; accessed 15.09.2007. 2. Harford T. The undercover economist. London: Little, Brown, 2006. 3. Clark G. A farewell to alms: a brief economic history of the world. Princeton, US: Princeton University press, 2007. 4. Sowell T. Curing poverty or using poverty? www.realclearpolitics.com. Jan 10 2006. Accessed 15.09.2007. Competing interests: None declared |
|||
|
|
|||
|
Fabio Ferri-de-Barros, MD, FSBOT (Brasil), PhD (student) Pediatric Orthopaedic Surgeon The Hospital for Sick Children 555 University Av. Toronto On Canada M5G1X8
Send response to journal:
|
Enough evidence of inequalities of opportunities for human development and prosperity, determined by immutable circumstances such as family origin, place of birth, gender, and ethnic background within and across nations exist (1). Arguably, society cannot be held accountable for undesirable life outcomes determined by individual choice. In fact, individual choices must respect societal boundaries to ensure individual freedom. Equality of opportunities; however, is a crucial matter of social justice (2). In the context of globalization, the concept of society has expanded. The recent advances on information and communication technologies have enabled rapid knowledge exchange internationally (3). The availability of information has raised public awareness of inequality issues that are morally unacceptable in the context of abundant global knowledge and resources to address preventable human suffering. Brazil, for example, stands in the global arena as a middle-income country in which inequality of opportunities, mainly determined by family origin (4), has been a shameful hallmark (5, 6). Despite of significant economic growth, further development has been hampered by inequality of opportunities faced by a significant number of Brazilians. The United Nations Development Assistance Framework (UNDAF) 2007-2011 for Brazil was concluded in August 2005 to guide harmonized UN interventions for capacity development, at the country level, that are specific to the national context (6). The UNDAF 2007-2011 for Brazil, through a priority setting exercise, have determined five focal areas for action to foster human development in Brazil. The main goal is to reduce inequality of opportunities. The guiding principle of UN projects in Brazil is capacity development (6). “Grounded in ownership, guided by leadership, and informed by confidence and self-esteem, capacity development is the ability of people, institutions and societies to perform functions, solve problems, and set and achieve objectives. It embodies the fundamental starting point for improving peoples’ life quality” (3). Development strategies to “level the playing fields” (1) are grounded in principles of social justice and, in fact, will most likely lead to increased generation of wealth and prosperity worldwide (4,5). References 1. World Bank: Equity and Development. Oxford University Press; 2006. Report No.: 32204. 2. Roemer JE. Equality of Opportunity: A Progress Report. Soc Choice Welfare. 2002 April, 2002;19(2):455-71. 3. Lopes C, Theisohn T.: Ownership, leadership, and transformation: Can we do better for capacity development. 2003. 4. Bourguignon F., Ferreira FHG., Menéndez M.: Inequality of Opportunity in Brazil. Review of Income and Wealth. 2007 December 2007;53(4):585-618. 5. Marmot M. Achieving Health Equity: From root causes to fair outcomes. The Lancet. 2007 September, 29 - October, 5 2007;370(9593):1153-63. 6. UNDG - completed UNDAFs [homepage on the Internet]. [cited 3/17/2008]. Available from: http://www.undg.org/index.cfm?P=234&f=B. Competing interests: None declared |
|||