Two actions are possible for doctors wanting to promote human welfare in Africa

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7128.393 (Published 31 January 1998) Cite this as: BMJ 1998;316:393
  1. Guy Johnson, General practitionera
  1. a Sighthill Health Centre, Edinburgh EH11 4AU

    Editor—Logie and Benatar paint a depressing but accurate picture of the effects of poverty (exacerbated by the trade and aid policies of the rich nations of the world) on health and health care for the vast majority of sub-Saharan Africans.1 Although they end on a note of cautious optimism, thanks to the World Bank's new found commitment to alleviating poverty and the Highly Indebted Poor Countries Initiative, this may leave ordinary doctors in Britain feeling helpless in engaging with these desperately important but distant problems.

    Nathanson suggests that humanitarian action is the duty of all doctors.2 I would like to suggest two ways in which anybody can be “actively engaged in promoting human welfare and social reforms,” which should both have a direct effect on the suffering in Africa discussed by Logie and Benatar. The first is to sign the petition being organised by “Jubilee 2000,” a broadly based coalition of non-government organisations and churches. This proposal goes far beyond the limited Highly Indebted Poor Countries Initiative and suggests celebrating the millenium by writing off all the unpayable debt owed by the poorest countries to the G7 industrialised countries. This would make a huge difference to their ability to fund effective health services and safe water supplies. Further details are available from the campaigns team, Christian Aid, PO Box 100, London SE1 7RT.

    The second action that is possible concerns the little known multilateral agreement on investment, which is being negotiated in the “rich nations club,” the Organisation for Economic Cooperation and Development, and is due to be signed at the end of April. The main goal of this agreement is to improve investment opportunities for multinational corporations, and it achieves this by forbidding both discrimination between domestic and foreign investment and the imposition of any “performance requirements” on foreign investors. In the Third World this will make the development of appropriate and diversified industries impossible; environmental and labour will become unsustainable; and people will remain an easily exploitable source of sweat shop labour, with obvious detrimental effects on health. The agreement will allow multinationals to sue national and local government, which could cut into spending on health and social services. MPs must be told that this agreement is unacceptable. More details are available from the World Development Movement, 25 Beehive Place, London SW9 7QR


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