Comparative efficiency of national health systems

BMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7328.48 (Published 05 January 2002) Cite this as: BMJ 2002;324:48

Developed countries must pay attention to wider issues in helping developing countries

  1. Gordon Avery, locum consultant in public health medicine (gordon.avery@morgannwg-ha.wales.nhs.uk)
  1. Iechyd Morgannwg Health, Swansea SA1 1LT
  2. Institute of Development Studies, University of Sussex, Brighton BN1 9RE
  3. Global Programme on Evidence for Health Policy
  4. Evidence and Information for Health Policy
  5. Global Programme on Evidence for Health Policy, World Health Organization, CH-1211 Geneva, Switzerland
  6. Department of Public Health, Erasmus University Rotterdam, PO Box 1738, 3000 DR Rotterdam, Netherlands

    EDITOR—The contribution by Evans et al to the debate on the World Health Report 2000 deserves a comment on the wider issues of the findings rather than just on their validity. 1 2 The outstanding feature of the league table on performance is how well most of the countries of the European Union have done and how poorly the countries of sub-Saharan Africa have performed in comparison. This raises the question of whether we in the Western world should be exercising an even greater responsibility than previously for the health of those living in poorer countries.3 The key activities that must be included in the context of richer Western nations helping poorer ones are the following.

    World leaders, especially of the G8, should review the globalisation of the world economies with a view to removing unpayable debts, providing targeted economic aid directed towards sustainable development, making serious inroads into controlling the arms and drugs trade, and resolving conflict.

    International agencies should accelerate the development of health and social welfare plans, provide grants for education and training, and encourage research into the most efficient and effective ways of improving health.

    Voluntary and philanthropic agencies should enhance their outstanding work in the eradication of disease and famine, and the relief of disaster and poverty.

    National governments should increase aid directed towards tackling major diseases, improving education, primary health care, and health promotion, and towards encouraging sustainable development in agriculture.

    Political and religious leaders should set aside their differences and personal interests, and work together for the common good of the people they serve.

    Corporate business should engage in ethical and non-monopolistic business practices, which avoid exporting unhealthy products, encourage fair trade, pay fair wages, and help to build up commercial and economic foundations.

    Health professionals and academic institutions should carry out …

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