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Evolution of the approaches


So what is revolution all about ?

Modern medicine, although very successful, cannot overcome all the illnesses of this world. The costs are very high and there will never be enough doctors and hospitals for all. It is also relative: a sick child can be placed in an ICU (Intensive Care Unit), cured and sent back home, but there is no garantee than the same child will not be sick again.
The international Alma Ata conference (ex-USSR, 1978) on primary health care, marked a turning point. 150 countries adopted a new strategy based on health for all. This was a major change: leaving urban hospital based models behind, the objective is now to bring basic health care to local populations.
This new orientation emphasises prevention rather than cure, encouraging personal initiatives and community participation. Health is a complex domain. There are links that exist between a healthy diet and resistance to illness, between education of women and decrease in child mortality, between survival of children and decrease in child birth.


It is important to understand the link between costs and benefits. In 1978, the WHO eradicated a deadly disease: smallpox.
Vaccination and treatment are no longer necessary, it is estimated that the yearly savings that Western countries now make are more than the total cost of the eradication campain.
The advantages go beyond the health sector. For instance, a sick farmer is an unproductive farmer, therefore not a good consumer (in a utilitary sense). Health, education, food, productivity and prosperity are all linked to each other, for the individual human being as well as for the entire world population.
Before deciding if we have the will to contribute to this revolution, maybe we should ask ourselves how much will it cost not to have the revolution rather than the cost of the revolution itself.
To understand the problem of health in the world, we Westeners have to change our ideas.
It is not sophisticated procedures but rather simple and basic measures that will achieve progress in this domain. For example, drinking water, adequate sanitary installations, better food, immunisation and treatment of transmittable diseases (sexual and others such as malaria).
The 200 medicines listed in the basic WHO list are more useful and can save much more lives than the 25,000 medicines commercialised. We have to admit that our resources will never be enough so that the Western medical model can be available to all the inhabitants of our planet, and that we will save more lives if we focus on the social, preventitive and environmental aspects of health care.
In order to illustrate this, we can look at the sums of money invested in the medical domain. Health budgets do not even reach 1 dollar per person in third world countries, but can exceed 1,000 dollars in rich countries. How can we explain that increadible sums of money are spent to cure diseases in the "rich" countries, but that, in poor countries, people go blind or die because of lack of Vitamin A or simple immunisation programmes? Let us change our ideas, and forget the popular thought that health costs are always high. Primary health care is cheap, and the cost-benefit ratio is phenomenal.


We have to think about the future we are preparing for our children. The “Brandt Report” makes sober reading, one fighter plane costs as much as 40,000 health care centers in a developing country. This is what Robert McNamara already said about absolute poverty back in 1973 in Nairobi:
"Among those who survive, millions will lead a diminished life following severe brain damage, their growth stopped and their vitality diminished due to very poor diet." This is what absolute poverty is: Conditions of life so bad that it stops the development of the genetical potential we all have in us at birth. Conditions of life so degrading that it is an insult to humain dignity, but sadly so widespread that it is the lot of 40% of the population of developing countries."


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