As part of The Student Society's focus week: Apropos Afrika, the Society invites you to a meeting about public health challenges in Sub-Saharan Africa. South Africa’s Minister of Health declared: “Health systems around the world are designed for the rich, not for the poor”. He was referring to the continuing rise in health disparities despite decades of health aid efforts. When and where did it go wrong?
To gain some insight regarding this issue, one can examine the most recent outbreak of the Ebola virus in West Africa to see how incorporating market features in health policy and public health systems does more harm than good. Because most of the countries affected by the recent epidemic have been subject to structural adjustment programs initiated by the World Bank and IMF, they have been forced to initiate harsh austerity measures.
Some of these measures have affected the health sector within the different nations, depriving them of an adequate health system that would otherwise have been able to handle the epidemic. The International Monetary Fund denied Sierra Leone’s request, forcing the country to initiate a market-based health system, which excluded those who were unable to pay health charges. Public infrastructure has in a sense been eroded by such conditions of incorporating market features in social health policies.
However, in a capitalist environment such ‘truths’ are overlooked because they are not conducive in profit accumulation. The very fact that market-based health policies have led to major austerity measures like cutting the salaries of health employees is not critically engaged with because – at least in the case of the recent Ebola epidemic - it provides a space for another increasingly capitalist industry to enter: humanitarian aid.
Tanja Müller has argued that humanitarian aid discourse tends to ignore the structural origins of an epidemic, why local health services are actually so ill-equipped or under-staffed and whether or not this has anything to do with the how the international community engages with ‘Africa’ – which is through neoliberal policy prescriptions and strict structural adjustment programmes that often result in, among other issues, low wages for public servants.
When health policy is increasingly market-driven, it deters the possibility for supplying sufficient treatment for epidemics and/or other health issues. Because in a market controlled health policy, the drivers for medical research are pharmaceutical companies rather than stately funded institutions, profit ultimately decides the direction of drug development. Researchers, investors and company directors may be fully aware of humanitarian needs, but do not wish to take that economic risk. In such, medical research that may in fact benefit the majority of the world’s population is not conducted because it would not provide any substantial profit. Therefore, profit, the mere accumulation of economic capital takes precedence over human lives in a market based health system.
By examining the last Ebola epidemic, one can get an idea of why there may be consistent public health challenges in several countries in Sub-Saharan Africa. The Student Society’s 'Health and Politics: Change From Within' meeting this upcoming Tuesday 3 November, will offer more reflections on the matter.
By Lina Halvorsen