The idea of economic growth as central to development or the precursor for health, is fundamentally flawed. For example, globalization and the expansion of technology, especially where there are wage inequalities between different industries, has led to increases of income inequality (Birn et al. 2017). Rather than defaulting to mainstream approaches of disease control and imposing “responsibility” amongst the poor, and promoting lesser governmental role in social policy-making and implementation, existing global health approaches need to take into account the local and global social, political and economic realities, in order to lead to better long-term health (Birn et al. 2017).
One example of a mainstream approach to health is the idea that regulating trans-fat content or implementing a taxation program that taxes individuals or corporations for using harmful products, is a limiting behavioural approach that only threatens to amplify health inequities (Birn et al. 2017). An alternative to mainstream approaches to health is the degrowth framework (Birn et al. 2017).
Effective local measures, for example organic food production, universal social services, and the preservation of indigenous culture and tradition, as well as other methods not in line with modern day patterns of production, consumption and the accumulation of material wealth, has proven to improve the physical, social, economic and spiritual development (Birn et al. 2017). The model nation that has achieved these qualities is Bolivia (Birn et al. 2017).
Of all the fundamental prerequisites laid out in this Chapter (Chpt 13 -Textbook of Global Health), the strategy I believe is most essential to the making of a healthy society, is the ‘Reorientation of Health Services’ (Birn et al. 2017). By approaching health in a culturally sensitive manner, moving beyond curative care and instead towards holistic health, addresses the social determinants of health related to living conditions, broader societal matters, and the larger global political and economic order, thus influencing a positive movement towards equity and social justice.
The holistic approach to health is not a business model, but instead integrates local cultural traditions that are imperative to positively strengthening and empowering communities. An example of a mainstream approach to health that has proved to be detrimental are the microfinance institutions present in bangladesh. Though touted to enable borrows to empower the participating poor women, garnering widespread support in the global media, the poverty alleviation program has proved to only be beneficial to higher income borrowers who were able to use the extra income in improved education for their children (Raihan et al. 2017), but created a relationship of dependency amongst the poorest communities – a consequence of a globally-networked profit-seeking business influencing a domino-effect of collateral damage at the family, community, global level (Md Aslam and Chandran, 2016).
REFERENCES
Birn, A.-E., Pillay, Y., & Holtz, T. H. (2017). Textbook of global health.
Md Aslam, M., Chandran, V.G.R. (2016). Measuring Financial and Social Outreach Productivity of Microfinance Institutions in Bangladesh. Social Indicators Research. 127 (2): 505-527. DOI: 10.1007/s11205-015-0979
Raihan, S., Osmani, S. R., & Khalily, M. A. B. (2017). The macro impact of microfinance in bangladesh: A CGE analysis. Economic Modelling, 62(Complete), 1-15. doi:10.1016/j.econmod.2017.01.002
April Marie Canillo 