Globalisation can seriously damage your health

  Larry Causey of Baton Rouge, Louisiana got himself arrested to get medical treatment. Recent figures indicate that in the USA up to 4 million people lack health insurance and Larry Causey, who has waited four years for a cancer operation, is one of them. So he reported an armed robbery at the local post office. When the law enforcement officers arrived, Larry was waiting calmly after the robbery, he was promptly arrested and is now serving a sentence. However, as an inmate he has now received the medical treatment he needed.

Larry is relatively very well off compared to the millions whose lives are threatened from common illnesses caused by malnutrition and lack of basic health care; but he’s a victim of the decline in health care for the poor worldwide.

When I was a child the BBC used to broadcast worthy programmes extolling the campaigns to eradicate malaria, TB and cholera - all these campaigns were predicated on a commitment to humanitarian preventative interventions. Moreover, such activity was regarded as praiseworthy and my generation were brought up on exemplary tales of Albert Schweizer forsaking a glittering career to dedicate his manifold talents to alleviating suffering. It may have been regarded as paternalistic by the hypersensitive, but it was a reflection of real concern.

Certainly western humanitarianism always could count on the support from otherwise calculating hardhearted governments because of the fear that unless the west did something to alleviate poverty and disease then the local anti-Imperialists aided by the archenemies, the Communists, would step in to make converts.

But now in the era of triumphant liberal free trade capitalism there is no real reason for western governments to regard the underdeveloped world as anything other than cheap producers and potential consumers.  Western capitalism has lost the incentive to do good, the message to the  world’s poor echoes that of the French Premier who, when asked what message he had for the poor, said “Enrichissez-vous !”

But if external threat is what is needed, then it is coming fast in the wake of increased travel and labour mobility.

Western Imperialism wiped out as many indigenous peoples by transmissions of the diseases the brought with them as they did in battle.

The global commercialisation of slavery was based on the need for labour when the unfortunate indigenous populations of the New World proved unable to withstand the diseases and harsh work regime the Europeans brought with them.

The world’s first tropical medicine faculty was founded in Liverpool patronised by traders who wanted to maximise their returns by cutting down on the loss of labour to diseases on Africa’s west coast.

Globalisation has always brought disease with it and since at least 1851 there have been international efforts at cooperation to contain infectious diseases. But as labour becomes mobile and temporary the risk of infectious diseases grows. The short term response is bound to be a xenophobic call to halt immigration. The mass immigrations of the end of the nineteenth entry led to scares of the “yellow peril”. But the answer as ever, is preventative health care, not immigration controls.

The establishment of national health and welfare services in the teeth of opposition from establishment forces, has been one of the great achievements of the progressive movements. Such systems have been part of a national compromise between capital and labour; the labour movement has always had a perspective beyond the wage packet. However, globalisation has allowed capital to step outside these national compromises, indeed nowadays the preservation of welfare systems is presented as an unreasonable diversion of profits. That is the attraction of the global assembly line: cut costs by producing elsewhere and shift the burden of providing health care from the state funded by universal taxes onto the individual. Which brings us back to Larry Causey.

Health services throughout the world, particularly those aimed at the poor, are under strain as governments cut public spending to create what they are told will be attractive investment climates.

The World Bank reported in 2000 that the introduction at its behest of “user fees” to  make up for cuts in government health spending had led to a sudden drop in the use of health facilities by the poor within days of their introduction.

Within the EU itself concern for health has lagged way behind the drive to facilitate the internal market and only last year did the Commission adopt a communication on “a health strategy for the European Union”.

A more immediate impetus for serious attention to health care is likely to be the impending process of enlargement. The Soviet system had a primitive but universal health provision and all the  Central and East European countries queuing for membership of the EU shared that system. However, none of those applicant countries have experience of universal health care in a free market economy. They are joining the EU just when our own health systems come under increasing pressure of cuts in public expenditure to meet the criteria for the introduction of Single Currency.

It may take the return of epidemics caused by poverty to our continent before our political elites take health seriously again.

Michael Hindley is a former Member of the European Parliament.

May 2001