Geography Reference
In-Depth Information
4.3 HEALTH,
DISABILITY AND
DEVELOPMENT
Health, Disability and Development
Health is a central concern of development policy and planning. Many
of the Millennium Development Goals (see Chapter 1.5) identify global
health targets that aim to combat hunger and under-nourishment,
child- and maternal mortality, and the spread of HIV, malaria and
other infectious diseases. The focus on these global health concerns and
increases in donor aid in recent years, such as the Global Fund to Fight
AIDS, Tuberculosis and Malaria, have been broadly welcomed.
International development discourses tend, however, to adopt a univer-
salizing approach that constructs disease and ill health as global prob-
lems to be eradicated, and prioritizes large-scale biomedical
interventions to improve individuals' health. This has resulted in a lack
of focus on the structural inequalities that restrict access to healthcare
and lead to social exclusion.
The role of the state in meeting the healthcare needs of the popula-
tion in many countries in the global South has been undermined by
processes of globalization. Neoliberal ideologies underpinning globali-
zation shift structural decision-making power away from the state and
into global economic institutions, such as the World Bank and
International Monetary Fund (Evans, 2002). Although the neoliberal
agenda has been implemented in different ways in the global South
(Mohan et al., 2000), the conditionality associated with SAPs resulted
in cuts in government expenditure in health, education, housing and
public sector development, such as sewage disposal in many
heavily-indebted countries in the 1980s. SAPs also introduced user
fees, which reduced access to healthcare for poor people and opened up
greater opportunities for private providers of medical care and drugs.
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