What I would love most in ghd is one community where every thread was a conversation starter was a text of kim or farmer , and continued with community asking how we could spread the action learning. I am not sure if this is the right community for that but one has to start somewhere!
anyhow here's a current corker from Paul Farmer in the London review of books , and here's an extract that I particularly wanted to viralise wherever sustainability heath millennials turn shared information into social movement actions
A century of differing health outcomes, especially for infants and children, was at last coming to a close. In The Great Escape: Health, Wealth and the Origins of Inequality, the Princeton economist Angus Deaton describes ‘the reduction in global poverty since 1980’ as ‘the greatest escape in all of human history and certainly the most rapid one’.2
But economic growth doesn’t necessarily lead to a health revolution. For the past decade India has consistently ranked below only China as the world’s fastest growing economy, but it has failed to address some of the worst healthcare disparities in the world – and what may well be the highest global rates of childhood malnutrition and stunting. In An Uncertain Glory: India and Its Contradictions, Jean Drèze and Amartya Sen consider the plight of hundreds of millions of Indians who still live in poverty, often as a consequence of class, caste and gender inequality, without ready access to education, credit or any sort of social safety net.3 One of the questions Drèze and Sen ask is how to finance health services ranging from prevention to primary care to catastrophic illness:
A health system based on targeted insurance subsidies is very unlikely to meet basic norms of equity in healthcare, as four different sources of inequality reinforce each other: exclusion errors associated with the targeting process; screening of potential clients by insurance companies; the obstacles (powerlessness, low education, social discrimination, among others) poor people face in using the health insurance system … where access to healthcare is linked with the ability to pay insurance premiums.
Drèze and Sen draw on lessons from across the world, comparing China unfavourably with India in terms of democratic institutions, but noting that since it restored its rural health insurance scheme which was savaged a few decades back, China has surged ahead of India in all standard measures of health and wellbeing. So have Bangladesh, Mexico, Thailand and many other countries with radically different political systems. All have public health systems that aspire to universal coverage, though with varied success. Drèze and Sen are critical of the healthcare system in the US,
one of the most costly and ineffective in the industrialised world: per capita health expenditure is more than twice as high as in Europe, but health outcomes are poorer (with, for instance, the US ranking 50th in the world in terms of life expectancy). This system is also highly inequitable, with nearly 20 per cent of the population excluded from health insurance, and terrible health conditions and risks among deprived groups.