The World Health Day is celebrated annually on April 7 to commemorate the anniversary of the founding of the World Health Organisation (WHO) in 1948. The theme for World Health Day 2014 is vector-borne diseases.
Vectors are small organisms that carry disease from one infected person (or animal) to another. They are usually more frequent in tropical settings and places where drinking water is scarce and sanitary conditions are poor. The World Health Day 2014 campaign focuses on the commonest vectors, such as mosquitoes, flies, ticks, bugs and freshwater snails which can spread diseases that cause serious diseases such as malaria, dengue, leishmaniasis and yellow fever.
It is estimated that the most deadly vector-borne diseases, i.e. malaria, caused 660.000 deaths in 2010, most of them, African women and children. However, the diseases that are growing at the most alarming pace worldwide are dengue and Chagas disease. They are among the most neglected diseases according to WHO, the ones causing the highest morbidity and mortality rates, and can be considered the diseases of the poor, of those who cannot afford the drugs developed by pharmaceutical companies.
Within its role as a defender of the right to health, it is important that WHO endeavours to raise awareness on the relevance of those diseases and launch campaigns aimed at making them more visible among those who do not suffer them. Denouncing their connection to poverty, social exclusion, inequality and general level of healthcare protection, shouldn’t be considered less important.
Even Paul Krugman, the Nobel Prize laureate in Economics, quotes a report which states that “one of the crucial aspects of welfare, child malnutrition –which causes a chronic ill health condition and severe health hindrances i.e. physical as well as intellectual impairments–, doesn’t improve at all when the economy grows faster”, since the causes of such plagues are “an unequal distribution of wealth and an inefficient implementation of basic public services”.
This year, on April 7, in the Spanish State, where such diseases have an extremely low incidence and magnitude, the defence of the right to health and universal health coverage has to point out that inequality and poverty constitute major threats to our health. For a couple of weeks now, organisations such as the OECD, the EU or Caritas Diocesana, which are in no way suspects of introducing a revolutionary bias to the interpretation of the problem, point out that the policies implemented by the Spanish Government in 2010 had no other effect than increasing social inequalities in Spain.
In the Spanish State territory, the risk of poverty among the under-18s was 29.9 in 2012, almost nine points above the average of the EU, which was 21.4%, according to the 2013 Eurostat data. Besides, the rate of school failure is almost double the average European rate. The gap between rich and poor has also grown more than in any other OECD country between 2007 and 2010, a period where the income of the 10 percent richest people fell by 1% annually, whereas the income of the poorest fell by 14% annually.
On the one hand, social aid is ill-designed and not sufficiently oriented to the needs of the most deprived part of the population. As a case in point, the rate of unemployment is two and a half times above the EU average, whereas the social assistance spending is similar. On the other hand, according to the data provided by the Technicians Syndicate at the Budget Ministry (Gestha), fiscal fraud in Spain amounts to over 70,000 million euros per year, from which 72% correspond to great fortunes and big companies. This figure is equivalent to the healthcare system total budget and substantially higher than the annual interests of the Spanish public debt. Tax Justice Network estimates that the deposits drawn from Spain currently in tax havens amount to 550, 000 million euros.
All these realities are the result of deliberate policies presented as inevitable, but which aren’t in any respect. Besides, those realities have a direct impact on our current health condition, with a higher incidence of diseases associated to stress, such as depressions, alcoholism and other additions; or those associated with poor diet, etc. Both will bring negative consequences regarding future health condition and life expectancy of that 30% of the children living in the most vulnerable situation. That’s due to the fact that our health condition depends on a set of social determiners such as our diet, our pregnant mother life conditions and the first two years of our lives, on the level of education, ours and our parents’ –especially our mother’s–, having an adequate housing, a decent work, as well as enjoying real possibilities to participate in society and in the political life. All of this, complemented with an adequate water supply and a fair distribution of wealth.
The Govern’s decisions contrary to the interests of the majority reflect a clear option of legislative policy that benefits only very specific social groups. One example is the envisaged cutting of pensions, which are to save 809 millions euros in 2014, according to what’s stated in the financial plan report. However, in the same financial year, there will be a shortfall of more than the double of the above mentioned figure (1,657.43 millions), as a consequence of the tax advantages which are to be applied to the private pension schemes, benefiting only the highest incomes.
Another example. The tax reform, will problably end up including a measure that may seem harmless, which is the tax relief applied to the contributions to private healthcare schemes on the ground that those using private services will constitute cost savings for the public healthcare system. But the fact that the double insurance system will produce savings to the public healthcare system is unclear. To date, the soundest study on this respect conducted in Spain (“Changes in the demand for private medical insurance following a shift in tax incentives”. Rodríguez, M. y Stoyanova, A. in Health Economics no. 17-2008, pp-185-202) stated that the re-introduction of a 15% tax relief in Catalonia would mean a loss of tax incomes higher than the theoretical increase in the public spending resulting from its non re-introduction.
One last example. According to Càritas’s complaint, with half the amount of money which is seemingly going to be invested in rescuing highways that should never have been built, 700,000 households with no income at all could be rescued (500,000 if those with minimal incomes are not counted).
The three examples above prove that a minority of people with highest incomes are deliberately favoured at the expense of public systems of re-distribution of wealth –health, education, pensions–, and thus the health condition of the majority of the population is undermined. That’s why, on the World Health Day we should demand that, prior to its implementation, every single policy has to be filtered for relevance and quality in order to discover its impact on the health status of the population; regardless of whether we are dealing with the construction of a highway, of a hospital, or the privatisation of the water supply service. Since no policy’s option is neutral.
Eduardo García Langarica
Member of the Medicus Mundi Executive Board
Article published originally in the author’s blog “Médico, cúrate a ti mismo“
Translated from Spanish by Sílvia Aymerich