Bu-lat-lat (boo-lat-lat) verb: to search, probe, investigate, inquire; to unearth facts Volume III, Number 42 November 23 - 29, 2003 Quezon City, Philippines |
GATS
Ruins Third World Health
The
General Agreement on Trade in Services (GATS) is destroying public health in
Third World Countries. This was the view of the speakers in the International
Conference on Challenges in Health Work Amidst Globalization and War held last
Nov. 8 at the Palm Plaza Hotel in Manila. BY
ALEXANDER MARTIN REMOLLINO (Left)
Maria Hamlin Zuñiga of Nicaragua, global coordinator of the International
People’s Health Council, delivers the keynote address at the international
health conference in Manila, Nov. 8. The
GATS, which aims to liberalize the entry of multinational corporations in the
service sector, was one of the items in the agenda of the failed 5th
Ministerial Meeting of the World Trade Organization (WTO) in Cancun, Mexico last
September. The
GATS is seen as a mechanism that would pave the way for the further
commercialization of public health services in the Third World, a process
started by the International Monetary Fund (IMF) and the World Bank (WB). In
a paper read at the health conference, Alliance of Health Workers (AHW) chair
Emma Manuel said that for the past two decades or more, the structural
adjustment programs of IMF-WB forced governments to dismantle their public
services and allow foreign-based health care, education and water corporations
to provide services for profit. Health for a feeCiting
a report by the WB in 1998, Manuel noted that 40 percent of projects in the
Bank’s portfolio are on health, nutrition and population and nearly 75 percent
of projects in sub-Saharan Africa included the establishment or expansion of
user fees. “The
World Bank’s health ‘reforms’ have included making people pay for their
health care, reducing public services to a few programs, and turning over the
rest of government services to profit-making endeavors,” Manuel said. Because
of this, she said, people cannot afford medicines and thus die of curable
diseases. In
Ghana, for instance, user fees in rural clinics contributed to the doubling of
child mortality between 1983 and 1993. Likewise, in Zambia, life expectancy
dropped from 54 to 40 years as a result of the commercialization of health
services. In one of the regions of Nigeria, maternal deaths rose by 56 percent
and hospital births declined by 46 percent after user fees for admission were
introduced. In
Ghana, Nigeria, and Kenya, people’s use of clinics and hospitals usually
dropped by half within the first two weeks after user fees were introduced. As
health services are liberalized, governments are forced to decrease subsidies
for public hospitals. As a consequence, fewer and fewer people are able to
afford public health services. For example, in Manila’s San Lazaro Hospital, a
government hospital that serves people stricken with communicable diseases,
admission decreased from 22,774 patients in 1999 to 17,444 in 2002. Health care as serviceHealth is one of the social services on which the programs and policies of the IMF-WB and the WTO have taken their toll. According
to Maria Hamlin Zuñiga, global coordinator of the International People’s
Health Council, “Health care reform, in many of our countries, is synonymous
with the increasing privatization of health services and the contracting of
services within the public health system. While those who are wealthy have the
opportunity to access health care, the distribution of risks is immensely
greater for the poor.” Citing
the WB 2004 Development Report, Zuñiga, who hails from Nicaragua, said that
the Bank itself “recognizes
various important issues that civil society and social movements have been
stressing for years: “Basic services are failing poor people; there is no such
thing as a ‘one-size-fits-all’ recipe to readdress this issue; and social
accountability and citizens’ control and participation are keys to make things
better.” Manuel,
meanwhile, said that third world governments abandon their responsibility to
peoples as they comply with the provisions of GATS. “The governments’
adherence to the neoliberal doctrine of globalization and the WTO has kept the
Third World countries in perpetual crisis,” she said. “In
the Philippines, contrary to the promises of economic development and
prosperity, with the WTO the country remains sick and utterly dependent,” she
added. Manuel also said that the solution to the problem of deteriorating health systems rests on changing the whole international economic order. Bulatlat.com Photo courtesy of Council for Health and Development We want to know what you think of this article.
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