Inequalities in Health Care and the Role of Macroeconomic Policy

Health care is in crisis all across the globe. There are few sectors in which so much progress has been made, and still so much remains to be done. Although there is no doubt that human longevity has increased as more diseases are under control and better nutrition has spread to more people, those advances have been offset by the rise of new diseases (such as AIDS and SARS) and new means of spreading them. Health crises also exist because poverty still has not been eradicated in many parts of the world, resulting in widespread malnutrition, unsanitary conditions, illiteracy, and a lack of health care. In addition, there are crises due to spiraling costs of medical care and the inability of public or private sectors to spread basic and preventive health care. These problems are especially acute in developing countries. Global expenditure on health exceeds $56 billion per year, but less than 10 percent of that is directed towards diseases that affect 90 percent of the population.1 Moreover, in the last 20 years, pharmaceutical companies have introduced 12,000 new compounds, of which only 11 fight tropical diseases. Developing countries are even more strapped for health-care resources, both human and physical, than the more developed countries, and this strain on resources limits the quantity and quality of health care that their populations receive. Although there is enormous variety among countries with respect to public health problems, without a doubt it is Africa that hosts the greatest concentration of pervasive problems and poses the greatest challenges for disease eradication and improved health.