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Health, human dignity and partners
for poverty reduction
April
is our Health Month. This gives all of us the important possibility to
make a contribution to improving the health of the disadvantaged. It also
gives us the chance to understand our health challenges better.
This is especially important given the very unfortunate
reality that some in our society and elsewhere in the world, seem very
determined to impose the view on all of us, that the only health matters
that should concern especially the black people are HIV/AIDS, HIV, and
complex anti-retroviral drugs, including nevirapine.
We still await the results of the work being done by
a number of government agencies to give us as accurate a picture as possible
of the causes of death in our country, which up-to-date information we
do not have. This report will help us to improve our planning with regard
to the interventions we need to make to move closer to the achievement
of the goal of health for all.
We will have to ensure that the information contained
in the report reaches as many of our people as possible. This is necessary
because the matter of the health of all our people is of critical concern
and importance to our movement and country. To respond correctly, we have
to be informed by the real health situation of our people.
The majority of our people are poor. Necessarily, therefore,
our policies are focussed on the issue of the alleviation and eradication
of poverty. We are implementing many programmes aimed at ensuring that
we lift the burden of poverty that weighs heavily on the shoulders of
our people.
We are working continuously to develop and expand our
economy. Among other things, this should help to reduce the levels of
unemployment and therefore increase the number of people who earn a means
of livelihood. The larger economy also enables us to generate the resources
necessary to fight poverty.
In a few years, we have restructured our budget expenditure
to ensure that more public resources are directed towards the poor. Because
of this, it has been possible to allocate more resources to such areas
as pensions and other welfare payments, water and sanitation, health services
and infrastructure, nutrition, housing and electricity.
Our Integrated Rural Development and Urban Renewal Programmes
have selected those geographic areas in our country that have the highest
concentration of poverty and therefore the social ills that result from
this poverty.
Some of these social ills are the diseases of poverty
to which millions of people in our country are prone. It is for this reason
that, as we discuss our Health Month, we have mentioned the centrality
for us of the objective of poverty alleviation and eradication.
There is a determined and aggressive attempt to hide
the truth about the direct and immediate relationship between poverty
and health. Huge resources are devoted to the accomplishment of this objective.
There is virtually no discussion in our country about the diseases of
poverty that regularly claim the lives of hundreds of thousands of our
people.
Some individuals, engaged in politics and public health,
have achieved and seek to obtain public prominence, on the basis of leading
an extremely harmful and unacceptable campaign to deny our people all
information and knowledge about the incidence of diseases of poverty in
our country. We are told that we must accept the harm these persons cause,
and their insult of an entire people, as the very essence of free democratic
expression.
Despite the propaganda offensive, the reality is that
the predominant feature of illnesses that cause disease and death among
the black people in our country is poverty. This poverty impacts on health
in a variety of ways, all of which are well known and recognised throughout
in the world.
This impact ranges from poor nutrition, unavailability
of clean water and proper sanitation, unhygienic environmental conditions,
unaffordability of drugs and medicines, inadequate or unavailable health
services and infrastructure, low levels of education, the effect of rapid
urbanisation, to social breakdown within communities.
The truth is that poverty causes illness and death.
The truth is also that ill-health causes poverty. As we work during Health
Month to address issues of health, including AIDS, we must understand
these fundamental truths, as a necessary condition for the success of
the sustained campaign we must wage to ensure the continuous improvement
of the health of our people.
The Director-General of the WHO, Dr Gro Harlem Brundtland,
spoke at a meeting in Washington D.C. on October 27, 1999. Inter alia,
she said:
"The 20th century has brought about dramatic improvements
in health, but the unfinished agenda is there before us: more than a billion
human beings have been left behind in the health revolution. The burden
of disease and disability on the poor remains unbearable in many parts
of the world both in terms of suffering and the economic strain it leads
to.
"Today, respiratory diseases, diarrhoea and perinatal
conditions remain the main contributors to the overall global burden of
disease and to mortality among children, against a backdrop of chronic
malnutrition. But at the same time, and in the same countries of the developing
world, we face the mounting burden of heart diseases, cancer, diabetes,
accidents and mental health conditions, against a backdrop of ageing and
new risk factors of which tobacco is the most prominent. The epidemic
of tobacco use will make it the single largest cause of disability and
premature death in the coming twenty years.
"We recognise that poverty is multi-dimensional by nature and has
several causes, including poor health, and several cures, including health
status improvement. WHO has to build and strengthen knowledge about the
links between poverty and health. In all areas, we need to work with like-minded
partners committed to poverty reduction."
In a speech entitled 'Health and Poverty Eradication',
a senior health official, Dr O. Walker, attached to the WHO Regional Office
for Africa, told a UN General Assembly Working Group in New York on May
18, 2000, that:
"Given that poverty remains a major contributor
to ill-health and premature death in the African Region, the anti-poverty
advocacy role of the health sector must be greatly enhanced."
Bangladesh, in Asia, is also a poor country. It understands
and approaches the issue of diseases of poverty with great seriousness.
A report datelined: Dhaka, Bangladesh 24 May 2001, states:
"Forty prominent experts meeting in Dhaka today
have called for health services in Bangladesh to refocus on the needs
of the poor. The meeting, which involved leading thinkers from the government,
private sector, research institutions, NGOs and the media, highlighted
the destruction caused by the seven health conditions most responsible
for deaths among poor people. These conditions, named the 'diseases of
poverty', include tuberculosis, malaria, childhood diseases (respiratory
infections, diarrhoeal diseases, measles), maternal and perinatal conditions
and HIV/AIDS.
" 'The diseases of poverty are responsible for
more than half of the deaths in this country,' said Prof. Abul Barkat,
after presenting a paper to the meeting. 'This burden is almost entirely
borne by the poor. What's particularly unjust about this situation is
that all of these diseases are easily preventable.' "
For its part, the U.S. University of Virginia says:
"Diseases of poverty demand the attention and co-operation
of the entire world community. Our common humanity requires that our resources
be directed at preserving and enhancing life wherever it is endangered,
and poverty increases the frequency and severity of disease. Moreover,
our common humanity is biological as well as ethical, and diseases of
the poor can and do become diseases of the rich. In a shrinking world,
to seek health behind barricades is not only selfish, it is bad science.
Building on existing strengths locally and internationally, the Centre
for Global Health will be dedicated to alleviating diseases of poverty.
"Thus, our focus is on understanding and ameliorating
of the costs of diseases of poverty. Effectively addressing the growing
health threats from the diseases of poverty may well be the greatest imperative
and challenge to our survival as a civilization respectful of human dignity."
Dr O. Walker also pointed to what needs to be done,
to which we must respond, to reinforce what we are doing already. He said:
"Health needs to be promoted in the home, community
and the workplace with emphasis on the following:
- ensuring a positive political and legal environment
- promoting community empowerment
- ensuring access to gainful employment
- guaranteeing healthy working conditions
- enhancing environmental health and safety
- guaranteeing access to safe water and sanitation
- guaranteeing access to formal and non formal education
- ensuring access to safe food
- promoting healthy life style
- guaranteeing safe and affordable housing
- establishing and/or strengthening social protection
systems."
Because of the pursuit of particular agendas,
regardless of the health challenges facing the majority of our people,
who happen to be black, in our country there is a studied and sustained
attempt to hide the truth about diseases of poverty.
If we allow these agendas and falsehoods to form the
basis of our health policies and programmes, we will condemn ourselves
to the further and criminal deterioration of the health condition of the
majority of our people. We cannot and will not follow this disastrous
route. We are both the victims and fully understand the legacy of centuries-old
and current racism on our society and ourselves.
We will not be intimidated, terrorised, bludgeoned,
manipulated, stampeded, or in any other way forced to adopt policies and
programmes inimical to the health of our people. That we are poor and
black does not mean that we cannot think for ourselves and determine what
is good for us. Neither does it mean that we are available to be bought,
whatever the price.
Health Month must help us to form and strengthen the
partnerships of which the WHO DG spoke, based on commitment to poverty
reduction, the improvement of the health of the poor and human dignity
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