PHA-Exchange> Re: [IPHCWORLDWIDE] WHO Commission on Macroeconomics and Health: Possibility of Collaborative Analysis

Mon Jan 14 18:24:42 PST 2002

  ----- Original Message ----- 
  From: David Legge 
  To: IPHCWORLDWIDE at yahoogroups.com ; PHA-Exchange at kabissa.org ; health-fin at lists.vicnet.net.au 
  Sent: Tuesday, January 15, 2002 7:05 AM
  Subject: [IPHCWORLDWIDE] WHO Commission on Macroeconomics and Health: Possibility of Collaborative Analysis

  Globalisation on trial
  world health warning issued

  Report of WHO Commission on Macroeconomics and Health

  A high level WHO commission has warned the rich world that unless there is a dramatic increase in development assistance for health the legitimacy and stability of the current regime of global economic governance may be seriously threatened.  

  The report
  The report of the WHO Commission on Macroeconomics and Health (CMH) is now available at:  
  <http://www3.who.int/whosis/menu.cfm?path=whosis,cmh&language=english>
  This report will have a big impact on policies and programs in the field of health development.  It is a major intervention in discussions about official development assistance including the role of the World Bank (and PRSPs).  

  Opportunity
  The debate around the report will also provide an important opportunity to challenge neoliberal orthodoxy in development policy and to further undermine the legitimacy of the prevailing regime of global economic governance.  
  The purpose of this posting is to invite health activists, NGOs and academics, who see in this regime of global economic governance the major causes of health stagnation in the developing world, to a collaboration in developing a strong response to the CMH: building uopn its sombre warning to the captains of capital while challenging many of its assumptions and conclusions. 

  Background
  The WHO Commission on Macroeconomics and Health (CMH) was established by the Director-General of WHO in January 2000.  The Commission was chaired by Professor Jeffrey Sachs of Harvard.  It members and helpers included former ministers of finance, people from the World Bank, the International Monetary Fund, the World Trade Organisation, the United Nations Development Program, the Economic Commission on Africa and the Organisation for Economic Cooperation and Development.  The Commission was financially supported by the Bill and Melinda Gates Foundation, the Rockefeller Foundation and the UN Foundation and by the governments of the UK, Luxembourg, Ireland, Norway and Sweden.  The CMH presented its final report to Dr Bruntland in December 2001.  
  The Commission set up six working groups, on: health, economic growth, and poverty reduction;  international public goods for health; mobilisation of domestic resources for health;  health and the international economy;  improving health outcomes of the poor;  development assistance and health. The reports of the working groups are indexed at: <http://www3.who.int/whosis/cmh/cmh_papers/e/papers.cfm?path=cmh,cmh_papers&language=english>

  [you may need to reconstitute this URL if it gets broken in transmission]

  WHO Director-General Dr Gro Harlem Brundtland welcomed the report of the WHO Commission on Macroeconomics and Health on December 20th 2001:  "This report is a turning point," she said.  "It will influence how development assistance is prioritized and coordinated in the years to come." 

  A provisional assessment
  It is a difficult report to analyse.  The argument is tortuous and quite selective in its use of evidence.  In places it stretches fact, logic and credulity to the point of combustion.  It is difficult to read the strategic purpose of the DG in commissioning the report and that of the members of the Commission in framing their presentation.  It is clear that the report is meant to be read at several different levels.  
  The core of the report is this: globalisation is on trial: unless there is a dramatic increase in development assistance for health care in low income countries the legitimacy and stability of the current regime of global economic governance will be seriously threatened.  It is a warning to the G8, the Paris Club and the Bretton Woods institutions to slow down on globalisation and redirect significant resources to health care in the poorer countries.
  This is quite a finding, given the members of the Commission - which is partly why it is such an important opportunity for engagement. 
  However it is a big report and is accompanied by dozens of working group reports.  There is a lot of material to absorb and consider.  This raises questions about how Third World governments, health activists, NGOs and academics who had already come to this central conclusion might respond to the report.  

  A global collaboration in analysing and responding to the CMH report?
  I have read the report and most of its working group reports and I have prepared a preliminary analysis which I have posted at:
  <http://users.bigpond.net.au/sanguileggi/PrelimAnalCMHReport.html>
  I hope this preliminary review will encourage people to read and think about the CMH report.  I hope that the perspectives that I have presented may be useful to others in the task of interpreting, analysing and critiquing the report. 
  However, the work involved in considering thoroughly the report and that of the working groups is not trivial.  The Commission had the resources of Bill Gates and the World Bank at its disposal.  The networks of activists, NGOs and academics who might wish to take the opportunity to challenge the logic and legitimacy of the current regime of global governance do not have such resources.  But we have our own experts and we are in touch with the current lived circumstances of different settings and different countries.  
  So I am proposing a global collaboration around the task of analysing and responding to the CMH report.  
  A global analysis would need a coordinating function; a systematic approach to analysis and critique; a coordinated approach to generating alternative strategies and policy principles; a process and avenues for dissemination and follow up.  I really don't know how these should be organised.  

  Process and outcomes 
  As I envisage it the material outcomes of this collaboration would be a collection of articles published in a very wide range of websites and journals.  They might or might not be identified as arising from this collaboration (which might or might not be blessed with an formal name).
  I am expecting that through this collaboration people in different parts of the world might collaborate in producing different critiques or commentaries for different purposes and different audiences.  
  As a starter I have produced the preliminary analysis addressed above.  I would like to publish this commentary but I am not sure where and I would greatly appreciate feedback and commentary on the current draft before I do.  
  Perhaps the commentary might serve as a useful framework for claiming and allocating the work which is yet to be done.  
  Another framework would be the set of working papers referenced above.  

  A global collaborative critique?
  Please read the report and my preliminary analysis and answer the following questions: 
    ·       Do you agree that the report of the CMH justifies a strong and critical response?  
    ·       Do you agree that we could organise and collaborate in a globalised analysis and response through the medium of this and related lists? 
    ·       How does a loosely knit global community of health activists undertake such a project?  
    ·       What can you and your organisation contribute to such a process? 
    ·       Are there particular aspects of the report that you would like to focus upon?

  Best wishes

  david legge

  David Legge
  School of Public Health
  La Trobe University, Victoria, 3086, Australia
  http://www.latrobe.edu.au/publichealth/references/profiles/dgl4sph.htm
  +61/(03) 9489 1934 (hm/ph); +61/(03) 9479 5849 (wk/ph)
  +61/(03) 9482 1201 (hm/fx); +61/(03) 9479 1783 (wk/fx)
  Mobile phone: 0408 991417
  email: d.legge at latrobe.edu.au 
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