PHA-Exchange> The Upcoming PAHO/WHO Election

[Aviva]

>
> The Role and Future of Public Health in the Americas: Ethics versus
Economics
>
>         Washington, September 12, 2002-- "The moment of truth for public
> health in the Americas has arrived. Do we remain under the heel of
economic
> determinism or do we value health as the means to enrich, empower and
> enhance our human and social capital?"
>
>         That is the issue today, says Dr. Mirta Roses, current Assistant
> Director of the Pan American Health Organization, and one of two
candidates
> in the closely contested election for Director of PAHO that will take
place
> on Wednesday, September 25.
>
> PAHO is the oldest international health institution in the world
> and the World Health Organization's regional office for the Americas.
>
>         Dr. Roses, a liberal Argentinian medical doctor, and the first
> female candidate for a major post in any Interamerican Organization in 100
> years, has spent 30 years in the field of public health, the last 18 of
> them at PAHO. Her conservative opponent is Dr. Jaime Sepulveda, a Mexican
> who works in the Institute of Public Health, and has less experience in
the
> delivery of technical cooperation and in United Nations activities.
>
>         "For some people, health is an expenditure that has to be
> justified with economic arguments," asserts Dr. Roses. "This is a mistake
> that is too often made by opinion leaders and policy-makers. Economic
> calculations and financial considerations, although they must be
evaluated,
> should not be the driving force and over-riding criteria for the most
> important decisions about health.
>
>         "Health programs are the reflection of the ethical decisions of a
> country. They mirror the value scale that is assigned to life and human
> development in general, and more specifically, the value of every person's
> life, particularly women and children, the elderly and the disabled.
>
>         "For most people public health consists of giving more years to
> life and more life to the years. This holistic approach is about promoting
> good health and wellness, preventing and controlling risks, and having
> vaccines and drugs available to prevent or cure diseases when they appear.
> Improving the quality of life is the realm of the State. This was the
basic
> philosophy underlying the "Health for All" movement in the late 70s. But
> starting in the 80s it became increasingly necessary to demonstrate the
> economic value of health in order to receive or be allocated the level of
> resources either needed or deserved. I am against this approach."
>
>         Dr. Roses went on to say that "almost every country's Constitution
> in the Americas enshrines the view that access to health is a right of the
> people. And yet although everyone knows that water is a basic element for
> the support of life, health and human dignity, it became essential to
prove
> the cost-benefit relationship for communities to get water. But what is
not
> questioned (so long as someone pays for it) is the fact that as much water
> is
> needed to maintain the grass of a golf course in one day as to sustain the
> needs of 100 families in one week."
>
>         The Argentinian doctor added: "The result of the election for
> Director of PAHO on September 25 will determine whether acces to health is
> considered a fundamental right to be guaranteed for all or is only
> justifiable with the arguments of economic returns. My choice is clear."
>
>         Pre-election predictions suggest that Mexico, the United States
> of America, France, Canada, and Colombia will vote for Dr. Sepulveda,
while
> Argentina, Brazil, Uruguay, Paraguay, Bolivia, Dominican Republic, El
> Salvador, Barbados, Jamaica and Cuba are in favor of Dr. Roses.
> Altogether, 38 Ministers of Health will be casting ballots, but many
> countries in Central and South America and the Caribbean have not yet
> indicated their position.
>