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Putting Public Health at the Center of the Struggle against Poverty

CAMBRIDGE: One great challenge facing humanity is reducing the huge gaps in income and wealth between the world’s haves and have nots. Globalization by itself is not doing the job. Now, Dr. Gro Bruntland, the head of the World Health Organization, has taken up the challenge. She points to the desperate health conditions of the world’s poor as one of the greatest barriers to economic development, and is mobilizing the world community to do something about it.

In mid-January, Dr. Bruntland appointed a new global Commission on Macroeconomics and Health (CMH), and honored me by appointing me as its Chairman. The Commission’s task is enormous, but easily described: to help put global public health at the center of a new strategy of global economic development. The Commission will meet in various parts of the world – Asia, Africa, Latin America, Europe – in the coming two years, and will issue its report and recommendations at the end of 2001.

Market reforms by themselves cannot lift a population from poverty if people are simultaneously struggling with epidemics of AIDS, or malaria, or tuberculosis, or chronic malnutrition, or other crippling health problems. Populations battling with disease lack the energy, productivity, or means to invest in their own future. Studies show that when life expectancy is low, so too are many kinds of investments in the future, such as school attendance, personal saving by households, and foreign investments.

Throughout modern history, improvements in public health have speeded economic development. It was Britain’s rising agricultural productivity in the 18th century, for example, which helped to raise nutrition levels and reduce the burden of infectious diseases, that helped to initiate the Industrial Revolution. It was U.S. investment in eradicating hookworms from its Southern states in the early 20th century that improved health conditions in the American South, and which helped to bring about a boom in investments in that previously impoverished region.