Academic journal article Bulletin of the World Health Organization

Overcoming Inequity Means Finding Approaches That Work

Academic journal article Bulletin of the World Health Organization

Overcoming Inequity Means Finding Approaches That Work

Article excerpt

For a long time, international health statistics were crudely equated with the disparities in gross domestic product (GDP), and Gwatkin points out the inadequacies of such an approach. A more insightful one is now being devised, which involves analysing the situation of the vulnerable population on the one hand, and social inequalities in access to health care, on the other.

Two major earlier efforts have not provided the expected results. In spite of its far-reaching targets and global approach, "health for all by the year 2000" has not durably improved the conditions of the most vulnerable. And the structural approach, although it focused on the necessary reform of health care systems, has not reduced the inequalities between the rich and the poor either in industrialized countries or in developing ones, despite the drastic structural readjustment schemes the latter were forced to carry out.

Other approaches deserve consideration. They are perhaps less bold but could just possibly be more efficient in the long run. These would involve identifying a limited number of priority pathologies within a congruent geographic area. The next step would be to reform the organization of health services around the prevention and control of these diseases. In certain areas of the world, the example of acquired immunodeficiency syndrome (AIDS) may serve as a model. …

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