Stem Cell Progress Best Achieved When Good Minds and Good Hearts Get Together
BYLINE: Solly benatar
Advocate Donrich Jordaan's reply to my concerns about private stem cell banks (August 28) has some, but limited, validity.
While he is correct that stem cell therapy has exciting potential for the future, unproven treatments are regrettably already being fraudulently offered in the marketplace by unscrupulous vendors.
Making legitimate profits is indeed acceptable, but Jordaan fails to distinguish between making profit and illegitimately accruing massive profits through kick-backs that pervade the business of private hospitals and health insurance.
Jordaan's speculation about the benefits of stem cell banks within the private sector is not supported by scientific data or ethical arguments. Instead, he asserts the worn-out myth (based on a utopian market ideology) that economic growth is the best solution to social inequities.
It is now widely recognised, even by some prominent economists with the courage to escape from blinkered perspectives, that "trickle down" or "levelling up" is much less than touted, and that economic growth alone is not sufficient to ensure adequate distribution of the benefits of growth.
Another shortcoming of Jordaan's response is his confident use of simplistic catchphrases such as "levelling down and levelling up", as if these provide definitive insights without any need for further analysis of what they mean.
He seems oblivious of the extensive scholarly evidence that privatisation of medicine and the relentless pursuit of wealth have, globally, diminished rather than improved the health of whole populations.
The same applies in South Africa where, in the past few decades, under the influence of privatisation, the proportion of doctors working in the public health service has decreased from 65% to 35% and disparities in health are wider than ever. There is no evidence of any levelling up, and Jordaan provides no evidence that privatising stem cell banks and research would have any different effect.
Erosion of public sector medicine, aggravated by excessive growth of the private sector, is also impeding the future of medical education and research vitally needed to improve health in our country (Benatar, New England Journal of Medicine 2004).
Countering unnecessary privatisation is thus not a levelling down process. Rather it is a fair means of reducing inequity by thwarting subtle forms of theft and focusing on unmet needs. It also enhances national capacity to educate health professionals for both the private and public sectors and to promote national capacity for training researchers for the future.
Moreover, advocating healthcare as a market commodity both eclipses and undermines the concept of healthcare as a caring social function. He totally ignores the ethical requirement to make healthcare widely accessible on an equitable basis - one of the most important challenges facing democratic societies. …