Affordable Health Care Access for Everyone

Thursday, March 21, 2002
By David Suzuki

In Canada, it seems that hardly a day goes by without a news story about the debate over health care or the gradual erosion of health-care service in this country.

But while Canada fights to maintain one of the world's best health care systems, we mustn't forget about those who don't have the luxury of such a debate in the first place.

For many of the world's people, access to decent health care remains a dream. Although 50 years ago many professionals in the field proudly proclaimed that we would soon conquer infectious disease, that simply hasn't happened. Millions still die from diseases like malaria and tuberculosis every year. Many more die from relatively new diseases like AIDS — the vast majority in poor countries. Today, almost one-third of all deaths in low- and middle-income countries are due to communicable diseases, problems associated with childbirth, and poor nutrition.

That's not to say we haven't come a long way. We have. Between 1960 and 1995, for example, life expectancy in low-income countries improved by an average of 22 years. During the same period, the rate of death for children under the age of 5 in these countries was cut in half.

Still, every year 1.6 million children in low-income countries die from diseases like measles and tetanus — diseases which are minimized by vaccinations in wealthy nations. And almost all of the half-million women who die due to complications during pregnancy live in poor nations. So we still have a long way to go.

The challenge is not insurmountable. As writers from the World Health Organization, the World Bank, and other groups point out in a recent edition of the journal Science, small-scale, local health projects all over the world show how much can be accomplished with a minimum of resources.

For example, after investing $5 million in a vaccination program, the country of Malawi saw childhood deaths from measles plummet. In fact, no child has died from measles in Malawi in the past two years. Many other projects have also been successful, such as in Bangladesh, where a community health worker program has reduced child mortality by 30 percent. And in Thailand during the 1960s and '70s, a program that doubled the number of midwives led to 75 percent fewer deaths during pregnancy.

Ecosystem health plays a big role in the health of any society — especially poorer nations where people literally live off the land. In sub-Saharan Africa, poor soil quality is greatly hindering food production, leading to poor nutrition and ill health. Africa is one of the few areas of the world where food production, health quality, and life expectancy have actually decreased substantially in recent decades. In the last 30 years, the number of Africans with insufficient access to food has doubled to more than 180 million people.

This too can change. Soil fertility can improve with better agricultural practices — and these need not include the addition of expensive commercial fertilizers. In many cases, fertility can be restored using crop rotation and fallow practices. For example, certain types of fast-growing trees, when interspersed with maize crops, can help accumulate nutrients and provide wood fuel that would otherwise come from cutting nearby forests. After the trees are cut, the leaves and pods are then hoed into the soil, providing a valuable boost of nitrogen. Such practices have been shown to increase maize yields by two to four times, thereby reducing hunger.

Canada's annual health care budget is about $100 billion to cover 30 million people. A global program geared at reducing health inequities between the richest and poorest nations will cost about $27 billion annually, but it will help more than 4 billion people. Surely there's room in our debates to think about that.

Copyright 2002, David Suzuki Foundation
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