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Press releases Saturday 23 April 2005

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(1) COUNTING THE HUMAN COST OF INTERNATIONAL TRADE

(2) WHO NEEDS HEALTH CARE—THE WELL OR THE SICK?

(1) COUNTING THE HUMAN COST OF INTERNATIONAL TRADE

(Death on the road to international development)
http://bmj.com/cgi/content/full/330/7497/972

International trade is creating a global road safety crisis that only serves to inhibit development and perpetuate poverty, argues an expert in this week's BMJ.

Every year in Africa 200,000 people are killed on the roads and millions seriously injured.

Some of these deaths are attributable to the activities of international development companies, such as the Commonwealth Development Corporation, now owned by the Department for International Development of the UK government.

In 2003, CDC made a pre-tax profit of £15.6m from its investment in Africa.

Captains of industry are excited about international trade because of its potential to increase profits. But if businesses had to pay the full social and environmental costs of transport then trade would be much less efficient and they would show little enthusiasm for it, writes Professor Ian Roberts.

Fortunately for business, ordinary people pay much of the costs, so that business in Africa is lucrative.

According to the World Health Organisation the economic losses associated with traffic injuries in developing countries is nearly $100bn, twice as much as all overseas development assistance. "These losses only serve to inhibit development and perpetuate poverty," he argues.

The government's response to global road safety crisis is to provide funding for the Global Road Safety Partnership, which involves corporate giants such as car makers Ford and DaimlerChrysler, and drinks multinational Bacardi-Martini. "Are these the socially responsible philanthropic organisations that will bring road safety to Africa, or has the department put the fox in charge of the chickens?" asks Roberts.

"Creating wealth in poorer countries is a noble aim but it is immoral for the Department for International Development to continue to pay insufficient heed to the human cost of transport," he concludes.

Contact:

Ian Roberts, Professor of Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, London, UK
Email: ian.roberts@lshtm.ac.uk

(2) WHO NEEDS HEALTH CARE—THE WELL OR THE SICK?

(Who needs health care—the well or the sick?)
http://bmj.com/cgi/content/full/330/7497/954

Shifting drug spending from the worried well in rich countries to those with treatable disease in poorer nations will benefit the health of everyone, argues a doctor in this week's BMJ.

Seventy per cent of the UK population is taking medicines to treat or prevent ill health or to enhance wellbeing. How can this level of medicine taking be appropriate in a population which, by all objective measures, is healthier than ever before? asks Dr Iona Heath.

In a study of people living in Bihar (the poorest state in India) and the United States, rates of self reported illness were disturbingly low in Bihar and enormously high in the United States. It seems that the more people are exposed to contemporary health care, the sicker they feel, writes the author.

And as the overall health of a population increases, more money can be made from selling healthcare interventions for the healthy majority than for the sick minority, she adds. For instance, weigh the huge amount invested in the vast bureaucracy of health promotion in the UK against the waiting times for interventions of proved effectiveness and the neglect of care of frail elderly people.

Are we sure that the balance sheet of preventive activity really offers more good than harm?

A tax on preventive drugs sold in rich countries could be used to fund drugs in poor countries, she suggests. This would benefit people in both rich and poor countries.

Contact:

Iona Heath, General Practitioner, London, UK
Email: iona.heath@dsl.pipex.com

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