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Nobel Prize-winning economist Amartya Sen

Exclusive interview to Siddharth Varadarajan of The Hindu

January 9, 2005

We need a radical change in the way health delivery in the public sector occurs. India spends a lower percentage of GDP on public health than almost any other country, including those of similar income levels. The neglect here is massive, particularly because this has led to both the substandard delivery of public health and the development of an immensely exploitative private enterprise in healthcare that survives on the deficiencies — and sometimes absence — of public health attention.
What we found in the Pratichi Trust survey in West Bengal but also much more sharply in Jharkhand — and based on other information we have, the picture seems fairly widespread — is that when patients go to many of the primary health centres, they find no one there. Sometimes, when they find someone, they will be referred to private doctors. Also, the medical system in the public sector offers no diagnostics, even of basic illnesses like malaria or TB. Patients are usually told to go to private practitioners for testing. Sometimes the testing isn't very good and, in any case, the economic cost could be ruinous.

On top of that, the care that is often provided by the private sector comes from quacks. We found an incredible proportion of quacks in Jharkhand, particularly, but a significant proportion even in West Bengal, who provide almost no serious medical attention and instead give saline injections for malaria, which is not really known anywhere in the world as a cure.

Bill Gates

2005 World Health Assembly

May 16, 2005

In my view—and there is no diplomatic way to put this: The world is failing billions of people. Rich governments are not fighting some of the world’s most deadly diseases because rich countries don’t have them. The private sector is not developing vaccines and medicines for these diseases, because developing countries can’t buy them. And many developing countries are not doing nearly enough to improve the health of their own people.

Let’s be frank about this. If these epidemics were raging in the developed world, people with resources would see the suffering and insist that we stop it. But sometimes it seems that the rich world can’t even see the developing world. We rarely make eye contact with the people who are suffering—so we act sometimes as if the people don’t exist and the suffering isn’t happening.
All these factors together have created a tragic inequity between the health of the people in the developed world and the health of those in the rest of the world.

It says that child mortality should be reduced by two-thirds by the year 2015. I want this to be achieved. It is unnecessary and unacceptable that a child dies every three seconds, that more than 26,000 children die every day, that more than 10 million children die every year.
 
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