Making Social Justice the Ultimate Goal

In the global health field, we generally understand that investing in health is critical for a nation to prosper. But would you consider a lack of investment in health to be a social injustice?

The United Nations’ Under Secretary-General Michel Sidibe thinks so. In this short interview with CCTV News, he talks about how the Ebola outbreaks in Guinea, Liberia, and Sierra Leone have exposed global health failures and explains why health is an investment, not an expenditure.

Prior to watching his interview I’d never really labeled a weak health system as a social injustice in my mind. But health is a right and a shortage of health workers, the inability to provide basic health services, and lack of infrastructure – all of which have become very apparent in the Ebola outbreak – are in fact social injustices. So I think this is a very apt way to label the current situation as it puts a broader lens on the issues and ties everything into the bigger picture of the role of health in society.

His interview made me think of universal health coverage (UHC) because the definition of UHC requires social justice. It addresses the issues of access, equity, and capacity. I wonder if there will be an increased focus on moving towards UHC for the three Ebola-affected countries as part of their rebuilding efforts.

What do you think will be the biggest social justice issues coming out of the Ebola outbreaks? And how do you think we can best address them?

Spotlight on Brazil: The World Cup and More Doctors

The World Cup ended on Sunday and with all the controversy surrounding host country Brazil, I found myself wondering about their health care system. I knew access to basic health services was one of the main points of protest against the Brazilian government’s spending for the World Cup, but I didn’t know all the details.

A few quick searches online provided me with the information I wanted and led me to this video from the Pan American Health Organization (PAHO) documenting the impact of the arrival of doctors in two Brazilian towns that previously had no doctors. According to the World Health Organization, there is a serious shortage of doctors in Brazil with 1.8 physicians for every 1,000 people. Although the Constitution calls for free health care for all citizens, the reality is that there are major inequalities in access to health services with 700 neglected municipalities and a lack of local primary health care.

The PAHO video focuses on Mais Medicos (More Doctors) – a program between the Brazilian and Cuban governments that allows Cuban doctors to work in under-served Brazilian communities for three years. I did some more searching online and learned that the program is part of an initiative by President Dilma Rousseff to import 13,000 foreign doctors in order to address the shortage of medical professionals. The program has been criticized and although I agree with some of the points of opposition (How are their foreign credentials vetted for local standards? How does this translate to a long-term plan to address the larger issues with health care in Brazil?) I think the reception of Cuban doctors by local Brazilian doctors was too harsh.

Despite the controversy surrounding the program, the PAHO video illustrates its positive outcomes through patient testimonials about improved access to health care, fewer journeys to far away hospitals, and increased treatment and service quality. Residents in the two remote communities featured in the video are quite happy with the program and appreciative to have basic health care.

What do you think? Does the program provide enough value to balance costs and outweigh the risks? Watch the video and share your thoughts in the comments below.