Pathogenesis: A History of the World in Eight Plagues

by Jonathan Kennedy

If the Alma-Ata Declaration had been implemented, it would have provided low-income countries with the equipment they needed to clamber out of the poverty trap. Unfortunately, the optimism of Alma-Ata was quickly undermined by high-income countries—most notably the U.S. and the UK, where the arrival of Ronald Reagan and Margaret Thatcher on the scene in the late 1970s and early 1980s marked a fundamental shift in political consensus. Their new economic orthodoxy harked back to the laissez-faire approach of the previous century. In this new environment, “Health for All” was deemed too radical and too political. The focus shifted to taking out infectious diseases one by one using medicines and technology, without tackling the poverty and powerlessness that are the underlying causes of ill health. The U.S. and its allies reduced their funding to the WHO. Instead they funneled money for global health projects into organizations like the World Bank, which gave them more control because member states’ voting power is proportional to their financial contribution.[43]