From Marvelous Momentum to Health Care for All - Success Is Possible with the Right Programs
![handle is hein.journals/fora86 and id is 351 raw text is: Response
From Marvelous Momentum'
to Health Care for All
Success Is Possible With the Right Programs
Intelligent Design
PAUL FARMER
The last quarter of the twentieth century
saw little investment in international health
or in the health problems of the world's
poor. Over the past few years, as Laurie
Garrett notes (The Challenge of Global
Health, January/February 2007), driven
by the Hv/AIDS pandemic, a marvelous
momentum for health assistance has been
built and shows no signs of abating. But
after this upbeat introduction, Garrett
proceeds to lay out the perils associated
with this new momentum, chief among
them that an influx of AIDS money has
drawn attention away from other health
problems of the poor, weakened public
health systems, contributed to a brain drain,
and failed to reach those most in need.
I respond as a physician who has
lived through the dry spell, seen the rains
coming, and witnessed the burgeoning of
the first sprouts of hope in a long time.
Because many others who work in places
such as rural Africa and Haiti--the exam-
pies used by Garrett in her essay--also see
the threat of bad seeds ruining the harvest,
I will not dispute her argument about the
disproportionate use of scarce health-care
resources. In fact, I agree with most of her
claims. I would rather focus on how the new
enthusiasm about global health can be
translated into efforts to close the widening
outcome gap between rich and poor.
The stakes are enormous. It is well
known in development circles that huge
amounts of aid have often brought few
improvements to the lives of the world's
poorest. A first principle for the emerging
global health movement, in fact, might
well be Do not emulate the mainstream
aid industry. That said, aid is not bad in
itself, and if managed appropriately it can
achieve impressive results. The end of the
funding drought has been a tremendous
boon, especially for the destitute and sick
(and those who provide care to them).
It is worth comparing the situation in
2oo2, the year the Global Fund to Fight
AIDS, Tuberculosis, and Malaria made its
first pledges, with that of today. Garrett
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From Marvelous Momentum to Health Care for All - Success Is Possible with the Right Programs
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