I
do disagree with you about putting the money into development instead of health.
Andrew T. Price-Smith made a marvelous study of the impact of diseases on
state capacity. He showed that the higher the damage of disease, the
greater the impact on the capacity of the state to handle it--about a 9 year
deleterious impact. Declining state capacity negatively affected health
for only about 4 years.
Price-Smith
suggested a negative spiral: disease causes lowered state capacity,
and the lowered capacity then makes coping with diseases worse, and the
diseases then lower state capacity further. Unless we can do something
to cope with diseases--HIV, malaria, dengue, TB--African states may collapse. Paving highways, buying buses, increasing electricity
aren't going to help as much as dealing with health issues. (See Health
of Nations, MIT Press 2002.)
One
of the problems we have to find a way to work around is the liberal
philosophic position of the United States.
The US supports human rights, but defines those rights in strictly
political terms:
voting, elections, competition for office, turnover.
Their view is narrow and individualist.
Most
Americans have a knee-jerk reaction against "socialized
medicine."
Remember, Ronald Reagan even cut the public health program, on
the grounds that he didn't want government doctors competing against private
physicians.
The US will only support prevention and development.
European
countries, and the rest of the world, adopted a communitarian
view, with emphasis on social rights.
All members of the community, because of the membership, should have
shelter, food, clothes, education, health care.
Citizen identities are "thick" unlike the thin, legalistic
identities of liberalism.
When
the Europeans helped eliminate US representation on the UN Human Rights
Commission, they were making it possible for the UN to promote a broad
health care program in Africa.
We'll have to target pharmaceutical firms and NGOs, not the
US. You will have to include more on prevention--there
will never be enough drugs to treat everyone; prevention will help
in the long run. Use the US funds for prevention.
