How trade harms Third World health

There has probably never been more interest in Third World health than there is now. And there has probably never been a greater appreciation of the causes of Third World illness, and the interrelationship of these causes with First World wealth, trade and politics. At times, there also seems to be First World political will to do something about it all — but that soon peters out.

Any book that starts with a glowing endorsement from Archbishop Emeritus Desmond Tutu deserves serious attention. What really works about this book is the mixture of personalised case studies, with a serious, rational and evidence-based exploration of data on such macro issues as trade deficits, World Bank loans and multinational companies’ trade practices. The link between Sath, a 27-year-old Cambodian woman who we meet on the first page, and who dies in complicated childbirth, and structural adjustment, the International Monetary Fund, the Group of Eight and (dare I utter it) globalisation, is made explicit.

While there may be little in this book that is new to the serious student of these issues, what is provided is a thoroughly comprehensive review and explication of the issues. The writing is clear and accessible, although I rapidly tired of the use of “etc”.

From personal experience through travelling and talking to colleagues working in the Third World, there seems to be little positive progress in terms of turning back the tide of poverty, illness and economic stagnation. In many ways governments have failed, as have United Nations agencies.

Now it seems to be the turn of the mega-philanthropists; witness the work of the Gates Foundation and the Ellison Institute. Only time will tell whether they make any difference. At a time when the world is richer than ever before, there are more acutely poor people than ever before, and this is clearly a deep tragedy. At least we can continue to try to understand the multiple, complex and interrelated reasons for it, and try to do something about it.

David WilkinsonDeputy Head of School, Professor of Primary Care, University of Queensland, QLD