Canadian Journal of Public Health

, Volume 102, Issue 3, pp 204–206 | Cite as

Why Are Some Settings Resource-poor and Others Not? The Global Marketplace, Perfect Economic Storms, and the Right to Health

  • Ted SchreckerEmail author


Analyses of how health system priorities should be set in resource-poor settings are routine in the health ethics and policy analysis literature. Less attention is devoted to asking why some settings are resource-poor and others not. Asking this question must be considered a central task of global health research. Comparison of the relatively meager resources devoted to improving the health of the poor with the sums routinely mobilized for other purposes serves as a basis for ethical reflection and a route into necessary questioning of power imbalances in the world economy. The 2008 financial crisis and related developments underscore the urgency of such questioning, and the value of research and advocacy collaborations (for example, between the human rights and public health research and practice communities) focused specifically on the destructive consequences of the global marketplace for health.

Key words

Globalization resource allocation economic conditions ethics 


Dans les travaux publiés sur l’éthique de la santé et l’analyse des politiques, on trouve couramment des analyses de l’établissement des priorités des systèmes de santé dans les milieux pauvres en ressources. On consacre cependant moins d’attention à se demander pourquoi certains milieux sont pauvres en ressources et d’autres non. Or, poser cette question devrait être une tâche centrale de la recherche en santé mondiale. Nous avons comparé les ressources relativement maigres qui sont consacrées à améliorer la santé des pauvres avec les sommes importantes que l’on réunit systématiquement dans d’autres buts, et nous en avons fait la base d’une réflexion éthique et une voie vers un questionnement nécessaire des déséquilibres de pouvoirs dans l’économie mondiale. La crise financière de 2008 et ses répercussions soulignent l’urgence d’un tel questionnement, ainsi que l’utilité des collaborations entre les chercheurs et les défenseurs des droits (p. ex., entre les communautés de recherche et de praticiens en droits humains et en santé publique) qui portent spécifiquement sur les conséquences dévastatrices du marché international pour la santé.

Mots clés

mondialisation allocation de ressources économie éthique 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Abou Zahr C, Ali M, Boerma T, Bos E, Chou D, Hakkert R, et al. Trends in Maternal Mortality: 1990 to 2008: Estimates developed by WHO, UNICEF, UNFPA and The World Bank. Geneva, Switzerland: WHO, 2010. Available at: (Accessed March 30, 2011).Google Scholar
  2. 2.
    Prata N, Sreenivas A, Vahidnia F, Potts M. Saving maternal lives in resource-poor settings: Facing reality. Health Policy 2009;89:131–48.CrossRefGoogle Scholar
  3. 3.
    Williams P. What will it take to stop the needless deaths of millions of women and children each year. J Paediatrics Child Health 2010; Available at: doi:10.1111/j.1440–1754.2010.01731.x (Accessed March 30, 2011).Google Scholar
  4. 4.
    Prata N, Sreenivas A, Greig F, Walsh J, Potts M. Setting priorities for safe motherhood interventions in resource-scarce settings. Health Policy 2010;94:1–13.CrossRefGoogle Scholar
  5. 5.
    Commission on Social Determinants of Health. Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health (Final Report). Geneva: World Health Organization, 2008. Available at: (Accessed March 30, 2011).Google Scholar
  6. 6.
    Evans RG, Barer ML, Marmor TR (Eds.). Why Are Some People Healthy and Others Not? The Determinants of Health of Populations. Hawthorne, NY: Aldine DeGruyter, 1994).Google Scholar
  7. 7.
    UNAIDS. AIDS Epidemic Update 2009. Geneva: UNAIDS, 2009).Google Scholar
  8. 8.
    Cheng M. AIDS experts wonder if focus is right. Associated Press January 18, 2008).Google Scholar
  9. 9.
    Over M. Prevention Failure: The Ballooning Entitlement Burden of U.S. Global AIDS Treatment Spending and What to Do About It. Working Paper 144. Washington, DC: Center for Global Development, 2008. Available at: (Accessed March 30, 2011).Google Scholar
  10. 10.
    Médecins Sans Frontières. No Time to Quit: HIV/AIDS Treatment Gap Widening in Africa. Brussels, Belgium: MSF, 2010. Available at: (Accessed March 30, 2011).Google Scholar
  11. 11.
    McNeil DG. At Front Lines, AIDS War Is Falling Apart. New York Times May 9, 2010).Google Scholar
  12. 12.
    Global Fund to Fight AIDS, Tuberculosis and Malaria. Resource Scenarios 2011–2013: Funding the Global Fight against HIV/AIDS, Tuberculosis and Malaria. Geneva: Global Fund, 2010. Available at: (Accessed March 30, 2011).Google Scholar
  13. 13.
    Barofsky N. SIGTARP Quarterly Report to Congress, July 21, 2009. Washington, DC: Office of the Special Inspector General for the Troubled Asset Relief Program (SIGTARP). Available at: July2009_Quarterly_Report_to_Congress.pdf (Accessed March 30, 2011).Google Scholar
  14. 14.
    Lordon F. Le jour où Wall Street est devenu socialiste. Le Monde Diplomatique October, 2008).1,5.Google Scholar
  15. 15.
    Thomas B, Dorling D, Smith GD. Inequalities in premature mortality in Britain: Observational study from 1921 to 2007. BMJ 2010;341. Available at: (Accessed March 30, 2011).
  16. 16.
    Chan M. Globalization and Health: Remarks at the United Nations General Assembly, New York City, October 24, 2008 [online]. Available at: (Accessed March 30, 2011).Google Scholar
  17. 17.
    Schrecker T. Labor markets, equity, and social determinants of health. In: Labonté R, Schrecker T, Packer C, Runnels V (Eds.). Globalization and Health: Pathways, Evidence and Policy. New York: Routledge, 2009; 81–104. Available at: (Accessed March 30, 2011).Google Scholar
  18. 18.
    Sassen S. Two stops in today’s new global geographies: Shaping novel labor supplies and employment regimes. Am Behavior Scientist 2008;52:457–96.CrossRefGoogle Scholar
  19. 19.
    Hellman JA. The World of Mexican Migrants: The Rock and the Hard Place. New York: The New Press, 2008).Google Scholar
  20. 20.
    Schrecker T. The power of money: Global financial markets, national politics, and social determinants of health. In: Williams OD, Kay A (Eds.). Global Health Governance: Crisis, Institutions and Political Economy. Houndmills, UK: Palgrave Macmillan, 2009; 160–81.CrossRefGoogle Scholar
  21. 21.
    Sassen S. When local housing becomes an electronic instrument: The global circulation of mortgages - A research note. Int J Urban Regional Res 2009;33:411–26.CrossRefGoogle Scholar
  22. 22.
    World Bank, International Monetary Fund. Global Monitoring Report 2010: The MDGs after the Crisis. Washington, DC: World Bank, 2010).CrossRefGoogle Scholar
  23. 23.
    DeParle J, Gebeloff R. Across U.S., Food Stamp Use Soars and Stigma Fades. New York Times November 29, 2009).Google Scholar
  24. 24.
    Eckholm E. Surge in Homeless Children Strains School Districts. New York Times September 6, 2009).Google Scholar
  25. 25.
    Sassen S. A savage sorting of winners and losers: Contemporary versions of primitive accumulation. Globalizations 2010;7:23–50.CrossRefGoogle Scholar
  26. 26.
    Smaller C, Mann H. A Thirst for Distant Lands: Foreign Investment in Agricultural Land and Water. Winnipeg, MB: International Institute for Sustainable Development, 2009. Available at: (Accessed March 30, 2011).Google Scholar
  27. 27.
    Cotula L, Vermeulen S, Leonard R, Keeley J. Land Grab or Development Opportunity? Agricultural Investment and International Land Deals in Africa. London/Rome: International Institute for Environment and Development, Food and Agriculture Organization of the United Nations (FAO), International Fund for Agricultural Development (IFAD), 2009. Available at: (Accessed March 30, 2011).Google Scholar
  28. 28.
    von Braun J, Meinzen-Dick R. “Land grabbing” by foreign investors in developing countries: Risks and opportunities. Policy Brief 13. Washington, DC: International Food Policy Research Institute (IFPRI), 2009. Available at: (Accessed March 30, 2011).Google Scholar
  29. 29.
    Zoomers A. Globalisation and the foreignisation of space: Seven processes driving the current global land grab. J Peasant Studies 2010;37:429–47.CrossRefGoogle Scholar
  30. 30.
    Conceição P, Mendoza RU. Anatomy of the global food crisis. Third World Q 2009;30:1159–82.CrossRefGoogle Scholar
  31. 31.
    Ruel MT, Garrett JL, Hawkes C, Cohen MJ. The food, fuel, and financial crises affect the urban and rural poor disproportionately: A review of the evidence. J Nutr 2010;140:170S–176S.CrossRefGoogle Scholar
  32. 32.
    Dawe D, Drechsler D. Hunger on the rise: Number of hungry people tops one billion. Finance and Development 2010;40–41. Available at: (Accessed March 30, 2011).Google Scholar
  33. 33.
    Addison T, Arndt C, Tarp F. The Triple Crisis and the Global Aid Architecture. Working Paper 2010/01. Helsinki, Finland: World Institute for Development Economics Research, 2010. Available at: default/2010–01.pdf (Accessed March 30, 2011).Google Scholar
  34. 34.
    Falk R. An inquiry into the political economy of world order. New Political Economy 1996;1:13–26.CrossRefGoogle Scholar
  35. 35.
    Nygren-Krug H. 25 Questions and Answers about Health and Human Rights. Geneva: World Health Organization, 2002).Google Scholar
  36. 36.
    Pogge T. Severe poverty as a human rights violation. In: Pogge T (Ed.). Freedom from Poverty as a Human Right: Who Owes What to the Very Poor? Oxford: Oxford University Press, 2007; 11–53.Google Scholar
  37. 37.
    Schrecker T, Chapman A, Labonté R, De Vogli R. Advancing health equity in the global marketplace: How human rights can help. Soc Sci Med 2010;71:1520–26.CrossRefGoogle Scholar
  38. 38.
    Brinks DM, Gauri V. A new policy landscape: Legalizing social and economic rights in the developing world. In: Gauri V, Brinks DM (Eds.). Courting Social Justice: Judicial Enforcement of Social and Economic Rights in the Developing World. Cambridge: Cambridge University Press, 2008; 303–52.CrossRefGoogle Scholar
  39. 39.
    Somers M. Genealogies of Citizenship: Markets, Statelessness, and the Right to Have Rights. Cambridge: Cambridge University Press, 2008).Google Scholar
  40. 40.
    Bernhardt A, Boushey H, Dresser L (Eds.). The Gloves-Off Economy: Workplace Standards at the Bottom of America’s Labor Market. Ithaca, NY: Cornell University Press, 2008.Google Scholar

Copyright information

© The Canadian Public Health Association 2011

Authors and Affiliations

  1. 1.Institute of Population HealthUniversity of OttawaOttawaCanada

Personalised recommendations