The Economics of Global Health Political and economic concerns have often guided global health interventions. As mentioned previously, early efforts to control yellow fever were tied to the completion of the Panama Canal. However, the precise nature of the link between economics and health remains a matter for debate. Some economists and demographers argue that economic development is the key to improving the health status of populations, while others maintain that ill health is the chief barrier to development in poor countries. In either case, investment in health care, and especially in the control of communicable diseases, should lead to. | Chapter 002. Global Issues in Medicine Part 3 The Economics of Global Health Political and economic concerns have often guided global health interventions. As mentioned previously early efforts to control yellow fever were tied to the completion of the Panama Canal. However the precise nature of the link between economics and health remains a matter for debate. Some economists and demographers argue that economic development is the key to improving the health status of populations while others maintain that ill health is the chief barrier to development in poor countries. In either case investment in health care and especially in the control of communicable diseases should lead to increased productivity. The question is where to find the necessary resources to start the predicted virtuous cycle. International financial institutions including the World Bank and the IMF have counseled limited investments and the capping of social expenditures in health and education. The socioeconomic argument was that a balanced budget and a friendly investment climate that is privatization deregulation decreased trade barriers devalued currencies and debt repayment would favor development and thus improve health outcomes. The limitations on social-sector spending recommended for many poor countries by the World Bank and the IMF from the 1970s through the 1990s tended to confirm the opposite view. In the poorest countries already-tiny health-sector budgets were further constricted. Moreover health-sector spending in many poor countries channeled a majority of resources toward city hospitals that served mostly élites who were able to pay consequently in the past quarter-century little spending went toward addressing the problems that most affected poor people in poor countries. Since 1999 spurred by the leadership of the Gates Foundation and the growing interest in addressing novel and persistent challenges such as AIDS spending on health in poor countries has increased with 40 .
