Moral Imagination: The Missing Component in Global Health
Moral Imagination: The Missing Component in Global Health
Solomon R. Benatar is Professor of Medicine and Director of the Bioethics Centre, University of Cape Town, Cape Town, South Africa, and Visiting Professor in Medicine and Public Health Sciences at the University of Toronto, Toronto, Ontario, Canada. E-mail: sbenatar@uctgsh1.uct.ac.za
The deplorable state of global health and the failure to improve this state have been debated extensively. Recent editorials in the Lancet in relation to the failure of Roll Back Malaria and the potential failure of the 3 by 5 programme [1,2] illustrate how disappointment, surprise, and admonitions about such failures are usually followed by optimism about the success envisaged from future efforts [1,3].
There are several possible reasons for our failure to make adequate progress in improving global health. First, it seems that there is generally more interest in doing research to acquire new knowledge than in using existing knowledge, unless it is commercially profitable—illustrating how market forces are a more powerful influence on the practice of medicine than health needs [4]. Second, concern for those who are most severely affected by ill health seems to be generally transient, perhaps because they are anonymous and out of sight, but maybe also because their lives are less highly valued [5,6]. Third, there is a tendency to focus on new technologies through “silo” (narrowly contained) approaches to improving global health [7–9]. Fourth, there is insufficient attention to the social determinants of health [10,11].
Finally, while many are concerned about the plight of others, collective action through nongovernmental organisations can only achieve limited results, and there is reluctance to acknowledge and more explicitly address the indirect, causal, complex global system forces that underlie poverty and many fatal diseases [5,11–15]. Fortunately, there is now growing recognition that new infectious diseases pose a major threat to human health and security worldwide [16,17], and that imaginative new solutions are needed to improve global health [18,19].
Solomon R. Benatar is Professor of Medicine and Director of the Bioethics Centre, University of Cape Town, Cape Town, South Africa, and Visiting Professor in Medicine and Public Health Sciences at the University of Toronto, Toronto, Ontario, Canada. E-mail: sbenatar@uctgsh1.uct.ac.za
The deplorable state of global health and the failure to improve this state have been debated extensively. Recent editorials in the Lancet in relation to the failure of Roll Back Malaria and the potential failure of the 3 by 5 programme [1,2] illustrate how disappointment, surprise, and admonitions about such failures are usually followed by optimism about the success envisaged from future efforts [1,3].
There are several possible reasons for our failure to make adequate progress in improving global health. First, it seems that there is generally more interest in doing research to acquire new knowledge than in using existing knowledge, unless it is commercially profitable—illustrating how market forces are a more powerful influence on the practice of medicine than health needs [4]. Second, concern for those who are most severely affected by ill health seems to be generally transient, perhaps because they are anonymous and out of sight, but maybe also because their lives are less highly valued [5,6]. Third, there is a tendency to focus on new technologies through “silo” (narrowly contained) approaches to improving global health [7–9]. Fourth, there is insufficient attention to the social determinants of health [10,11].
Finally, while many are concerned about the plight of others, collective action through nongovernmental organisations can only achieve limited results, and there is reluctance to acknowledge and more explicitly address the indirect, causal, complex global system forces that underlie poverty and many fatal diseases [5,11–15]. Fortunately, there is now growing recognition that new infectious diseases pose a major threat to human health and security worldwide [16,17], and that imaginative new solutions are needed to improve global health [18,19].
posted by Aloyzio Achutti at 5:14 PM
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