N. H. ANTIA'
The World Development Report 1993:
A Prescription for Health Disaster
The World Development Report 1993: Investing in Health is an example of cleverly crafted display of concern for the deteriorating health of the world's poor .by the same institution which serves the vested interests of Western governments and multinational corporations, who, in their frantic search for the material resources of the entire planet, have reduced the majority of its human populace to a state of abject poverty. This has undermined the very basis of their health. Coming from a bank the Report is couched in the language of statistics, economics and cost-effectiveness with a new index like DALY which further obscures the stark unpleasant reality of the poverty trap and its real cause.
The first impression of the Report that strikes the reader in a need-based country like ours is the underlying arrogant. Western, ethnocentric approach which not only refuses to accept responsibility for the creation of the present situation but also implies that the solution must also be only through Western medicine based on Western science and technology and Western economic paradigms. The forty individuals and institutions who have contributed to the production of this Report are almost entirely of Western origin based in the USA, Europe and Geneva. They have totally ignored the existence of reports such as that of Sokhey,1 Bhore,2 and the ICSSR/ICMR,3 committees based on practical knowledge and experience of the problems of health, as well as of the underlying socio-economic and political causes of poverty in a need-based country like ours. The recommendations of these committees as also of our National Health Policy4 provide a far greater understanding of the reality of the problems as also for their solution. The Bank ignores the fact that it was the Westernised elite—so well cultivated by them—of which the medical profession is a part, that has played a major role in sabotaging the post-Independence model of development as well as implementation of the health policy advocated by the Bhore Commi-
Director, Foundation for Research in Community Health, Bombay.
Social Scientist, Vol. 22, Nos. 9-12, September-December 1994