Equity, Health, and International Relations HEALTH AND EQUITY IN THE WORLD IN THE ERA OF “GLOBALIZATION”

The author critically discusses some of the major arguments given for the growth of inequalities in health in the world today. He also questions the “technocratic, ” “humanistic, ” or “apolitical ” discourse used by most international agencies in their analysis of the growing inequalities, a discourse that obscures the actual causes of this growth: the power relations among and within countries. Since the late 1970s and early 1980s, a new position has become dominant in the world’s major economic and political circles that assumes we are witness-ing a new and unprecedented situation, referred to as the “globalization ” of the economy. According to this position, the globalization of commerce, invest-ments, and finance has become a major force behind the setting of public poli-cies, including health policies. The power of governments to shape national pol-icy is being considerably limited and diminished by an increasingly competitive international economy. The only choice of governments is to join in and facilitate the process, to open up their countries to globalization, since any resistance to doing so will be penalized. According to a recent World Health Organization (WHO) document, countries that resist globalization “will find themselves marginalized in the world community and in the world economy ” (1). Indeed, we have seen how much pressure the U.S. government and the International Mone-tary Fund (IMF) have been putting on Russia and the Southeast Asian and Latin American countries to open up their economies, to help them integrate into the global economy and thus solve their economic and financial crises. To that effect, in order for their countries to participate in the welfare and well-being assumed to result from integration into the global economy, govern-ments must create conditions favorable to the mobility of commerce, invest-ments, and financial transactions. They should achieve this through policies that include, among other things, lowering taxes on capital investments an