Dr. Jeffrey Sachs of Columbia University
All the recent progress in taming infectious diseases
will mean little without systemic changes
in the design, financing, management and delivery of health care around the world, health economist Dr. Jeffrey Sachs told an NIH audience
Sachs, a best-selling author, Columbia University
professor and Fogarty scholar-in-residence, reviewed elements of epidemiology, politics and economics—all operating against a backdrop of extreme poverty—to explain a grim global health reality.
Citing a $35 billion “financing gap”—or one-tenth of 1 percent of “rich world wealth”—between current funding and what is needed, Sachs said 9 million people die each year of preventable and treatable diseases. “That’s not because people don’t want to stay alive, that’s because of the nature of extreme poverty.”
While annual health care spending in poor countries is only about $15 a person, he estimates,
$50 a person is needed to provide the personnel, physical structures, diagnostics, preventive
measures and therapeutics needed for basic health care.
The lecture, which filled Masur Auditorium, was part of Fogarty’s year-long 40th anniversary celebration and was cosponsored by the Foundation
for the NIH.
Sachs said public health ought to be built from a “global system design” analogous to the world’s air safety practices; based on a set of rigorous and uniform standards applied in all countries—
from the airport to the traffic control system, maintenance and insurance.
“We need training programs like Fogarty’s” to create cadres of in-country researchers, professional community health workers and public health managers,
he said. “This was once called by the IMF and the World Bank ‘bureaucracy.’ That’s not ‘bureaucracy,’ it’s creating systems.”
While $5 trillion worldwide has been earmarked for bailouts and stimulus packages,
Sachs says the world’s poor and sick have been ignored.
“We still haven’t figured out the real proportionality of life on the planet,” he said, noting that while Western institutions have given $5 trillion in “stimulus and bailouts” in the past year, “we haven’t given a penny to the poorest of the poor…We not only can afford, in partnership with others, to assure health for all, there is no way we can afford not to do it” lest developing-world problems “come here with a vengeance.”
Noting that AIDS was probably a worldwide pandemic killing millions during the 50 years between its transmission to humans and the Western world becoming aware of it, Sach said that today “we have a full worldwide pandemic of instability,
of poverty, of mass migration, of violent conflict, of hunger and of new and re-emerging pathogens in a tightly connected world.
“With all of our knowledge…and with all our wealth I believe we can do better.”