A friend who advises a big multilateral organisation on public health puts its succinctly. "Health is a human right. A society that recognises that is advanced. One that doesn't is backward." My friend insists that South Asian countries could lift themselves out of poverty by recognising his simple formula for success. India could be Singapore, and Nepal, New Zealand if only citizens had the right to be healthy. People would take care of the rest, no need for vast injections of foreign capital and expert expats clogging the roads and buying up all the organic veggies.
Of course, getting to perfect public health wouldn't be easy. It would mean clean drinking water for every last slum dweller and street kid. It would require social reform on a grand scale, sweeping away patriarchal nonsense that leaves women and girls undervalued, undernourished and overworked. Medicines and medical treatment would have to be available on demand, not just in cities but in the most remote and mountainous corners of this region. Doctors would have to provide high quality to care to all, not just those who can pay, and patients would have to be educated and aware of their own role in avoiding disease and recovering from illness.
In short, my friend, himself a doctor who for many years practised what he preaches, is a revolutionary. He wants societies remodelled on the notion that everyone has the unfettered right to free and high quality health care, backed up with education. He's a pacifist of long standing and his religious beliefs rule out any form of militarism or coercive behaviour. His revolution involves consent and hard work, not guns or peasant armies. His storm troopers would be public health workers and teachers infiltrating every last nook and cranny, administering enlightenment and responsibility in equal doses. He is of course somewhat of an extremist, but think of all the people who found Nelson Mandela, Gandhi and BP Koirala dangerously militant in their "extreme" approach to freedom. What if my friend, or someone like him, could lead a peoples' movement that demanded good health as a fundamental right. And it would not be a movement that tried to shake a cruel elite into dispensing this medicine, it would be a mass mobilisation of people prepared to work for their own salvation and good health. At least that's what he says. "No point in expecting bad governments to change and start doing the right thing," he insists, "That's what made people ill in the first place. They don't care and they never will. We need to do it ourselves."
What a wonderful thought, no riots, no confrontations with police, no marches on palaces or parliaments, just vast legions of people asserting their right to health by building dispensaries, setting up schools and getting on with it. My friend tells me that good things like DOTS programmes for TB and mass vaccinations against polio only work as grassroots efforts, supported by the people and run by them. Look to western Nepal and the way that communities are carrying out AIDS awareness, bucking local trends, spending hardly any money and shunning the bureaucratic, Pajero-loving culture of the expat-government nexus in the capital. There's a natural ally (yes, that's right, an ally!) just across the southern border and I don't mean the babus of Delhi or the sensation-starved Star News crews. I'm talking about India's drug companies, Ranbaxy, Dr Reddy's, Cipro and others, who are snatching AIDS treatments from the grasping hands of Big Pharma, the western drugs multinationals, and making them available cheaply to needy locals.
There were loud cheers when South Africa's government won a court battle to allow public distribution of cheap, technically illegal anti-AIDS drugs for the 25 percent of its adult population who are HIV-positive. My friend has no ambitions to be Mandela or Gandhi, but he's on to something. A public health revolution, based firmly on principles of ahimsa, could just be the Next Big Thing. Repeat after me "health is a human right, health is a human right....."