The flipside of globalization is medical tourism. This is a system in which the relatively well off from developed countries swarm to developing countries in search of low cost health care. In such a scenario it is the poor in these “tourism destinations” that suffer as it draws doctors away from the core basic healthcare system. Third world political leadership needs to address these concerns urgently. If they fail, the health disparity will only widen between the rich and poor of these countries.
Writing from India, which contributes approximately 1/6th of the world population, I feel that the healthcare situation in India deserves a mention. Countries like India, experiencing an epidemiological transition following the economic boom, are now finding it tough to tackle the double burden of communicable and non-communicable diseases. On one hand India has to deal with the malnutrition and poverty affecting the poor and on the other the burden of lifestyle diseases like diabetes and hypertension is reaching epidemic proportions in the middle class. Only strong political will can achieve a more equitable distribution of wealth in health. For an optimal health scenario, the economic growth and prosperity of any country has to be spread equally. The problems in this area come up when arbitrary decisions are taken by the governments without consulting doctors in matters pertaining to health care. For example, the political establishment in India has decided to implement one year of rural service to all fresh medical graduates to serve the rural poor. For such a programme to succeed a programme, it has to get the goodwill and support of the doctors concerned. No doctor would oppose such a programme if they were given a decent remuneration for their services in such difficult rural areas (4). However with the government proposing paltry salary for these doctors, there have been vehement protests. As an Indian doctor I do feel that it is the honor of a doctor that is at stake. No financial or political reasons can justify such a punishment of doctors, paying them peanuts for doing this noble work. On a positive note, the Indian government is contemplating a ban on smoking in public places .This has come across stiff resistance from the tobacco lobby and trade unions, despite both parties possessing strong political clout. The ministry is determined to implement the proposed ban. They view public smoking as an important issue of public health, and are highly concerned about the adverse effect it has on children who view smoking as a symbol of being chic and fashionable.
Politics and health are interrelated to such an extent that they can never be considered separately. Much remains to be done in the area of politics and health, but I have hope that our generation of doctors working together with politicians as a team for global health will greatly improve the situation.
