The role of ethics and ideology in our contribution to global health

The topic of this article has vividly interested the author for many years. It is fascinating to him that the issues at stake have not changed for the last 30 years or so. As proof of this – and on purpose – references quoted are both those published before 1985 and after 1995 (Table 1). Considerable material on this topic was already available from the mid 1970s on. The end result has been the (re)construction of a scenario that has been stubborn to change and that looks into most of the, still highly relevant, burning questions of then and now on the issues pertaining to the title of this contribution for debate. It will be of interest to the reader to see how we often need to be reminded of the things our peers had evidence of and wrote about long before us – as the examples of Dr. Virchov and of the Alma Ata Declaration, for instance, show.

Figures & data

Table 1. This is a review of old and new evidence

Post-1995	Pre-1995
2 J. Lawn, J. Rohde, S. Rifkin, M. Were, V. Paul, M. Chopra. Alma-Ata 30 years on: revolutionary, relevant, and time to revitalize. Lancet 2008; 372: 917–27.	1 Winikoff B. Political commitment and health policy. In: Winikoff B, ed. Health and national policy. Cambridge, MA: MIT Press; 1978.
3 Donabedian A. An introduction to quality assurance in health care. New York: Oxford University Press; 2003.	6 Bantje H. Constraint mechanisms and social theory in health education. Mimeo, BRALUP 1978; University of Dar Es Salaam, Tanzania. Presented at the XI International Congress of the IUNS, Rio de Janeiro, August 1978.
4 Commission on social determinants of Health. Closing the gap in a generation health equity through action on the social determinants of health. Geneva: World Health Organization; 2008.	7 Moore-Lappé F, Beccar-Varela A. Mozambique and Tanzania: asking the big questions. San Francisco, CA: IFDP; 1980.
5 Clemens MA, Kenny CJ, Moss TJ. The Trouble with the MDGs: confronting expectations of aid and development success. World Develop 2007; 35: 735–51.	10 Adapted from Omo-Fadaka J. Water planning and management-an alternative view. IFDA Dossier, 7 May 1979.
8 Schuftan C. Human rights-based planning: the n9w approach. Ecol Food Nutr 2003; 42: 1, 32–9.	11 Brown L. The twenty-ninth day. Washington DC: World-Watch Institute; 1978.
9 Schuftan C. Objectivity of the planning process is nothing but a myth. Human Rights Reader 56. Available from: www.humaninfo.org/aviva, under No. 69 [Cited 1 October 2009].	12 Rahman A. Science for social revolution. IFDA Dossier, 4 February 1979.
15 Turiano L, Smith L. The catalytic synergy of health and human rights: the people's health movement and the right to health and health care campaign. Health Human Rights 2008; 10: 1, 143–53.	13 Sigurdson A. Better analytical tools and social intelligence. The Lund Letter on Science, Technology and Basic Human Needs, Letter No. 6, July 1978.
16 Schuftan, C. The human rights discourse in health. Perspec Global Develop Technol 2005; 4: 2, 245–50.	14 Critchfield R. The village the world as it really is…it's changing. USAID Agenda 1979; 2: 8.
17 Cornwall A, Brock K. Beyond buzzwords ‘poverty reduction,’ ‘participation’ and ‘empowerment’ in development policy, Overarching Concerns Programme, Paper No. 10. Geneva: United Nations Research Institute for Social Development; 2005. Available from: http://www.unrisd.org/80256B3C005BCCF9/(httpAuxPages)/F25D3D6D27E2A1ACC12570CB002FFA9A/$file/cornwall.pdf [Cited 1 October 2009].	19 Echeverria J. Sovereignty of needs, reversal of unjust enrichment. IFDA Dossier, 15 January 1980, p. 94.
18 Luttrell C, Quiroz S. Linkages between human rights-based approaches and empowerment; 2007. Available from: http://www.poverty-wellbeing.net/en/Home/Empowerment/document [Cited 1 October 2009].	25 Klemeyer C, Bertrand W. Misapplied cross-cultural research. In: British Sociological Association, eds. Health and formal organizations. London: Prodist; 1977, p. 217.
20 Schuftan C. The emerging sustainable development paradigm: a global forum on the cutting edge of progressive thinking. In: Barten F, van der Gulden J, eds. Health and sustainable development: visions on health and sustainable development; 2002. Chapter 2.3. Nijmegen, The Netherlands: Nijmegen University Press, pp. 27–35.
21 Perkins D. Speaking truth to power: empowerment ideology as social intervention and policy. Am J Community Psychol 1995; 23: 765–94.
22 Speer P, Hughey J. Community organizing: an ecological route to empowerment and power. Am J Community Psychol 1995; 23: 729–48.
23 Schuftan C. A primer for a national action plan to operationalize the right to health care. Human Rights Readers 98–100. Available from: www.humaninfo.org/aviva, under No. 69 [Cited 1 October 2009].
24 Schuftan C. Human rights have to go from the conceptual, to policy, to action. Human Rights Reader 163. Available from: www.humaninfo.org/aviva, under No. 69 [Cited 1 October 2009].
26 Schuftan C. Of claim holders, duty bearers and agents of accountability. Human Rights Reader 178. Available from: www.humaninfo.org/aviva, under No. 69 [Cited 1 October 2009].
27 Schuftan C. In human rights work we are in a struggle not only for accountability, but also against impunity. Human Rights Reader 194. Available from: www.humaninfo.org/aviva, under No. 69 [Cited 1 October 2009].

Lawn J. Rohde J. Rifkin S. Were M. Paul V. Chopra. M. Alma-Ata 30 years on: revolutionary, relevant, and time to revitalize. Lancet. 2008; 372: 917–27.

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Winikoff B. Political commitment and health policy. Health and national policy. Winikoff BMIT Press. Cambridge MA, 1978

 Google Scholar

Donabedian A. An introduction to quality assurance in health care. Oxford University Press. New York, 2003

 Google Scholar

Bantje H. Constraint mechanisms and social theory in health education. Mimeo, BRALUP 1978, University of Dar Es Salaam, Tanzania. Presented at the XI International Congress of the IUNS, Rio de Janeiro, August1978.

 Google Scholar

Commission on Social Determinants of Health. Closing the gap in a generation health equity through action on the social determinants of health. Geneva: World Health Organization. 2008.

 Google Scholar

Moore-Lappé F, Beccar-Varela A. Mozambique and Tanzania: asking the big questions. IFDP. San Francisco CA, 1980

 Google Scholar

Clemens MA, Kenny CJ, Moss TJ. The trouble with the MDGs: confronting expectations of aid and development success. World Develop. 2007; 35: 735–51.

 Web of Science ®Google Scholar

Adapted from. Omo-Fadaka J. Water planning and management–an alternative view. IFDA Dossier, 7 May1979.

 Google Scholar

Schuftan C. Human rights-based planning: the new approach. Ecol Food Nutr. 2003; 42(1):32–9.

 Web of Science ®Google Scholar

Brown L. The twenty-ninth say. World-Watch Institute. Washington DC, 1978

 Google Scholar

Schuftan C. Objectivity of the planning process is nothing but a myth. Human Rights Reader 56. Available from: www.humaninfo.org/aviva, under No. 69 [Cited 1 October 2009].

 Google Scholar

Rahman A. Science for social revolution. IFDA Dossier, 4 February1979.

 Google Scholar

Turiano L, Smith L. The catalytic synergy of health and human rights: the people's health movement and the right to health and health care campaign. Health Human Rights. 2008; 10(1):143–53.

 Google Scholar

Sigurdson A. Better analytical tools and social intelligence. The Lund Letter on Science, Technology and Basic Human Needs, Letter No. 6, July1978.

 Google Scholar

Schuftan C. The human rights discourse in health. Perspect Global Develop Technol. 2005; 4(2):245–50.

 Google Scholar

Critchfield R. The village the world as it really is … it's changing. USAID Agenda. 1979; 2: 8.

 Google Scholar

Cornwall A, Brock K. Beyond buzzwords ‘poverty reduction,’ ‘participation’ and ‘empowerment’ in development policy, Overarching Concerns Programme, Paper No. 10. Geneva: United Nations Research Institute for Social Development. 2005. Available from: http://www.unrisd.org/80256B3C005BCCF9/(httpAuxPages)/F25D3D6D27E2A1ACC12570CB002FFA9A/$file/cornwall.pdf [Cited 1 October 2009].

 Google Scholar

Echeverria J. Sovereignty of needs, reversal of unjust enrichment. IFDA Dossier, 15 January1980, p. 94.

 Google Scholar

Luttrell C, Quiroz S. Linkages between human rights-based approaches and empowerment; 2007. Available from: http://www.poverty-wellbeing.net/en/Home/Empowerment/document [Cited 1 October 2009].

 Google Scholar

Klemeyer C, Bertrand W. Misapplied cross-cultural research. In: British Sociological Association. Health and formal organizations. London: Prodist. 1977, p. 217.

 Google Scholar

Schuftan C. The emerging sustainable development paradigm: a global forum on the cutting edge of progressive thinking. In: Barten F, van der Gulden JHealth and sustainable development: visions on health and sustainable development. Chapter 2.3. NijmegenThe Netherlands: Nijmegen University Press. 2002, pp. 27–35.

 Google Scholar

Perkins D. Speaking truth to power: empowerment ideology as social intervention and policy. Am J Community Psychol. 1995; 23: 765–94.

 PubMed Web of Science ®Google Scholar

Speer P, Hughey J. Community organizing: an ecological route to empowerment and power. Am J Community Psychol. 1995; 23: 729–48.

 PubMed Web of Science ®Google Scholar

Schuftan C. A primer for a national action plan to operationalize the right to health care. Human Rights Readers 98–100. Available from: www.humaninfo.org/aviva, under No. 69 [Cited 1 October 2009].

 Google Scholar

Schuftan C. Human rights have to go from the conceptual, to policy, to action. Human Rights Reader 163. Available from: www.humaninfo.org/aviva, under No. 69 [Cited 1 October 2009].

 Google Scholar

Schuftan C. Of claim holders, duty bearers and agents of accountability. Human Rights Reader 178. Available from: www.humaninfo.org/aviva, under No. 69 [Cited 1 October 2009].

 Google Scholar

Schuftan C. In human rights work we are in a struggle not only for accountability, but also against impunity. Human Rights Reader 194. Available from: www.humaninfo.org/aviva, under No. 69 [Cited 1 October 2009].

 Google Scholar