A COLOMBIAN mayor's solution to his city's drug problem, the downside of "donor driven" aid and the links between poverty and health are the main themes of a World Health Organisation (WHO) conference which is being held in Ireland this week.
Dr Rodrigo Guerrero, former mayor of the so called "drug capital of the world", Cali, Colombia, will give his view on the twin issues of poverty and improved health at the conference, which is being co sponsored by the WHO and the Government at St Patrick's College, Maynooth.
Entitled "Poverty and Ill Health in Developing Countries it is expected to attract up to 50 non governmental organisations from Africa, Europe, Japan and the US, as well as representatives of the US state of Maryland's department of health and mental hygiene.
Dr Guerrero, who is now an adviser on violence with the Pan American Health Organisation, earned a reputation for his successful and innovative approach to his city's drug problem.
"Poor people don't need gifts, they just need opportunities," he has said. "One problem is that development is a social process, and social processes take time, which is bad news for donors.
The three day conference, which opens on Wednesday, aims to share experiences about the health consequences of poverty in developing countries. It will debate the central issue identified in the 1995 World Health report - that extreme poverty is listed in the International Classification of Diseases as the world's biggest killer and greatest cause of suffering and bad health.
That report estimated that more than a fifth of the world's 5.6 billion people live in such poverty with consequent reduced life expectancy in poor countries - as low as 40 years in parts of subSaharan Africa, compared to 75 years in many industrialised countries. Per capita spending on health in the poorest countries has plummeted, due to a combination of severe cute in government expenditure and official aid. The Organisation for Economic Co operation and Development has estimated that overall development aid dropped by almost $5 billion between 1992 and 1993.
Spearheading the WHO's new approach is its Division of Intensified Co operation with Countries and Peoples in Greatest Need (ICO), which offers technical co operation to more than 30 of the world's poorest countries. ICO's deputy director, Dr John Martin, is a Queen's University, Belfast medical graduate with considerable international experience, who contends that health cannot be dealt with in isolation. His division's approach is forcing a reevaluation of the WHO's traditional role.
Dr Martin, who visited Dublin recently to plan the conference with the Departments of Health and Foreign Affairs, believes public sector health financing has a key role to play. "Although reform in the past has been virtually equated with privatisation, it is becoming increasingly clear that unregulated private markets are incapable of achieving the broad mix of objectives that health systems seek to satisfy.
"Nor can we sit and watch banks and donor development agencies operate in developing countries in a well meaning, but unco ordinated manner", he has said.
Poverty in Ireland - classified as a developed country - will not be addressed at the conference, which will be opened by the Minister for Health, Mr Noonan. Ireland is one of only four countries in the developed world that had pledged to increase the ratio of its overseas development aid to GNP in the coming years. The Irish perspective will be provided by the Minister of State for Foreign Affairs, Ms Joan Burton, and Sister Ursula Sharpe of the Medical Missionaries of Mary.
The conference is the second in a series of international meetings. Further details are available from Ms Bernadette Day, Health Services Development Unit, the Institute of Public Administration, (01)6686233.
