Launched in Cape Town, the Global Health Watch 2 is an alternative world health report and includes the voices of civil society organisations and scientists from around the world.

More than half the people in the world (3,5-billion) live in poverty and although more money is now available for health, this is not being used wisely or efficiently and it also isn’€™t reducing inequalities, according to the Global Health Watch

The report shows that while global health spending has risen, crucial public health priorities have been neglected ‘€“ donors favour curative approaches and many overlook the importance of preventing sickness by supporting the supply of clean water and sanitation. Around 4 500 children die every day because of poor hygiene and sanitation.

‘€œThe grim reality for millions of people is a depressing and undignified life of having to live in a smelly world full of untreated shit,’€ write the authors.

‘€œIn many areas, people are reduced to defecating in plastic bags and throwing their faeces (flying latrines) into ditches; they may defecate in fields and behind bushes, or in flimsy structures from which their faeces fall into ponds or lakes (hanging latrines) and contaminate sources of drinking water. Children walk over faeces-ridden fields barefoot to schools.’€

The GHW found that the proportion of development assistance allocated to improving access to clean water and adequate sanitation had actually fallen since 1990 and slum dwellers in Lagos, Nigeria pay 40 times as much for water as residents in downtown New York.

There was also a lack of co-ordination and coherence among donors and global health institutions, and higher transaction costs among a bewildering number of actors, including increasing numbers of highly-paid consultant and bureaucrats, the GHW said.

The report makes stinging criticisms of key global actors, including the World Health Organisation (WHO), the World Bank and the Gates Foundation. The report calls on governments to stop the Bank from meddling in health politics and expresses concern that although the Gates Foundation has injected vast sums of money into global health, it operates in an undemocratic way and reinforces a medical-technical approach.

The GHW also highlights the pressure exerted on the WHO by ‘€œpowerful and vested interests’€ that would prefer WHO’€™s activities and programme to have a more biomedical and less political focus.

The report also hits out at the ‘€œrich developed world’€ where there is a lack of access to essential health care for asylum seekers and migrants. The developed world hosts only 30% of official refugees and asylum seekers globally, but it implements increasingly harsh measures to prevent people from seeking and receiving asylum.

In Australia AU$160-million of foreign aid was used to detain asylum seekers in off-shore detention centres, for example.

‘€œWhile rich countries benefit from the extraction of natural resources from many poor countries, the people from those countries who seek a better life are shunned, stigmatized and incarcerated,’€ the GHW said.

The report said that the world’€™s global health crises were often presented as problems that are unfortunate, unforeseen or tragic. They are rarely presented as an outcome of policies that work in favour of the rich and powerful.

This is the second Global Health Watch, with the first one launched a few years after the first People’€™ Health Assembly which was held in Bangladesh in 2000 when some 1 500 people from 75 nations attended and drew up the People’€™s Health Charter. The Charter called for action on the root causes of ill-health and the lack of access to essential health care, setting the agenda for the People’€™s Health Movement.- health-e news.