Putting public health first

Today I ate lunch on a park bench looking at the White House. I'm in sunny Washington DC for the launch of our new briefing paper. It looks at challenging the myths about private health care in poor countries and why governments must be at the centre of scaling up health care in these countries.

DC has had a very exciting few weeks, with nearly 2 million people braving freezing temperatures - and in some cases frostbite - to watch the inauguration of America's new president. 'Obama' talk is everywhere... as well as Obama cupcakes, mints and graffiti.

One of the many things Obama has pledged to change is health care in America. In 2007 he said,'[It is] wrong when 46 million Americans have no healthcare at all. In a country that spends more on healthcare than any other nation on Earth, it's just wrong.'

This issue, making health care a reality for all, is central to Oxfam's campaigning work. While America isn't a poor country it demonstrates, to me, a major flaw in private health care - that in reality it does not deliver to all - even in the richest country in the world.

Recently Oxfam has noticed a growing trend in which influential donors and organisations see the private sector as a solution for health care in poor countries. But the evidence to date shows this approach is very risky - the majority of private sector health care in poor countries is unregulated, is more costly and doesn't reach those most in need. Have a look at our photo slideshow to see what a lack of quality public health care means for people living in poverty

The truth is that in Africa nearly 40% of so-called 'private providers' are in fact unqualified shopkeepers selling drugs of unknown quality. We are asking: is this really the answer for achieving quality health care for all?

The paper also examines countries that have successfully scaled up health care through public government provision, such as Botswana, Sri Lanka, Malaysia and Costa Rica that were all able to cut child deaths by between 40 and 70 per cent in just 10 years.

There is no doubt that health care in many poor countries needs massive scaling up. It's also clear that it's the government, not the private sector, which should be at the centre of this. Our video from India illustrates this clearly.

Have a look at the full report: 'Blind Optimism, Challenging the myths about private health care in poor countries'.

Nancy Holden, Oxfam GB Campaigner