Bitter Pills:Medicines & The Third World Poor | Page 18

an onslaught on poverty and inequality. In the words of the Tanzanian Food and
Nutrition Council, a "society that is perpetuating malnutrition cannot be treated
with medicine. It has to develop and be restructured in such a way that all its
members are ascertained all their basic human needs". (40)
Most illness is in fact self-limiting through the body's own defence mechanisms.
This makes good nutrition crucial in fighting disease. Dr. Klouda observes from
Tanzania; "If the nutritional status of the nation improved, that, at one blow,
would do more for the health of the population than any other measure. The health
services have only a limited role to play in this." (4"
The ICSSR and ICMR report confirms that ill-health has to be tackled with political
and economic measures. "... there are millions of individuals whose illness arises
basically from malnutrition. No 'pills' can help them; and the only way to prevent
their morbidity and mortality is to make a direct attack on poverty itself through
such programmes as guaranteed employment at reasonable wages." |421
This prescription for better health is borne out by the experience of developed
countries such as Britain. The diagrams overleaf trace the rapid fall in infant
mortality rates over the last century. Diagram 1 shows that deaths of babies in
their first year of life had already fallen dramatically before the advent of modern
life-saving drugs which, with the exception of small-pox vaccine, were not generally
available until the 1930s. (43) In fact, as Diagram 2 demonstrates, the major
impetus to better health in Britain from the mid-nineteenth century can be directly
attributed to public health measures and social legislation which improved the
living standards of working people. (44) Higher wages and welfare benefits made
it possible for the poor to eat properly. Public health measures radically improved
conditions in the densely- populated urban areas, particularly with the provision
of clean water supplies, sanitation, sewerage and new housing. Finally, improved
health care contributed to the prevention of early deaths. Infant mortality fell
sharply at the turn of the century, when the Midwives Act (1902) came into force.
The fact that medicines can be seen to have played a relatively minor role in the
trend to better health in countries like Britain is of course no argument against
their potential value in developing countries today. Most deaths in the Third World
are caused by infectious diseases that can now be treated with drugs.
It is also clear that when the first modern drug treatments became available their
impact was soon felt in speeding up recovery and preventing deaths. TB was once
a major killer in Britain. From the end of the nineteenth century public health
measures, better diet and improved housing contributed to a dramatic fall in TB
deaths. By the 1940s the TB death rate was still declining, by about 3% a year.
But when the first modern antituberculous drugs became generally available in
the early 1950s, the fall in TB deaths increased to 15% a year. |451
Over the past thirty years drugs have made a tremendous impact in controlling
some specific diseases. One of the most obvious successes is the eradication of
smallpox with smallpox vaccine. There are numerous examples of drugs which
have made major contributions to the relief of human suffering. These include
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