The World Development Report 1993 and Human Rights
Health and Human Rights: An International Journal
his series of reports from the World Bank started 17 years ago in 1976, so its birth coincided with the developments that led up to the 1978 Alma-Ata Declaration on Primary Health Care. Much of the 1993 report (which concentrates on health) could be seen as an appendage to that declaration in that it states yet again that health infrastructures fail to meet the health needs of people (most particularly the poorest) partly because the health systems are inefficient, badly managed, poorly
... ged, poorly targeted, and inadequately financed; and partly because there is still a large number of people who are very poor and poorly educated (especially women). The pity is that the opportunity has not been seized to move the debate beyond that of Alma-Ata-yet much has happened in health since that time. In particular, a great deal of clarity has been achieved in separating the relative values of health systems, and of social and economic environments, in their differing impacts on people's health. The report seems very muddled about this distinction. It is this distinction that would allow us to develop the potential for the linking of improvements in health with those in human rights, since lack of these rights reflect the inequalities in power and the distribution of resources that lead to poor health. If we could achieve such honesty, we would be able to move away from the terribly simplistic social and economic indicators for health that are used by bodies such as the World Bank.