Sociopolitical determinants of international health policies

Authors

  • Pol De Vos General Epidemiology and Disease Control Unit, Public Health Department, Institute of Tropical Medicine, Antwerp, Belgium. MD, PhD in Medical Sciences.
  • Patrick Van der Stuyft General Epidemiology and Disease Control Unit, Public Health Department, Institute of Tropical Medicine, Antwerp, Belgium. MD, PhD in Medical Sciences.

DOI:

https://doi.org/10.17843/rpmesp.2013.302.207

Keywords:

Health public policy, Health care reform, Primary health care

Abstract

For decades, two opposing logics dominate the health policy debate: A comprehensive health care approach, with the 1978 Alma Ata Declaration as its cornerstone, and private competition logic, emphasizing the role of the private sector. We present this debate and its influence on international health policies in the context of changing global economic and sociopolitical power relations. The neoliberal approach is illustrated with Chile’s health sector reform in the 1980s and the Colombian reform since 1993. The comprehensive ‘public logic’ is shown through the social insurance models in Costa Rica and in Brazil, and through the national public health systems in Cuba since 1959, and in Nicaragua –during the 1980s. These experiences emphasize that health (care) systems do not naturally gravitate towards greater fairness and efficiency, but that they require deliberate policy decisions.

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Published

2014-02-10

Issue

Section

Symposium

How to Cite

1.
De Vos P, der Stuyft PV. Sociopolitical determinants of international health policies. Rev Peru Med Exp Salud Publica [Internet]. 2014 Feb. 10 [cited 2024 Mar. 28];30(2). Available from: https://rpmesp.ins.gob.pe/index.php/rpmesp/article/view/207

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