David G Legge

Humanity is desecrating our earthly home (UNEP 2019). The immediate causes are self-evident. The deeper structural causes are more contentious. The appropriate responses (in policy and practice) are even more controversial: address the root causes or deploy the dynamics which created the problem in the first place.

The policy slogan of 'universal health coverage' promises unversal access to an 'essential' package of services and protection against medical impoverishment. In this extended analysis (current draft here) the promises of UHC are sharply interrogated. 

This project is designed as a resource for people who worry about population health, health care and / or public health and are keen to explore a political economy approach to health policy. The worriers in focus include health science students (undergraduate and postgraduate), health policy analysts (however labelled or located), and health activists everywhere.

In my presentation at PHA4, I argued

The vision of the Enlightenment, collectively planned, technically resourced, social progress, is under siege. It is under challenge from market fundamentalists (who argue that blind market forces carry fewer risks of unintended adverse consequences than government decision-making) and from religious fundamentalists (who find greater comfort in religious faith than from the promises of the Enlightenment).

What does this history tell us about the dynamics and strategies of movement building for ‘health for all’? What are the continuities across different streams of engagement, across time and place, within this movement? How might we analyse this history to draw more specific lessons for organisations and networks like the People's Health Movement which are seeking to strengthen this global social movement?

This paper (pre-print here) and published in Critical Public Health (here) started out as a review of Howard Waitzkin's recent book (below) but developed from there.  It has ended up as a reflection on four recent publications: 

Introduction

Statistical comparisons are important resources for the comparative study of health systems.

The following comparative tables have been extracted from WHO’s Global Health Observatory (the selected countries are somewhat arbitrary).  See:

In this paper (here) I review the social movement literature focusing on reports which are particularly relevant to the Health for All movement. The review is directed to identifying strategic uncertainties in terms of movement building and the corresponding priority research questions.  This paper is based on a review prepared as a contribution to PHM research on civil society engagement in the struggle for Health for All.

Data, information and knowledge are core resources for policy, practice and activism in relation to health care and population health. However, they do not stand apart from the struggle for health equity. They are not simple representations of an objective reality, ‘out there’. They are produced in social practice and bear the imprint of power; they are embedded in languages which are framed by the experiences and aspirations of those who shape their use.

This paper (December 2016) describes the current program of ‘WHO reform’; identifies the main problems being addressed and evaluates the strategies of reform.  This analysis is contextualised within the contemporary structures and dynamics of global governance. The purpose of this analysis is to inform policy and advocacy around the directions of reform and of global health governance more broadly. 

Health and health care matter. They matters to individuals and families for reasons which are at the core of our humanity. They matter to policy makers for reasons of solidarity, security and stability.

The complexity of the global economy tends to discourage global activism; the fog created by the cacophony of competing accounts of how the global economy works, what are the problems, and what should be done further obscures insight and foresight. This presentation provides a graphical representation of the national and global political economies. This presentation can be viewed online here; you will need to hit 'open' for the internal links to work. It is quite long.

These notes here (1.14 MB) were prepared for a short course presented in Brunei for WPRO and the Brunei Ministry of Health. The notes bring together and update materials prepared as part of the La Trobe China Health Program over many years. They are still a work in progress. Feedback appreciated.