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Evaluación Crítica del World Health Report 2000



Espacio en espera de la aprobación para su reproducción del Profesor Vicente Navarro, profesor del  Public Policy Program, Johns Hopkins University, USA-Pompeu Fabra University, Spain; School of Public Health, Johns Hopkins University,


Assessment of the World Health Report 2000

Vicente Navarro

Lancet 2000; 356: 1598-601

(Ver Artículo original en The Lancet)

Entre tanto he aquí las conclusiones del mismo:


Most experts in health care would agree that the assessment of health-care systems is not an exact science. As in many dimensions of the scientific project, the barrier between science and ideology is not an impermeable one; on the contrary, it is highly porous. The WHO's June, 2000, report is a good example. The issue under discussion, therefore, is what values sustain the ideology reproduced in the WHO report and whether these values are a help or a hindrance on the road to a healthier world.

The principal values reproduced in the WHO report are those that sustain the dominant conventional wisdom in the foremost medical, financial, and political arenas in the USA and other major more-developed countries, based on two main assumptions. The first is the belief that the most prominent health problems our societies now face can be resolved by technological-scientific medical bullets or interventions, without reference to changes in the social, political, and economic environments in which these problems are produced. The second assumption is that the supposed "failures" of health-care systems are due to an excessive reliance on public interventions without allowing for the development of the (assumed) great potential of the private sectors. Thus, there is a growing call for increased partnership between public and private interests in which the latter are increasingly influential in shaping the nature of public decisions. In the new wisdom, client demand replaces patients' needs, risk is valued over security, market shares dominate over government planning, and entrepreneurship dominates over public services. This conventional wisdom has become almost a dogma, which, like all dogmas, is based more on faith than on evidence. It is wrong for the WHO report to uncritically reproduce this thinking.


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