From Poverty to Power Green, Oxfam 2008 - weman

4 RISK AND VULNERABILITY HEALTH RISKShigher wages in richer countries. 75 The African Union estimates thatlow-income countries subsidise high-income countries to the tune of$500m every year through the loss of their health workers. 76A human security approach to reducing vulnerability to ill healthrequires action to empower poor people and communities, enablingthem where possible to prevent ill health striking, to cope with it ifthey are unsuccessful, and to recover as quickly as possible thereafter.Communities must be given much greater say in how services aredelivered.Human security also requires effective state protection, in theshape of a health system that provides universal access. Tacklinginequality means a shift to primary and rural health care and makingservices work for women, by promoting and retaining female staff andsupporting women as users of health-care services. Solving the workforcecrisis will require governments to pay decent salaries, recruitmore staff, and invest in decent health planning systems. They mustalso invigorate the public service ethos, which has taken a batteringfrom the anti-state message of governments and aid donors alike inrecent decades. Governments need to invest in free primary care,abolishing any remaining user fees, and to focus on preventive ratherthan purely curative services (health professionals the world overshare the same desire for the latest high-tech toys, when money isoften much more effectively spent on basic health education). Richcountries can help by not luring away qualified nurses and doctors, apoint discussed in Part 5.People will always fall ill, but whether sickness destroys lives islargely determined by social, political, and economic conditions. HIV,while still a personal trauma, is no longer a death sentence in richcountries. In poor ones, however, health shocks such as HIV all toooften are a cataclysmic addition to the daily toll of ill health, whichweakens and undermines poor people, communities, and countries intheir struggle for development. The chances of enjoying good healthare unforgivably skewed between rich and poor people and countries.Sickness and poverty feed off each other, and the best way to addressthem involves bringing together states and citizens, backed by theresources and global collaboration of the international community.241