Swine Flu Shows Need for Good Public Health Systems

The swine flu demonstrates the need for vigorous public health systems the world around.

A major reason for the spread of the epidemic has been the sorry state of the Mexican health care structure.

“The beleaguered Mexican government is under sharp criticism for not moving faster to respond to the outbreak, not having the expertise to identify unfamiliar strains and not alerting global health organizations sooner,” Newsday reports.

When the flu began taking its toll, Mexico didn’t have a single facility to test for the virus, and so samples had to be sent to the United States and Canada. Mexican health officials were slow to pick up on the initial outbreak of the disease, and, by the government’s own admission, still have not been able to reach out to the public in an effective manner.

Indeed, a Mexican schoolteacher says she knew something quite extraordinary was happening more than a month before the government opened its eyes when her schoolkids started falling systematically ill.

“We never had this kind of epidemic in the world,” Jose Angel Cordova, Mexico’s health secretary, offered by way of explanation when questioned about his government’s sluggishness.

Adding to the strains on public health systems in countries around the world has been the free-market dogma of getting the government out of health care. This has resulted in a whole slew of measures, ranging from the privatization of public entities to user fees for government health facilities. At the forefront of imposing this egregious doctrine have been the World Bank and the International Monetary Fund (IMF). Apparently, they have left their mark on Mexico, too.

“Mexican health policy expert Gustavo Leal told the CIP Americas Program that the notorious delay in the response of the federal government can be attributed in part to the decentralization of healthcare promoted by international finance institutions such as the World Bank,” Laura Carlsen of the Americas Program writes on her blog.“ ‘This broke down the chain of command and the flow of information,’ Leal said.”

In a paper in an anthropology journal, Professor Suzanne Schneider of Moravian College dissects the Mexican decentralization experience and concludes that the process has been a sham, only shifting the responsibility but none of the authority to the local level.

“While the right to social security and health care declines, the rhetoric of prevention and community participation places responsibility for change at the level of the municipality and by default, on the shoulders of community residents,” Schneider writes. “Problematically, community residents are expected to carry out projects that are prioritized based upon a conception of health and well-being that is external to their own experience and which overlooks their ‘real’ needs.”

Carlsen points out on her blog that the one Mexican entity that has responded well to the crisis is the Mexican Social Security Institute, whose staff is vigorously tending to the sick and filing medical reports from around the country. Pro-free-market ideologues have been trying to privatize the institution for ages. The Mexican people should be thankful that they failed in their attempts.

Now, the swine flu has gone global and will be testing the health systems of many other countries, including the United States. Governments around the world need to have robust public health care systems in place to respond to such emergencies.