By Daniel Henao (Grupo Reproducción, Universidad de Antioquia, Colombia & EV 2012)
Although US citizens commonly refer to their country as America, the truth is their country only occupies around 20% of the total area of the continent. On the US Southern border begins Latin-America: a collection of nations that share – besides languages derived from Latin like Spanish, Portuguese and French– the heritage of post-colonization. The combination of European, native Indigenous and African cultures is at the origin of the Latin-American identity. This diversity has not been easy to integrate – we have thus also often imported foreign models to help build and govern our societies. We have copied, first from Europe and then from “America”, our political and legal institutions and even the type of music we listen to. Nonetheless, without any doubt, among all these foreign influences the neoliberal economic model has had the deepest impact on our lives.
Latin-America has the highest economic inequality worldwide. On the very same day you can experience how it is like to live in Oslo and Kinsana without leaving Rio de Janeiro, Mexico City or Lima. Despite the recent excellent economic performance in many of the countries in the region, we have failed miserably when it comes to redistributing this (increasing) wealth. The neoliberal economic model has proven to be inefficient to promote equity; and even as rising inequality has been recognized as an intrinsic trade-off in free market economies we have spent decades to mitigate these deleterious effects by further deepening neoliberal reforms ! – hoping for a ‘trickle down’ effect to materialize eventually. Predictably, it never did. We have been trying to correct the incorrectible!
Inequalities have triggered dangerous consequences for us. Latin-American cities present the highest homicide rates in the world: sometimes they are even higher than in countries where full blown armed conflicts are going on. Furthermore, the diverse epidemiological profiles that characterize inequal societies frequently create complex demands that health systems are not able to adequately respond to. In Brazil, for instance, the unified health system should be prepared to deal with communicable diseases in the poorest regions, non-communicable diseases in the wealthiest ones, and should also be able to respond to the huge burden of intentional injuries. These demands could distort even the most effective health system.
So, why are we perpetuating an economic model that intrinsically generates inequalities?
It is true that if we want to move towards a better world we should directly try to address the political and economic causes underlying the present-day world. The collective health and Latin-American social medicine movement have been pushing these efforts for more than five decades emphasizing the necessity for structural change. With the post-MDGs, we now have an extraordinary opportunity to build a better world. The novel development goals should start from the bitter lesson we have learned in Latin-America: if we fail to modify the neoliberal economic model we will continue producing inequalities.
Finally, the new world we are heading for after the Millennium Development Goals should definitely include general aims (i.e. Universal Health Coverage) but should also include diverse strategies according to the context. That’s a second lesson we learnt over the years in this part of the world: in Latin-America we have been importing foreign solutions for too many years. It is time to make the best of our diverse traditions. It is time to build the new identity the new world requires, drawing on the wisdom from all parts of the world.