The Health of Nations: Towards a New Political Economy

By Gavin Mooney. London: Zed Books, 2012. ISBN: 978-1-780320-601-hb.

The Health of Nations: Towards a New Political Economy is highly critical of the structurally unjust world we live in and its failure to address the global burden of disease. In clear, concise language, Gavin Mooney ably explains the reasons for global ill health and offers viable solutions. The book is sharp and crisp, highly informative and makes compelling reading from the very first page.

In this slim-volume, 212-page book, Mooney deals with the global response to ill-health, criticising macroeconomic and global economic systems from the perspectives of neoliberal political economy. He also demonstrates that neoliberalism fosters individualism and inequality, which are bad for health, and shies away from solidarity and social cohesion, which are good for health.

There are six parts to the book. Part I, the introduction, deals with neoliberalism and its impact on global health, and Mooney very aptly demonstrates that neoliberalism ‘kills’. He starts off by asking why, in an astoundingly wealthy world, there is so much ill health and premature death, and states upfront that there must be a terrible problem with healthcare systems and societies. Mooney goes on to highlight the huge disparities between the rich and poor and the fact that poorer countries are more likely to have smaller proportions of their healthcare resources in the public sector. He also emphasises that privatisation of healthcare in poor countries is encouraged by the rich West and by global institutions like the World Bank.

Part II analyses the problems underlying healthcare and health, as well as the policies that deal with them and why these are failing. Mooney places a great deal of blame on the capitalism that results from neoliberalism, which has direct economic consequences for health and also negative impacts on the social aspects. He shows how neoliberalism dominates global institutions, breeds inequality and individualism and suppresses a sense of community. Part III uses a series of case studies to illustrate these points, ranging from the country-specific to those related to organisations.

In contrast, Part IV proposes a communitarian approach to the problems of global ill health. It argues that the communitarian model offers a new political economy of health by providing more egalitarian and caring societies at all three levels – local, national and global. Healthcare systems will be transformed into social institutions, where citizens will be empowered to make decisions about social determinants of health. Part V presents case studies to demonstrate the positive impact of community participation in Kerala, India; the Cuban focus on strengthening the social determinants of health; and the influence that empowered communities have had on health in Venezuela.

Part VI concludes with the need for urgent reform, both within individual countries and at the level of global institutions like the World Bank.

Ames Dhai ( amaboo.dhai@wits.ac.za)

S Afr J BL 2013;6(2):72. DOI:10.7196/SAJBL.292