A Fundamental Shift in the Approach to International Health by Who, Unicef, and the World Bank: Instances of the Practice of “Intellectual Fascism” and Totalitarianism in Some Asian Countries

Abstract

Navarro has used the term "intellectual fascism" to depict the intellectual situation in the McCarthy era. Intellectual fascism is now more malignant in the poor countries of the world. The Indian Subcontinent, China, and some other Asian countries provide the context. The struggles of the working class culminated in the Alma-Ata Declaration of self-reliance in health by the peoples of the world. To protect their commercial and political interests, retribution from the rich countries was sharp and swift, they "invented" Selective Primary Health Care and used WHO, UNICEF, the World Bank, and other agencies to let loose on poor countries a barrage of "international initiatives" as global programs on immunization, AIDS, and tuberculosis. These programs were astonishingly defective in concept, design, and implementation. The agencies refused to take note of such criticisms when they were published by others. They have been fascistic, ahistorical, grossly unscientific, and Goebbelsian propagandists. The conscience keepers of public health have mostly kept quiet.

Delivery of priority health services: searching for synergies within the vertical versus horizontal debate

“…Banerji (1999) argues that vertical programmes do not promote community self-reliance. He also claims that global vertical programmes may not take into account variations among and within countries, ignoring the possibility that a onemodel-fits-all approach will not be feasible and that local contexts need to be taken into consideration during planning and implementation.…”

The potential for multi-disciplinary primary health care services to take action on the social determinants of health: actions and constraints

“…In this context the potentially redistributive role of PHC in dealing with underlying causes is inevitably controversial and contested, uncomfortably positioning PHC services as one of the key meeting points between biomedicine and sociological understandings. Comprehensive PHC may be opposed because it is perceived to be (and may actually be in practice) threatening to the social, economic and political status quo given that its aim is to reduce health inequities by challenging the inequitable structures which underpin them [16,23]. This position raises many questions for the ways in which PHC services are able to respond to SDH and what factors support or impede responses.…”

“The problem is ours, it is not CRAIDS’ ”. Evaluating sustainability of Community Based Organisations for HIV/AIDS in a rural district in Zambia

“…Atun et al [52] suggest that limited evidence does not allow for clear conclusions about when vertical approaches are desirable. Specifically in relation to sustainability, two studies [53,54] found that vertical programmes create unfavourable conditions for sustainability once donor funding ceases, and a decrease in community self-reliance. The limited evidence shows that vertical programmes are effective as a temporary time-limited measure (the key term here is temporary).…”