In interrogating the loaded question of ‘what ails the world’ within the field of public health, assessments of different world regions as well as historical, socio-political and economic contexts of countries will garner varying results in response to this question. Nevertheless, in examining broader conditions within medium and lower-income countries of the Global South, and as exemplified within some advanced-industrialized, and higher-income countries such as the United States, the issue of access to healthcare services, or otherwise access to health care infrastructure and resources, is the primary ailment in the field of public health administration. In particular, whereas a country such as the United States moved recently to expand access to Medicaid and other healthcare programs and services for low-income households through the Affordable Care Act, for most world regions, resources and infrastructure which would enable access to healthcare services is often sorely lacking. Overarchingly, for some of the world’s poorest populations, despite crusades by non-governmental organizations, foreign interests, and wealthy individuals from so-termed “First World” countries to “eradicate” various diseases from malaria to HIV/AIDS to polio in “Third World” countries, as it were, poor communities worldwide continue to significantly lack access to public health care facilities and resources.
In this view, before the treatment of any health condition, disease or epidemic can be executed in the world, basic infrastructure and resources must exist to accommodate the provision of services to individuals and communities. Unfortunately, however, in current world dynamics and hierarchies, a dearth of access to health care infrastructure— inasmuch as meagre access to health care facilities, health care personnel due to the “brain drain” of professionals, and meagre access to financial resource—is the principle ailment in the field of global, public health. The ailment and global epidemic of limited access to basic healthcare and educational services for most of the world’s population is undoubtedly linked to the economic ailment and dilemma of global income inequality and wealth distribution. In purview of global income inequality between countries of the Global North and Global South, inadequate access to resources whether in health care services or education comes to function as merely a side effect of imbalances in the distribution of global economic and human resources.
The ailment of inadequate health care access is not an absolute and given condition, it is a series of policy decisions by governments, multilateral organizations and the global community. With the breadth of technological, scientific and medical progress in the world, epidemics in the public health sector and access to health care resources ought to not be an ailment in the world. Nonetheless, market-oriented (as opposed to human-resource-oriented) policy prescriptions of the Washington Consensus, unbalanced terms of trade under neo-liberalism, and weak or corrupt institutions of governance within countries of the Global South, (who are often supported by powerful governments of the Global North), contribute to global income inequality. Global income inequality as an economic ailment, in turn, facilitates the public health ailment of unequal access to health care infrastructure and services within the world.