Int J Health Serv
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Obesity has reached global epidemic levels, and two-thirds of Americans are now either obese or overweight. But the U. S. government, along with the powerful food industry, is trying to thwart the World Health Organization's efforts, through its proposed Global Strategy on Diet, Physical Activity, and Health, to make even the most commonsense recommendations on diet.
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Health care systems spend a relatively high percentage of their resources on the purchase of medicines, and the poor spend a disproportionate amount of their income on pharmaceuticals. There is ample evidence in the literature that drugs are very poorly used. World Bank-led health reforms aim at improving equity, efficiency, quality, and users' satisfaction, and it will be difficult to achieve these goals without making medicines accessible and affordable. ⋯ The authors found that the World Bank identified and recommended a set of pharmaceutical policies that matched the needs of the region. But, as revealed through fieldwork and a review of the literature, the recommended pharmaceutical interventions were left out of the health reforms, and most of the loans that included pharmaceutical interventions allocated funds only to the purchase of drugs. The authors formulate four hypotheses that may explain the lack of congruence between the recommended policies and the strategies financed by World Bank health reform loans to the Latin American region.