Le bidonvile de Mathare au Kenya

Inequality seriously damages health

Rony Brauman

Medical doctor, specialized in tropical medicine and epidemiology. Involved in humanitarian action since 1977, he has been on numerous missions, mainly in contexts of armed conflicts and IDP situations. President of Médecins sans Frontières from 1982 to1994, he also teaches at the Humanitarian and Conflict Response Institute (HCRI) and is a regular contributor to Alternatives Economiques. He has published several books and articles, including "Guerre humanitaires ? Mensonges et Intox" (Textuel, 2018), "La Médecine Humanitaire" (PUF, 2010), "Penser dans l'urgence" (Editions du Seuil, 2006) and "Utopies Sanitaires" (Editions Le Pommier, 2000).

The main objective of the United Nations Development Millennium Goals - a consensus if ever there was one - is to end poverty. Wiping out illiteracy, ensuring access to safe drinking water and education, and reducing maternal and child mortality are seemingly unarguable aims.

And indeed, one can agree with the idea of redistributing wealth in the form of services to those who don't have them - that is, after all, the raison d'être of most NGOs - without being part of the political consensus behind it.

Poverty, measured by a variety of indices (income, access to services, etc.), is in reality defined only in relation to wealth, and not in absolute terms. We sense intuitively that material scarcity is only intolerable in comparison with abundance. Studies (on the biology of stress See Richard Wilkinson, Mind the Gap: Hierarchies, Health and Human Evolution. London: Weidenfeld and Nicolson, 2000, in particular) support this perception, showing that a feeling of social inferiority leads to chronic anxiety, itself the cause of various illnesses.

That's why the dizzying increase in the gap between the world's rich and poor over the past thirty years calls for other responses than those offered by the compassionate conservatism underpinning the millennium goals. Improving the lot of humanity is less about reducing poverty than about fighting inequality. For the poor to be less poor, the rich have to be less rich.

To cite this content :
Rony Brauman, “Inequality seriously damages health”, 23 septembre 2010, URL : https://msf-crash.org/en/blog/humanitarian-actors-and-practices/inequality-seriously-damages-health

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