Health and Economic Development
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Health and Economic Development
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Health and Economic Development Arachu Castro and Paul Farmer
WHAT
IS
ECONOMIC DEVELOPMENT? Development A bridge with no river. A tall facade with no building. A sprinkler on a plastic lawn. An escalator to nowhere. A highway to the places the highway destroyed. An image on TV of a TV showing another TV on which there is yet another TV. Eduardo Galeano
Most development paradigms are evolutionist and rest on a belief in the inseparability of a number of processes. As societies “evolve” toward higher degrees of technical, economic, demographic, and political complexity, improvements in health and education necessarily follow for the majority of the population. The roots of modern theories of economic development can be traced to European social theory of the 18th century. In the early part of the century, Claude Henri de Rouvroy, Comte de Saint-Simon, set forth an organicist theory of social order. Blending scientific naturalism and the rationalism of the Enlightenment, this theory introduces the concept of an orderly progression of civilizations toward increasing levels of technological and economic advancement. Later in the century, a number of economists and philosophers—including Adam Smith, Thomas Malthus, Friedrich Hegel, and Jeremy Bentham—further promoted the idea of the
teleological evolution of societies. They were followed in the 19th century by figures such as Auguste Comte (1830), Herbert Spencer (1852), Karl Marx (1857/1964), Lewis Henry Morgan (1864/1965), and Fredrick Engels (1884/1902), who classified societies into different stages of development: evolution from one level to the next was considered a necessary step toward progress. This concept of evolutionary determinism was further developed by Darwin (1859/1964) in the biological sciences. Development, originally grounded in these ideas of progress and social evolution, could be achieved through technological achievements that could bring poverty— which was often termed “underdevelopment”—to an end. The management of poverty, as Escobar has noted, “called for interventions in education, health, hygiene, morality, and employment and the instilment of good habits of association, savings, child rearing, and so on” (Escobar, 1995, p. 23). In Europe, Asia, and in parts of the Americas, this new domain of social intervention (often at the national level) laid the groundwork for the developmentalist proje
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