Lancet Comment: 2013, An Anniversary, and a Time to Take Stock

“The past is something best forgotten; only in theory is it the father of the present. In practice, it is only a wildly unrelated dream, a chamber of horrors.” So concluded Tom Rath is Sloan Wilson's classic modern novel, The Man in the Gray Flannel Suit. It's a harsh judgment—as befits a book that seeks to expose the futility of the corporate rat-race—but nevertheless reminds us that rarely are the predicaments of today simply, or linearly, connected to events of the past. 2013 is the 20th anniversary of one of the most celebrated—and vilified—reports in the history of health. The World Development Report 1993 (entitled, benignly, Investing in Health) is not a “chamber of horrors”.

 

There is much in it that one would wish now to celebrate as visionary. A resolute concern with using the fruits of economic growth to benefit the poor. An emphasis on investing in education, especially for girls. Promoting and protecting the political and economic rights of women. Shifting spending on health away from tertiary facilities and more towards primary care and public health. Ensuring the delivery of cost-effective packages of care. And strengthening the administration of health services. Many contemporary concerns in global health—making pregnancy safer, tobacco control, and aid effectiveness—are all prefigured in this most important of World Bank reports, written by a team led by Dean Jamison. But there is a but. More