Health-Care For All: History of a ‘Third-World’ Dilemma

In the 1960s to 1980s, a heated controversy arose as to how best medical care could be delivered to individuals living in rural ‘third-world’ communities. This became polarised: should the national health budget be directed to primary health care with the exclusion of tertiary care (including hospitals)? This became confused with the training of medical personnel, including doctors. Of course, a balanced approach is what is required.

Now that the NHS under the present government is rapidly becoming oriented towards primary health care, this third-world controversy of nearly half a century ago might well be worthy of consideration. After a decade, and more, working in Nigeria, Uganda, Zambia and Saudi Arabia, as well as in Papua New Guinea, the author became increasingly convinced that a balanced viewpoint, i.e. between curative and preventive medicine was both essential and the only way forward in both developing and developed countries. That is a simple ‘message’ and the underlying theme in this book.

About the author: Professor Gordon Cook, DSc, MD, FRCP is a physician with a special interest in tropical and infectious diseases, and a medical historian; he was formerly a Medical Specialist, Royal Nigerian Army; Lecturer in Medicine, Makerere University, Uganda; Professor of Medicine, The University of Zambia; Professor of Medicine, Riyadh University, Saudi Arabia; Professor of Medicine, The University of Papua New Guinea; Visiting Professor of Medicine, The Universities of Basrah and Mosul, Iraq; and Visiting Professor, Quatar.