| Abstract: |
This chapter is organized into two parts. Part I shows how healthcare systems - set up in a period when infectious diseases were dominant - have locked in a focus on treating acute-care episodes. It further demonstrates how global health has come to focus a narrow set of low-cost, magic-bullet solutions, based on historical successes in eradicating smallpox. It argues that these healthcare systems and this smallpox paradigmare inappropriate for caring for people who have chronic, long-term illnesses, and reveals an alternative model of 'liberatory medicine' based on chronic care models that could improve patients' outcomes at lower cost. Part II reveals that public health initiatives have been skewed towards medical interventions rather than preventative approaches. This has manifested itself in major gaps in the research base for understanding how chronic diseases can be prevented at low cost. Nevertheless, it is argued that, despite gaps in the evidence base, there are a clear set of proven strategies to reduce the suffering and occurrence of chronic diseases in an entire population. © Oxford University Press, 2011. All rights reserved. |
