Shifting drug spending from the worried well in rich countries to those with treatable disease in poorer nations will
benefit the health of everyone, argues a doctor in this week's BMJ.
Seventy per cent of the UK population is taking medicines to treat or prevent ill health or to enhance wellbeing. How can
this level of medicine taking be appropriate in a population which, by all objective measures, is healthier than ever before?
asks Dr Iona Heath.
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In a study of people living in Bihar (the poorest state in India) and the United States, rates of self reported illness were
disturbingly low in Bihar and enormously high in the United States. It seems that the more people are exposed to contemporary
health care, the sicker they feel, writes the author.
And as the overall health of a population increases, more money can be made from selling healthcare interventions for the
healthy majority than for the sick minority, she adds. For instance, weigh the huge amount invested in the vast bureaucracy
of health promotion in the UK against the waiting times for interventions of proved effectiveness and the neglect of care of
frail elderly people.
Are we sure that the balance sheet of preventive activity really offers more good than harm?
A tax on preventive drugs sold in rich countries could be used to fund drugs in poor countries, she suggests. This would
benefit people in both rich and poor countries.
Iona Heath, General Practitioner, London, UK
(Who needs health care-the well or the sick?)
bmj/cgi/content/full/330/7497/954