Harare — EVERY day we read about financial crises. New phrases have been invented, like quantitative easing (a euphemism for stealing from the workers or less unit of the currency), bank bailouts, stimulus packages etc.

The unfair distribution of power, money and resources determines what sort of health an individual, family, community or a country may face in the short term, because modern health care has become a commodity, like biscuits, rather than a human right, like sunlight.

Each country has put forward its own ideas on how to deal with financial crisis. Most popular notions advocate that all spending must be curtailed.

But, realising the current inequality in access to health, will that not result in a two-tier health service?

The IMF maintains that the financial crisis is hitting the real economy very hard.

Several health studies have shown unequivocally, that wealth (that does not mean income only) is closely related to the degree of ill health. The downturn in economic activity in every country means that more people will be economically poor.

The ILO predicts that the global unemployment rate will rise from 5,7 percent of the employable population, worldwide, in 2007 to above 7 percent in 2009, and this equates to about 50 million people more being unemployed.

In rich countries, such as the UK, European Union, the US and Japan, unemployed people are protected by social safety nets. In poorer developing countries, no work means starvation or destitution or dependence on donor funding.

Even the poorest worker will also suffer as the value of the US$ is planned to decrease, thereby resulting in an increase of the "brain drain" to more developed countries.

Even when one can get a job, the pay may not cover basic expenses, a fact brought home forcibly to civil servants on a monthly allowance of US$100.

The World Bank predicts in 2009 the working poor will be of the order of 800 million people, and these will need help if they get ill.

More sinisterly, the decline in earning capacity will mean a country like Zimbabwe will no longer determine policies; rather, that health policies will be determined for them by global NGOs, un-elected and under experienced organisations and no health workers.

In other words, the health service will be determined rather by cost than real need, and it is not difficult to predict whether the former banker or former house worker will find it hardest to meet basic needs.

Globally the effects of the economic downturns are even more severe. I include three more contrasting pictures, which I think can speak for themselves.

The different policy of economic global order since 1980 illustrates the reality on the ground, especially the failure of markets to deliver global public goods and protection of the environment, and is now very clear.

It is time for a new plan, which has equity at its heart, and the obscene income inequality we have seen both between and within countries are not justified morally, politically, or on the basis of security.

This is the opportunity for us to change from more and more selfishness and material acquisition to caring for people who have less opportunity than ourselves.

In other words, it is about "a new deal," -- investing in measures that improve the quality of life for everybody.

It is always amazing to me that the economists never learn from past mistakes and are only led by financial indicators. It would be unwise to leave solutions to economic crisis to economists alone.

After all, they are the ones, primarily, who got us into the mess. We must learn to work together for the benefit of all in the society.

The WHO found that it would cost US$100bn to upgrade the World slums, and a few months ago, that amount was too big for any organisation to source.

Yet more than 5 trillion (US$5 000 billion for those who cannot see the dishonesty of World Politics) have been found quickly to bail out the financial sector of rich countries.

Also we need to look in global health at rapid progress toward the ideas that promote vertical health, disease-based approaches. They cannot work effectively. I am not alone in believing this.

The "big three" of Aids, TB, and malaria have diverted resources and staff from the basic Primary Health Care system of the country. As one contributor to the recent College of Primary Care Physicians Symposium in Masvingo put it, you cannot put the roof on a house before you lay the foundation.

Is male circumcision (because it has the money) more important than maternal mortality? I think the idea of "front loading" international aid donation by raising the money in the capital markets for urgent needs -- with the promise of the Government from development assistance for immediate initiatives (from donors and NGOs) in future years, thus protecting both taxpayers in rich countries and unemployed in poorer countries -- seems to present one solution.

I quote from an article by Andrew Jack, who attended as a pharmaceutical correspondent, the G20 meeting in Washington:

"Ultimately, the new climate requires far greater co-operation between donors, combining resources to operate joint programmes, sacrificing duplicative and time consuming reporting requirements and a selfish obsession with planting their own flags on projects.

"It demands restructuring and greater collaboration between implementing agencies, including non-governmental organisations working in the field. It also requires greater rigour, transparency, and an insistence from donors to seek greater accountability through independent assessments of how well their money is being spent.

"A recent study on UNAIDS, for instance, argued the need for more focus on evidence-based techniques in its spending."

We as Zimbabweans are used to addressing challenges in effectively overcoming the causes.

We need to urgently formulate long-term policies for Health, which are owned by all Zimbabweans and benefits us all.