The Struggle for Health Medicine and the politics of underdevelopment

The first edition of The Struggle for Health was published in 1985 and was widely acclaimed by those seeking a broader and deeper political understanding of ill health, beyond the medical model of care. It was a revolutionary book, charting new ways of understanding and tackling the causes of ill health, and suggesting strategies to enable health for all. This second edition includes health problems that have emerged since the 1980s, notably HIV/AIDs, COVID-19, and other epidemics, and the increase in non-communicable diseases, such as cardiovascular disease and diabetes. It examines some of the health impacts of globalization, specifically on the food and pharmaceutical value chains, and considers the consequences of climate change on the health of populations. However, this edition does not depart from the core message of the original book: Health for All can only be achieved through a more equitable distribution of wealth, resources, and power. The Struggle for Health, Second Edition, utilises the same approach as the first, with a narrative that begins with diseases, then describes historical trends and the limitation of the medical (and commercial) model of care. At each juncture, it asks the question 'WHY' - why do people, especially children, still die in large numbers throughout the world, from wholly preventable diseases? Why is it that appropriate provision for health care is not available to every individual in the world? What changes can be made to improve this situation? Most importantly, this edition presents a strengthened call to action, building upon the original work and advocating for systemic changes to ensure justice and equity in health for all.

1 - Snapshots of (ill)health around the world
2 - Global disease patterns
3 - Health, population and inequality
4 - The medical contribution
5 - Health policies and health care in the context of neoliberal globalization
6 - The commercialization of health care: Medicine, business and the state
7 - Changing medicine, changing society

David Sanders, Emeritus Professor, was the founding Director of the School of Public Health, University of the Western Cape, South Africa; a founding member of the People's Health Movement (global and South Africa); Honorary Professor, Department Paediatrics and Child Health, University Cape Town. An internationally recognized academic, David managed to bridge the divide between academia, socialist politics and health activism. He was not afraid to speak truth to power in the pursuit of health justice, and inspired health care workers to see beyond curative care to the social and commercial determinants of health.