Industrial development as a social determinant of health: historical reflections from Tanzania and Zimbabwe
Bio: Maureen Mackintosh is Professor of Economics at the Open University, and a development economist specialising in the economics of markets for health care and medicines, with particular reference to African health systems. She is PI on a collaborative research project with Tanzanian, Kenyan, Indian and UK colleagues called “GCRF Inclusive societies: How to link industrial and social innovation for inclusive development: lessons from tackling cancer care in Africa“, funded by the UK ESRC. Recent publications include Mackintosh, M. Banda, G. Tibandebage P and Wamae, W. (eds) (2016) Making Medicines in Africa: the Political Economy of Industrializing for Local Health Palgrave Macmillan open-access.
Abstract: It is a commonplace that the health-related industries – i.e the manufacturing of pharmaceuticals, medical supplies and medical devices, their marketing techniques, and the nature and sources of the underpinning research – have shaped and transformed the organisation, behaviour and outcomes of health systems across the world since 1945. Yet the industrial structure of these industries, globally and nationally, their ongoing transformations, and the consequent reshaping of health systems and health outcomes – including huge inequities – through industrial influence, is a striking absence within the large literature on the social determinants of health since the 2008 landmark report, Closing the Gap in a Generation. This seminar, based on ongoing work with Geoffrey Banda, Julius Mugwagwa, Smita Srinivas and Paula Tibandebage, uses historical evidence, and a historical political economy framework of analysis, to bring this inter-sectoral relationship out of the shadows for Tanzania and Zimbabwe from their colonial eras. The seminar explores evidence for two propositions: that the co-evolution of health-related industries and health services locally, in each of these two countries, is a driver of health care access and outcomes; and second, that the particular evolution of the local industrial and health sectors is deeply embedded in the local political economy context. It ends with some reflections on implications for local health and industrial policy.