General Info - WPA Leadership / Executive Committee
MESSAGE FROM THE WPA PRESIDENT
Globalization and Mental Health
Despite promises of a more prosperous life for humanity, globalization has become an explosive and provocative term, in view of the major world discrepancies it has created. Globalization did not reflect itself as a one world government securing satisfactions to all. The financial and technological innovations that were supposed to bring the world together managed to create unprecedented crises. Economically, nearly a billion and a half people have no access to clean water, and a billion live in miserably substandard housing. Spiritually, as Gandhi said, many people are so poor that they can only see God in the form of bread. Morally, more than 40,000 children die each day from malnutrition and disease. Democratically, 1.3 billion people live on incomes of less than one dollar a day. As regards the efficiency of world leadership, wealth is allowed to be concentrated in fewer and fewer hands, so that the world's three richest individuals have assets that exceed the gross domestic product of the poorest 48 countries.
The impact of globalization on mental health was no different. Globalization of mental health should have meant globalization of ethics and human rights of mental patients, globalization of knowledge and technological progress conducive to mental health and globalization of access to mental health care. Globalization in psychiatry means equity in providing mental health services and outcome of research work to all mental patients. It should not mean globalization of the pharmaceutical industry where companies merge, creating a Mafia, to achieve the best profit possible, ignoring the needs of the poorer countries and poorer patients. Yet this is, unfortunately, today’s reality.
The mental health budget remains the Cinderella of the total health budget. While the total health budget represents 7-14% from the gross national product in industrial countries, it ranges from 1-5% in the developing ones. World Ban estimated that 80% of the total health budget in the world is spent on 10% of the population and 20% of the total health budget in the world is spent on 90% of the population with a health budget for individual USD 3500 in USA to one Dollar in some countries.
In summary, the gap is widening between the societies enjoying knowledge, technology and the ability to control events and other societies still backward, frustrated, helpless and unable to follow the progress and self actualization.
In 1999, the Ordinary General Assembly of the World Psychiatric Association approved the proposal made by the Nicaraguan Psychiatric Association regarding the preparation of "a continuous surveillance project on the effects worldwide of the economic adjustment policies which are being applied under different names in the countries with lowest per capita income, producing different negative effects over the mental health of the majority of the population, which is precisely the most necessitous". As a result, the WPA Executive Committee created the Task Force on Globalization and Mental Health chaired by Prof. Roger Montenegro, to produce a fair position statement on Globalization and Mental Health.
In 2002 the taskforce produced a Consensus Statement on Globalization and Mental Health which was endorsed by the General Assembly in Yokohama.
The statement called on all WPA components to raise public and government awareness that the effects of globalization will be optimized only when improvements in health and well-being become central objectives of national economic policy and the design and management of the international economic system; that mental health is part of public health, and the improvement of mental health through health promotion and service provision is part of the national and international public health agenda.
The statement appealed to psychiatrists to be in a position to actively shape policy, to form alliances nationally and internationally to lobby for a more equitable distribution of resources and quality of care, and to ensure that governments are aware of the implications for human rights of the effects of globalization on mental health and the lives of people with mental illness and their families.
‘As practitioners of medicine, we must be aware of the ethical implications of being a physician, and of the specific ethical demands of the specialty of psychiatry. As members of society, we must advocate for fair and equal treatment of the mentally ill, for social justice and equity for all.. We serve patients by providing the best therapy available consistent with accepted scientific knowledge and ethical principles.. We should be aware of and concerned with the equitable allocation of health resources’.
Such are the provisions of the Madrid Declaration, which we, members of the WPA, have endorsed and accepted as our professional ethical reference. Even when challenged with the obstacles imposed by globalization, we should remain committed to our mandate.
Prof. AHMED OKASHA
President WPA
President WPA
