Almost everywhere the poor suffer poor health and the very poor suffer appallingly. Addressing this problem, both between countries and within countries, constitutes one of the greatest challenges of the new century. Failure to do so properly will have dire consequences for the global economy, for social order and justice, and for civilization as a whole. A major focus on the health of the poor is now evident in the strategies of the major international and bilateral development agencies and of those governments that have a clearly articulated health strategy. This is appropriate and important.
Poor health is a common consequence of poverty and poverty can be a consequence of poor health.
The vicious cycle takes its inexorable toll. Recent thinking has sought to bring health to the centre of the development debate by asserting that poor health is a component, rather than a consequence or cause, of poverty. This is a desirable trend but caution is necessary. Low income is clearly a necessary and sufficient condition of poverty, but poor health is neither. It is the explicit goal of many health sector interventions to transform poor unhealthy populations into poor healthy populations, thus breaking the link between disease and poverty.