Or Priorities Review, Richard Feachem’s work on the Health of Adults in the Developing World and Christopher Murray’s Global Burden of Disease Project ?that would prove to be the most influential in identifying chronic disease as an issue for the global South and reconfiguring the relationship between development levels, disease patterns and healthcare models (Feachem et al., 1992; Jamison et al., 1993; Murray and Lopez, 1996). There were many reasons for why the Bank’s efforts proved to be so influential. First, this was a time when the Bank’s investment in health-related projects grew exponentially, making it the world’s premier health institution and pushing the WHO to the sidelines (Brown et al., 2006; Chorev, 2012). Second, the Bank’s experts articulated a new understanding of the relation betweenD. Reubi et al. / Health Place 39 (2016) 179?development and disease that made it possible to think NCDs as an issue for LMICs. They suggested that one should stop classifying all developing countries together and recognise instead their growing economic and epidemiological diversity (Frenk et al., 1989; Jamison and Mosley, 1991). Specifically, complexifying Omran’s model, they recommended distinguishing between two groups of developing countries: (i) low-income, usually African or South Asian, countries typified by infectious diseases and malnutrition; and (ii) middle-income, mostly East Asian or Latin American, countries characterised by a Bay 41-4109MedChemExpress Bay 41-4109 double burden of both infectious and chronic diseases (Jamison and Mosley, 1991). It was this second group ?whose emergence was due to the success of existing PHC programmes at reducing infant mortality and changing patterns of risk such as unhealthy lifestyles generated by rapid urbanisation and rising incomes ?that was the novelty and allowed the Bank’s specialists to associate developing countries and chronic diseases for the first time (Bobadilla et al., 1993; Jamison et al., 1993; Mosley et al., 1993). Third, the claims about changing patterns of disease and development made by the Bank’s experts seemed to be supported by the new, allegedly more rigorous estimates of worldwide mortality and morbidity generated by Murray’s Global Burden of Disease project, something which was critical at a time when evidenced-based approaches were becoming all the rage (Murray and Lopez, 1996; Reubi, this issue). Fourth, the Bank’s experts ensured that the problem of NCDs in the global South gained traction by linking it with a question that came to Mitochondrial division inhibitor 1 site dominate the political agenda in most developing countries after the energy crises and global recession of the 1970s: how to finance healthcare systems in the face of mounting national debts and budgetary restrictions? (Rowden, 2009; Reubi, 2013). They did so through the notion of double burden of disease burden characteristic of the new, second group of developing countries, arguing that it would substantively add to the financial strain already impacting these countries’ healthcare systems (Frenk et al., 1989; Jamison et al., 1993). Fifth, unlike the WHO, the Bank was not wedded to PHC and was able to outline alternative healthcare models (Chorev, 2012). In particular, it argued that PHC programmes, with their focus on rural populations, infectious diseases and child and maternal health, had become too limited and called for a new healthcare model articulated around rational policies, epidemiological surveillance, cost-effective interventions focused on prevention a.Or Priorities Review, Richard Feachem’s work on the Health of Adults in the Developing World and Christopher Murray’s Global Burden of Disease Project ?that would prove to be the most influential in identifying chronic disease as an issue for the global South and reconfiguring the relationship between development levels, disease patterns and healthcare models (Feachem et al., 1992; Jamison et al., 1993; Murray and Lopez, 1996). There were many reasons for why the Bank’s efforts proved to be so influential. First, this was a time when the Bank’s investment in health-related projects grew exponentially, making it the world’s premier health institution and pushing the WHO to the sidelines (Brown et al., 2006; Chorev, 2012). Second, the Bank’s experts articulated a new understanding of the relation betweenD. Reubi et al. / Health Place 39 (2016) 179?development and disease that made it possible to think NCDs as an issue for LMICs. They suggested that one should stop classifying all developing countries together and recognise instead their growing economic and epidemiological diversity (Frenk et al., 1989; Jamison and Mosley, 1991). Specifically, complexifying Omran’s model, they recommended distinguishing between two groups of developing countries: (i) low-income, usually African or South Asian, countries typified by infectious diseases and malnutrition; and (ii) middle-income, mostly East Asian or Latin American, countries characterised by a double burden of both infectious and chronic diseases (Jamison and Mosley, 1991). It was this second group ?whose emergence was due to the success of existing PHC programmes at reducing infant mortality and changing patterns of risk such as unhealthy lifestyles generated by rapid urbanisation and rising incomes ?that was the novelty and allowed the Bank’s specialists to associate developing countries and chronic diseases for the first time (Bobadilla et al., 1993; Jamison et al., 1993; Mosley et al., 1993). Third, the claims about changing patterns of disease and development made by the Bank’s experts seemed to be supported by the new, allegedly more rigorous estimates of worldwide mortality and morbidity generated by Murray’s Global Burden of Disease project, something which was critical at a time when evidenced-based approaches were becoming all the rage (Murray and Lopez, 1996; Reubi, this issue). Fourth, the Bank’s experts ensured that the problem of NCDs in the global South gained traction by linking it with a question that came to dominate the political agenda in most developing countries after the energy crises and global recession of the 1970s: how to finance healthcare systems in the face of mounting national debts and budgetary restrictions? (Rowden, 2009; Reubi, 2013). They did so through the notion of double burden of disease burden characteristic of the new, second group of developing countries, arguing that it would substantively add to the financial strain already impacting these countries’ healthcare systems (Frenk et al., 1989; Jamison et al., 1993). Fifth, unlike the WHO, the Bank was not wedded to PHC and was able to outline alternative healthcare models (Chorev, 2012). In particular, it argued that PHC programmes, with their focus on rural populations, infectious diseases and child and maternal health, had become too limited and called for a new healthcare model articulated around rational policies, epidemiological surveillance, cost-effective interventions focused on prevention a.
