Contenu du sommaire : Institutions et santé dans les pays en développement

Institutional Deficiencies and the Rationing of Access to Health
Services in Developing Countries: Markers and Challenges The economic analysis of the links between institutions and development is crucial with regard to the challenges linked to the health situation and the conditions of the access to health services of populations in disadvantaged countries. Besides the insufficiency of the aid for development, this paper puts emphasis on the major role of institutional deficiencies in explaining the persistence of the critical health situation of these populations. First, we analyze the causes and features of “internal” deficiencies within the developing countries themselves as well as those characterizing donator countries and multilateral organizations. We then examine the challenges and the conditions implied by the remedy of these institutional deficiencies.

Is health a global public good or a human right ?
This article analyses the bases and the meaning of the concepts of human rights and global public goods, in the field of health. We wonder about the relevance of two approaches, the first one considers health as a public good, and the second one is a “human rights based” approach. We try to underline the advantages of the second approach and to show that, despite the many declarations in favour of the human rights, the public good approach and the economic priorities are still prevailing in the world governance for health.

Socioeconomic trajectories of health systems regulation indeveloping countries: an institutionalist issue. The aim of this article is to revisit health policies trajectories in low developing countries, using a socioeconomic framework. Firstly, one remarks several stylized facts wich draw the trend of such trajectories. Secondly, we try to give a sense to evolutions of health policies in developing countries, highlighted with the conventionalist socioeconomic "grammar", developed by L. Thévenot and L. Boltanski. This permits to consider that the analysis of health policies in developing countries is an institutionalist issue.

Health systems in low-income countries :towards a revision of institutional arrangements ? Low-income countries face numerous challenges in the health sector. Resources currently dedicated to health services are insufficient and there is a need for an increase in the efforts from the North. Yet, a reflection on the way health systems are organised in the South is required as well. A reconfiguration of the institutional arrangements structuring health systems raises several questions. This article reviews a few of them and advocates that the reform of the health sector gets more attention.

Access to AIDS Treatments in Africa:Analysing Multinationals Patent strategy According to Attaran and Gillespie-White (2001), there is no link between patents and poor access to HIV/AIDS treatments in Africa since multinationals patent a few. Questioning what the authors call the rule and the exceptions, this paper shows that multinationals use patents as entry barriers towards southern generics producers, which impedes access to medicines and hinders the industrial development of these generics producers.

Healthcare accessibility in Mauritania :Capabilities approach and institutional stakes Mauritania has developed specific health policies for a long time. The country remains, however, highly affected by strong inequalities and difficulties concerning healthcare accessibility. In a first section, we propose an analytical framework following the capability approach and A. Sen ‘s works. We focus on different forms of accessibility in the case of healthcare. In a second section, we illustrate this framework using mauritanian data. Finally, we conclude on the idea of health threshold as reference mark for local population accessibility to health.

Which system of financing of the access to the care of the populations in the developing countries? The case of the districts of health in Burkina Faso

The implementation of cost-recovery and the unequal distribution of health care services between cities and countryside, explain the reduction in health care access in Burkina Faso. To face this context it is necessary to reconsider the manner in which health districts are financed and to reduce the household contribution to a level compatible with the ability to pay for the majority of the population. Without this change, the system will continue to produce serious social inequalities. Patients will seek services in the private sector, or among traditional practitioners causing the public system to decline further and finally producing less services and health resources.

Another Globalization : Changes In The Present Laudering Money Process
In this article, we notice three major mutations which caracterize today the forms of concealing and integrating the illegal funds : the emergence of offshore finance centers, the formation of financial underground networks and the presence of skilled launderers represent the main trends of this illégal financial activity. It is very important to take into account these last mutations for understanding better and perhaps controling the recent development of the money laundering. The author concludes emphasizing the risk that legal private business as public economy need in the futur more and more ressources from criminal organizations.