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BY: LISA SOWLE CAHILL, PhD

Dr. Cahill is J. Donald Monan Professor, Theology Department, Boston College, Chestnut Hill, MA.

The majority of the Earth's people lack what most Americans would consider the essentials of a healthy life. Half the people in the world — nearly three billion — live on less than $2 a day. About 790 million people in the developing world, almost two-thirds of them from Asia and the Pacific, are chronically undernourished. Lack of access to clean water and basic sanitation are huge causes of disease and death, especially for young children. According to UNICEF, 30,000 children die daily from poverty; 1.8 million die every year from diarrhea.

It would take about $9 billion in additional funds to provide water and sanitation for all in the developing world, $12 billion to provide women with medical care needed for pregnancy and childbearing, and $13 billion to cover basic health and nutrition. Now consider this: Europeans spend $11 billion a year for ice cream. Americans spend $8 billion a year for cosmetics. The United States and Europe combined spend $12 billion for perfumes. We Americans and Europeans spend $17 billion for pet food. And world military spending has risen to an incredible $780 billion.¹

Key to Catholic Activism
The key to Catholic activism for change in the current worldwide system of health care injustice is Catholic social teaching. Catholic social teaching is centered on the concepts of, first, the dignity of the person and, second, the common good. According to the modern papal social encyclicals, people have an inherently social nature, entailing both rights and responsibilities to others and to society.² Every person has a right to share in the benefits of the common good; but everyone also has a right and a duty to contribute one's share to the welfare of others, to the whole community, and even to the global community of humankind, especially the least well-off and most vulnerable.

Since the Second Vatican Council, the common good has been restated as the "universal common good." The common good belongs to "the entire human family," since everyone is made in the image of God and is entitled to "everything necessary for leading a life truly human."³ Catholic social teaching stresses that there is an international political and economic responsibility to protect the common good, a responsibility often tied to international government as embodied by the United Nations.⁴

But Catholic social teaching is not just a theory. Its values and ideals are embodied in a vibrant tradition of Catholic social action. It demands participatory and democratic political action aimed at improving the conditions of social life on which the common good depends. This means that, across all levels of society and politics, everyone committed to health care justice should become an advocate for more just national and international policies and practices. Such action includes empowering people in marginalized communities to become advocates on their own behalf.

In 2000, the United Nations Millennium Declaration set goals to improve the health picture for the world's poorest. It called world leaders to achieve, by 2015, a reduction by half of those living in extreme poverty or without access to safe drinking water. It aimed to reduce perinatal mortality by three-quarters and to reduce infant mortality by two-thirds. It called for a halt to the spread of HIV/AIDS, malaria, and other diseases of the poor, and for empowerment of women as a major way to combat poverty, hunger and disease for entire families and communities. Yet only five donor countries have thus far made significant levels of progress toward the aid promised to meet these goals. Although the United States has given the most in dollar amounts, that must be considered in view of the fact that, of the major donor countries, it has given the smallest percentage of its national income.⁵

A Special Responsibility
We who live in "developed" nations have a special responsibility to ensure that our own high quality of life — including access to high-tech and innovative medical care and general economic and cultural prerogatives — is not enjoyed at the expense of those around the world who lack access to the basic necessities of life. Pope John Paul II spoke out against the "unacceptable gap that separates the developing world from the developed in terms of the capacity to develop biomedical research for the benefit of health care assistance and to assist peoples afflicted by chronic poverty and dire epidemics."⁶ To accept the status quo of poverty and exploitation, he said, is "to commit an injustice and fuel a long-term threat for the globalized world."

To avoid committing such an injustice, we must take a closer look at research dollars spent on tests and therapies that will benefit only those fortunate enough to live in rich countries, or to have substantial incomes or good health insurance. We should also show an attitude of healthy criticism toward economic and military policies that serve our "national self-interest" but erode the living conditions of the developing world. We must make sure that U.S. policies do not define development or channel funds in ways that neglect education, nutrition, and health care for girls and women. Typically, women are responsible for conserving family resources; for providing food and water; and for care of children, the sick, and the elderly. The economic and social empowerment of women is one of the best ways to build up the health and resources of communities struggling to escape poverty.

Pope John Paul II makes a special point of holding up the example of Christ's commitment to the poor and of exhorting societies as a whole (not just their Christian members) to practice the social virtue of "solidarity." "Solidarity responds morally to the growing interdependence among all individuals and nations that is the hallmark of globalization. Solidarity is not a feeling of vague compassion or shallow distress at the misfortunes of so many people, both near and far. On the contrary, it is a firm and persevering determination to commit oneself to the common good; that is to say, to the good of each and every individual, because we are all really responsible for all."⁷

Toward Global Health Justice
What does this "firm and persevering determination" look like in practice? At the international level, Catholic organizations such as Catholic Relief Services, Caritas International, an international Catholic organization called CIDSE (International Cooperation for Development and Solidarity), the lay organization Sant'Egidio, Jesuit Refugee Services, Maryknoll, and even the Vatican, are active in trying to provide health-related services and to change worldwide spending patterns and national and international policies. A key example is Catholic involvement in international activism around the AIDS crisis, both to provide services to AIDS victims and to advocate making patented drugs available at lower prices for lower-income persons and nations. Although the Catholic Church is probably better known for its opposition (which may be diminishing*) to the use of condoms to prevent HIV transmission, it is equally true that the church is the single greatest provider of services to AIDS victims in the world. Vatican spokesmen have also publicly criticized international trade rules that prevent access to life-saving drugs for AIDS and other diseases.

*The African bishops' conference, SECAM, published a 2003 pastoral letter, Our Prayer for You Is Always Full of Hope, in which it asserted that the use of condoms to prevent AIDS is a matter of conscience. Reportedly, Pope Benedict XVI has established a commission to reconsider the morality of condom use for the purpose of preventing infection.

Pope John Paul II appreciated that the common good includes health care and protection from risk of disease. He applied this specifically to AIDS, saying "care and relief centers for AIDS patients" can "give everyone new reasons for hope and practical possibilities for life."⁸ Before most people realized the magnitude of AIDS as an international crisis, John Paul II asserted that:

AIDS threatens not just some nations or societies but the whole of humanity. It knows no frontiers of geography, race, or age or social condition. The threat is so great that indifference on the part of public authorities, condemnatory or discriminatory practices toward those affected by the virus or self-interested rivalries in the search for a medical answer should be considered forms of collaboration in this terrible evil which has come upon humanity.⁹

In 2004, a Vatican representative excoriated international pharmaceutical companies whose patents, protected by the World Trade Organization, keep the price of necessary drugs out of reach of the poor.¹⁰

A Catholic ethic for global health care must respect the dignity and empower the agency of all those affected by poverty and disease. It must involve local, regional, national, international, transnational, and global actors to act in solidarity with those who suffer. And it must mobilize Catholics at every level to act for the global common good by affirming health care as a Christian duty and a human right and by adopting the option for the poor as the first step toward global health justice.

NOTES

1. "Poverty Facts and Stats," Global Issues (www.globalissues.org/TradeRelated/Facts.asp), accessed February 1, 2007.
2. On the social encyclicals, see Kenneth R. Himes, ed., Modern Catholic Social Teaching: Commentaries and Interpretations, Georgetown University Press, Washington, DC, 2005.
3. "Gaudium et Spes," in Austin Flannery, ed., Vatican Council II: The Conciliar and Post-Conciliar Documents, vol. 1, Costello Publishing, Northport, NY, 1975, paras. 24-26.
4. Pope Paul VI, Populorum Progressio, 1967, paras. 76-78.
5. See UN Development Project, Investing in Development: A Practical Plan to Achieve the Millennium Development Goals, January 2005 (www.millenniumproject.org.orunmp.forumone/eng_html_03.html) accessed June 2005.
6. Pope John Paul II, quoted in Catholic Health Association, Genetics, Science, and the Church: A Synopsis of Catholic Church Teaching on Science and Genetics, St. Louis, 2003, p. 7.
7. Pope John Paul II, Sollicitudo Rei Socialis, para. 38, in David J. O'Brien and Thomas A. Shannon, eds., Catholic Social Thought: The Documentary Heritage, Orbis, Maryknoll, NY, 1992, p. 421.
8. Pope John Paul II, Evangelium Vitae, 1995, para. 88.
9. Pope John Paul II, quoted in "Live and Let Live," a statement of the Catholic Agency for Overseas Development (CAFOD) for the World AIDS Campaign 2003-4 (www.cafod.org.uk/public_policy_and_analysis /
   policy_papers/hiv_and_aids/live_and_let_live). The pope made the statement while on a trip to Tanzania in September 1990.
10. "Vatican Condemns AIDS Drug Firms," BBC News, January 29, 2004 (http://news.bbc.co.uk/2/hi/europe/3442217.stm).

The next installment of "Thinking Globally," to be published in the July-August issue of Health Progress, will feature the Hospital Sisters Mission Outreach, based in Springfield, IL. This program distributes donated medical equipment and supplies — much of it recycled from U.S. health care facilities — to clinics and hospitals in developing countries, expanding health care to people in need.