The Sachs report: Investing in Health for Economic Development--or increasing the size of the crumbs from the rich man's table? Part I.

The Commission on Macroeconomics and Health report (Sachs report) of 2001 has been heralded as inspiring and groundbreaking and is being adopted as the blueprint for global health policymaking. This article argues that the report is deeply conservative and unoriginal. It encourages medico-technical solutions to public health problems; it ignores macroeconomic determinants and other root causes of both poor health and poverty; it reverses public health logic and history; it is based on a set of flawed assumptions; it reflects one particular economic perspective to the exclusion of all others; and it recommends greater amounts of charity while preserving the status quo of a deeply unjust and irrational international economic order. A set of assumptions deriving from a neoliberal approach to health underlies the report. The author proposes an alternative set of assumptions deriving from a social justice and human rights-based approach to health.