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In: Resources, environment, and population: present knowledge, future options, edited by Kingsley Davis and Mikhail S. Bernstam. New York, New York/Oxford, England, Oxford University Press, 1991. 25-43. (Population and Development Review. Vol. 16. Supplement)Sustainable development is a relatively new economic term in the common vocabulary. Above all it is important to realize the critical difference between growth and development. In the past growth has been viewed as the ideal and as such all our economic measuring systems are based upon it. However, measuring the circular flow of exchange value makes it impossible to take into account the effect upon the environment that growth has. This old method was suitable in the past because of a misperception that growth is unlimited. A better way of measuring economics is to examine the entropic throughout of matter/energy. This system of measurement is consistent with the 1st and 2nd laws of thermodynamics and consistent with the fact that we live in a finte world with finite resources. Thus, the old system only measures the scale but not the allocation of resources and per capita consumption. While the independence of allocation from distribution is widely known, the independence of allocation from scale is not. No matter how large the population or per capita consumption rate, an optimal allocation will be found for every scale. Yet measuring scale is of critical importance. If a ship is overloaded, it does not matter how evenly distributed the load is, it will sink. Some method must be devised and implemented which will keep economic scale within the limits of ecological carrying capacity. Achieving sustainable development will require some rethinking and a change of priority. Thus, qualitative improvement could be labeled development, and quantitative improvements could be labeled growth. Thus a steady state economy could continue to develop without growing. This is how planet Earth operates and economics is just another open system that must be allowed to develop without growing.
Assessment and implementation of health care priorities in developing countries: incompatible paradigms and competing social systems.
Social Science and Medicine. 1984; 19(4):373-84.This paper addresses conceptual issues underlying the assessment and implementation of health care priorities in developing countries as practiced by foreign development agencies coping with a potentially destabilizing unmet social demand. As such, these agencies mediate the gap between existing health care structures patterned around the narrow needs of the ruling classes and the magnitude of public ill-health which mass movements strive to eradicate with implications for capitalism at large. It is in this context that foreign agencies are shown to intervene for the reassessment and implementation of health care priorities in developing countires with the objective of defending capitalism against the delegitimizing effects of its own development, specifically the persistence of mass disease. Constrained by this objective, the interpretations they offer of the miserable state of health prevailing in developing countries and how it could be improved remains ideological: it ranges between "stage theory" and modern consumption-production Malthusiansim. Developing countries are entering into a new pattern of public health which derives from their unique location in the development of capitalism, more specifically in the new international division of labor. Their present position affects not only the pattern and magnitude of disease formation but also the effective alleviation of mass disease without an alteration in the mode of production itself. In the context of underdevelopment, increased productivity is at the necessary cost of public health. Public health improvement is basically incompatible with production-consumption Malthusianism from which the leading "Basic Needs" orientation in the assessment and implementation of health care priorities derives. Marx said that "countries of developing capitalism suffer not only from its development but also from its underdevelopment." (author's modified)