Abstract
BackgroundIn a restricted sense, the resource curse is a theory that explains the inverse relationship classically seen between dependence on natural resources and economic growth. It defines a peculiar economic and political environment, epitomised by oil extraction in sub-Saharan Africa.MethodsBased on secondary research and illustrations from four oil-rich geographical areas (the Niger Delta region of Nigeria, Angola, southern Chad, Southern Sudan), I propose a framework for analysing the effects of the resource curse on the structure of health systems at sub-national levels. Qualitative attributes are emphasised. The role of the corporate sector, the influence of conflicts, and the value of classical mitigation measures (such as health impact assessments) are further examined.ResultsHealth systems in a resource curse environment are classically fractured into tripartite components, including governmental health agencies, non-profit non-governmental organisations, and the corporate extractive sector. The three components entertain a range of contractual relationships generally based on operational considerations which are withdrawn from social or community values. Characterisation of agencies in this system should also include: values, operating principles, legitimacy and operational spaces. From this approach, it appears that community health is at the same time marginalised and instrumentalised toward economic and corporate interests in resource curse settings.ConclusionFrom a public health point of view, the resource curse represents a fundamental failure of dominant development theories, rather than a delay in creating the proper economy and governance environment for social progress. The scope of research on the resource curse should be broadened to include more accurate or comprehensive indicators of destitution (including health components) and more open perspectives on causal mechanisms.
Highlights
In a restricted sense, the resource curse is a theory that explains the inverse relationship classically seen between dependence on natural resources and economic growth
The theoretical framework behind this observation relies on the concept of 'rentier state', whereby governments in a capacity to rule in the absence of a functioning tax system are less accountable for misallocation of resources and poor governance
The analysis addresses the nature of contractual relationships between these categories of agencies, in an attempt to see how much they can contribute to the build-up of a coherent and equitable health system
Summary
The resource curse is a theory that explains the inverse relationship classically seen between dependence on natural resources and economic growth It defines a peculiar economic and political environment, epitomised by oil extraction in sub-Saharan Africa. Social indicators of development have shown utterly slow progress over the last one or two decades, as SSA is clearly lagging behind other parts of the world [3] Marginalised in their pursuit of traditional lifestyles, settled at the insecure margins of fast expanding urban landscapes, or driven in an apparently inescapable transition between both conditions, large segments of sub-Saharan populations are still living in extreme poverty whilst stepping on untapped wealth. Considering the broader links that health systems entertain with economic, political and social contexts, resource curse theories are a necessary entrance gate for health system research in mineral-rich areas impacted by extractive industries
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