Interrogating scarcity: how to think about 'resource-scarce settings'

Health Policy Plan. 2013 Jul;28(4):400-9. doi: 10.1093/heapol/czs071. Epub 2012 Aug 16.


The idea of resource scarcity permeates health ethics and health policy analysis in various contexts. However, health ethics inquiry seldom asks-as it should-why some settings are 'resource-scarce' and others not. In this article I describe interrogating scarcity as a strategy for inquiry into questions of resource allocation within a single political jurisdiction and, in particular, as an approach to the issue of global health justice in an interconnected world. I demonstrate its relevance to the situation of low- and middle-income countries (LMICs) with brief descriptions of four elements of contemporary globalization: trade agreements; the worldwide financial marketplace and capital flight; structural adjustment; imperial geopolitics and foreign policy. This demonstration involves not only health care, but also social determinants of health. Finally, I argue that interrogating scarcity provides the basis for a new, critical approach to health policy at the interface of ethics and the social sciences, with specific reference to market fundamentalism as the value system underlying contemporary globalization.

Keywords: Resource allocation; globalization; health ethics; justice; scarcity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Delivery of Health Care / ethics
  • Developing Countries / economics
  • Health Policy
  • Health Resources / supply & distribution*
  • Policy Making
  • Social Justice