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Public health is top priority in Uganda (part II)

Last week we responded to a piece titled “Without Health, Uganda Can’t Achieve Wealth” – authored by the United States ambassador to Uganda, Deborah R Malac.

We stated that our point of departure with Ambassador Malac was when she asserted that “it is well past time for Ugandan authorities to begin investing more in the health and well-being of their own people, not just large-scale infrastructure projects”.

We asserted very strongly in the contrary that to invest in energy and infrastructure is ultimately to invest in the enduring wellbeing of wananchi. We argued that to counterpose investment in health to investment in energy and infrastructure is to agree to a democratization of not only debilitating and cyclical poverty, but endemic ill-health of wananchi.

We referred to lessons from the history of the United States and other older democracies, where health care was initially localized and built around communities.

Today, we conclude this discussion by reflecting on the qualitative impact of industrialization on the fundamental socio-economic transformation of the United States. Our central argument here is that without industrialization, quality and comprehensive modern health care for all can only be a mirage. Provision of such health care shall become reality in a fundamental sense, as we sort out the challenges of industrialization.

Writing in 1906, German economist Werner Sombart described America as “the Canaan of capitalism, its promised land”. “It is only there”, opined the American economic historian William N. Parker, “that the tendencies of Western capitalism could find fullest and most uncontrolled expression”.

American capitalists had almost a free hand in gaining control of a country unimaginably rich in natural resources. It is critically important to appreciate that in this sense of an economic and political system, the American economy became predominantly capitalist only by 1900. The earlier years can be divided into three periods.

The first period, from 1600 to 1790, was characterized by handicraft-subsistence production alongside elements of a semi-capitalist economy stemming from commercial production of tobacco. The most commercialized sectors of the economy were predominantly staffed by enslaved and semi-enslaved workers.

During the second period, 1790-1865, several industries became organized along capitalist lines and some sectors of agriculture lost their subsistence character until by the period’s end, agriculture as a whole was producing for the market. As this unfolded, a class of free and unfree workers (read slaves) grew rapidly.

In the third period, 1865-1920, economic development attained an extraordinary pace as industry and, increasingly, agriculture became completely subject to capitalist forces.

While Karl Marx identified free labor with capitalism, in the US, semi-free and un-free labor were important. The US was the first modern capitalist country to develop from a colonial status, from a slave base, and with an enormous natural-resource endowment. Above all, American capitalists utilized more violence against their workers than in any other capitalist country.

American society from the colonial period onwards was the very opposite of equalitarianism. The robbery of the Red Indians’ land constituted the basis of America’s claim to unparalleled economic sufficiency and generosity. Without robbed Indian land, the developments in nearly two centuries of colonial history would have been unthinkable.

During the 17th and 18th centuries, land was the principal means of production in America. While they did not engage in piracy on the high seas, European-Americans stole other people’s wealth wholesale.

By the end of the 19th century, land had receded as the central means of production. Manufacturing and railroads took the forefront, along with new financial industries.

Until around 1900 or so, the distribution of wealth and income in the US had been less concentrated than in Europe, reflecting mainly relatively easier access to land ownership here – but this ended around 1900. Thereafter, concentration of wealth in the US exceeded or matched that of industrial capitalist countries elsewhere.

Around the same time, the United States became the most favored home for great wealth throughout the world. This period of full-scale industrialization is synonymous with moguls and magnates: Cornelius Vanderbilt (railroads and shipping); Andrew Carnegie (steel industry);JP Morgan (financier and banker); Henry Ford (industrialist and founder of the Ford Motor Company, etc.)

It is the equivalent of that period that we in Uganda have no choice but to sort out right now – and urgently. The rest shall be added thereto. While our friends and development partners must continue advising and assisting as best as they can, we must determine our own priorities of priorities – in line with objective necessity. In the final analysis, no country in the world owes us a living.


The author is a private secretary, political affairs, State House.


0 #1 Lakwena 2017-04-24 07:34
In other words, where does Mafabi go and/or take his immediate, near/distant family members for medical check up and treatment?

If it is not to the public health facilities, then he should shut up.
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