Contemporary globalisation has three key elements. Two - long-distance trade and the diffusion of ideas and technology - have existed, albeit in less intense forms, for millennia (Landes 1999). Its third element, increasingly free of social constraint, is capitalism, still in many ways intellectually wedded to a time when human impact on the earth was puny. This triad, with increasing technological capacity, now threatens the ecological and social fabric of civilisation.
Two writers were especially influential in the development of capitalism. Adam Smith, though mindful of the risk of monopolies (Schlefer 1998), enumerated numerous advantages to material production made possible by specialisation, self-interest, and the rule of law. David Ricardo's theory of ‘comparative advantage’ demonstrated how, under certain assumptions, free trade could result in mutual gains. Taken at the most extreme, these theories lead to the view that an ‘invisible hand’ can act automatically to maximise economic efficiency, and, implicitly, public welfare. The laissez-faire capitalism that marked early and mid-19th century Britain accompanied, though it did not necessarily cause, spectacular increases in productivity. But soon, this extreme form of capitalism proved socially unsustainable (Gray 1999).
During the early industrial revolution, life expectancy in the provincial British towns and cities probably deteriorated (Szreter 1997), and few of the health gains which eventually emerged should be uncritically attributed to the market economy. Much credit belongs to policies initiated by reformers, often wealthy, reacting to the excesses of ‘blind’ capitalism, detailed, for example, by the novelist Charles Dickens. Other reforms included improved occupational safety standards, a widened franchise, an upgrading of state-provided education (Gray 1999, p 14) and a resurgence of smallpox vaccination (Szreter 1997). Internationally, agitation helped to end the slave trade. None of these reforms were ‘economically rational'. Smith's invisible hand clearly needed guidance.
The resurgence of marketism
The 25 years following World War II, a time of comparatively restrained marketism, witnessed the highest growth rates in history. Primary health care, decolonisation, war-fostered technological and organisational improvements, and greater intellectual and public support from the more advanced economies helped to spread the wealth and create the hope needed to make significant improvements in the living standards of the newly described ‘developing countries' also seem plausible.
The inaugural speeches of presidents Truman and Kennedy each pledged to reduce Third World poverty (Butler 2000a).