Page 33 - GHES-2-3

Global Health Economics and
Sustainability
Innovating sustainable specialized healthcare

well as to explore the concept of change, particularly in there is a difference between charity and philanthropy. Less
terms of effecting behavioral change. For example, the well-off people can make small donations of money and
author has recently signed an agreement to consult for contribute their spare time (charity), but it is those of high
a large Jamaican pharmaceutical distribution company. net worth who can make sustained and significant financial
The specific goal is to set up a neurosciences division and commitment to a cause, addressing the underpinnings of
expand the range of pharmaceuticals for patients with a social condition (philanthropy). Kenya does quite well
neurological conditions, aligning several stakeholders from the perspective of charity. Kenya’s growing middle
and leveraging the corporation’s existing supply chain for classes contribute 22% of their monthly income, typically
affordable generics. Innovation, regardless of its pace, is through informal gifts and support to family, friends,
always a change, but not all change is innovative. and neighbors. Charitable giving, while generous, does
not result in financial hardships, suggesting that there
3.2. Social capital is a capacity to give more. Indeed, in Kenya, as stated in
Social capital, a sociological concept, describes the the Charities Aid Foundation (CAF) 2019 World Giving
connections within and among social networks and the Index, more than half of people donated money to charity,
impact these social relationships have on productivity compared to less than a third in 2010. In another metric
(Putnam, 2000). Simply put, “it is a public good that used by the CAF, helping a stranger in the past month – an
generates positive externalities by facilitating cooperation indirect measure of social capital – 68% of Kenyans had
th
for the achievement of common goals” (Kawachi et al., done so, placing Kenya 4 in the world in this measure of
1997, p. 1491-1498). No stronger connection exists than in charity and ahead of highly charitable and philanthropic
th
th
the area of health (Szreter & Woolcock, 2004). Caribbean countries such as Canada (9 ) and New Zealand (10 ) (CA
societies are well-known for their economic disparities, Foundation, 2019).
underscored by data from the US indicating a 14.6-year 3.3. Social entrepreneurialism and corporate social
difference in lifespan between males in the top 1% of responsibility (CSR)
income and those in the bottom 1% (Dizikes, 2016).
While the author views philanthropy as the main vehicle
Social capital and human capital are interrelated and for funding specialized centers of excellence in Jamaica,
affect health outcomes (Miller et al., 2006). Human capital it is also necessary to consider the concept of social
itself requires definition and distinction from social entrepreneurialism. In a social enterprise, the business
capital, as it speaks to the innate abilities of individuals or itself is formed to address a specific social condition. Profit
populations that promote economic activity. The benefits of is not the end goal, as it is in typical for-profit businesses,
a stronger economic environment toward fostering better but rather a means to an end – the alleviation of a social
healthcare are partially reflected in Table 1. However, social condition. Business can thus be a force for doing good. Dees
capital is eroded by inequality. Since reduced social capital et al. (2004, p. 301) suggest that a social entrepreneur is
is associated with poorer health and well-being outcomes one who develops a “strategic service vision, a competitive
(Kawachi et al., 1997), measures to address inequality strategy, a strategy for building networks and partnerships,
should produce a complementary improvement in health leads, retains, and rewards people, manages (their board)
and well-being, as an influential model suggests (OECD & entrepreneurially, treats donors as investors, works with
CERI, 2010). Indeed, countries with greater egalitarianism (different) communities, develops viable earned income
have less variance in health (Islam et al., 2006). Despite this strategies, considers the scale of the project and strategies
appealing model (Miller et al., 2006), a major limitation in for success, and is able to manage organizational change.”
the work on social capital generation is the lack of clear As defined by Say (1855, p. 3): “The entrepreneur shifts
evidence of benefit from attempts to improve social capital economic resources out of an area of lower and into an area
toward greater health-care equality (Uphoff et al., 2013). of higher productivity and greater yield.”
Another relevant comparison is the East African Entrepreneurs thus create value, typically understood
country of Kenya, which is quite similar to Jamaica in in terms of money. However, in social entrepreneurship,
several ways. Despite its poor standing in the GPEI, Kenya, value creation is measured by the alleviation of a social
has a longstanding culture of giving called Harambee, condition. “The entrepreneur always searches for change,
rooted in self-help and cooperative work as a key driver responds to it, and exploits it as an opportunity.” (Drucker,
for their giving. There is a wide range of individual and 2014). Metaphorically, identifying opportunity was best
community giving, with religion being the second biggest characterized by Wayne Gretzky of hockey fame, when he
motivation for giving, second to personal attachment to said, “I skate to where the puck is going to be, not where it’s
a cause (CA Foundation, 2019). As previously discussed, been.” (Kirby, 2014).

Volume 2 Issue 3 (2024) 5 https://doi.org/10.36922/ghes.2717