Asa Cristina Laurell

Asa Cristina Laurell is recognized as one of the most emblematic figures of Latin American social medicine. Social medicine seeks to understand the health impacts of social and economic conditions on people as groups, distinct from the way Western medicine treats patients as individuals. Understood as an extension of hygiene, social medicine in Latin American originates from the work of German physician Rudolph Virchow (Cueto & Palmer, 2014). Social medicine claimed that biomedical factors were not the only causes of health problems and diseases. Based on this understanding, social medicine practitioners of Latin America study political, social, and environmental factors that are basic to health. Thus, a group of researchers and doctors of social medicine in Latin America created a website for the collection of works by Dr. Laurell. They emphasize in the introducing statement of the website that the knowledge and purpose of social medicine depend on neither sponsorships nor those who commodify health but simply commit to people’s health itself:

“Esta página la hacemos un grupo de personas que compartimos un compromiso con la salud, no cuenta con patrocinios ni mucho menos de los que la han convertido en un negocio...” [This page is made by a group of people who share a commitment to health, but does not depend on sponsorships and even less on those who have turned it into a business...]

Dr. Laurell is a well-known health expert in Mexico but was born and educated in Sweden. She studied medicine at the University of Lund where, even as a student, she actively protested against political agendas she disagreed with, such as the Vietnam War. In 1967, Dr. Laurell obtained a scholarship to study public health at the University of California-Berkeley, U.S., where she graduated with a Master of Public Health with a specialty in epidemiology. During her stay in Berkeley, she continued her activism by supporting the struggles of the African American movement against racial discrimination and for their civil rights. Dr. Laurell emigrated to Mexico in 1971 and gained Mexican citizenship. She worked at the National Autonomous University of Mexico (UNAM) from 1972 to 1976 as a professor and researcher on socio-medical issues.

In 1976, Dr. Laurell was invited to participate in the Master’s in Social Medicine at the Universidad Autónoma-Xochimilco (UAM-X). During her academic career at UAM-X, she published tirelessly on issues such as “health-disease as a social process,” “work and health process” and from 1989 onwards “social policy and health and social security policy.” Dr. Laurell’s publications on Latin American social medicine provides concrete study examples on essential concepts like ‘social class’ and ‘work process’ (Laurell, 1989). She also has done participatory research on workers’ health with her colleagues in Mexico, collecting data on characteristics of labor process, risks, and health damage (Laurell et al, 1992). Her publications also include critical views of the neoliberal health policies that have been experimented in Latin American countries, guided by international financial agencies (Laurell, 2000). Overall, Dr. Laurell’s studies not only offer a detailed understanding of health policies of Mexico but also a very comprehensive view of how health reforms in other Latin American countries have been and need to be more progressive. In 1987, Dr. Laurell obtained the degree of Doctor in Sociology at the Faculty of Political and Social Sciences of the Universidad Nacional de Misiones (UNAM) of Argentina. She served as an advisor and teacher in universities and health ministries in most Latin American countries on the subject of incorporating social sciences in the study of health. Dr. Laurell is also a founding member of the Latin American Association of Social Medicine (ALAMES) which was led by Juan Cesar Garcia, an Argentinian physician and sociologist. The formation of ALAMES was inspired among Latin American scholars who critiqued the health practices that “focused on biological parameters without adequately considering the impact of social, political, economic, and cultural factors on the health-illness continuum of populations” (Tovar, 2007).

At the same time, Dr. Laurell fought passionately in politics for the Mexican left. In 1987, Dr. Laurell joined the presidential campaign of the National Democratic Front and participated in the founding of the Party of the Democratic Revolution (PRD) in 1989. She was an elected member of the first, second, and third National Council of the PRD and a vice president of the third National Council. Thanks to her active political participation, Dr. Laurell was appointed Secretary of Health of the Government of the Federal District by Andrés Manuel López Obrador in December of 2000. She recalled this year as “a historical political crossroads” of Mexico in an interview with the journal Social Medicine (citation). Though the PRD lost the national presidential election to the National Action Party (PAN), which was conservative and neoliberal, it won as the governing party of Mexico City. Both PRD and PAN had defeated the Institutional Revolutionary Party (PRI) which was the official party for the previous 71 years. The PRI’s leftist-populist agenda had been contaminated by corruption and thus, despite the rightist party’s victory for presidency, PRD’s victory, as a third party, in Mexico was significant.

Taking the golden opportunity, Dr. Laurell merged her profound academic knowledge of health systems and social security as the Secretariat. She implemented the Alimentary Pension which reached a universal coverage by 2002, made health protection a constitutional right in 2003, and built the Medical Services and Free Drugs Program (PSMMG) for residents of Mexico City without social security. In May of 2006, the Legislative Assembly approved a law that confers the right to obtain medical services and free medicines to the uninsured residents of the Federal District and obliged the Federal Government to provide them. In terms of the health infrastructure, two new hospitals, four health centers, and a community clinic were constructed and 25 existing hospitals were reconstructed with new medical equipment. In 2006, the Legitimate Government in Mexico (GLM) took office and Dr. Laurell was named Secretary of Health of the government. On November 20, 2006, Laurell read proposals of the GLM:

“We will enforce the right to health of all Mexicans. Today, over half the population is not protected by social security. The right to health is not guaranteed, be it because the money to pay for medical attention and medications is not available or because there is an absence of services where people live...The Legitimate Government will fight to guarantee free medicine and medical services to all Mexicans.”

Dr. Laurell’s experience as a government official offers a direct insight to how ideas of Latin American social medicine can manifest as public policies with specific examples of Mexico City Government (Laurell, 2017). Thanks to scholars like Asa Cristina Laurell, Latin American countries strive to implement progressive health policies built around the universal guarantee of a right to health.

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References

Cueto, M. & Palmer, S. (2014). “Medical Innovation in the Twentieth Century” In Medicine and Public Health in Latin America. Cambridge University Press.

Laurell, A. C. (1989). Social Analysis of Collective Health in Latin America. Social Science & Medicine, 28(11): 1183-1191.

Laurell, A. C. (2000). Structural Adjustment and the Globalization of Social Policy in Latin America. International Sociology, 15(2): 306-325.

Laurell, A. C. (2017). What Does Latin American Social Medicine Do When It Governs? The Case of the Mexico City Government. American Journal of Public Health, 93(12): 2028-2031.

Laurell, A. C., Noriega, M., Martinez, S., & Villegas, J. (1992). Participatory Research on Workers’ Health. Social Science & Medicine, 34(6): 603-613.

Por el derecho a la salud. (n.d.). Retrieved from http://asacristinalaurell.com.mx/

The Social Medicine Portal. (2007). “Interview with Dr. Asa Cristina Laurell: Secretary of Health of the Legitimate Mexican Government, headed by Andres Manuel Lopez Obrador” Social Medicine, 2(1): pp. 46-55.

Tovar, M. T. (2007). ALAMES: Organizational Expression of Social Medicine in Latin America. Social Medicine, 2(3): 125-130.