In addition to comprehensive health policy, it is essential to develop what Dr Julio Frenk (23) of Mexico calls 'healthy policies'. Explicit attention must be paid to the mental health consequences of social and economic decisions; for example, the imposition of 'structural adjustment' on the economy of the developing countries must be accompanied by corrective measures to blunt the impact on the poor. Policies that reduce poverty, encourage gainful employment, and provide universal basic education, primary health care, decent housing, and adequate nutrition are all prima facie goods. They are not merely a concession to an abstract vision of social justice—they have tangible effects on the health of individuals and communities.

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