These two decades were characterised by a great deal of biomedical research to find better treatments, and efforts to improve services in a growing global economy. However, there was also a staggering burden of untreated illness in the developing world. Two things happened that brought about what some would call a revolution and others would call a coup in the health field: first, the economic crises of the late 1980s-early 90s, the regular fallout of capitalist economies; second, the downfall of the former Soviet Union and the accompanying crisis of confidence in socialist thinking, including support for the role of the state as the primary provider of health care and other social welfare programmes.

As a result, in the health field, as in so many other areas, led by the World Bank and with a lot of help from WHO after Dr Brundtland took over, proponents of capitalist thinking and economics moved in and took over, granting little recognition to what came before in terms of the development of health care priorities or health services.