Global Health

Global Health*

• an area for study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide.

• emphasises transnational health issues, determinants, and solutions; • involves many disciplines within and beyond the health sciences and

promotes interdisciplinary collaboration; • is a synthesis of population-based prevention with individual-level

clinical care.

*Consortium of Universities for Global Health Executive Board, 2009

What do we mean by global health?

“an area for study, research, and practice that places a priority on improving health and achieving health equityfor all people worldwide”

Koplan et al (2009)

“health issues that transcend national boundaries and governments and call for actions on the global forces that determine the health of people”

Kickbush (2006)

“collaborative international research and action for promoting health for all”

Beaglehole & Bonita (2010)

“worldwide improvement of health, reductionof disparities, and protection against global threats thatdisregard national borders”

MacFarlane et al (2008)

Global health in perspective*

*Koplan, J.P., T.C. Bond, and M.H. Merson et al. (2009). “A Definition of Global Health: New Field or New Name?” Lancet, in press.

Learning objectives

• Be cognizant of the linkages between local & global health problems.

• Bring a global perspective to key health problems

• Understand the mandates, roles and approaches of key global health actors.

• Understand the political economy of global health issues.

International political economy of health

Quarantine: the birth of global health policy

The black death

Slave trade

The birth of tropical medicine

International Sanitary Conferences

L’Office Internationaled’Hygiene Publique (OIHP)

The League of Nations Health Organization

The Pasteur institute

The Rockefeller Foundation

Office of Malaria control in war areas1942-1945

The Center for Disease Control (CDC)(1946)

WHO Constitution (1946)

“The attainment by all peoples of the highest possible level of health”

“…Health is a state of complete physical, mental and social well being and not merely the absence of diseases or infirmity”

The 1st World Health Assembly (1948)

WHO functions:1. Direction and coordination of international health work2. Normative functions3. Research and technical cooperation

United Nations International Children Fund –UNICEF (1946)

The cold war effect: 1949-1956

Global malaria eradication: 1955-1978

Malaria eradication commando: 1959

Small Pox Eradication: 1959

United Nations Population Fund –UNFPA : 1967

Alma Ata Conference (1978)

Health for all in the year 2000

The attainment by all peoples by the year 2000 of a level of health that will permit them to lead a socially and economically productive life.

Primary health care is the key to attaining this goal.

Selective vs comprehensive primary health care

World Health Assembly voted to freeze WHO’s budget (1982)

US withhold contribution to WHO’s regular budget (1985)

WHO Essential Drug Program (WHA 31.32)

International Code on Breast Milk Substitutes

(WHA 34.22)

The Washington Consensus

• Privatization• Reducing public expenditure• Trade liberalization

The growing role of the World Bank