L12 The role of international actors in Global Health

Which type of global health actors does the following description refers to ?

• government - to - government or to sub - government level

Bilateral

• refers to aid assistance provided by one government to another government. In practice a donor government may provide funding to NGOs within its own borders

Which type of global health actors does the following description refers to ?

• Organizations within the UN system relevant to health

Multinational (Multilateral) organization

Which type of global health actors does the following description refers to ?

• Organizations outside of the UN system relevant to health

  • E.g. World Bank Group

Multinational (Multilateral) organization

Suggest the Multinational / Multilateral organization within the UN (United Nations) system relevant to health. (9)

• WHO (World Health Organization, 1948)

• UNICEF (U.N. Infant & Children’s Emergency Fund,1946)

• UNFPA (Population Fund, 1967)

• UNDP (U.N. Development Programme , 1965)

• FAO (Food & Agricultural Organization, 1943)

• UNESCO (U.N. Educational, Scientific and Cultural Organization, 1945)

• UNHCR (U.N. Refugee Agency, 1950)

• WFP (World Food Programme , 1962)

• UNODC (U.N. Office on Drugs & Crime,

Start with “Un”

Who is the current director of WHO ?

Dr. Tedros Adhanom Ghebreyesus

• Develops & disseminates International Classification of Disease (ICD - X) codes

What does the WHO priorities for “Health for all” suggest ? (5)

• The right of every individual to basic health services (Top priority)

• Ensuring universal health coverage without impoverishment 貧窮 is the foundation for achieving the health objectives of the Sustainable Development Goals (SDGs)

• Require strong partnerships from: ; aim to broaden and intensify its engagement with a wider range of stakeholders across public , private and civil society

  • National Governments

  • Bilateral and multilateral agencies

  • Civil society

  • The private sector

• Handling health emergencies by engaging with diverse stakeholders to make health care and protection from infectious disease outbreaks

  • E.g. Natural disasters, climate change, mass population, anti-microbial resistance, deliberate health threats

• Improve the health, rights & dignity of women, children and adolescent in order to achieve SDG

  • E.g. solve gender gaps, violence problem

    • female genital mutilation, Coercion

When did Unicef (United Nations Children's Fund) established ?

1946 by the United Nations

What did Unicef focus on ?

• War II on children in Europe & China

• Mainly focus on world’s most vulnerable children

• Devotes most of the resources to the poorest countries and to children younger than 5

What are the objectives of Unicef (6)

1. Young child survival and development

2. Child protection from violence, exploitation and abuse

3. Quality basic education for all, gender equality

4. HIV/ AIDS prevention (parent - to - child transmission), care & support, orphaned 成為孤兒 children

5. Advocacy and partnerships for child rights

6. Humanitarian action

List the 4 child health interventions initiated by Unicef, and 3 extra interventions ?

GOBI

1. G – Growth monitoring

2. O – Oral rehydration for diarrhea

3. B – Promotion of breastfeeding

4. I – Childhood immunization

---

Birth spacing/ family planning (F), food supplementation (F),

promotion of female literacy (F) were subsequently added

Where did the funding to Unicef come from ?

Government provide 2/3 funding, rest of the funding came from national committee (private entities/ NGOs) & millions of individuals who contributed in voluntary bases

Suggest a well-known campaign that raised a good funding for Unicef

Check out for Children (1995)

• It is a partnership between UNICEF, the world’s leading children’s organisation , and Marriott International Inc.

What is the role of Bank in multilateral development ?

To lend and grant money to low - and middle - income countries and economies in transition to help promote their economic and social development

• Owned by their member countries

• Would not earn money through their lending operations

• They channel financial resources from high - income countries, through bonds sales 發行債券 & grants, to low - & middle - income countries

• Loans money to poor countries on advantageous term not available in commercial markets

• Lend money to countries with per capital below a certain point with a reduced rate 低利率貸款 / lend money interest free 提供無息貸款 to the poorest countries

• Provide rant to some countries for special activities that affect the poor (e.g. HIV/ AIDS)

What is the aim & objective of world bank group ? (3)

1. Ending extreme poverty

2. Building shared prosperity

3. Promote sustainable development

List the 5 organization of world bank group

1. The International Bank for Reconstruction and Development (IBRD)

2. The International Development Association (IDA)

3. The International Finance Corporation (IFC)

4. The Multilateral Investment Guarantee Agency (MIGA)

5. The International Centre for Settlement of Investment Disputes (ICSID)

What is the role of The International Bank for Reconstruction and Development (IBRD) and The International Development Association (IDA) ?

They promote institutional, legal and regulatory reform

What is the clients target for The International Bank for Reconstruction and Development (IBRD)

Governments of member countries with per capital income between US$1025 and $6055

What is the clients target for The International Development Association (IDA)

Governments of member countries with per capital income less than $1025

What is the role of The International Finance Corporation (IFC)

To promote private sector development

What is the clients target for The International Finance Corporation (IFC)

Private companies in 183 member countries

What is the role of The Multilateral Investment Guarantee Agency (MIGA)

To provide instruments for political investment risk management

What is the clients target for The Multilateral Investment Guarantee Agency (MIGA) and The International Centre for Settlement of Investment Disputes (ICSID)

Foreign investors in member countries

What is the role of The International Centre for Settlement of Investment Disputes (ICSID)

To provide facilities for conciliation 調解 and arbitration 仲裁 of international investment disputes

What is the products from The International Bank for Reconstruction and Development

• Technical assistance

• Loans

• Policy advice

What is the products from The International Development Association

• Technical assistance

• Interest free loans (credits)

• Policy advice

What is the products from The International Finance Corporation

• Long-term loans

• Risk management

• Advisory services

What is the products from The Multilateral Investment Guarantee Agency

• Political risk insurance

What is the products from The International Centre for Settlement of Investment Disputes

• Dispute settlement facilities

What is the largest bilateral agencies ? What is the purpose of this agency ?

USAID

(U.S. Agency for International Development)

• Promotes US foreign policy 美國外交政策 goals by advancing economic and social development all over the world

  • provides large contracts to US NGOs to provide capacity-building services and tools to recipient countries.

Suggest the goal of USAID (4)

1. Disaster relief

2. Poverty relief

3. Technical cooperation on global issues, including the environment

4. Socioeconomic development

Suggest the aims and goal of USAID in global healthcare perspective (4)

• Ending preventable child and maternal deaths

• Creating an AIDS - free Generation

• Protecting communities from infectious diseases

• Building resilient and sustainable health systems in partner countries

List the examples of bilateral agencies

• USAID (U.S. Agency for International Development)

• DFID (U.K.)

• SIDA (Sweden)

• CIDA and IDRC (Canada)

• DANIDA (Denmark)

• JICA (Japan)

List the example of NGOs

• Oxfam

• CARE

• Save the Children/UK (& US)

• International Red Cross

• Doctors without Borders

• Project Hope

• International Rescue Committee

• Freedom from Hunger

• Child Family Health International

• Doctors for Global Health

• BRAC

What is the alternate name for NGO (Non-governmental organization) ?

Private voluntary organization (PVO)

What is the main role of NGO ?

• Provide approximately 20% of all external health aid to developing countries

• Receive funding from private sources/ receive grants from governments or global health partnerships

What is the largest NGO in the world that involved in international development work ?

• BRAC

  • Currently working in 11 countries in Asia & Africa

What are working areas / aspect of BRAC ? (4)

• Human rights and social empowerment

• Education and health

• Economic empowerment and enterprise development

• Disaster preparedness

What is the core health programme of BRAC ? Describe it + give example (2)

A community - based approach to primary healthcare called “Essential Health Care” (EHC)

• Workers are locally recruited women and deliver door - to - door health services in rural areas

• combining promotive, preventive and basic curative services

  • sell essential healthcare products such as soaps & condoms.

  • Health Worker with BRAC and supervises community health volunteers

Suggest the benefits to the community of having BRAC

Easy accessibility to information and services related to health promotion, disease prevention and cure

Suggest the benefits for the workers in BRAC

Skill & knowledge enhancement, empowerment and earning through selling of drugs and basic health commodities to their patient populations

Suggest the benefits to the country of having BRAC

Reduce vulnerability of the poor, enhance and empower the female, prevent sliding back into the vicious cycle of the extreme poverty

What is the main role or Doctors Without Borders ?

It is an international, independent, medical humanitarian organization that delivers emergency aid to people affected by
• Armed conflict
• Epidemics
• Natural disasters
• Exclusion from healthcare

Suggest examples of global health problems that affect an exceptional number of people in a large number of countries that require the partnership between NGOs and WHO

TB, Malaria, Polio

• Organization will then work together to tackle the most important burdens of disease

Describe how large is the partnership scale to stop TB

Composed of 1,300 partners , including countries, development agencies, private sector organizations and NGOs

What is Onchocerciasis ?

Since 1974

• Caused by a worm called Onchovera volvulus which enters its human through the bite of an infected blackfly

• Flies breed in waters in fertile riverside regions

• A pernicious disease 惡性疾病 afflicting approximately 26 million people worldwide

• Causing blindness

Explain how does the international partnership addressing Onchocerciasis problem

The first step was initiated by World Bank President’s visit to West Africa and then led the Onchocerciasis Control Programme (OCP) [African Programme for Onchocerciasis Control (APOC) @1995] in conjunction with 連同 WHO , the UN Food and Agriculture Organization (FAO) and UNDP

• Research budget

• Large scale of larvicide spraying programme

• Introduction of a powerful drug ( ivermectin ) against the disease in 1980s

  • operates in 16 countries that need mass treatments with ivermectin: community-directed treatment

By 2002 OCP halted transmission of onchocerciasis in 11 West African countries