L2 Globalization & Health

Definition of globalisation

Globalization is how the contemporary 當代的 world is becoming more interconnected, with events in one part of the worid having an impact elsewhere.

3 factors in globalization to public health

1. Global changes are shaping the broad determinants of health

2. Health status and outcomes are being variably influenced by globalization

3. Societies must adapt to the changing determinants of health and outcomes

Suggest examples of determinants of health (8), which one is the most heaviest affected by global changes ?

• Employment

• Housing

• Education

• Water

• Sanitation

• Agriculture

• Food production

• Restructuring human societies in diverse ways

Suggest examples of how Health status and outcomes are being variably influenced by globalization

• Raise new patterns of health

• New disease linked due to consequent restructuring of human society

  • Population density increase also increase disease rate

• New diseases and re-emerging

• Health inequalities across countries

  • Poverty will cause inaccessibility of healthcare

• Produce winners and losers of health outcomes

Suggest example of disease related to climate changes

(Emerge and re-emergence)

• Malaria & Dengue fever, yellow fever

Suggest example of liberalised trade in food & drinks (due to globalization) that most affected health

• Tobacco use & alcohol

Suggest 4 risk (cause) of infectious disease in globalisation world

1. Interaction of human population and local environment

2. Urbanization

3. Population mobility

4. Impact on global change

Suggest and explain an example of how Interaction of human population and local environment become the risk of infectious disease in globalisation world

e.g. Agrarian 農業的 societies

live close to domesticated animals, demonstrate susceptibility to zoonotic (同動物有關) infections.

• Nipah virus: Bat borne

Suggest and explain an example of how Urbanization become the risk of infectious disease in globalisation world

e.g. Influenza, plague 鼠疫 & SARS

People are more susceptible to crowd diseases, including spread by close contact

Suggest and explain an example of how Population mobility become the risk of infectious disease in globalisation world

Population mobility causing meningococcal disease

• e.g. Muslims attend Hajj go to Mecca in Saudi Arabia

• 3 million people from more than 160 countries participate this event

• Expansion of local facilities

• Greater wealth

• Greater opportunity spread of global diseases

• Secondary epidemics in other countries lasting over 2years

Suggest and explain an example of how impact on global change become the risk of infectious disease in globalisation world (4)

e.g. Malaria, Yellow fever, Dengue fever

• Natural environment changing e.g. pollution, growth in human settlement which alters climate

• From rise in surface global temperature ( Global Warming)

• Extreme weather

• Mosquito Vectors thrives in higher temperatures

Suggest the most serious type of infectious disease threat of all due to globalization – democratic infections

• Common cold

  • 200 types of rhinovirus causing common cold

How many episodes of flu occur in adult annually ?

Average 2-4

Around how many years will an abrupt change in virus (antigenic shift) in which no people have protection occur ?

every 10 -12 years

Which virus caused a global outbreak in 2009 ?

H1N1

What is International Health Regulation (IHR) ?

• a framework that helps countries minimize the impact and spread of public health threats

• a key feature of global health governance

• to detect and respond to a communicable outbreak

When does WHO intervened and updated IHR in concerns to globalization ?

2002

When does WHO reform / revise the IHR accelerared by out-brakes ?

2007

Describe the importance / content of the revised IHR

Under the revised IHR, all countries are obligated to report any adverse health events that has the potential to spread beyond their borders which includes:

• Infectious disease

• Outbreaks

• Threats to human health

• All events potentially constituting a public health emergency of international concern (PHEIC) from both government and non government sources

Suggest 2 examples of how trade liberalisation related to chronic disease

Tobacco & Alcohol expanded byTransitional corporation (TNCs)

• Liberation facilitated a shift in market share from traditional markets to emerging markets in Asia, Latin America

• Major aims: Increase supply, more extensive marketing, lower prices

Livestock Increase production for chronic diseases

• From trade in oilseeds and corn to produce more live stock feed

• Dramatic increase in livestock production

• Thus increase in meat consumption

• Increase meat and dairy products

• Increase fast foods and processed foods

Explain the role of Foreign Direct Investment (FDI)

• FDI is an investment by an enterprise from one country into an entity or affiliate in another

  • The foreign enterprise becomes an affiliate 附屬機構 of the parent company, thereby creating or joining a Transitional corporation TNC. FDI is one of the mechanisms through which TNCs enter new markets, and it reflects an intention to remain invested over the long term.

• Expands markets, increase supply: strong investment in tobacco, unhealthy food, and alcohol products,

What does Nordic approach emphasise to address global influences on chronic diseases ?

social, environmental, and commercial influences on health need to be addressed through government regulation, fiscal policy, and intersectoral action, combined→supported by NGOs

What does U.S. approach emphasise to address global influences on chronic diseases ?

given primacy 首要地位 to the importance of individual responsibility→health education→supported by industry

What means by brain drain ?

• Health workers migrate from poor to rich countries (to look for a better working condition)

  • lead to shortage of skills

What countries are emerging pharmaceutical players ? (both producers & consumers)

• Brazil, China, and India

Pharmaceutical industry focus on which types of market ?

These companies seek high profit

• Focus the rich world

• Focus exclusively on conditions with sufficient buyers

  • E.g. Treat obesity & impotence

Pharmaceutical industry is “Globalizing”, rather than Globalized

How many drugs did WHO listed as essential drugs for countries ?

220

Explain what is patent protection ?

If drug companies make a successful drug with billions of money dumped for research and development, they will rely on patent protection 專利保護 under intellectual property rights(IRP) 智慧財產權

The agreement on Trade related property rights (TRIPS) under IRP can grant legal means that no company can replicate the drug for a period of time.

• Poor countries will not get to reach for these drugs

• New drugs continue to be expensive and exclusive to the rich 富人專屬

If drugs expire in patent protection or unprotected they can be sold and manufacture generic version at competitive prices

What does Doha declaration suggest ?

• It consider to balance the creation of new medicines and access to medicines

• It stated that WTO 世貿組織 members had the right to grant compulsory licenses and engage in parallel importing where “public health crises” made this necessary.

• It also extended exemptions on pharmaceutical patent protection for the poorest countries until 2016.

What is the key focus of nursing education in globalization ?

• Nursing education have adapted from shifting from local to more universal & address transcultural nature of health

• Use of technologies