HLTH 350 Test 1 (made)

Most CITED definition of global health

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

“5 Ps” of Global Health

policy, practice, priorities, people, planet

Evolution of Global health

tropical medicine - international health - global health

Tropical Medicine

instrument of power (tied to colonization); aimed at keeping colonizers alive in the colonial tropics (fight disease common in the tropics)

International Health

apply principles of public health to challenges that affect low and middle-income countries (high-income countries support resource constraints in these places) - focus on countries that are NOT your own

The “global” in global health

scope of problem NOT location; transnational health solutions and determinants, emphasis on commonalities

WHY global health

increased global connectivity (disease spreads more easily); transnational determinants of health (climate change); collective exposure to health threats; countries need mutual partnerships

Glocalization

global outlook adapted to local conditions - using global health knowledge to address local problems

Global Health Indicators

a way of tracking progress towards internationally agreed goals; benchmarking performance against other countries; tools to identify gaps/prioritize resources

4 Domains of Indicators

health status, service coverage, risk factor, health systems

5 Criteria of Global Health Indicators

well defined, validity, reliable, feasible, usefulness/relevance

Utilitarian Values

produce greatest good for greatest number of people; it is wrong not to prevent suffering if the actions needed will not cost us anything significant

Problem with Utilitarian Values

Tyranny of the majority (suffering of the minority gives happiness to the majority)

Humanitarian Values

acting virtuously towards those in need based on compassion, empathy, or altruism; we believe it is good to do good

Challenges with Humanitarian Values

dependency syndrome, structural issues not addressed

Religion as Moral Framework

influences motivations and values = influences health policy

Human Rights as Moral Framework

highest standard of health is a fundamental right - entitlements vs freedoms (reproductive rights)

Equity and Social Justice as Moral Framework

people believe in equity and fair distribution; take action because of these values (want justice for others)

How are moral values used in global health (3)

to mobilize support for specific actions, for advocacy, guides decision-making

Unintended consequences of purposive action (social theory)

actions have unforeseen consequences and may not achieve the desired aim, and may result in unanticipated and undesirable outcomes; can be caused by ignorance, negligence, gaps in knowledge, or chance

Social Construction of health/illness (social theory)

ideas/meanings of health and illness are socially and culturally constructed, which influences how policy makers act; stigma

Social Suffering and Structural Violence (social theory)

suffering is sometimes caused or intensified by the state; caused by social forces; social structures can limit people from reaching full potential

Biopower (social theory)

the ways political governance exerts its effects via the control of bodies/populations

Climate Determinism

skeptical about the possibility of acclimatization and belief that hot climates are inherently dangerous; used to justify colonialism and slavery

Tropical Diseases

things found outside Europe; most studied were diseases that affected colonizers (not colonized people)

International Health Regulations (2005)

an agreement between 196 countries (and WHO member states) to work together for global health security; aims to protect, prevent, control, and provide public health response to international spread; embrace an “ALL-HAZARDS” strategy

Public Health Emergency of International Concern

an extraordinary event; constitutes public health risk to other states; potentially requires a coordinated international response

After Declaration of PHEIC

member states are required to share information for risk assessment, adjust response plans as needed, implement recommendations from the emergency committee

Balancing Dynamic for recommendations(3 Parts)

recommendations do NOT infringe on trade travel, are based on science, and do NOT infringe on human rights

Global Health Security - Proactive and Reactive

activities required to minimize the danger and impact of acute public health events (build capacity to detect and combat disease)

Pathogens are considered a security threat when…

fast-moving transmission, little scientific knowledge, no known treatment, high mortality, fear

Global Health Security Index (6 Categories)

prevention, detection/reporting, rapid response, health systems, compliance with international norms, risk environment

What is the Global Health Security Index

comprehensive assessment of global health security capabilities; helps identify gaps in countries; ranks countries in each category

WHO criteria for conducting emergency risk assessment (4)

scale of event, urgency, complexity, context = grading of emergency (1-3)

What is a Pandemic Agreement?

an international instrument under the WHO Constitution to strengthen pandemic prevention, preparedness, and response

Why is a pandemic agreement necessary?

inequities witnessed in COVID-19, weak preparedness, great loss of human life and disruptions to households and society at large, need for equity in access to tools to prevent/prepare for pandemics

Key Highlights of Pandemic Agreement (4)

national sovereignty, one health, pathogen access and benefit sharing, health equity and international solidarity

Global Health System Definition

comprised of a group of actors whose primary intent is to improve health, along with rules/norms governing their interactions

Transnational Actors engage in…(5)

improving health, protecting health security, promoting human rights, responding to humanitarian crises, facilitating international development

Essential Functions of Global Health System (4)

production of public goods, management of diseases across borders, mobilization of solidarity, stewardship

Sovereignty Challenge

health is responsibility of federal government (interest in improving health of OWN country might impact health of other countries)

Sectoral Challenge

health is multisectorial - need to look to other sectors to tackle health problems

Accountability Challenge

who are state non-actors accountable to?

Moral Challenge

challenge for actors with different priorities/interests

Precautionary Principle

action should be taken to mitigate catastrophic risk, even in the absence of complete evidence of the benefits/risks of the intervention

Application of precautionary principle should be…(5)

proportional to chosen level of protection, non-discriminatory, consistent with similar measures already taken, based on examination of potential benefits/costs, subject to review

Civil Liberties and Public Health

dynamic balance - need to protect against risk AND protect rights and freedoms of individuals

Freedom of Expression and Misinformation balance

government must address misinformation (vaccines, origin of disease…) while respecting freedom of expression

Unintended consequences of response

balance desired outcome with negative consequences

Digital Surveillance

must respect many ethical and legal boundaries

Integrity and trust in public procurement balance

certain practices may erode trust

Delivery of Social Welfare Programs

need to balance those who take advantage of the system and those who need access but don’t get it

Treaty

binding agreements between nations and become part of international law

Articles

provisions within treaties that defines specific rights, obligations, or procedures agreed upon by sovereign states