Global Health and International Policy Notes

Introduction to Global Health and International Policy

• Discussion of global health focusing on its history, major institutions, and issues like climate change and pandemics.

Historical Context

• Colonial and Tropical Medicine: Aimed at protecting colonizers from diseases while ignoring indigenous needs.
• Impact on health systems in colonized regions in Africa, Central, and South America.
• Concept of resistance: Indigenous populations vs. colonizers adapting to local diseases over time.

Post-World War II Developments

• Establishment of WHO and UN signifying a shift towards international health collaboration.
• The idea that wealthy nations should assist poorer nations in health initiatives transitioned from colonial frameworks.
• WHO's role: Setting norms, managing disease trends, but limited in direct program implementation, relying on funding from richer nations.

Role of UNICEF

• Focused on child health, vaccination, nutrition, and promoting breastfeeding.
• Uses funding effectively for programs like Vitamin A supplementation and malnutrition treatment with products like Plumpy Nut.
• Comparison with WHO: UNICEF has a larger budget due to effective fundraising, e.g., holiday cards.

US Funding Dynamics

• Withdrawal from WHO by the Trump administration jeopardizing global health collaborations due to heavy US contributions (16% of WHO's revenue).
• Importance of US partnerships in global health and implications of cutting funding.

Understanding Multilateral Organizations

• World Bank:
• Fundraising based on return on investment rather than humanitarian needs; its influence on health policy is mixed.
• Voting power based on economic size.
• International Monetary Fund (IMF):
• Steps in during financial crisis but imposes strict structural adjustment programs affecting local health services.

Bilateral Organizations

• Agencies like USAID and PEPFAR created to assist other governments but come with political strings, often favoring US interests.
• Example: PEPFAR's biased programming towards certain populations based on administration's political leanings.

Philanthropy's Role in Global Health

• Private foundations like Gates and Rockefeller play significant roles but their priorities may diverge from local needs.
• Concept of 'global health by philanthropy' raises concerns about dependency on specific funding sources.

Impact of Current US Policy

• Discussions on how the current administration's approach to foreign aid impacts global health initiatives and how this needs re-evaluation.

US Foreign Aid Historical Timeline

• Brief history from post-WWII aid programs to present, emphasizing changes in policy, particularly during varying administrations.

Encouragement of Discussion

• Think critically about the role of the US in global health historically and in the future, focusing on funding and policy shifts, and the concept of "soft power" in diplomacy.

Additional Readings and Future Engagements

• Assigned readings relevant to the discussions and encourage deep engagement in class discussions to build understanding of these complex topics.