Global Health Notes

Global Health and its Significance

• Interconnectedness of Health

  • Health is a global concern; diseases cross borders, impacting societies universally.
  • Epidemics and pandemics expose the fragility of human health and disrupt political stability, focusing attention on global health.

• Covid-19

  • Emerged as a central global health issue in 2020; over 100 million infections in the first year.
  • High mortality rates in vulnerable populations led states to impose social restrictions and border controls.
  • The pandemic highlighted the need for cohesive global health strategies and collective action.

Underlying Values of Global Health

• Historical Foundations

  • Universal moral values regarding health span across cultures and belief systems.
  • The Hippocratic Oath, foundational to medical ethics, has influenced healthcare practices since 500–300 BCE.

• Four Basic Moral Principles of Biomedical Ethics

  1. Autonomy: Respect for patient choices.
  2. Beneficence: Duty to contribute to patient welfare.
  3. Non-maleficence: Obligation to avoid harm.
  4. Justice: Fair distribution of health resources.

• Global Health Definitional Framework (Koplan et al. 2009)

  • A field focused on improving health and achieving equity worldwide, emphasizing transnational health issues and interdisciplinary collaboration.
  • The slogan “no one is safe until all are safe” encapsulates the interconnected nature of health globally.

Rights, Responsibilities, and Health Inequalities

• Human Rights and Health

  • The 1966 International Covenant on Economic, Social and Cultural Rights acknowledges the right to the highest attainable health standards.
  • Differing views on health responsibilities exist across cultures, affecting international cooperation on health issues.

• Health Care Entitlement vs. Right to Health

  • Citizens have a right to healthcare, but this does not guarantee personal health, particularly if lifestyle choices endanger it.
  • Policymakers balance health priorities based on limited resources, leading to inequities, especially where public health funding is scarce.

Global Health Disparities and Determinants

• Changing Disease Patterns

  • Shift from communicable diseases (e.g., measles) to non-communicable diseases (e.g., diabetes) globally.
  • Poor populations continue facing traditional health issues but now also contend with lifestyle diseases due to global dietary changes.

• Social Determinants of Health

  • Health is influenced by conditions of birth, living environment, employment quality, and aging.
  • Political decisions and resource distributions critically shape health outcomes in societies.

• Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs)

  • MDGs set health-related targets culminating in 2015, stimulating global health activities, particularly in child and maternal health.
  • SDGs expanded health goals to cover broader health determinants and challenges, including mental health and non-communicable diseases.

Global Health Financing and Systems

• Healthcare Financing Structures

  • Various health financing mechanisms across countries lead to stark disparities in health access and outcomes.
  • Public and private funding dynamics are central to healthcare accessibility debates globally.

• Health Workforce Challenges

  • Shortages of healthcare professionals impede the realization of universal health coverage goals.
  • Migration of healthcare professionals from poorer to richer states creates workforce disparities that minimize care in underserved areas.

Global Health Law and Regulation

• International Health Regulations (IHR)

  • Legal framework for managing public health emergencies; addresses transnational disease threats.
  • WHO can declare a Public Health Emergency of International Concern (PHEIC), enforcing state obligations for response.

• Challenges in Compliance and Response

  • Non-compliance with health regulations due to state sovereignty; economic implications hinder transparent data sharing on health crises.

Health and Security in Conflict

• Securitization of Health
  • Health is increasingly seen as a national security issue, leading to the development of health strategies interlinked with international security concerns.
  • Global pandemics can exacerbate inequalities and highlight the need for collective health governance.

The Future of Global Health

• Exploiting Health Crises for Solidarity

  • Establishing connections across divided societies through health initiatives can foster peace and cooperation.
  • The ongoing challenge remains addressing the inequities exacerbated by globalization and ensuring equitable health access for all.

• Lessons from Covid-19

  • The pandemic illuminated vulnerabilities in global health systems and the necessity for equitable access to resources and coordinated efforts to combat health crises.

Conclusion

• Understanding global health requires a nuanced grasp of underlying ethical imperatives, global disparities, and the dual nature of health as both a right and a public good.
• Greater interdependence revealed by crises presents both challenges and opportunities for future global health strategies.
• Crisis response and national health policies must evolve to counteract inequalities and provide accessible healthcare globally.