🌏Global Studies Unit 8 – Global Health and Well–being

Key Concepts in Global Health

• Global health focuses on improving health and achieving health equity for all people worldwide
• Encompasses various disciplines, including public health, medicine, economics, social sciences, and environmental studies
• Emphasizes prevention and treatment of diseases and conditions that disproportionately affect low- and middle-income countries (LMICs)
  • Infectious diseases (malaria, HIV/AIDS, tuberculosis)
  • Maternal and child health issues
  • Malnutrition and micronutrient deficiencies
• Addresses health disparities and inequalities within and between countries
• Recognizes the importance of social, economic, and environmental factors in shaping health outcomes
• Promotes collaboration and partnerships among governments, organizations, and communities to address global health challenges
• Aims to strengthen health systems and improve access to essential health services and technologies

Historical Context of Global Health

• Global health has evolved over centuries, shaped by various factors such as colonialism, industrialization, and globalization
• Early international health efforts focused on controlling the spread of infectious diseases across borders
  • Quarantine measures and sanitary conventions in the 19th century
  • Establishment of the World Health Organization (WHO) in 1948
• Decolonization and the Cold War era saw a shift towards vertical disease control programs and the emergence of new global health actors
  • Eradication of smallpox in 1980 through a global vaccination campaign
• The HIV/AIDS pandemic in the 1980s and 1990s highlighted the need for a more comprehensive and coordinated global health response
• The Millennium Development Goals (MDGs) in 2000 set targets for improving health and development in LMICs
• The Sustainable Development Goals (SDGs) in 2015 further emphasized the importance of addressing social, economic, and environmental determinants of health

Major Global Health Challenges

• Infectious diseases continue to pose significant threats to global health
  • COVID-19 pandemic has highlighted the ongoing risk of emerging and re-emerging diseases
  • Antimicrobial resistance is a growing concern, making it harder to treat common infections
• Non-communicable diseases (NCDs) are the leading cause of death worldwide
  • Cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes
  • Rising prevalence of NCDs in LMICs due to changing lifestyles and aging populations
• Maternal and child health remains a critical issue in many parts of the world
  • High rates of maternal mortality and morbidity, particularly in sub-Saharan Africa and South Asia
  • Preventable childhood diseases and malnutrition contribute to high child mortality rates
• Mental health disorders are increasingly recognized as a major global health challenge
  • Depression, anxiety, and substance use disorders are among the leading causes of disability worldwide
• Environmental health threats, such as air pollution, water contamination, and climate change, have significant impacts on human health
• Health inequities persist within and between countries, with vulnerable populations often facing greater health risks and barriers to accessing care

Social Determinants of Health

• Social determinants of health (SDH) are the conditions in which people are born, grow, live, work, and age that shape their health outcomes
• Socioeconomic status (SES) is a key determinant of health
  • Lower SES is associated with poorer health outcomes and higher mortality rates
  • Factors such as income, education, and occupation influence access to resources and health-promoting opportunities
• Social and community networks provide support and influence health behaviors
  • Strong social connections are associated with better mental and physical health outcomes
• Physical environment, including housing, neighborhood conditions, and access to green spaces, impacts health
  • Exposure to environmental hazards (air pollution, lead) can lead to adverse health outcomes
• Health care system access and quality vary widely within and between countries
  • Financial barriers, geographic distance, and cultural factors can limit access to care
• Discrimination and social exclusion based on factors such as race, ethnicity, gender, and sexual orientation can negatively impact health
• Early childhood experiences and development have long-lasting effects on health throughout the life course
  • Adverse childhood experiences (ACEs) are linked to chronic health problems in adulthood

Health Systems and Policies Worldwide

• Health systems are responsible for delivering health services and improving population health
• Health system building blocks include service delivery, health workforce, information systems, medical products and technologies, financing, and leadership/governance
• Different types of health systems exist worldwide
  • Beveridge model: Government-funded and operated (United Kingdom)
  • Bismarck model: Funded by mandatory insurance with private providers (Germany)
  • National health insurance: Government-funded with private providers (Canada)
  • Out-of-pocket model: Limited government involvement, high private expenditure (many LMICs)
• Universal health coverage (UHC) is a goal to ensure all people have access to needed health services without financial hardship
  • Achieving UHC requires strengthening health systems and increasing public health expenditure
• Health policies shape the organization, financing, and delivery of health services
  • Policies can address issues such as health promotion, disease prevention, and health equity
• Health system performance varies widely across countries
  • Factors such as health expenditure, health workforce density, and quality of care influence health outcomes

International Health Organizations

• World Health Organization (WHO) is the leading international agency for global health
  • Sets global health priorities, provides technical assistance, and coordinates international health responses
  • Plays a crucial role in monitoring health trends, setting norms and standards, and supporting health system strengthening
• United Nations agencies, such as UNICEF and UNAIDS, focus on specific health issues
  • UNICEF works to improve the health and well-being of children worldwide
  • UNAIDS leads the global effort to end the AIDS epidemic
• Global health initiatives and partnerships bring together multiple stakeholders to address specific health challenges
  • Global Fund to Fight AIDS, Tuberculosis and Malaria mobilizes and invests resources to support countries in combating these diseases
  • Gavi, the Vaccine Alliance, works to improve access to vaccines in LMICs
• Non-governmental organizations (NGOs) play a significant role in global health
  • Médecins Sans Frontières (MSF) provides medical assistance in crisis situations and advocates for neglected populations
  • Bill and Melinda Gates Foundation is a major funder of global health research and programs
• Academic institutions and research centers contribute to global health through research, education, and capacity building
  • Collaborate with partners in LMICs to address local health priorities and strengthen health systems

Current Trends and Future Directions

• Increasing recognition of the importance of addressing social determinants of health and health inequities
  • Efforts to promote health in all policies and intersectoral collaboration
• Growing emphasis on health system strengthening and resilience
  • Investing in primary health care and community-based services
  • Improving health information systems and data for decision-making
• Advances in technology and innovation are transforming global health
  • Digital health tools (mobile health, telemedicine) are expanding access to health services
  • New vaccines, diagnostics, and treatments are being developed for various diseases
• Climate change and environmental sustainability are increasingly recognized as critical global health issues
  • Efforts to mitigate the health impacts of climate change and promote planetary health
• Shifting global health governance and financing landscape
  • Increasing role of non-state actors and public-private partnerships
  • Transition from development assistance to domestic financing in many LMICs
• Emphasis on health security and preparedness for emerging health threats
  • Strengthening global surveillance, early warning systems, and outbreak response capacities

Ethical Considerations in Global Health

• Health equity and social justice are central ethical principles in global health
  • Ensuring fair distribution of health resources and opportunities
  • Addressing health disparities and inequalities within and between countries
• Respect for cultural diversity and local contexts is essential in global health practice
  • Engaging communities and stakeholders in the design and implementation of health interventions
  • Ensuring cultural sensitivity and appropriateness of health services
• Ethical challenges arise in the allocation of limited resources
  • Balancing individual and population-level health needs
  • Prioritizing interventions based on cost-effectiveness, equity, and urgency
• Research ethics in global health contexts require careful consideration
  • Ensuring informed consent, minimizing risks, and maximizing benefits for participants
  • Addressing power imbalances and ensuring local ownership and capacity building
• Ethical dimensions of global health governance and accountability
  • Ensuring transparency, inclusivity, and accountability in decision-making processes
  • Balancing national sovereignty with global health priorities and obligations
• Ethical implications of health-related trade and intellectual property policies
  • Ensuring access to essential medicines and technologies in LMICs
  • Balancing incentives for innovation with public health needs and affordability