Global health governance Flashcards
Decolonization
Decolonization is the process of addressing and undoing the effects of colonialism, which often involved one country taking control over another and imposing its own culture, systems, and values. In the context of health, decolonization means recognizing and challenging how colonial histories and power imbalances have shaped health systems and practices. It involves:
- Acknowledging that colonial histories have impacted health inequalities and practices.
- Respecting and integrating local knowledge and practices that were often overlooked or suppressed by colonial powers.
- Empowering local communities to take control of their own health and healthcare decisions.
Overall, decolonization aims to create a more equitable and just approach to health by addressing past injustices and valuing diverse perspectives and practices.
Global Health System
It’s complex!
(ostensibly) There is a coordinated effort to address global health issues
Important because health problems transcend borders
Today we’re going to talk about some of the key players:
* International organisations
* National/local organisations
* Civil Society Organisations (CSOs)
* Private sector
* Donors/funders
Key International Organizations
United Nations and UN organisations:
* World Health Organization (governed by World Health Assembly)
* UNICEF
* Others as relevant (e.g., UNHCR, UNDP, UNFAO)
Development Banks
* International Monetary Fund
* World Bank
* Regional Banks (e.g., ADB, AfDB, IADB)
The United Nations Explained
was made after ww1 countries wanted to prevent horrific world conflicts, leaders of these countries created the League of nations, dedicated to preventing the outbreak of further wars
this failed in ww2, league was wholey ineffective in preventing war.
UN born after ww2, after the ratification of “the charter of the UNITED NATIONS” between US, UK, china, france, soviet union
UN has 6 principle organs, that oversee the organisations main functions:
- general assembly
- security council
- economic and social concil
- int. court of justice
- the UN secretariat
- trusteeship council
- general assembly deals with
questions of international peace
admission of member states
un budget
security council
maintaining global peace and security
- economic and social concil
has jurisdiction over matters of economy, social welfare, environment and international development
ICJ
rules on matters of international law
Key Public National/Local Organizations
Ministries/Departments of Health
Public health agencies (e.g., CDC in USA)
Regulatory bodies (e.g., TGA in Australia)
Social security programs (e.g., NHS in UK, Medicare in Australia)
Civil Society Organisations
Non-Governmental Organisations
Community Groups
Unions
Faith-based organisations
Professional associations
You might like to read more on ‘Structural Adjustment’
Civil Society Organisations
Médecins Sans Frontières (Doctors Without Borders, MSF)
International Committee of the Red Cross (ICRC)
International Federation of Red Cross and Red Crescent Societies (IFRC)
Save the Children
International Planned Parenthood Federation
Private sector
Pharmaceutical companies
Health insurers
Private healthcare
Donors/funders
Donors/funders
National Governments
Philanthropists (e.g., Gates Foundation)
UN Agencies (although they receive funds themselves)
World/regional Banks (although often these are ‘loans’)
Research councils
Global health initiatives
The Global Alliance for Vaccines and Immunization (Gavi)
The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund)
Challenges in Global Health System Governance
Coordination
Funding
Power Imbalances
Authority?
So…
The global health system is complex, and many entities play multiple
(sometimes conflicting) roles
Global health governance is essential for addressing health issues that
cross borders
Effective cooperation between countries and organizations is key to
overcoming global health challenges
What is the role of the World Health
Organization in improving global health?
The WHO:
● Develops and publishes standards/guidelines
● Monitors health trends
● Funds/coordinates research and advocacy
● Promotes health education
Priority areas:
● Achieving universal health coverage
● Maximising health and wellbeing for all
● Responding to health emergencies
BUT:
● Does not have regulatory power
● Does not ‘practice’ health (except in health emergencies)
Refugee and migrant health
● More than 1 billion people are on the move globally, about 1 in 8 of the global population.
● Of this total, 281 million people are international migrants and 84 million are forcibly displaced (48 million are internally displaced, 26.6 million are refugees, 4.4 million are asylum seekers).
– Refugees have fled their country and been recognised internationally as needing protection from persecution (and are thus entitled to basic services and protection). Asylum-seekers have not been recognized, yet (they are seeking refugee status)
● Among the forcibly displaced, 35 million are children and 1 million were born into refugee life.
● The number of people on the move is expected to grow due to poverty, lack of security, lack of access to basic services, conflict, environmental degradation and disasters.
What does it mean to ‘decolonize’ global health?
The health of individuals, and the health systems of countries, have been shaped and continue to be impacted by the historic legacies of colonialism, in the form of unequal power dynamics and structural
inequalities/violence
Some ways we can decolonize global health include:
● Knowing, understanding and challenging historical legacies
● Redistributing power and resources
● Promoting local leadership and expertise
● Producing research and health knowledge equitably
● Tackling structural violence
Non-governmental organisations
Refugee and migrant health
● Migration could both improve or diminish an individual’s health status. Refugees and migrants often face worse health outcomes in countries of transit and destination due to
barriers including language and cultural differences, institutional discrimination and restricted use of health services.
Refugee and migrant health
● Social, political and economic exclusion can result in poverty, homelessness and
exploitation, which can create a higher risk for noncommunicable diseases.
Why humanitarian health?
● War and conflict
● Famine
● ‘Natural’ disasters
○ Earthquakes
○ Floods
