The Role of International Organizations in Shaping Global Health Policies. A Comparative Study of the Cases of Who and Global Fund.
CHAPTER ONE
The objective of the Study
The main objective of this study is to investigate the role of international organizations in shaping global health policies. a comparative study of the cases of who and global fund. Specific objectives include to:
- Assess the impact of globalization on health and global health-related problems.
- Examine the effect of poverty on global health problems.
- Explore the impact of urbanization and lifestyle on global health problems.
- Investigate the effect of lack of access to basic social amenities on global health problems.
- Review global policies aimed at mitigating health-related problems.
CHAPTER TWO
LITERATURE REVIEW
Conceptual Review
A Brief Overview of the Evolution of Global Health
Although the idea of GH first emerged in health literature in the 1940s, it didn’t become active again until the 1990s. Few academics, working within a liberal framework, took up its varied expressions and explored its theoretical foundation. According to this concept, a healthy state is necessary for equal and conditions development. Its primary focus as a component of public health was on medical and health problems with worldwide implications that may be efficiently resolved by global solutions. The WHO made contributions to GH science and research throughout this time ( Lee & Smith, 2021).
The Dag Hammarskjold Foundation likewise advanced the notion of health “beyond” national boundaries (as in the case of GH today) in 1975 as part of its proposals for a new global order. The Foundation called for redefining “development” to include health as an integral component, acknowledging that health is a political problem. Now, development was to be viewed as:
In line with the “basic needs approach,” which was reflected in the Alma-Ata Declaration of 1978 and the “Health for all by the year 2000” target adopted by the World Health Assembly in 1977, the WHO shifted towards strategies more attentive to the development of basic health services, community participation, and the immediate health needs of the population (Reinsberg & Wick, 2021). The “Selective Primary Health Care” approach, however, was developed by US-led bilateral and multilateral organisations just a year later, leading to the restructuring of health systems into “vertical programmes” and a complete break from the all-encompassing inter-sectorial strategy envisioned at Alma-Ata ( Bozorgmehr & Gooshki, 2022).
But by the early 1980s, structural adjustment policies had virtually eliminated all liberal thought (SAPs). These were preceded by rising debt due to the price of oil, as well as numerous economic crises in nations like Argentina, Chile, and Uruguay in the late 1970s and Brazil, South Africa, and several Asian nations in the 1980s. The economic crisis that had initially developed as a result of the developing world’s debt to these funding bodies deepened further with the growing dominance of international funding agencies and the push to liberalise the movement of capital to open up local financial systems and force competition in open markets ( Piot, 2021). The liberal approach lost its power. The main global players at this stage became the IMF and the World Bank, imposing a “one size fits all” Health Sector Reform (HSR) as part of SAPs in most developing countries.
The majority of low- and middle-income countries were going to suffer greatly as a result of the extension of health reforms ( Kickbusch, Gleicher & Buse, 2021). The fundamental change from welfare capitalism’s liberal policies to the HSRs of the neoliberal era, established by the World Bank between 1970 and 1980, became obvious. As a result, the term “HSR” was preserved and promoted, taking on a new definition as a tool of developed-nation foreign policy and denoting global transfers of knowledge, technology, skills, expertise, and most importantly, funds ( Salam, & Evershed, 2021).
CHAPTER THREE
THE EFFECTS OF URBANIZATION, LIFESTYLE, AND POVERTY ON PROBLEMS WITH GLOBAL HEALTH
Urbanization and Health
Urbanization is the term used to describe the widespread migration of people from rural to urban areas. In 2019, more than half of the world’s population, or almost half of all people on earth, live in metropolitan areas, according to the United Nations. This number is anticipated to rise to 6 billion people by 2041. (Acheampong & Kpogli, 2021).
For analytical purposes, urbanisation is frequently limited to geographical increase despite being a complicated and multifaceted phenomenon. Urban health is influenced by the type and pattern of such spatial growth (UN-Habitat and the World Health Organization, 2020). Urbanization and health have a complicated relationship. For example, in East Africa, even low levels of urbanisation are sufficient to facilitate access to health care so that a reduction in child stunting is measurable (Ameye and De Weerdt, 2020). (Ameye and De Weerdt, 2020). Yet, as air pollution rises and widespread respiratory issues result, urbanisation may also make health issues worse (Ali, 2019). Budgets for municipal governments have been cut or purposefully kept low during the last few decades due to the worsening urban problems. Local public agencies’ ability to prepare for and respond to health emergencies, as well as their ability to coordinate and engage with other players in civil society, social movements, and the corporate sector, is constrained by a lack of funding and institutional support. Particularly in quickly expanding urban regions, local administrations frequently lack the time, money, and expertise to work with and support neighbourhoods and households (Amiresmaili, M., & Hashemi, 2020).
Urbanization is causing a change in the health of populations through the social environment, physical environment, delivery and access to healthcare (1). Countries are unable to cope with the rapid pace of urbanization in providing essential services (1). Urbanization also may mutate the epidemiology of infectious diseases risking rapid spread (2). This can be observed in the recent Covid-19 pandemic. Urbanization, therefore, exacerbates disease transmission and disrupts the provision of quality health services (3). Health improvement is dependent on infrastructures, technologies and guidelines that deliver clean sanitation and water (4). However, despite efforts made, cities are plagued with severe water shortages (4). Thus, increasing the vulnerability of populations to health risks, especially for those living in poor communities(Ayotte & Margolis, 2020).
CHAPTER FOUR
Global Health Governance and Policy
With the keyword “globalisation,” the most prominent internet search engine returns roughly 52,400,000 results in 2018, compared to 35,800,000 results in 2015 and only 7,000,000 results in 2005. (Kickbusch & Reddy, 2021). There is disagreement over the definition of this term, which characterises a crucial aspect of the modern period, despite it being increasingly and widely used. Others see globalisation as a century-old process of integration that has seen an impressive acceleration since the second half of the last century, while some see it as merely a new, alluring term to rename the expansion of the neo-liberal development model (which we prefer to define as “neoliberal globalisation”) (Buse, Hawkes, & Heath, 2022).
Regardless of the interpretation, people, goods, and illnesses are flowing quickly across borders as a result of technical advancements in communications and transportation as well as the ever-increasing degree of global interconnection. More and more, global individuals and governments must deal with these concerns, which have global aspects and call for global solutions (Abbasi, 2020). Also, the temporal aspect of globalisation is altered by the escalating pace of technological, environmental, and microbiological change. Moreover, cognitive shifts have changed conventional cultures and habits, such as production, distribution, and consumption patterns, while also making it easier to share knowledge. Both of these environmental changes have had a direct impact on health. Mankind currently faces unparalleled global, or planetary, social, economic, and environmental concerns (Lee & Smith, 2020).
New infectious diseases are emerging and spreading, chronic, degenerative, and socio-behavioural pathologies are becoming more common, the right to health is frequently contested or denied, utilitarian approaches view human health as a factor of economic growth rather than a right in and of itself, and access to care is frequently restricted as part of macroeconomic interventions, including public spending (Kickbusch, 2021).
CHAPTER FIVE
SUMMARY OF FINDINGS, CONCLUSION AND RECOMMENDATIONS
Summary of Findings
The study aimed to assess the impact of globalization, poverty, urbanization and lifestyle, lack of access to basic social amenities, and global policies on global health-related problems. The findings of the study showed that globalization has both positive and negative effects on health. While it has facilitated access to new treatments, technologies, and health information, it has also resulted in the spread of infectious diseases and increased exposure to harmful substances. Poverty has been identified as a significant contributor to global health problems, as individuals living in poverty experience higher rates of infectious diseases, malnutrition, and inadequate healthcare. Urbanization and lifestyle changes have been linked to a range of health problems, including cardiovascular diseases, obesity, and mental health issues. The lack of access to basic social amenities such as clean water, sanitation, and education has been identified as a major factor in the spread of infectious diseases in developing countries. Finally, the study found that global policies aimed at mitigating health-related problems have had some successes, but there are still significant gaps in their implementation and effectiveness.
The study found that globalization has increased the spread of infectious diseases, such as HIV/AIDS, tuberculosis, and malaria, due to increased travel and trade. It has also led to the emergence of new diseases, such as SARS and COVID-19, through increased interactions between humans and animals. However, globalization has also facilitated the sharing of health information, technology, and resources, which has led to improvements in healthcare delivery and disease prevention.
Regarding poverty, the study found that poverty is a major contributor to global health problems, particularly in developing countries. Poor individuals are more likely to suffer from malnutrition, infectious diseases, and inadequate healthcare, and are also more vulnerable to environmental health risks. Poverty reduction programs, including those that target food security, education, and healthcare access, are crucial to improving global health outcomes.
In terms of urbanization and lifestyle, the study found that rapid urbanization and changes in lifestyle behaviours, such as unhealthy diets and sedentary lifestyles, have led to an increase in non-communicable diseases, such as diabetes and cardiovascular disease. Urban areas also experience higher levels of air pollution and environmental health risks, which can contribute to respiratory illnesses and other health problems.
The study found that lack of access to basic social amenities, such as clean water and sanitation, is a significant contributor to the spread of infectious diseases in developing countries. Lack of education and limited access to healthcare services further exacerbate health disparities and contribute to poor health outcomes.
Finally, the study found that while global policies aimed at mitigating health-related problems, such as the United Nations’ Sustainable Development Goals, have had some successes, there is still a significant gap in their implementation and effectiveness. Addressing these gaps will require increased funding for global health initiatives, greater collaboration between countries and organizations, and a focus on building strong health systems in developing countries.
Overall, the findings of this study underscore the complex and multifaceted nature of global health-related problems. Addressing these issues will require a comprehensive approach that includes addressing poverty, improving access to basic social amenities, and promoting healthy lifestyles, among other interventions. Further research is needed to better understand the underlying mechanisms and interactions between these factors and to develop and evaluate effective interventions to mitigate the impact of these problems on global health.
Conclusion
The present study has aimed to examine the impact of globalization, poverty, urbanization, lack of access to basic social amenities, and global policies on global health-related problems. The study has found that globalization has both positive and negative effects on health, with the negative effects often outweighing the positive. Poverty has been identified as a significant contributor to global health problems, with poor populations experiencing higher rates of infectious diseases, malnutrition, and inadequate healthcare. Urbanization and lifestyle changes have also been linked to a range of health problems, including cardiovascular diseases, obesity, and mental health issues. The study has also identified the lack of access to basic social amenities such as clean water, sanitation, and education as major factors in the spread of infectious diseases in developing countries. Finally, the study has reviewed various global policies aimed at mitigating health-related problems and found that while they have had some successes, there are still significant gaps in their implementation and effectiveness.
Recommendations
The following recommendations are made in this research work:
- Globalization should be managed in a way that prioritizes the protection of human health, including the development of international regulations and standards for trade, health, and the environment.
- Poverty alleviation programs should be prioritized to ensure that all individuals have access to adequate healthcare, nutrition, and social services.
- Urban planning should prioritize health-promoting environments, including green spaces, active transportation, and access to healthy foods
- Efforts should be made to increase access to basic social amenities such as clean water, sanitation, and education, particularly in developing countries.
- Global policies aimed at mitigating health-related problems should be strengthened and implemented with greater consistency and transparency. This includes increased funding for global health initiatives, greater collaboration between countries and organizations, and a focus on building strong health systems in developing countries. By implementing these recommendations, we can work towards mitigating the negative impact of globalization, poverty, urbanization, lack of access to basic social amenities, and global policies on global health-related problems, thereby improving the health and well-being of individuals and communities around the world.
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