Global Health Challenges and Solutions

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Questions and Answers

What is the primary role of the International Council of Nurses (ICN)?

To serve as a global community supporting nurses (correct)

To specifically address Indigenous health issues

To regulate nursing practices in individual countries

To act as a union representing nurses' rights

Which organization is primarily focused on advocacy and represents a specific group of nurses?

College of Nurses of Ontario (CNO)

Association for Nurses of Indigenous ancestry (correct)

International Council of Nurses (ICN)

Ontario Nurses' Association (ONA)

What differentiates the Ontario Nurses’ Association (ONA) from other nursing organizations listed?

It focuses on improving global health care standards.

It is an advocacy group funded by nurses.

It functions as a union representing nurses. (correct)

It is a regulatory body for nurses in Ontario.

What is a common goal among the nursing organizations mentioned?

Advocating for improved health care Signup and view all the answers

Which organization aims to empower and mentor Black nurses specifically?

Canadian Black Nurses Alliance (CBNA) Signup and view all the answers

What factors significantly shape health disparities in populations?

Structural violence Signup and view all the answers

Which of the following describes the significance of health systems in resource-poor settings?

They require comprehensive strategies for effective health delivery. Signup and view all the answers

What is the main concern regarding well-intentioned global health projects?

They can exacerbate pre-existing inequalities. Signup and view all the answers

What does a biosocial approach to global health emphasize?

Interdisciplinary analysis and social change. Signup and view all the answers

How do social determinants impact health outcomes?

They significantly influence access to health resources. Signup and view all the answers

What is the relationship between social suffering and health policies?

Coordination between both is essential for effective interventions. Signup and view all the answers

What aspect of global health does social theory help to clarify?

The dynamics of power and authority in health delivery. Signup and view all the answers

What is a potential outcome of ignoring the role of structural violence in health?

Perpetuation of existing health inequities. Signup and view all the answers

What is a potential issue with parallel private systems in healthcare?

They may avoid complex cases to focus on easier treatments. Signup and view all the answers

Why might doctors have an incentive to keep public waiting lists long?

To encourage patients to seek private care. Signup and view all the answers

What does Bill 124 limit for public sector nurses in Ontario?

Annual wage increases to 1%. Signup and view all the answers

What is a requirement for private clinics to operate under the new Ontario reforms?

They must show detailed staffing plans. Signup and view all the answers

What are some concerns that arise from Bill 7, More Beds, Better Care Act?

It may allow involuntary transfers of patients to long-term care homes. Signup and view all the answers

How has the court responded to Bill 124, which restricts nurse wages?

It ruled the law unconstitutional. Signup and view all the answers

Under what circumstance is medical assistance in dying (MAiD) allowed to be provided?

Only by Nurse Practitioners in specific situations. Signup and view all the answers

Which aspect of the Ontario reforms is aimed at regulating new clinics?

New clinics must comply with minimum staffing requirements. Signup and view all the answers

What does the principle of universality in the Canada Health Act (1984) ensure?

All eligible residents receive health services on uniform terms. Signup and view all the answers

Which statement best describes the concept of portability in the Canada Health Act (1984)?

It allows insured individuals to maintain coverage when moving within Canada. Signup and view all the answers

What is NOT a condition of the universality principle under the Canada Health Act (1984)?

Discrimination based on age is allowed. Signup and view all the answers

According to the Canada Health Act (1984), how long can the waiting period be for health coverage in a new province?

No longer than three months. Signup and view all the answers

Which of the following best defines the implications of universality within the Canada Health Act?

Health coverage is guaranteed for all regardless of their status. Signup and view all the answers

What does the Canada Health Act (1984) require regarding services provided outside of Canada?

Coverage is typically not provided unless prior approval is granted for non-emergency services. Signup and view all the answers

Which of the following is a characteristic of the universality principle as outlined in the Canada Health Act?

Access to health services must be uniform and non-discriminatory. Signup and view all the answers

What happens to an insured individual who travels abroad according to the Canada Health Act's principle of portability?

They maintain personal coverage, subject to limitations. Signup and view all the answers

What is a consequence of 10% of patients not taking their medication due to cost?

Increased healthcare costs Signup and view all the answers

What role does the government play in the pharmaceutical industry?

Regulates the industry and reviews new drug applications Signup and view all the answers

Which of the following best describes the neo-liberal approach to the pharmaceutical industry?

Leaving the market to self-regulate and police its activities Signup and view all the answers

What is the average period of patent exclusivity from approval to expiry in Canada?

11 years Signup and view all the answers

What consequence did the ending of quicker generic drug licensing have on costs in Canada?

Costs of medications soared Signup and view all the answers

What major issue was noted regarding the majority of new drugs approved between 1997 and 2012?

Less than 10% were significant therapeutic advances Signup and view all the answers

How has the approval process for new drugs changed in recent years?

It is now faster, often with less evidence and more post-approval safety concerns Signup and view all the answers

Why is it critical for the government to maintain independence from the pharmaceutical industry?

To avoid conflicts of interest and protect public health Signup and view all the answers

Study Notes

Multidrug-resistant and extensively drug-resistant TB

Multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) are significant health concerns, posing a challenge to global health efforts.

Water management

Water management is a critical aspect of global health, impacting sanitation, disease prevention, and overall well-being.

Global political economy

Global political economy influences health inequities, shaping access to healthcare resources and influencing the distribution of health burdens.

Health Disparities

Global health disparities are evident in mortality rates, disability-adjusted life years (DALYs), and life expectancy, with low-income countries disproportionately bearing the burden of infectious and non-infectious diseases.

Social determinants of health, such as education, income, and social class, significantly impact health outcomes.
Structural violence, encompassing social, political, and economic factors, contributes to health disparities.

Global Health Delivery

Equitable access to health interventions is crucial, requiring comprehensive health systems in resource-poor settings.
Interdisciplinary approaches are essential for addressing global health challenges.
Broad-based social change is vital to address root causes of ill health, including poverty, inequality, and environmental degradation

Future Directions

A biosocial approach, interdisciplinary analysis, and practical application are essential for reimagining global health in the future.

Understanding the Complexities of Global Health Delivery

Social theory is fundamental to understanding and interpreting medical and public health interventions and their limitations.
Global health and development projects can have unintended negative consequences.
The divide between theory and practice in global health is influenced by the historical role of social scientists in colonialism.

Theories of Power and Authority

Social theories provide insights into the dynamics of power and authority in global health.

The concept of social suffering acknowledges the interconnectedness of medical and social problems, emphasizing the need for coordinated social and health policies.

Nursing Organizations

Nursing organizations can have cooperating, competing, and conflicting interests.
The International Council of Nurses (ICN) is a global community representing over 28 million nurses, supporting and investing in the profession.
The College of Nurses of Ontario (CNO) regulates the nursing profession in Ontario.
The Registered Nurses Association of Ontario (RNAO) advocates for nurses and improved healthcare.
The Ontario Nurses' Association (ONA) is a union representing nurses.
These organizations advocate for nurses and generally for improved healthcare, but their interests may differ and sometimes conflict.
Despite their diversity, nursing organizations often provide evidence-based information that can be helpful in evaluating information.

Other Examples of Nursing Organizations:

Indigenous Nurses Association of Canada: promotes the health of Indigenous populations and advocates for Indigenous rights.
The Canadian Black Nurses Alliance (CBNA): aims to empower and support Black nurses through mentorship and advocacy.
Filipino Nurses of Quebec (FNQ): provides support and advocacy for Filipino nurses in Quebec, reflecting a long history of Filipino involvement in the Quebec healthcare system.

Universality

The Canada Health Act (1984) enshrines universality as a key principle of Canadian healthcare, ensuring all eligible residents receive insured health services on uniform terms and conditions, regardless of race, gender, income, ethnicity, or religion (or health status).

Portability

The Canada Health Act's portability principle guarantees that Canadians are insured by their home provincial/territorial plan when they move to another province or territory.

Private Care System Concerns

Parallel private systems may leave expensive cases to the public system, “cherry-picking” patients who are healthier and younger or who have conditions that are easier and cheaper to treat.
Doctors in the private sector may be incentivized to keep public waiting lists long, encouraging patients to seek private care due to higher earnings.

Ontario Bill 124 (2019) Limited public sector nurses to a 1% per year increase, declared unconstitutional by courts, but Ontario has appealed the decision and is settling wage claims with unions.
Bill 60, Your Health Act (2023) allows private, for-profit clinics to provide services under OHIP, sparking debate about the potential impact on public healthcare.
MAiD (Medical Assistance in Dying): legalized under specific circumstances in the Criminal Code (R.S.C. 1985 c. C–46) and can be provided by Nurse Practitioners.
Bill 9 (1999) proposed a Nurses Bill of Rights, intended to ensure nurses could provide appropriate care and enforce these rights against the government.
Bill 7, More Beds, Better Care Act, 2022 (S.O. 2022, c. 16) allows government-selected long-term care homes to receive suitable patients from public hospitals without their consent. This includes the ability to share confidential medical information and potential fees for families who refuse a transfer.

PHARMA INDUSTRY POLICY

The federal government regulates the pharmaceutical industry, balancing cost control with drug safety and approval of new drugs.
Concerns exist about potential compromises to government independence due to the expensive nature of pharmaceutical research and development (R&D).

The Pharma Industry and Government Relationship:

Lexchin (2017) highlights the intertwined nature of Pharma and government interests, arguing that the government's role as a watchdog may be compromised.
Pharma focuses on developing new drugs and generating profits, while the government benefits from economic activity created by the industry.

Neo-Liberalism in Pharma

Neo-liberalism philosophy favors smaller government and market self-regulation, leading to government deference to industry in areas like drug licensing and post-marketing surveillance.
Industry fees now fund the government's drug approval process.
Industry can potentially punish government agencies by withholding fees for delays in processing applications.

Delay: Patents and Drug Approval

Patents protect the right to make and sell a drug, expiring eventually.
Patents must be filed before a drug is approved, and delays can cost millions.
The current drug approval process is faster, with less evidence, leading to concerns regarding post-approval safety.

Patent Protection

The patent exclusivity period was extended in 2011.
The exclusivity period between approval and patent expiry averages 11 years, benefiting industry but increasing costs for Canadians.
Canada has shifted towards a focus on patent protection.
Drug prices are largely determined by what people are willing to pay, rather than R&D costs.

Innovation: New Drug Evaluation

Many new drugs approved do not represent significant therapeutic advances.
Between 1997 and 2012, less than 10% of new drugs were considered significant therapeutic breakthroughs.
The current system is costly and flawed, requiring alternatives to protect the value of R&D while avoiding the costs associated with patents.
Government independence from industry is crucial.

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Description

This quiz explores critical issues in global health, including multidrug-resistant tuberculosis, water management, and health disparities. It also examines the impact of social determinants on health outcomes. Test your knowledge about these pressing challenges and their implications for health equity.