Intro to Global Health: Definitions and Scope

• Global health involves access to medications, geographic factors, environmental concerns, and government health priorities.
• Tropical medicine focuses on diagnosing and treating infectious diseases in resource-poor, tropical environments.
• International health uses public health principles to aid low and middle income countries, considering global and local influences.
• Global health's scope addresses transnational health solutions and determinants, emphasizing commonalities.

Why Global Health Now?

• Increased connectivity.
• Transnational health determinants.
• Collective exposure to transnational health threats.
• Mutual partnerships.

Global Health and Public Health

• Both emphasize population-level policies.
• Emphasis on health as a public good.
• Global perspective on scientific inquiry.
• Commitment to interdisciplinary approach.

Types of Global Health Indicators

• Direct indicators measure health directly, such as mortality rates.
• Indirect indicators reflect social determinants like environmental factors.

Domains of Global Health Indicators

• Health status indicators cover mortality, fertility, and disease.
• Service coverage indicators reflect priorities in health service coverage.
• Risk factors indicators include nutrition, environment, behavior, and injuries.
• Health systems indicators measure health systems inputs and outputs.

Criteria for Global Health Indicators

• Well-defined.
• Validity for accurate measurement.
• Reliability for consistency.
• Feasibility.
• Usefulness and Relevance.

Moral Frameworks

• Utilitarian values aim for the greatest good for the greatest number.
• Humanitarian values involve acting virtuously towards those in need through empathy and altruism.
• Religious values influence motivations and actions in health policies.
• Human rights include entitlements (access) and freedoms (reproductive rights).
• Equity and social justice.

Common Uses of Moral Values in Global Health

• To mobilize support.
• For advocacy purposes.

Importance of Moral Values in Global Health

• Provide tools for analysis of issues and decisions.
• Shape global health interventions differently.
• For understanding individual decisions and actions.

Social Theories in Global Health

Unintended Consequences

• Actions have unforeseen consequences, often undesirable, due to ignorance, negligence, or chance.

Social Construction

• Ideas, knowledge, and the meaning of illness and health are socially and culturally constructed.

Social Suffering

• Pain and suffering are caused by social factors like economics and politics, and sometimes by bureaucratic indifference.

Biopower

• Political oversight increasingly influences control of bodies and populations, using data to allocate health services.

Public Health Emergencies of International Concern

History

• Traditional control measures became inadequate.
• International cooperation became necessary.
• The International Sanitary Convention (ISC) in 1892 focused on cholera quarantine.

The International Health Regulations (IHR)

• In 2005, agreement among 196 countries to work together for global health security.
• IHR aims to prevent, protect against, control, and respond to the international spread of disease.
• Includes measures at ports, airports, and ground crossings.

After PHEIC Declaration

• Member states must share critical information.
• Adjust response plans if necessary.
• Implement recommendations from the emergency committee.
• There is no middle ground.

WHO Key Areas for Emergency Risk Monitoring

• Outbreaks of infectious diseases.
• Emergencies due to natural hazards.
• Emergencies due to human-induced hazards.
• Events from exposure to toxic materials.

WHO Criteria for Emergency Risk Assessment

• Scale of event.
• Urgency of response
• Complexity, range of health consequences and concurrent emergencies.
• Context, level of health system resources, and public perception.

Grading Health Emergencies

• Ungraded: Monitored.
• Grade 1: Minimal, local response.
• Grade 2: Moderate, requires international response.
• Grade 3: Substantial, requires substantial international response.

Drivers of Humanitarian Emergencies

• Conflicts.
• Global climate emergency.
• Economic factors.

Objective of Humanitarian Action Response

• Save lives.
• Alleviate suffering.
• Maintain dignity.

The Humanitarian Space

• Space for humanitarian actors to deliver services according to principles.

Humanitarian Actors

• Wide range of local and international organizations and agencies.

Principles of Humanitarian Response:

• Humanity: Alleviating human suffering, protecting life, health, and dignity.
• Neutrality: Not taking sides in conflicts.
• Impartiality: Assistance based solely on need.
• Independence: Autonomy from political, economic, or military objectives.

Evolution of Global Health Security Regime

• Unilateral quarantine regime: limited international cooperation.
• Sanitary conference regime: nascent international cooperation.
• Institutionalized sanitary coordination regime: Self interest for disease eradication everywhere.
• Health cooperation of regime: Establishment of the WHO

Global Health Prioritization

• Influenced by political and moral values.

Neglected Tropical Diseases

• Affects 1 billion people, requires treatment for 1.62 billion annually.

Canada's Commitments

• Improve health service quality and accessibility.
• Increase access to comprehensive sexual and reproductive health.
• Improve gender sensitive nutrition.

Understanding Global Health Priorities

• Consider actors involved.
• The type of frames they advance.
• Forms of collective action they organize.

Actors

• Legitimacy, power, and motives

Global Health Frames

• How publics understand and portray health issues.
• Encompass beliefs about the issues causality and solutions.

Types of Frames

• Securitization evokes fear.
• Moralization.
• Technification frames issues scientifically.

Securitisation

• Securitisation is the fastest way to get support.

Development Assistance for Health (DAH)

• Financial assistance to low and middle income countries to improve health.

The Global in Global Health

• Health issues concerning many countries.
• Transnational determinants and solutions.

Transnational Actors

• Improving and protecting health.
• Promoting human rights.
• Responding to crises.
• Facilitating international development.

Locations of Actors

• Most in USA.
• Doctors Without Borders.
• World Health Organization.
• Bill Gates Foundation.

Essential Functions of the Global Health System

• Production of public goods.
• Management of disease across borders.
• Mobilization of solidarity.
• Stewardship.

Major Governance Challenges

• Sovereignty.
• Sectoral.
• Moral.
• Accountability.

Sectoral Challenge

• Addressing unhealthy diets.

Accountability Challenge

• State actors accountable to citizens.

The Moral Challenge

• Driven by need and health equity.

Governance Issues during Pandemic

• Vulnerability: Inequalities in educational opportunities and housing.

Public Health and Civil Liberties

• Public health measures protect against risk.
• Civil liberties protect individual rights.

Precautionary Principle

• Action should be taken to mitigate catastrophic risk.

Food Security and Malnutrition

• Lack of regular access to enough safe and nutritious food.

Four Dimensions:

• Physical availability.
• Economic access.
• Food utilization.
• Stability.

Acute vs. Chronic Food Security

• Acute manifests at a specific point in time and chronic is long term.

What Drives Hunger?

• Political stability.
• Place of residence.
• Gender and crises.
• Climate variations.

Minimum Standards for Humanitarian Food Aid

• Appropriateness and acceptability
• Food quality and safety
• Equitable distribution
• Transparent supply chain management

Development Food Aid

• Long term
• Tools, seeds and livestock
• Training in agricultural techniques
• School feeding programs
• Nutritional support
• Improving logistics to transport food

Tied Food Aid

• Withdrawn to the procurement of goods and or services from the donor country and or a restricted number of countries

Emergency Food Assistance

• Short term response to address immmediate needs of refugees and displaced people

United Food Assistance

• The provision of food commodities by one country to another, free of charge or under highly concessional terms, to assist the country in meeting its food needs