0
What is global health and
how can it be applied ?
Division of international and humanitarian medicine –
Department of comm...
Outline
• Let’s first have your insights – group work
• Global health: a new paradigm or just a
fashion ?fashion ?
• From ...
Group work
• 10 minutes
• One rapporteur
Questions:Questions:
1. What does the term «global health» evoke to
you ?
Where do we start?
“Health is a state of complete
physical, mental, and socialphysical, mental, and social
well-being and ...
Public Health
"the science and art of preventing disease,
prolonging life and promoting health through
the organized effor...
Global health: a new paradigm or just
a fashion ?
• Recent change in terminology : from
«international» to «global health»...
Global health: a new paradigm or just
a fashion ?
• Bunyavanitch and Walkup
interview with 29
international health leaders...
From international health
to global health
A long history…
The Roots of International Health: Colonialism and
Tropical Med...
Any changes or old wines
of international health in
the new bottles of neo-
liberal discourses ?
Some common trends
1. Health strategies tend to be developed outside of
countries where health problems exist.
2. Approach...
From international health
to global health
“ the term ‘global health’
emerged as part of larger
political and historical
p...
International health
• Focuses on health issues in other countries in
comparison with our own, stressing
differences rathe...
Characteristics that makes global
health ”global”
• Central concern with the interconnectedness among
populations
• The co...
From international health
to global health
“The shift from international to global
health can be said to be occurring wher...
Global health
3 main features
1. Trans-national: health issues and determinants
that transcend national boundaries
2. Heal...
Global health:
Towards a common definition
“Global health is an area for study, research, and
practice that places a prior...
Differences between Global, International, and
Public Health
Source: Koplan, J.P., T.C. Bond, and M.H. Merson et al. (2009...
Globalization
“A set of processes intensifying human
interaction across economic, political,
sociocultural, environmental ...
Global connectivity
Global Connectivity
mobile phone subscriptions (billions)
In 2013, there are almost as many
mobile-cellular subscriptions ...
Global Connectivity
Internet users by development level, 2003-2013
Source: ITU World Telecommunication/ICT 2013 Facts and ...
Global Connectivity
In 2013, over 2.7 billion people are using the
Internet, which corresponds to 39% of the
world’s popul...
Malaria supply chain data
collection using mobile
phone
and an open source cloud-
based mobile data
collection platformcol...
Globalization and mass media
until 1980s media systems
(print and broadcast) national
in scope
• trade in books, films, mu...
Global Mobility
World Air Transport in 2012
and World Passenger Traffic Forecastskilometresperformedpassenger-kilometresperformed
World Air Transport in 2012
and World Passenger Traffic Forecasts
World Passenger Traffic increased by 4.5% in
2012, corre...
Cognitive dimension of global change
• Changes to how we
think about
ourselves and the
world around us
• Mass media
cultur...
Health in the context of globalization
“the world is rapidly being
moulded into a shared social space by
economic and tech...
Health in the context of globalization
• World become single entity
• Increased movements of information, services
and peo...
Globalization and Economy
From economic perspective, globalisation is
characterised by:
• Increase in international trade
...
Globalization:
Opportunities or threat to health?
“All the indications are that the current forms
of globalisation are mak...
Impacts of globalization on health
• Spread of Communicable Diseases and Non Communicable Diseases
SARS Outbreak, Avian In...
Global health threats: Bioterrorism
Between November 2002 and July 2003,
an outbreak of SARS spread from Hong
Kong to infect individuals in 37 countries
becam...
An example of
health risk at the
human-animal-
ecosystem
interface
H5N1 viruses are thought
to be circulating
endemically ...
Cumulative number of confirmed human cases for
avian influenza A(H5N1) reported to WHO, 2003-2012
(as August 2012)
608 cas...
Global Trade of Harmful Products
Global Trade of Harmful Products
In 2011, tobacco use killed almost 6 million
people, with nearly 80% of these deaths
occu...
Global health threats- Lifestyles
related health challenges
Trade in health services & health
workers’ brain drain
Doctors from abroad in numbers
and percentage
Adapted from the WHO ...
Climate changes and health threats
United States Areas Vulnerable to Dengue
Fever
Source: Natural Resources Defense Counci...
Health and its determinants
• Determinants of health are the direct or
indirect causes of a disease
• either direct (proxi...
Health and its determinants
Health and its determinants
Example:
• Smoking is a proximal determinant of health
status, while the economic, demographic...
Health in the context of globalization
Conceptual framework for globalisation and population health.
Huynen et al. Globali...
Obesity: Web of causation
How does all this link to this course?
• Human & eco-systems health are linked
• Both are shaped by material, biological, ...
Human & eco-systems health
Courtesy: G.Rayner & T. Lang
An interesting podcast
on the concept of
ecological public health
from the British Medical
Journal:
http://bit.ly/1hBo3v2
What are these conceptual models
trying to do?
• Address complexity
• Capture dynamics and interactions
• See health as sh...
Applying a systemic approach to
global health challenges
• Newly Emerging and Re-emerging Diseases of Public
Health Import...
The International
Council for Science
(ICSU) Programme
on Health and
Wellbeing in theWellbeing in the
Changing Urban
Envir...
http://bit.ly/13IxC8t
http://bit.ly/1hBpaec
Capacity of slum dwellers/informal settlements
to improve total health and wellbeing
Global Health as “Unifying Paradigm”
• Acknowledge complexity and adopt a
systemic approach
• Enable the integration of pu...
Global Health Education
• Call for reforms
• From evidence based problem based
learning system thinking,
• Build competenc...
Global Health Research
Examples:
• Impact of globalization on health and
intersectoral policies
• Healthcare delivery in r...
Global Health advocacy
• Adopting a Human-Rights approach and taking a
position in favour of equity and social justice
at ...
Global health not just an academic
field
“Global Health is not merely academic: in fact,
promoting an ethic of social resp...
“Education either functions as an instrument which is
used to facilitate integration of the younger generation
into the lo...
The University of
Geneva undertook in
2012 an all faculties
mapping exercice
assessing the
University’s expertiseUniversit...
www.genevahealthforum.org
Thank you for your attention
Questions?Questions?
What is global health? Dr Slim Slama, Geneva University Hospitals
What is global health? Dr Slim Slama, Geneva University Hospitals
What is global health? Dr Slim Slama, Geneva University Hospitals
What is global health? Dr Slim Slama, Geneva University Hospitals
What is global health? Dr Slim Slama, Geneva University Hospitals
Upcoming SlideShare
Loading in...5
×

What is global health? Dr Slim Slama, Geneva University Hospitals

577

Published on

Published in: Health & Medicine, Education
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
577
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
27
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Transcript of "What is global health? Dr Slim Slama, Geneva University Hospitals"

  1. 1. What is global health and how can it be applied ? Division of international and humanitarian medicine – Department of community medicine, primary care & emergency how can it be applied ? Dr Slim Slama, MD, MPH Division of International & Humanitarian Medicine Geneva University Hospitals September 11, 2013 slim.slama@hcuge.ch
  2. 2. Outline • Let’s first have your insights – group work • Global health: a new paradigm or just a fashion ?fashion ? • From «international» to «global» • Health in a context of global changes • Global Health in practice
  3. 3. Group work • 10 minutes • One rapporteur Questions:Questions: 1. What does the term «global health» evoke to you ?
  4. 4. Where do we start? “Health is a state of complete physical, mental, and socialphysical, mental, and social well-being and not merely the absence of disease or infirmity.” World Health Organization
  5. 5. Public Health "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices ofthe organized efforts and informed choices of society, organizations, public and private, communities and individuals." C.E.A. Winslow, 1920
  6. 6. Global health: a new paradigm or just a fashion ? • Recent change in terminology : from «international» to «global health» A field growing in popularity and visibility• A field growing in popularity and visibility over the past several years • Is this shift in terminology trendy, trivial, or trenchant?
  7. 7. Global health: a new paradigm or just a fashion ? • Bunyavanitch and Walkup interview with 29 international health leaders in 1999: 50% thought thein 1999: 50% thought the new vocabulary was meaningless jargon; 50% thought a major shift was underway but seemed unable to clearly articulate what it was Bunyavanich, S. and R. B. Walkup (2001). "US public health leaders shift toward a new paradigm of global health." American journal of public health 91(10): 1556.
  8. 8. From international health to global health A long history… The Roots of International Health: Colonialism and Tropical Medicine The Interwar period and the Origins of InternationalThe Interwar period and the Origins of International Health Institutions The Postwar Period and the era of Decolonization: from Disease Eradication to Primary Health Care Health Care in the 1980s and 1990s: From Primary Health Care to Disease Eradication The Global Health Era
  9. 9. Any changes or old wines of international health in the new bottles of neo- liberal discourses ?
  10. 10. Some common trends 1. Health strategies tend to be developed outside of countries where health problems exist. 2. Approaches to health tend to be selective rather2. Approaches to health tend to be selective rather than comprehensive. 3. Health programs are linked to economic development but serving ideological/political purposes 4. Neglect of underlying determinants of health
  11. 11. From international health to global health “ the term ‘global health’ emerged as part of larger political and historical processes, in which WHO found Brown, T. M., M. Cueto, et al. (2006). "The World Health Organization and the transition from “international” to “global” public health." Journal Information 96(1). http://1.usa.gov/SoodPs processes, in which WHO found its dominant role challenged and began to reposition itself within a shifting set of power alliances.
  12. 12. International health • Focuses on health issues in other countries in comparison with our own, stressing differences rather than the commonalities between nationsbetween nations • Historically linked to missionary work and disease control in low-income countries • Involved the efforts from wealthier northern countries to improve the health of peoples living in poorer southern areas of the globe
  13. 13. Characteristics that makes global health ”global” • Central concern with the interconnectedness among populations • The consequences of globalization on evolving patterns of health, disease, and social determinants • The consequences of globalization on evolving patterns of health, disease, and social determinants • The transfer of health risks across national borders (Harvard Global Health Institute 2012)
  14. 14. From international health to global health “The shift from international to global health can be said to be occurring where the determinants of health or health outcomes circumvent, undermine or are oblivious to thecircumvent, undermine or are oblivious to the territorial boundaries of states and, thus, beyond the capacity of individual countries alone to address through domestic institutions.” Lee and Collin (2005)
  15. 15. Global health 3 main features 1. Trans-national: health issues and determinants that transcend national boundaries 2. Health equity for all with a focus on the global2. Health equity for all with a focus on the global socioeconomic, environmental and cultural factors that determine health 3. Collaborative (or collective) action: critical importance of collaboration across countries, sectors and disciplines
  16. 16. Global health: Towards a common definition “Global health is an area for study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide. Global health emphasises transnational health issues,Global health emphasises transnational health issues, determinants, and solutions; involves many disciplines within and beyond the health sciences and promotes interdisciplinary collaboration; and is a synthesis of population-based prevention with individual-level clinical care.” Source: Koplan, J.P., T.C. Bond, and M.H. Merson et al. (2009). “Towards a common definition of global health”. The Lancet, Volume 373, Issue 9679, 6 June 2009-12 June 2009, Pages 1993-1995
  17. 17. Differences between Global, International, and Public Health Source: Koplan, J.P., T.C. Bond, and M.H. Merson et al. (2009). “Towards a common definition of global health”. The Lancet, Volume 373, Issue 9679, 6 June 2009-12 June 2009, Pages 1993-1995
  18. 18. Globalization “A set of processes intensifying human interaction across economic, political, sociocultural, environmental andsociocultural, environmental and technological realms. These changes are evident across spatial, temporal and cognitive boundaries.” Kelley Lee, LSHTM
  19. 19. Global connectivity
  20. 20. Global Connectivity mobile phone subscriptions (billions) In 2013, there are almost as many mobile-cellular subscriptions (6.8 Source: ITU World Telecommunication/ICT 2013 Facts and Figures. Available at: http://bit.ly/1aA8eqB mobile-cellular subscriptions (6.8 billion) as people in the world, with more than half in the Asia-Pacific region
  21. 21. Global Connectivity Internet users by development level, 2003-2013 Source: ITU World Telecommunication/ICT 2013 Facts and Figures. Available at: http://bit.ly/1aA8eqB
  22. 22. Global Connectivity In 2013, over 2.7 billion people are using the Internet, which corresponds to 39% of the world’s population. Source: ITU World Telecommunication/ICT 2013 Facts and Figures. Available at: http://bit.ly/1aA8eqB world’s population. In the developing world, 31% of the population is online, compared with 77% in the developed world.
  23. 23. Malaria supply chain data collection using mobile phone and an open source cloud- based mobile data collection platformcollection platform (Magpi) in Zambia
  24. 24. Globalization and mass media until 1980s media systems (print and broadcast) national in scope • trade in books, films, music,television for decades, but broadcasting and publishingdecades, but broadcasting and publishing industries largely domestically owned and regulated • deregulation and privatisation of media and communication systems since 1980s • advent of new satellite and digital technologies
  25. 25. Global Mobility
  26. 26. World Air Transport in 2012 and World Passenger Traffic Forecastskilometresperformedpassenger-kilometresperformed
  27. 27. World Air Transport in 2012 and World Passenger Traffic Forecasts World Passenger Traffic increased by 4.5% in 2012, corresponding to 3 billion passengers and2012, corresponding to 3 billion passengers and 43.5 million aircraft departures Source: International Civil Aviation Organization (ICAO) http://bit.ly/1aAaYV9
  28. 28. Cognitive dimension of global change • Changes to how we think about ourselves and the world around us • Mass media culture • Culture • Wants/needs culture • Advertising firms • Consultancy firms • Research institutions • religious groups political parties Wants/needs • Aspirations • Knowledge • Values • Ideologies
  29. 29. Health in the context of globalization “the world is rapidly being moulded into a shared social space by economic and technological forces and that developments in one region of the world candevelopments in one region of the world can have profound consequences for the life changes of individuals and communities on the other side of the globe” Held et al. (1999)
  30. 30. Health in the context of globalization • World become single entity • Increased movements of information, services and people • Across borders of countries• Across borders of countries • Facilitated by – IT : improved communication – Policies on various sectors
  31. 31. Globalization and Economy From economic perspective, globalisation is characterised by: • Increase in international trade • Foreign Direct Investment• Foreign Direct Investment • Capital Market Flows • “Openness”of individual countries economy to the rest of the world
  32. 32. Globalization: Opportunities or threat to health? “All the indications are that the current forms of globalisation are making the world a safe place for unfettered market liberalism and the consequent growth of inequities. This economic globalisationisgrowth of inequities. This economic globalisationis posing severe threats to both people’s health and the health of the planet.” Professor Fran Baum Flinders University, Australia (2001)
  33. 33. Impacts of globalization on health • Spread of Communicable Diseases and Non Communicable Diseases SARS Outbreak, Avian Influenza (H5N1) Obesity, DM and increase in lifestyle related NCDs Global Trade including liberalisation in health services• Global Trade including liberalisation in health services Brain drain, medical tourism, telemedicine Access to Medicine and Drugs (IPs) Tobacco trade • “Forced adoption” of adverse health policies Privatisation User fees Private Health Insurance
  34. 34. Global health threats: Bioterrorism
  35. 35. Between November 2002 and July 2003, an outbreak of SARS spread from Hong Kong to infect individuals in 37 countries becaming a pandemic, with 8,422 cases and 916 deaths worldwide Global health threats- Emerging infectious diseases
  36. 36. An example of health risk at the human-animal- ecosystem interface H5N1 viruses are thought to be circulating endemically in poultry in China, Egypt, Indonesia, Viet Nam, Bangladesh and India
  37. 37. Cumulative number of confirmed human cases for avian influenza A(H5N1) reported to WHO, 2003-2012 (as August 2012) 608 cases, 359 deaths, 15 countries
  38. 38. Global Trade of Harmful Products
  39. 39. Global Trade of Harmful Products In 2011, tobacco use killed almost 6 million people, with nearly 80% of these deaths occurring in low- and middle-income countries.countries. When considering 2010 deaths with tobacco industry revenue, the tobacco industry realizes almost $6,000 in profit for each death caused by tobacco
  40. 40. Global health threats- Lifestyles related health challenges
  41. 41. Trade in health services & health workers’ brain drain Doctors from abroad in numbers and percentage Adapted from the WHO 2006 World Health Report, Chap 5, p.98, Table 5.1
  42. 42. Climate changes and health threats United States Areas Vulnerable to Dengue Fever Source: Natural Resources Defense Council: http://www.nrdc.org/health/climate/
  43. 43. Health and its determinants • Determinants of health are the direct or indirect causes of a disease • either direct (proximal) or indirect (distal) • The health effects of distal determinants are• The health effects of distal determinants are often mediated through proximal and intermediary determinants • Distal determinants cannot be acted upon through direct health sector interventions Lerer LB et al. Health for All: vision to strategy – the role of health status and determinants. World Health Statistics Quarterly, 1998, 51: 7–20.
  44. 44. Health and its determinants
  45. 45. Health and its determinants Example: • Smoking is a proximal determinant of health status, while the economic, demographic andstatus, while the economic, demographic and social factors that promote tobacco use are distal determinants.
  46. 46. Health in the context of globalization Conceptual framework for globalisation and population health. Huynen et al. Globalization and Health 2005 1:14 doi:10.1186/1744-8603-1-14
  47. 47. Obesity: Web of causation
  48. 48. How does all this link to this course? • Human & eco-systems health are linked • Both are shaped by material, biological, social and cultural circumstances
  49. 49. Human & eco-systems health Courtesy: G.Rayner & T. Lang
  50. 50. An interesting podcast on the concept of ecological public health from the British Medical Journal: http://bit.ly/1hBo3v2
  51. 51. What are these conceptual models trying to do? • Address complexity • Capture dynamics and interactions • See health as shaped by different levels, dimensions or determinantsdimensions or determinants • Identify key transitions shaping human health • Spot key actors and institutions both making and breaking health • Place human health within biological, material, social and psychological processes
  52. 52. Applying a systemic approach to global health challenges • Newly Emerging and Re-emerging Diseases of Public Health Importance SARS, Avian Influenza, HIV/AIDS, Tuberculosis, Malaria • Increase Global Burden of Non-Communicable Disease• Increase Global Burden of Non-Communicable Disease and Unhealthy Lifestyle Diabetes Mellitus, Hypertension, Stroke, Obesity, Smoking • Health Care Delivery System Health Financing Issues, Efficiency, Equity, Access, Quality of Care
  53. 53. The International Council for Science (ICSU) Programme on Health and Wellbeing in theWellbeing in the Changing Urban Environment http://bit.ly/13IvRrU
  54. 54. http://bit.ly/13IxC8t
  55. 55. http://bit.ly/1hBpaec
  56. 56. Capacity of slum dwellers/informal settlements to improve total health and wellbeing
  57. 57. Global Health as “Unifying Paradigm” • Acknowledge complexity and adopt a systemic approach • Enable the integration of public health, medecine and disciplines beyond health sciences
  58. 58. Global Health Education • Call for reforms • From evidence based problem based learning system thinking, • Build competencies and skills to adapt to a• Build competencies and skills to adapt to a multicultural world • Interdisciplinarity
  59. 59. Global Health Research Examples: • Impact of globalization on health and intersectoral policies • Healthcare delivery in resource limited• Healthcare delivery in resource limited settings • Global health governance and diplomacy
  60. 60. Global Health advocacy • Adopting a Human-Rights approach and taking a position in favour of equity and social justice at local and international level. • Raising public awareness about global health disparities and ways to reduce themdisparities and ways to reduce them • Keeping a critical eye on policies and activities that influence health and health determinants • Understanding who are the key actors and how do they frame/influence global health issues • Giving a voice and listening to frontliners
  61. 61. Global health not just an academic field “Global Health is not merely academic: in fact, promoting an ethic of social responsibility both for the institutions and professionals involved, it embraces theinstitutions and professionals involved, it embraces the fields of research, education and practice, and aims to generate real changes in both the communities across society, bridging the gap between scientific evidence and operational decisions.” Chiara Bodini, CSI, Bologna, Italy
  62. 62. “Education either functions as an instrument which is used to facilitate integration of the younger generation into the logic of the present system and bring about conformity or it becomes the practice of freedom, the means by which men and women deal critically andmeans by which men and women deal critically and creatively with reality and discover how to participate in the transformation of their world.” Paulo Freire, Pedagogy of the Oppressed
  63. 63. The University of Geneva undertook in 2012 an all faculties mapping exercice assessing the University’s expertiseUniversity’s expertise in the field of global health. More than 400 people accross the University are involved in global health related activities.
  64. 64. www.genevahealthforum.org
  65. 65. Thank you for your attention Questions?Questions?
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×