Global factors are increasingly influencing national policymaking. Globalization has led to greater interconnectedness between countries through increased cross-border movement, trade, and cultural harmonization. Health issues are now global concerns addressed through various global actors and mechanisms beyond traditional inter-state cooperation. These include global civil society, public-private partnerships, and influence from international organizations, transnational groups, and domestic and foreign bureaucrats. Effective health policymaking now requires engagement with this complex global context and array of global actors.

1. Globalizing the policy process
Najibullah Safi, MD, MSc. HPM

2. Key terms
• Global civil society
– Groups which are global in their aims, communication or
organization
• Global public goods
– Goods which are undersupplied by market, inefficiently
produced by states, and which have benefits which are
strongly universal
• Globalization
– Complex set of processes which increase
interconnectedness and inter-dependency between
countries and people
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3. Introduction
• Global factors are playing an increasingly prominent
role in national policy making
– High income countries
– Low income countries
• Role of donors
– International trade rules (e.g. TRIPS)
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4. Globalization
• Increasing volume, intensity and extensiveness of
cross-border movement
• Removal of barriers to trade which have made greater
movement possible
• Harmonization of culture
• Globalization have three dimensions:
– Spatial: overcoming distance
– Temporal: the world has become faster
– Cognitive: thought process that shape perceptions of events
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5. Globalization cont.
• Different meanings of globalization
– Internationalization
– Liberalization
– Universalization (e.g. harmonization of culture)
– McDonaldization
– Super-territoriality
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6. Globalization and health
• Health is on the global policy agenda
• Achievements in health are critical to SDGs
• Domestic action alone - no longer sufficient
• New context (rules, actors, markets, tools)
requires new responses

7. Globalization and health cont.
• The impact of globalization on health is more evident
– Infectious diseases
• SARS 2003
• Polio 2003-04
• Ebola 2015-16
– Production, distribution and marketing of foods
– Effects of globalization on behavior
– The ability of health system to effectively respond to
threats e.g. brain drain
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8. Traditional inter-state cooperation for health
• International Health regulation (1969 – 2005)
• Formal arrangement for cooperation
– The United Nations
• WHO 1948 (192 members, 193 NGOs in official relations)
– Providing leadership on matters critical to health and
engaging in partnerships where joint action is needed
– Shaping the research agenda and stimulating the
generation, translation and dissemination of valuable
knowledge
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9. Traditional inter-state cooperation for health
cont.
– Setting norms and standards and promoting and
monitoring their implementation
– Articulating ethical and evidence-based policy options
– Providing technical support, catalyzing change, and
building sustainable institutional capacity
– Monitoring the health situation and assessing health
trends
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10. Traditional inter-state cooperation for health
cont.
• Other UN organizations
– WB, UNICEF, UNAIDS, UNDP, FAO, WFP UNODC
• The World Trade Organization (1995)
• Bilateral cooperation
– USAID, DfID, SIDA, JICA, GAC etc
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11. Modern cooperation in global health
• Non-state actors
• Emergence of policy through informal mechanism
• More emphasis is placed on:
– Global civil society: a diverse set of actors targeting a
diverse set of issues
– Transnational cooperation (commercial sector)
– Global public-private partnership
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12. Health policy triangle
Context
ProcessContent
Actors
- Individuals
- Groups
- Organizations

13. Globalizing the policy process
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Elected
Officials
Interest
Groups
International
Organization
Transnational
Civil Society
Domestic
bureaucrats

14. Thanks
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