Combining health and social protection measures to reach the ultra ...

More documents

Recommendations

Info

Access to healthsocio-cultural and ecological interactions,resulting in transborder processes andeffects” 2 . In order to focus the conceptualframework, however, the following importantfeatures of globalization are identified:✜ global governance structures;✜ global markets;✜ global mobility;✜ cross-cultural interaction;✜ global environmental changes.Based on Figure 1 and Table 1, it can beconcluded that these features all operate atthe contextual level of health determination,influencing the distal health determinants. Inturn, the changes in distal factors have thepotential to affect the proximal determinantsand, consequently, health. Figure 2 links theabove-mentioned features of the globalizationprocess with the identified healthdeterminants 2 .Globalization and distal healthdeterminantsFigure 2 shows that the processes ofglobalization can have an impact on theidentified distal health determinants. Below,the implications of the globalization processon these distal determinants will bediscussed in more detail.Health (-related) policiesGlobal governance structures areincreasingly gaining importance informulating health (-related) policies.Important institutions in global healthgovernance include the World HealthOrganization (WHO) and the World Bank(WB) 8 . The latter plays an important role inthe field of global health governance, as itacknowledges the importance of good healthfor economic development and focuses onreaching the Millennium DevelopmentGoals. The WB also influenced health(-related) policies together with theInternational Monetary Funds through theStructural Adjustment Programmes 9 and thePoverty Reduction Strategy 10 . In addition, thepolicies of the World Trade Organization(WTO) are also increasingly influencingpopulation health 9,11,12 . Fidler 13 argues that“from the international legal perspective, thecentre of power for global health governancehas shifted from WHO to WTO”. Opinionsdiffer with regard to whether WTOagreements provide sufficient possibilities toprotect the population from the adverse(health) effects of free trade or not 14 . InLevel/ Nature General determinants More detailed determinantsContextual levelInstitutional Institutional infrastructure Governance structurePolitical environmentSystem of lawRegulationEconomic Economic infrastructure Occupational structureTax systemMarketsSocio-cultural Culture ReligionIdeologyCustomsPopulationPopulation sizeStructureSocial infrastructureEnvironmental Ecological settings EcosystemsClimateDistal levelGeographical distributionSocial organizationKnowledge developmentSocial securityInsurance systemMobility and communicationInstitutional Health policy Effective public health policySufficient public health budgetHealth-related policiesEffective food policyEffective water policyEffective social policyEffective environmental policyEconomic Economic development Income/wealthEconomic equityTradeTrade in goods and servicesMarketingSocio-cultural Knowledge Education and literacyHealth educationTechnologySocial interactionsSocial equityConflictsTravel and migrationEnvironmental Ecosystem goods and HabitatservicesProximal levelInformationProductionRegulationInstitutional Health services Provision of and access tohealth servicesEconomic – –Socio-cultural Lifestyle Healthy food consumption patternsAlcohol and tobacco useDrug abuseUnsafe sexual behaviourPhysical activityStress copingChild careLifestyle-related endogen factors (bloodpressure, obesity, cholesterol levels)Social environmentSocial support and informal careIntended injuries and abuse/violenceEnvironmental Food and water Sufficient qualitySufficient quantitySanitationPhysical living environmentTable 1: Determinants of population health 2Quality of the living environment(biotic, physical and chemical factors)Unintended injuries068 ✜ Global Forum Update on Research for Health Volume 4
Access to health2001, WTO ruled that the French ban on the import of allproducts containing asbestos was legal on health grounds,despite protests from Canada 15,16 . However, protecting citizensagainst health risks in cases of scientific uncertainty is stilldifficult, as WTO is reluctant to accept precautionary traderestrictions 17 .Economic developmentOpinions differ with regard to the economic benefits ofeconomic globalization. On one side, “optimists” argue thatglobal markets facilitate economic growth and economicsecurity, which would benefit health (e.g. Frankel 18 , BenDavid 19 , Dollar and Kraay 20 and Feachem 21 ). On the otherside, “pessimists” are worried about the health effects of theglobal market. Baum 22 states that “the current forms ofglobalization are making the world a safe place for unfetteredmarket liberalism and the consequent growth ofinequities…posing severe threats to people’s health”. The2005 Human Development Report 23 argues that one of theprevailing “myths” of economic globalization is that openmarkets will result in an era of convergence; tradeliberalization “has done little to slow down themarginalization of sub-Saharan Africa” and the current“trading system favours the developed world”. In fact,notwithstanding some spectacular growth rates, especially inEast Asia, incomes declined between 1965 and 1997 in 16of the world poorest countries 24 .TradeDue to the establishment of global markets and a globaltrading system, there has been a continuing increase in worldtrade. According to the WTO, total trade multiplied by a factorof 14 between 1950 and 1997 25 . More recently, the year2004 saw an impressive growth in trade, which exceededaverage growth recorded over the preceding decade 26 . Todayall countries trade internationally and they trade significantproportions of their national income. The array of productsbeing traded is wide-ranging; from primary commodities tomanufactured goods. Besides goods, services are increasinglybeing traded as well 27 . In addition to legal trade transactions,illegal drug trade is also globalizing.Social interactions: migrationDue to the changes in the infrastructures of transportation andcommunication, human migration has increased atunprecedented rates. According to Held et al. 27 , tourism is oneof the most obvious forms of cultural globalization. However,travel for business and pleasure constitutes only a fraction oftotal human movement. Other examples of people migrating aremissionaries, merchant marines, students, pilgrims, militaries,migrant workers and Peace Corps workers 27,28 . Besides theseforms of voluntary migration, resettlement by refugees is also animportant issue. The UN Population Division estimates theglobal migrant population in 2005 at between 185 and 192million people 29 . However, the concerns regarding theeconomic, political, social and environmental consequences ofmigration are growing 30 and many governments are movingtowards more restrictive immigration policies.Social interactions: conflictsIn the aftermath of the terrorist attacks on September 112001, many questioned the possible links betweenglobalization and the risk on conflicts. On the one side,globalizations can decrease the risk on tensions andconflicts, as societies become more dependent on each.Others argue that the resistance to globalization has resultedin religious fundamentalism, and worldwide tensions andintolerance 31 . According to Huntington 32 , the increasingcross-cultural interactions will result in a “clash ofcivilizations”. Nassar 33 describes globalization as a processthat leads to a “migration of dreams” in which the world’spoor are able to learn of the luxuries of the western world;the increased degree of relative deprivation results in growingtensions. In addition, Zwi et al. 34 identify several other factorsthat are associated with both globalization and the risk ofconflicts, such as increased global trade in arms andinadequate policies.Social interactions: social equity and social networksGlobal communication, global mobility and cross-culturalinteraction can also influence cultural norms and valuesabout social solidarity and social equity. It is feared that theself-interested individualism of the marketplace spills overinto cultural norms and values resulting in increasing socialexclusion and social inequity. Exclusion involvesdisintegration from common cultural processes, lack ofparticipation in social activities, alienation from decisionmakingand civic participation and barriers to employmentand material sources 35 . On the other hand, however, thegeographical scale of social networks is increasing due toglobal communications and global media. Like-mindedpeople are now able to interact at distance through, forexample, the Internet. The women’s movement, the peacemovement, organized religion and the environmentalmovement are good examples of transnational networks 27 .The digital divide between poor and rich, however, can resultin social exclusion from the global civil society.KnowledgeThe knowledge capital within a population is increasinglyaffected by global developments in communication andmobility. The term “globalization of education” suggestsgetting education into every nook and cranny of the globe.Millions of people now acquire part of their knowledge fromtransworld textbooks. Most universities work together withacademics from different countries, students have ampleopportunities to study abroad and “virtual campuses” havebeen developed. In addition, television, film and computergraphics have greatly enlarged the visual dimensions ofcommunication. Many people today “read” the globalizedworld without a book 36 . Overall, it is expected that thesedevelopments will also improve health training and healtheducation (e.g. Feachem 21 and Lee 37 ).Ecosystem goods and servicesGlobal environmental changes are affecting the provision ofecosystem goods and services to mankind. TheGlobal Forum Update on Research for Health Volume 4 ✜ 069
Page 3 and 4:
Editorial Advisory Board:Luis Gabri
Page 5 and 6:
Contents096 Child immunization: acc
Page 7 and 8:
IntroductionResearch contributions
Page 9 and 10: IntroductionType IType IIType IIIPr
Page 11 and 12: Introductionmaking), takes account
Page 13: Access to healthStrengthening healt
Page 16 and 17: Access to healthTraining more healt
Page 18 and 19: Access to healthimperative for acti
Page 20 and 21: Access to healthReferences1.Further
Page 22 and 23: Access to healthDeterminantsAvailab
Page 24 and 25: Access to healthThe authors are inv
Page 26 and 27: Access to healthCombining health an
Page 28 and 29: Access to health100%Availability of
Page 30 and 31: Access to healthhypothesis that an
Page 32 and 33: Access to healthMandatory clinical
Page 34 and 35: Access to healthWhile there are som
Page 36 and 37: Access to healthItemDefinition/Expl
Page 38 and 39: Access to healthReferences continue
Page 40 and 41: Access to healthintegrating individ
Page 42 and 43: Access to healthA social determinan
Page 44 and 45: Access to healthemployment conditio
Page 46 and 47: Access to healthMaking human rights
Page 48 and 49: Access to healthResources outsideth
Page 50 and 51: Access to healthReferences1.McCoy D
Page 52 and 53: Access to healthand financial burde
Page 54 and 55: Access to healthDiscrimination as a
Page 56 and 57: Access to health“Two months ago I
Page 62 and 63: Access to healthIntergovernmental P
Page 64 and 65: Access to healthand conference stat
Page 68 and 69: InnovationTowards the development o
Page 70 and 71: InnovationMajor classificationMajor
Page 72 and 73: Innovation60% of enterprises5040302
Page 74 and 75: InnovationUsing the power ofintelle
Page 76 and 77: Innovationbe adapted - and harnesse
Page 78 and 79: InnovationFinancing of vaccine R&D-
Page 80 and 81: InnovationFinancing Ultimate Interm
Page 82 and 83: Innovationsome of this risk might b
Page 84 and 85: InnovationChild immunization:accele
Page 86 and 87: Innovationare revealing previously
Page 88 and 89: InnovationDeveloping countries % De
Page 90 and 91: Innovationcapacities. It is indeed
Page 92 and 93: InnovationSome plausible causes of
Page 94 and 95: Innovationwhere he was a programme
Page 96 and 97: Research resourcesResearch impact o
Page 98 and 99: Research resourcesBiotechnologists6
Page 100 and 101: Research resources1,61001,41,219080
Page 102 and 103: Research resourcesReferences1.The R
Page 104 and 105: Research resources✜ A group of nu
Page 106 and 107: Research resourcesReferences1.Inter
Page 108 and 109: Research resourcesThe threat of pan
Page 110 and 111:
Research resourcesChanging environm
Page 112 and 113:
Research resourcesPartnerships offe
Page 114 and 115:
Research resourcesWe encourage othe
Page 116 and 117:
Research resources181614No. of PPPs
Page 118 and 119:
Research resources12010080604020Pro
Page 120 and 121:
Research resourcesCapacity strength
Page 122 and 123:
Research resourcestreatment is prov
Page 124 and 125:
Research resourcesSmall scale busin
Page 126 and 127:
Research resourcesthis process in a
Page 128 and 129:
Research resourcesways. For instanc
Page 130 and 131:
Decision-making148 Delivering evide
Page 132:
Decision-makingChallenges in employ
Page 136 and 137:
Decision-makingUsing evidence forpo
Page 138 and 139:
Decision-makingdesire to publish. T
Page 140 and 141:
Decision-makingsystems development.
Page 142 and 143:
Decision-makingTowards evidence-inf
Page 144 and 145:
Decision-making✜ develop a critic
Page 146 and 147:
Decision-makingwas prior to 2001, a
Page 148 and 149:
Decision-makingGlobal and regional
Page 150 and 151:
Decision-makingHigh-incomeChildrenE
Page 152 and 153:
Decision-makingLow- and middle-inco
Page 154 and 155:
Decision-makingLow- and middle-inco
Page 156 and 157:
Decision-makingthan a quarter of th
Page 158 and 159:
Decision-makingThe potentials of in
Page 160 and 161:
Decision-makingGenerally, any resea
Page 162 and 163:
Decision-makingReferences1.Hawes H.
show all

Combining health and social protection measures to reach the ultra ...

Create successful ePaper yourself

Delete template?

Save as template?