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PubMed2003

Public health. Grand Challenges in Global Health.

This week an international panel announces a list of 14 Grand Challenges in Global Health, and scientists throughout the world will be invited to submit grant proposals to pursue them with funds provided by the Bill and Melinda Gates Foundation. We describe the characteristics of these challenges and the process by which they were formulated and selected after receiving over 1000 responses to a "call for ideas" from the scientific community.

Animals↗
PubMed2005

Advocacy for a new global health development paradigm: building alliances for global public health.

The past 25 years have produced a contradictory and conflicting context for health development. While global NGOs were enunciating a progressive political discourse promoting equity in health and development, elected conservative governments put in place measures that not only impoverished developing countries but also reduced international aid from richer countries. As a result, the structural adjustment policies of the past 25 years have decimated health and education services in poor countries. Recent international documents indicate a strong will by NGOs to regain leadership in the area of support to social development. In this effort to promote health as a human right and development as an avenue for achieving that goal, public health associations throughout the world should prepare for a leading advocacy role to rally partners in this endeavour.

Financing, Government↗
PubMed2006

Global health database.

The Global Health database is available from Ovid Technologies, Inc., and also from CABI Publishing, EBSCO, and DataStar/ DIALOG. This database is really the combination of two others--the Public Health and Tropical Medicine database, formerly produced by the Bureau of Hygiene and Tropical Diseases, as well as human health and diseases information that is extracted from the CAB Abstracts database. This column will provide readers with an overview of the Global Health database, as well as present some searching hints. The Ovid interface will be used.

Databases as Topic↗
PubMed2005

The role of NGOs in global health research for development.

BACKGROUND: Global health research is essential for development. A major issue is the inequitable distribution of research efforts and funds directed towards populations suffering the world's greatest health problems. This imbalance is fostering major attempts at redirecting research to the health problems of low and middle income countries. Following the creation of the Coalition for Global Health Research - Canada (CGHRC) in 2001, the Canadian Society for International Health (CSIH) decided to review the role of non-governmental organizations (NGOs) in global health research. This paper highlights some of the prevalent thinking and is intended to encourage new thinking on how NGOs can further this role. APPROACH: This paper was prepared by members of the Research Committee of the CSIH, with input from other members of the Society. Persons working in various international NGOs participated in individual interviews or group discussions on their involvement in different types of research activities. Case studies illustrate the roles of NGOs in global health research, their perceived strengths and weaknesses, and the constraints and opportunities to build capacity and develop partnerships for research. HIGHLIGHTS: NGOs are contributing at all stages of the research cycle, fostering the relevance and effectiveness of the research, priority setting, and knowledge translation to action. They have a key role in stewardship (promoting and advocating for relevant global health research), resource mobilization for research, the generation, utilization and management of knowledge, and capacity development. Yet, typically, the involvement of NGOs in research is downstream from knowledge production and it usually takes the form of a partnership with universities or dedicated research agencies. CONCLUSION: There is a need to more effectively include NGOs in all aspects of health research in order to maximize the potential benefits of research. NGOs, moreover, can and should play an instrumental role in coalitions for global health research, such as the CGHRC. With a renewed sense of purpose and a common goal, NGOs and their partners intend to make strong and lasting inroads into reducing the disease burden of the world's most affected populations through effective research action.

Journal Article↗
PubMed2006

Responsibility for global health.

There are several reasons for the current prominence of global health issues. Among the most important is the growing awareness that some risks to health are global in scope and can only be countered by global cooperation. In addition, human rights discourse and, more generally, the articulation of a coherent cosmopolitan ethical perspective that acknowledges the importance of all persons, regardless of where they live, provide a normative basis for taking global health seriously as a moral issue. In this paper we begin the task of translating the vague commitment to doing something to improve global health into a coherent set of more determinate obligations. One chief conclusion of our inquiry is that the responsibilities of states regarding global health are both more determinate and more extensive than is usually assumed. We also argue, however, that institutional innovation will be needed to achieve a more comprehensive, fair distribution of concrete responsibilities regarding global health and to provide effective mechanisms for holding various state and nonstate actors accountable for fulfilling them.

Developed Countries↗
PubMed2006

Whose progress? The language of global health.

The barrier to global health most often noted in Western discourse is the enduring disparity of access to medical technologies. This assessment of the circumstances in global health fits well within a bioethic centered on the equitable distribution of access to medical goods. Yet through an interrogative consideration of two episodes in the marketing of progress, namely the Century of Progress Exposition in Chicago (1933-1934) and one post-war spin on atomic development in the National Geographic, I suggest that the language of medical advancement continues to trade on a division between civilized, rational, scientifically developed peoples and the atavism of peoples by whom Western science gauges its progress. I recommend unremittingly self-critical attention to the dynamics of language and legitimization used within the Western academy by those who seek ostensibly to be of use in regions (powerfully) labeled as "developing."

Bioethics↗
PubMed2005

Global health priorities - priorities of the wealthy?

Health has gained importance on the global agenda. It has become recognized in forums where it was once not addressed. In this article three issues are considered: global health policy actors, global health priorities and the means of addressing the identified health priorities. I argue that the arenas for global health policy-making have shifted from the public spheres towards arenas that include the transnational for-profit sector. Global health policy has become increasingly fragmented and verticalized. Infectious diseases have gained ground as global health priorities, while non-communicable diseases and the broader issues of health systems development have been neglected. Approaches to tackling the health problems are increasingly influenced by trade and industrial interests with the emphasis on technological solutions.

Journal Article↗
PubMed2000

Should U.S. academic health centers play a leadership role in global health initiatives? Observations from three years in China.

Based on his work in Shanghai, China, the author believes that U.S. academic health centers (AHCs) should take a leadership role in global health initiatives. While acknowledging that most AHCs already have focused projects involving research or education with foreign institutions, he proposes a greater coordination of these projects into programs that, in some areas, could also be linked to clinical delivery systems where care may be provided. These AHC "platforms" overseas would be structured as a partnership between an AHC in the United States and one in the foreign country where the platform is located, to promote their missions of education, research, and service. For example, U.S. AHCs benefit, and are often dependent upon, international trainees who seek further clinical or research training in the United States. However, the identification of suitable candidates and career guidance, so the students' career choices could benefit their home countries, are often lacking. Thus, the United States is often viewed as facilitating a "brain drain" of future leaders in academic medicine from developing areas of the world. The author proposes a way to lessen this problem by shifting more on-site training to settings in the students' home countries, which could occur if AHCs were willing to develop overseas platforms. U.S. students would also benefit from access to medical training in foreign lands for both the cultural perspectives they offer and the unique diseases and medical situations encountered. He also suggests that shared platforms would lead to greater research opportunities for institutions in the United States and abroad. He argues for increased efforts at coordinating these activities with the rising demand for Western clinical services by multinational companies and U.S. expatriate communities overseas. The potential pitfalls of such initiatives as well as the need for permanent relationships are discussed. In conclusion, he believes that AHCs have an opportunity to establish global health initiatives through education, research, and patient care that will both enhance their own institutions and benefit the international community.

Academic Medical Centers↗
PubMed2005

Global health and equity. Part 1: setting the context.

Equity is considered one of the prerequisites and conditions for health. The pursuit of global health and equity is a relevant goal for nursing, based on the belief that health is a core phenomenon of interest to the discipline. In this article, the first in a two-part series, global health, equity and globalization are analysed. In addition, factors that contribute to global health inequity, including their relevance for nurses and nursing, are examined.

Altruism↗
PubMed2006

Ethics and governance of global health inequalities.

BACKGROUND: A world divided by health inequalities poses ethical challenges for global health. International and national responses to health disparities must be rooted in ethical values about health and its distribution; this is because ethical claims have the power to motivate, delineate principles, duties and responsibilities, and hold global and national actors morally responsible for achieving common goals. Theories of justice are necessary to define duties and obligations of institutions and actors in reducing inequalities. The problem is the lack of a moral framework for solving problems of global health justice. AIM: To study why global health inequalities are morally troubling, why efforts to reduce them are morally justified, how they should be measured and evaluated; how much priority disadvantaged groups should receive; and to delineate roles and responsibilities of national and international actors and institutions. DISCUSSION AND CONCLUSIONS: Duties and obligations of international and state actors in reducing global health inequalities are outlined. The ethical principles endorsed include the intrinsic value of health to well-being and equal respect for all human life, the importance of health for individual and collective agency, the concept of a shortfall from the health status of a reference group, and the need for a disproportionate effort to help disadvantaged groups. This approach does not seek to find ways in which global and national actors address global health inequalities by virtue of their self-interest, national interest, collective security or humanitarian assistance. It endorses the more robust concept of "human flourishing" and the desire to live in a world where all people have the capability to be healthy. Unlike cosmopolitan theory, this approach places the role of the nation-state in the forefront with primary, though not sole, moral responsibility. Rather shared health governance is essential for delivering health equity on a global scale.

Delivery of Health Care↗
PubMed2006

Workshop on global health trends for health professional education.

Global finance, trade, communication, media, politics, and the cultivation of overseas relationships to advance U.S. interests are among the forces that have engendered what we now know as globalization, a historical development towards worldwide interconnectedness. While manifest in diverse realms, globalization powerfully influences human health and health services and poses challenges for physicians and other health care professionals. To review these challenges and their ramifications, a workshop was convened at Howard University to consider the implications of global health trends for medical education. Highlights of the discussion are summarized here.

Education, Professional↗
PubMedDate not supplied

[Relation between global health and care consumption in Quebec immigrants].

This article examines the relationship between global health and care consumption in immigrants and native Quebecers. Care consumption is defined as the percentage of the population who consulted a health professional, while global health is represented by the ridit index. Mean values for ridit and care consumption do not differ significantly between immigrants and native Quebecers. The ridit increases significantly with age in native Quebecers and immigrants, indicating a progressive deterioration of global health for both groups. However, the relation between ridit values grouped for age and health professional consultation do not differ significantly between immigrants and native Quebecers. These results suggest a close link between global health and care consumption. The recently established immigrants represent an exception however. Those persons who arrived between 1980 and 1987 enjoy a better global health than native Quebecers, but consult health professionals in an identical manner.

Emigration and Immigration↗