Suchergebnisse

Global health diplomacy (GHD) has become an important field of investigation due to health concerns increasingly entering the foreign policy domain. Much of the existing academic writing focuses on North-South cooperation in global health, and emphasizes the role of security and economic interests by Northern countries as drivers of GHD. Chile presents a favourable environment for an expanded involvement in future GHD activities. However, there is little knowledge about what has been driving Chile's integration of health into foreign policy, and little effort to appropriate knowledge from international relations theories to better theoretically grasp the emergence of GHD.To fill this knowledge gap, we conducted a narrative literature review of the driving forces behind Chile's integration of health into foreign policy. Drawing on a popular analytical framework used in international relations scholarship, we identified driving forces of the integration of health into Chile foreign policy at three levels of analysis.At the international/global level of analysis, the main driving forces were related to national security concerns and compliance with regulations of international organizations. At the regional level, GHD was driven by a commitment to regional solidarity through mutually beneficial cooperation in response to neoliberal reforms; health coordination in emergencies; and protection of indigenous peoples. Finally, at the domestic level, drivers identified include economic interests of various productive sectors and how health regulations might impact those; the high degree of social inequity which impacts on access to healthcare; and management of natural disasters.Health actions in the context of international relations in Chile are still mainly motivated by more traditional foreign policy interests rather than by a desire to satisfy health needs per se. This seems to conform with findings of existing GHD scholarship that emphasize the importance of security and economic interests as driving forces of GHD, and how health is often appropriated instrumentally within foreign policy settings to achieve other goals. But the review also reveals that in the context of South-South cooperation (and regional health diplomacy), solidarity and normative considerations can be important driving forces as well. Finally, the review demonstrates that there has been an evolution from chiefly domestically focused health policies (e.g. maternal and child nutrition treatment) towards internationally inspired integrated policies (e.g. maternal and child nutrition promotion aligned with international guidelines).

BACKGROUND: Despite many efforts to achieve better coordination, fragmentation is an enduring feature of the global health landscape that undermines the effectiveness of health programmes and threatens the attainment of the health-related Sustainable Development Goals. In this paper we identify and describe the multiple causes of fragmentation in development assistant for health at the global level. The study is of particular relevance since the emergence of new global health problems such as COVID-19 heightens the need for global health actors to work in coordinated ways. Our study is part of the Lancet Commission on Synergies between Universal Health Coverage, Health Security and Health Promotion. METHODS: We used a mixed methods approach. This consisted of a non-systematic literature review of published papers in scientific journals, reports, books and websites. We also carried out twenty semi-structured expert interviews with individuals from bilateral and multilateral organisations, governments and academic and research institutions between April 2019 and December 2019. RESULTS: We identified five distinct yet interconnected sets of factors causing fragmentation: proliferation of global health actors; problems of global leadership; divergent interests; problems of accountability; problems of power relations. We explain why global health actors struggle to harmonise their approaches and priorities, fail to align their work with low- and middle-income countries' needs and why they continue to embrace funding instruments that create fragmentation. CONCLUSIONS: Many global actors are genuinely committed to addressing the problems of fragmentation, despite their complexity and interconnected nature. This paper aims to raise awareness and understanding of the causes of fragmentation and to help guide actors' efforts in addressing the problems and moving to more synergistic approaches.

Impact Statement: The European Union funded Go4Health research consortium researched the positioning of health in the Sustainable Development Goals providing expert commentary, policy advice, and engagement with key global, national, and local stakeholders. Go4Health critically examined national and multilateral input into the Sustainable Development Goals process, including the proposed governance structures for health. It advocated for the inclusion of human rights in the Sustainable Development Goals through a right-to-health framing in its analysis and advocacy. In line with the European Commission and World Health Organization, it argued that Universal Health Coverage best embodied these values and provided rigorous academic arguments, grounded in international law, and public health to support this approach. This research article aims to stimulate debate on the governance and implementation of global health policy frameworks such as the UHC2030 alliance and the High-Level Political Forum on sustainable development. The possible impact of the research is to advance the normative thinking and development of transnational global health policies that safeguard and advance human rights while acknowledging that the current political momentum is limited. However, we believe that transnational, shared, health risks will eventually also lead to shared transnational health responsibilities. This manuscript, and other publications by Go4Health, will contribute to develop such cosmopolitan health governance frameworks.

The Covid-19 pandemic disrupted "normal" modes of public sphere functioning and activated an experimental mode of coping, reinventing forms of publicness and communicative exchanges. We conceptualize the social responses triggered by the crisis as particular forms of public sphere resilience and assess the role of digitalisation and digital spaces in the emergence of distinct modes and dynamics of resilience. Four areas of enhanced public sphere experimentation are the basis of our conceptualisation: political consumerism, digital modes of solidarity, political protest mobilisation, and news consumption. We discuss overarching features of public sphere resilience across societal sub-spheres and highlight the dynamics and hybridities which structure the emerging public spaces. Resilience practices are accompanied by dynamics of politicisation and depoliticisation coupled with shifting boundaries of publicness and privateness. Our observations likewise reveal the dynamic interplay between resilience and resistance.

The policies of the G8 countries (the G7 industrialized countries plus Russia) matter for population health and the determinants of health worldwide. In the years before the 2005 Summit, relevant G7 commitments were more often broken than kept, representing an inadequate response to the scale of health crises in countries outside the industrialized world. The commitments made in 2005 by some G7 countries to increase development assistance to the longstanding target of 0.7% of Gross National Income, and by the G7 as a whole to additional debt cancellation for some developing countries, were welcome and overdue. However, Canada and the United States did not state timetables for reaching the development assistance target, and new conditionalities attached to debt relief may undermine the benefits for population health. Lack of adequate funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria, even after the September 2005 replenishment meeting, is unconscionable; yet even if those funds were provided, additional resources for developing country health systems would be needed. Similarly, widespread agreement on the need for improving market access for developing country exports was not met with any concrete policy response to the "asymmetrical" nature of recent trade liberalization; neither was the need to control the deadly trade in small arms. To respond adequately to global health needs, the G8 will need to adopt an agenda that more fundamentally alters the distribution of economic and political power, within and among nations.

Front Matter -- Contents -- Introduction -- I The Documents Reviewed: An Analysis -- Disease Control Priorities in Developing Countries -- World Development Report 1993: Investing in Health -- The Health of Adults in Developing Countries -- Human Development Reports, 1993 and 1994 -- Ninth General Programme of Work, 1996-2001 and Intensified Cooperation with Countries in Greatest Need -- The State of the World's Children, 1994 and 1995 -- Health Research: Essential Link to Equity in Development -- Global Comparative Assessments in the Health Sector -- Partnerships for Global Development: The Clearing Horizon -- Strategies for Sustainable Development -- II The Documents Considered: Reflections and Implications -- The Documents Considered: Reflections and Implications -- A Final Note.

The international sharing of virus data is critical for protecting populations against le-thal infectious disease outbreaks. Scientists must rapidly share information to assessthe nature of the threat and develop new medical countermeasures. Governmentsneed the data to trace the extent of the outbreak, initiate public health responses,and coordinate access to medicines and vaccines. Recent outbreaks suggest, however,that the sharing of such data cannot be taken for granted – making the timely inter-national exchange of virus data a vital global challenge. This article undertakes thefirst analysis of the Global Initiative on Sharing All Influenza Data as an innovativepolicy effort to promote the international sharing of genetic and associated influenzavirus data. Based on more than 20 semi-structured interviews conducted with key in-formants in the international community, coupled with analysis of a wide range ofprimary and secondary sources, the article finds that the Global Initiative on SharingAll Influenza Data contributes to global health in at least five ways: (1) collating themost complete repository of high-quality influenza data in the world; (2) facilitatingthe rapid sharing of potentially pandemic virus information during recent outbreaks;(3) supporting the World Health Organization's biannual seasonal flu vaccine strainselection process; (4) developing informal mechanisms for conflict resolution aroundthe sharing of virus data; and (5) building greater trust with several countries key toglobal pandemic preparedness.

Abstract Human-induced climate change will affect the lives of most populations in the next decade and beyond. It will have greatest, and generally earliest, impact on the poorest and most disadvantaged populations on the planet. Changes in climatic conditions and increases in weather variability affect human wellbeing, safety, health and survival in many ways. Some impacts are direct-acting and immediate, such as impaired food yields and storm surges. Other health effects are less immediate and typically occur via more complex causal pathways that involve a range of underlying social conditions and sectors such as water and sanitation, agriculture and urban planning. Climate change adaptation is receiving much attention given the inevitability of climate change and its effects, particularly in developing contexts, where the effects of climate change will be experienced most strongly and the response mechanisms are weakest. Financial support towards adaptation activities from various actors including the World Bank, the European Union and the United Nations is increasing substantially. With this new global impetus and funding for adaptation action come challenges such as the importance of developing adaptation activities on a sound understanding of baseline community needs and vulnerabilities, and how these may alter with changes in climate. The global health community is paying heed to the strengthening focus on adaptation, albeit in a slow and unstructured manner. The aim of this paper is to provide an overview of adaptation and its relevance to global health, and highlight the opportunities to improve health and reduce health inequities via the new and additional funding that is available for climate change adaptation activities.