Suchergebnisse

International audience ; AB STRACT This article analyses the impact of new institutional structures in global health governance (GHG) on the realization of social rights in poor countries. Focusing on the example of global HIV/AIDS politics. The article argues that new governance modes increase the participation of civil society groups and affected communities, but also that they are frequently instrumentalized by powerful actors to pursue their particular interests. In fact, increasing resources are mobilized for the fight against poverty-related diseases. The article concludes that, as the experience of HIV/AIDS politics, the conflicts around the TRIPS Agreement and the development of Global Public-Private Partnerships GPPPs suggest, GHG is characterized by a combination of moral values and material interests that does not guarantee a comprehensive realization of social rights, but which allows some progress in the fight against poverty-related diseases — a step toward realization of social rights.

Reflecting on the recent West African Ebola outbreak, this piece advocates for a critical and people-centered approach both to and within global health. I discuss the current state of the field as well as critical theoretical responses to it, arguing that an ethnographic focus on evidence and efficacy at the local level raises rather than lowers the bar for thoughtful inquiry and action. The current moment calls less for the all-knowing hubris of totalizing analytical schemes than for a human science (and politics) of the uncertain and unknown. It is the immanent negotiations of people, institutions, technologies, evidence, social forms, ecosystems, health, efficacy, and ethics – in their temporary stabilization, production, excess, and creation – that animate the unfinishedness of ethnography and critical global health.

Gesundheit und Medizin werden zunehmend von Faktoren beeinflusst, die über nationale Gesundheitssysteme und traditionelle Ländergrenzen hinausgehen. Der Fluss und Austausch von Waren, Informationen, Arbeitskräften, Patienten und Krankheitserregern zwischen Ländern verändert unser Verständnis von Gesundheit, den Determinanten von Gesundheit und die Art und Weise in der Medizin praktiziert wird. Weltweit wird zunehmend gefordert die medizinische Ausbildung an den Einfluss der Globalisierung anzupassen, unter anderem durch die Integration von Global Health in das medizinische Curriculum. Doch bis jetzt gibt es keine einheitliche Definition oder einheitliches Verständnis von Global Health. Diese Studie verwendet ein auf der Grounded Theory-Methodologie basierendes Mixed-Method-Design, um besser zu verstehen, wie GH in der medizinischen Ausbildung in Deutschland unterrichtet wird. Wir haben zehn Interviews mit elf Experten geführt und eine Online-Umfrage im Rahmen der Teilnehmervalidierung angeschlossen. Dabei ging es darum das Verständnis von GH, die Unterrichtsinhalte und die didaktische Vorgehensweise von Global Health-Lehrenden in Deutschland zu explorieren. Die Interviewinhalte wurden in vier Hauptfragen kategorisiert: (1) Was ist Global Health? (2) Welche Themen gehören zu Global Health? (3) Wie kann Global Health unterrichtet werden? und (4) Was ist wichtig für die Zukunft von Global Health? Als Ergebnisse zeigen wir die historische Entwicklung von Global Health, die Beziehung zu Public Health, International Health und Tropenmedizin, die Unterrichtsinhalte und -ziele, die Zielgruppen des Global Health-Unterrichts, Unterrichtsformen, didaktische Ansätze, Wege wie Global Health in das medizinische Curriculum integriert werden kann und Ideen zur Zukunft von Global Health im Allgemeinen und in der deutschen medizinischen Ausbildung. Das zentrale Ergebnis dieser Studie ist das Verständnis von Global Health als Umbrella Term. Dieser Begriff wurde von einem der interviewten Experten in einem Nebensatz verwendet und fand in einer Reihe der Interviews großen Anklang. Die Metapher des "Umbrellas" haben wir dann weiterentwickelt, um am Beispiel des Schirmes ("Umbrella"), der hinter einer Lichtquelle einen Kernschatten und einen umgebenden Halbschatten wirft, das Verhältnis zwischen Global Health und anderen Disziplinen wie Public Health, International Health und Tropenmedizin zu verdeutlichen und aufzuzeigen, wie einige Themen zum klaren Kern von Global Health gehören, während andere eher vom diffuseren Halbschatten abgedeckt werden. Im Kern von Global Health steht demnach das Verständnis der supraterritorialen Determinanten von Gesundheit. Diese Determinanten überschreiten traditionale Grenzen und Territorien und werden in der Regel nicht durch traditionelle Modelle der sozioökonomischen Gesundheitsdeterminanten erfasst. In unserem abschließenden Modell zeigen wir, wie das konkret aussehen kann, insbesondere für die medizinische Ausbildung. Global Health erfordert auf Grund seiner bereits im Namen enthaltenen Globalität und der damit verbundenen Komplexität einen transdisziplinären Ansatz und innovative Unterrichtsformen. Wir zeigen, wie diese in das medizinische Curriculum integriert werden können und dem übergeordneten Ziel dienen, Ärztinnen und Ärzte für das 21. Jahrhundert auszubilden mit einem Verständnis für die globalen Abhängigkeiten und deren Einfluss auf die Gesundheit, mit interkulturellen Kompetenzen und einem transformativen Ansatz, der Verantwortungsübernahme, sowie ein moralisches und politisches Bewusstsein fördert. Nach unserem Kenntnisstand ist dies die erste Studie, die ausführliche Interviews mit Global Health-Lehrenden in der medizinischen Ausbildung nutzt, um deren Global Health-Verständnis und -Praxis zu erkunden. Das Verständnis von Global Health als Umbrella Term ist dabei ein neues Konzept, dass einige der Diskrepanzen zwischen bisherigen Global Health-Definitionen zusammenführt. Mit den supraterritorialen Determinanten von Gesundheit als genuiner Kern von Global Health wird eine sauberere Definition und Abgrenzung zu anderen Disziplinen, Fächern und Feldern erleichtert. Das Global Health-Verständnis der von uns interviewten Lehrenden in der medizinischen Ausbildung spiegelt dabei die internationalen Diskussionen um die normativen Ansprüche und das koloniale Erbe von Global Health wider. Das Bewusstsein für diese Themen kann dabei zu einer Stärkung der Sozialwissenschaften innerhalb der medizinischen Ausbildung und damit einem tiefergehenden Verständnis von Medizin im Allgemeinen beitragen. Die Analyse der deutschen Global Health-Landschaft und der aktuellen politischen Entwicklungen belegt die Relevanz von Global Health in der heutigen Gesellschaft und seine wachsende Bedeutung im nationalen und internationalen politischen Geschehen. Das Verständnis von Global Health als Umbrella Term hat das Potential die weitere Zukunft von Global Health in Lehre, Forschung und Praxis mitzugestalten. Die Integration von Global Health in das medizinische Curriculum trägt dazu bei, Gesundheitsfachkräfte auf die Bedürfnisse einer globalisierten Welt in unserer Zeit vorzubereiten.

Health equality is the goal of global health policymakers (Weiss & Pollack, 2017).In the current political scenario, global health policy Development is facing significant challenges across the globe. Addressing these barriers is a complex task and requires coordination between global organizations across various healthcare domains. Our paper identifies barriers to the development of cohesive global health policy, and offer a few potential remedies in the development process of the same.

This think piece argues for the importance of administrative and bureaucratic labor –'mundane' things – in maintaining US-African global health research partnerships and the power relations within them. The daily work of accounting, compliance, and risk management undertaken by global health 'enabling systems' created by US universities contrasts with global health's heroic self-image and conjures up negative imaginaries of intransigent African bureaucracies, crumbling communication infrastructure, and corruption. These negative imaginaries help to authorize forms of US fiscal and administrative control that may contradict global health's ethic of partnership and its related goal of 'building capacity' in low-income partner nations, as well as feed 'creative accounting' practices by both partner entities. Critiquing these inequalities may seem risky in an era of 'America First' and threatened cuts to global health funding. In fact, advocating for equity in global health partnerships and prioritizing the building of African institutional capacity are only made more urgent by the current political climate.

Inequalities of one kind or another are a ubiquitous feature of human life. The more aspects of human experience researchers measure, and the greater the accuracy with which they measure them, the more inequalities they uncover. Some inequalities are generally thought to matter more than others: movements are formed to fight for greater income equality and equal rights to democratic participation, but not for an equal distribution of television sets. Inequalities in health are often thought to be particularly difficult to justify. This article examines which health inequalities on a global scale are unjust, and considers who should have the duties to rectify these injustices.

At the time of the covid-19 pandemic, most global health organizations had to adapt their work methods and processes to online collaborative tools such as Zoom, Google Meet or Webex Cisco. However, these new collaborative tools are mainly dedicated to staff. What about the participation of other stakeholders in the decision-making processes of these organizations? Based on a methodology that was initially developed to analyze the participation features of local governments' websites, this paper conducts a comparative analysis of the websites of 10 international health organizations. Some results are similar to e-participation in a local context: organizations use their website primarily to provide access to information rather than to engage with their stakeholders. This study also highlights the diversity of e-participation features and levels that GHG organizations offer to their audiences. Further research with a larger sample of organizations is needed to confirm these results. Au moment de la pandémie de la covid-19, la plupart des organisations internationales de la santé ont dû adapter leurs méthodes et processus de travail à des outils de collaboration en ligne tels que Zoom, Google Meet ou Webex Cisco. Cependant, ces nouveaux outils collaboratifs sont principalement dédiés au personnel. Qu'en est-il de la participation d'autres parties prenantes aux processus décisionnels de ces organisations ? Sur la base d'une méthodologie initialement développée pour analyser les caractéristiques de participation des sites internet des gouvernements locaux, cet article effectue une analyse comparative des sites internet de 10 organisations internationales de la santé. Cet article montre que les organisations de cet échantillon utilisent leur site internet principalement pour donner accès à des informations davantage que pour dialoguer avec différents publics. Cette étude met également en évidence la diversité des caractéristiques et des niveaux de participation en ligne que les organisations de la santé offrent à leurs parties prenantes. Des recherches plus approfondies et avec un échantillon plus large d'organisations sont nécessaires pour confirmer ces résultats.

Health has long been intertwined with the foreign policies of states. In recent years, however, global health issues have risen to the highest levels of international politics and have become accepted as legitimate issues in foreign policy. This elevated political priority is in many ways a welcome development for proponents of global health, and it has resulted in increased funding for and attention to select global health issues. However, there has been less examination of the tensions that characterize the relationship between global health and foreign policy and of the potential effects of linking global health efforts with the foreign-policy interests of states. In this paper, the authors review the relationship between global health and foreign policy by examining the roles of health across 4 major components of foreign policy: aid, trade, diplomacy, and national security. For each of these aspects of foreign policy, the authors review current and historical issues and discuss how foreign-policy interests have aided or impeded global health efforts. The increasing relevance of global health to foreign policy holds both opportunities and dangers for global efforts to improve health.

There is increasing understanding, globally, that climate change will have profound and mostly harmful effects on human health. This authoritative book brings together international experts to describe both direct (such as heat waves) and indirect (such as vector-borne disease incidence) impacts of climate change, set in a broad, international, economic, political and environmental context. This unique book also expands on these issues to address a third category of potential longer-term impacts on global health: famine, population dislocation, and conflict. This lively yet scholarly resource explores these issues fully, linking them to health in urban and rural settings in developed and developing countries. The book finishes with a practical discussion of action that health professionals can yet take.

This book is a collection of fictionalised case studies of everyday ethical dilemmas and challenges, encountered in the process of conducting global health research in places where the effects of global, political and economic inequality are particularly evident. It is a training tool to fill the gap between research ethics guidelines, and their implementation 'on the ground'. The case studies, therefore, focus on 'relational' ethics: ethical actions and ideas that emerge through relations with others, rather than in regulations.

Epidemiological modeling and simulation can contribute cooperatively across multifaceted areas of biosurveillance systems. These efforts can be used to support real-time decision-making during public health emergencies and response operations. Robust epidemiological modeling and simulation tools are crucial to informing risk assessment, risk management, and other biosurveillance processes. The Defense Threat Reduction Agency (DTRA) has sponsored the development of numerous modeling and decision support tools to address questions of operational relevance in response to emerging epidemics and pandemics. These tools were used during the ongoing COVID-19 pandemic and the Ebola outbreaks in West Africa and the Democratic Republic of the Congo. This perspective discusses examples of the considerations DTRA has made when employing epidemiological modeling to inform on public health crises and highlights some of the key lessons learned. Future considerations for researchers developing epidemiological modeling tools to support biosurveillance and public health operations are recommended.

Global health has developed as a concept over the past 25 years and signifies the efforts by a host of transnational actors directed toward health equity across the world. A holistic enterprise, global health involves not only the improvement of healthcare, but also embraces academic, political and educational perspectives. The complexity and scale of this endeavour challenges reductive approaches to intervention: many efforts to make matters better either do not work, or do not work as intended. As a result, there is a growing recognition of the importance of taking a systems approach to global health, yet without a clear articulation of what this means. This thesis seeks to answer the question of what is meant by a systems approach to global health. It explores the use of the word 'systems' in the global health literature, and widens this contextual understanding to some of the extensive literature on both systems thinking and systems practice. While a systems approach to global health is not currently clearly defined, systems engineering is identified as a highly developed, codified, body of knowledge which marries systems thinking with systems practice and which has been advocated as being relevant to healthcare. A recent consensus systems approach to healthcare improvement from the UK, at the interface of engineering and medicine, is identified as a candidate model for global health. A programme of primary research is described to assess the extent to which this systems approach to healthcare improvement is applicable to the broader enterprise of global health. The research takes the form of two embedded projects, across two countries, using narrative analysis to understand the lived experience of a range of global health actors. This experience is then synthesised using a framework approach to adapt both the content and structure of the candidate model. The result, a systems approach to global health, is presented as both a working definition and a visual model. The strengths of this model are also its limitations: while directly informed by the lived experience of those communities accessible to the research team, it remains silent on the experience of those beyond their purview. A future programme of action research is planned to refine the model, working within the global health community. ; NIHR Global Health Research Group on Neurotrauma WD Armstrong PhD Studentship

Although the resources and knowledge for achieving improved global health exist, a new, critical paradigm on health as an aspect of human development, human security, and human rights is needed. Such a shift is required to sufficiently modify and credibly reduce the present dominance of perverse market forces on global health. New scientific discoveries can make wide-ranging contributions to improved health; however, improved global health depends on achieving greater social justice, economic redistribution, and enhanced democratization of production, caring social institutions for essential health care, education, and other public goods. As with the quest for an HIV vaccine, the challenge of improved global health requires an ambitious multidisciplinary research program.

More than half of the world's 100 largest economies are corporations and an increasing proportion of global deaths are caused by exposure to highly-processed foods, alcohol, tobacco, and air pollution. This chapter explores the full spectrum of commercial activities that impact human health, starting with the historical perspective and moving to consider the various frameworks that have been developed in the past decade to harness and address these commercial determinants. Numerous examples are used to illustrate the actions of industry groups to subvert health-focused policies and foster a narrative that solely blames individuals for harmful levels of consumption. Common industry tactics are dissected and practical rebuttals are presented to tackle ubiquitous arguments. This chapter also redresses the current harm-focused CDOH balance by considering the positive direct and indirect impact that commerce and corporations can exert through their operations, closing with a selection of simple rubrics that can be used to conduct quick and nuanced assessments of individual firms. In sum, this chapter introduces readers to the field of CDOH, covers the core concepts with the attending historical, political and philosophical background, and provides the tools required to engage in CDOH research and advocacy.

Germany has become a visible actor in global health in the past 10 years. In this Series paper, we describe how this development complements a broad change in perspective in German foreign policy. Catalysts for this shift have been strong governmental leadership, opportunities through G7 and G20 presidencies, and Germany's involvement in managing the Ebola virus disease outbreak. German global health engagement has four main characteristics that are congruent with the health agenda of the Sustainable Development Goals; it is rooted in human rights, multilateralism, the Bismarck model of social protection, and a link between development and investment on the basis of its own development trajectory after World War 2. The combination of momentum and specific characteristics makes Germany well equipped to become a leader in global health, yet the country needs to accept additional financial responsibility for global health, expand its domestic global health competencies, reduce fragmentation of global health policy making, and solve major incoherencies in its policies both nationally and internationally.