ConsensusGlobalisation of international health
Section snippets
Background
WHO, once the main player in “directing and coordinating international health work” is now one of many. Other UN organisations are concerned with health; the World Bank now plays an increased financial and technical role in the sector, and bilateral agencies make significant contributions to health both at global and at national level. The private sector—consisting of a wide range of non-profit organisations, such as nongovernmental bodies (eg, Oxfam) or foundations (eg, Rockefeller), and
Direct challenges to health care in the year 2000
Although many of the direct challenges to health will be met by domestic health policies, some will depend heavily on international collaboration. Health care will be affected directly by predominant disease patterns, such as emerging infections, and by interventions to address them; health care will be affected indirectly by issues such as increased pollution. The understanding, monitoring, and treatment of emerging infections and resistance to existing drug therapy will demand global
Indirect challenges to health
Globalisation is increasingly acknowledged as a force that is changing many aspects of life far beyond financial markets and trade. Although some indirect challenges to health in the next century will not necessarily result from globalisation, changes in trade and markets, the movement of people, goods, and services (including trade in legal and illegal substances and in military arms), and communications over the past half-century will have consequences on health in the next 50 years (panel).
Winners and losers in the global economy—emerging health inequalities
Although the extent to which globalisation is affecting health is unclear, winners and losers in the world economy will undoubtedly emerge—both between and within countries. During the past two decades, for example, the least developed countries—which make up 10% of the world's population—have halved their share of world trade, and today account for only 0·3% of it.21 Whether or not such inequalities result primarily from globalisation, they have potentially severe repercussions for relations
Rethinking the role of international organisations
In view of the challenges that affect health care directly and indirectly, priorities need reordering and hard choices must be made. More attention needs to be paid to which functions international organisations are best able to undertake, and what national governments should be doing. Some functions may be better organised through intergovernmental networks than through multilateral organisations (issues of publichealth regulation, for example).
International organisations may have to increase
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