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Towards a common definition of global health

Towards a common definition of global health. Koplan, J. P., Bond, T. C., Merson, M. H., Reddy, K. S., Rodriguez, M. H., Sewankambo, N. K., & Wasserheit, J. N. (2009). Towards a common definition of global health. The Lancet, 373(9679), 1993-1995. doi:10.1016/S0140-6736(09)60332-9 Contributors

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Towards a common definition of global health

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  1. Towards a common definition of global health • Koplan, J. P., Bond, T. C., Merson, M. H., Reddy, K. S., Rodriguez, M. H., Sewankambo, N. K., & Wasserheit, J. N. (2009). Towards a common definition of global health. The Lancet, 373(9679), 1993-1995. doi:10.1016/S0140-6736(09)60332-9 • Contributors The Consortium of Universities for Global Health (CUGH) Executive Board developed the definition and reviewed and edited the manuscript (Kolpan et al., 2009)

  2. An area for study, research, and practice Improving health and achieving equity in health for all people worldwide. Emphasizes transnational health issues, determinants, and solutions Involves many disciplines within and beyond the health sciences and promotes interdisciplinary collaboration A synthesis of population-based prevention with individual-level clinical care. What is Global Health? (Kolpan et al., 2009)

  3. Can be thought of as A notion (the current state of global health) An objective (a world of healthy people, a condition of global health) A mix of scholarship, research, and practice (with many questions, issues, skills, and competencies) Global Health (Kolpan et al., 2009)

  4. The science and art of Preventing disease Prolonging life Promoting physical health and efficacy Through organized community efforts for Sanitation of the environment Control of communicable infections Education of the individual in personal hygiene Organization of medical and nursing services Development of social machinery What is Public Health? (Kolpan et al., 2009)

  5. Emerged in the mid 19th century The discipline on the basis of four factors: (1) decision making based on data and evidence (vital statistics, surveillance and outbreak investigations, laboratory science) (2) a focus on populations rather than individuals (3) a goal of social justice and equity (4) an emphasis on prevention rather than curative care. All these elements are embedded in most definitions of public health. Public Health (Kolpan et al., 2009)

  6. Defined by Merson, Black, and Mills as “the application of the principles of public health to problems and challenges that affect low and middle-income countries and to the complex array of global and local forces that influence them”. It was the term used for health work abroad, with a geographic focus on developing countries and often with a content of infectious and tropical diseases, water and sanitation, malnutrition, and maternal and child health. What is International Health? (Kolpan et al., 2009)

  7. Comparison: Global Health (Kolpan et al., 2009)

  8. Comparison: International Health (Kolpan et al., 2009)

  9. Comparison: Public Health (Kolpan et al., 2009)

  10. How does global health relate to globalization? • The spread of health risks and diseases across the world often linked with trade or attempted conquest. • The rapid increase in speed of travel and communication, as well as the economic interdependency of all nations has led to a new level and speed of global interconnectedness or globalisation. • Global health uses the resources, knowledge, and experience of diverse societies to address health challenges throughout the world. (Kolpan et al., 2009)

  11. The health impacts of globalisation: a conceptual framework • Huynen, M. MTE., Martens, P., & Hilderink, H. BM. (2005). The health impacts of globalization: a conceptual framework. Globalization and Health, 1(14). doi:10.1186/1744-8603-1-14 • Describes a conceptual framework for the effects of globalisation on population health. • Serving as 'think-model' • Providing a basis for the development of future scenarios on health (Huynen et al., 2005)

  12. The presented framework • 1) Defining the concept of population health and identifying its main determinants • 2) Defining the concept of globalisation and identifying its main features • 3) Constructing the conceptual model for globalisation and population health (Huynen et al., 2005)

  13. Population health • Human health is increasingly perceived as the integrated outcome of • Ecological • Social-cultural • Economic • Institutional determinants. (Huynen et al., 2005)

  14. What is Globalisation? • An extremely complex phenomenon • It is the interactive co-evolution of multiple technological, cultural, economic, institutional, social and environmental trends at all conceivable spatiotemporal scales. • Important features of the globalisation process: • Global governance structures • Global markets • Global communication and diffusion of information • Global mobility, cross-cultural interaction • Global environmental changes (Huynen et al., 2005)

  15. Multi-nature and multi-level framework for population health (Huynen et al., 2005)

  16. Rethinking global health research: towards integrative expertise • MacLachlan, M. (2009). Rethinking global health research: towards integrative expertise. Globalization and Health, 5(6). doi:10.1186/1744-8603-5-6 • The Bamako Call for Action on Research for Health • The ministerial conference theme of "Strengthening Research for Health, Development and Equity" • The agenda being to change the way in which health research is undertaken (MacLachlan, 2009)

  17. Nature of research and innovation for health improvement • Not sufficiently inter-disciplinary and inter-sectoral, especially in the context of the United Nations Millennium Development Goals • Need to mobilize all relevant sectors (public, private, civil society) to work together in effective and equitable partnerships to find needed solutions • Need to rethink our approach • To research in global and public health • To complement narrow research specialization with a new cadre of researchers who have expertise concerning the context and process of research, as well as its content, and the interplay of these knowledge domains. (MacLachlan, 2009)

  18. To enhance the likelihood of research utilization • What • Content • Where • Context • How • Process (MacLachlan, 2009)

  19. Example: The challenges presented by HIV/AIDS • What: Content knowledge • An appreciation of critical issues ranging across immunology, stigma and adherence to medication, and the different approaches to researching these • Where: Context knowledge • Require understanding how HIV/AIDS is patterned across society, its social epidemiology, especially with regard to gender, disability, age, place, and socioeconomic status • How: Process knowledge • Awareness of the systems of application that need to be involved in putting knowledge into action (MacLachlan, 2009)

  20. Global Health is a 'composite' field • Comprised of • Biological • Clinical • Social health sciences • Other disciplines such as engineering or political science (MacLachlan, 2009)

  21. Conclusion • Need a reconfiguring of knowledge, not simply a diminution or expansion of it. • Need to know more about how things fit together and can be put to good use. • Cannot simply hope for broad-minded health researchers to spontaneously spring forth. • Research training at postgraduate level should stress the value of integrative expertise as well as recognizing depth expertise. (MacLachlan, 2009)

  22. References • Huynen, M. MTE., Martens, P., & Hilderink, H. BM. (2005). The health impacts of globalization: a conceptual framework. Globalization and Health, 1(14). doi:10.1186/1744-8603-1-14 • MacLachlan, M. (2009). Rethinking global health research: towards integrative expertise. Globalization and Health, 5(6). doi:10.1186/1744-8603-5-6 • Koplan, J. P., Bond, T. C., Merson, M. H., Reddy, K. S., Rodriguez, M. H., Sewankambo, N. K., & Wasserheit, J. N. (2009). Towards a common definition of global health. The Lancet, 373(9679), 1993-1995. doi:10.1016/S0140-6736(09)60332-9

  23. The White Man's Burden • Almost 3 billion people live on less than two dollars a day • 804 million people in the world don't have enough to eat • 10 million children die every year from easily preventable diseases • AIDS is killing 3 million people a year and is still spreading

  24. How Rich Countries Got Rich and Why Poor Countries Stay Poor • The gap between the rich and the poor on this planet is larger then ever before and still growing • Even after three “Development Decades” that began in 1970 and trillions of dollars of development assistance, the situation is still dismal and getting worse. • Since 1970, the gap between the richest and the poorest nations has only increases.

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