European perspectives on global health: a policy glossary

1. Europe must make global health a priority
Globalisation has a profound
impact upon health
“Globalisation can be defined as the
“widening, deepening and speeding up of
worldwide interconnectedness in all aspects of
contemporary social life”. ( Held, et al 1999 )
“Although responsibilities for health remain
primarily national, the determinants of health
and the means to fulfil that responsibility are
increasingly global.” ( Jamison, et al 1998 )
The relationship between globalisation and health
is a two-way process. There are many direct and
indirect ways in which globalisation affects health.
The inverse is also true : a society which suffers
from a high burden of disease is not in a position to
participate effectively in the processes of globalisation
and therefore will not be able to share its benefits.
And a global disease outbreak can lead to significant
human and financial losses all around the world. The
interface between globalisation and health has all the
ingredients of a vicious spiral, but also the potential
for a virtuous circle. Europe is both affected by and
contributes to this in manifold ways :
• Globalisation leads to more rapid spread of
health problems, as a consequence of increasing
worldwide travel ( infectious diseases ) as well as
through the spread of consumption habits through
global marketing ( smoking, changing patterns
of food consumption ). Lack of control of global
disease spread can lead to a range of negative
impacts in both rich and poor countries as the
SARS epidemic and spread of obesity show.
• Globalisation has helped to increase scientific
and technological knowledge sharing for the
development of medicines, vaccines and medical
appliances, which allows new forms of treatment
and prevention to develop. It has also improved
communication and transport possibilities and
thus reduced the technical barriers to access
to medical information and treatment. Internet
communication has also drastically improved the
possibility of tracking and monitoring outbreaks of
infectious diseases.
• Access to medical progress has been more
unequal ; as the health sector has continued
to grow in developed countries, the economic
restrictions for the health sector in many poor
countries has increased. Reasons include :
pressures on public expenditures, sometimes
due to conditions imposed on structural
adjustment loans, increasing prices for newly
developed medical inputs due to more stringent
international property rights rules, low research
and development ( R&D ) expenditures on many
tropical diseases, donor focus on disease-specific
programmes and lack of priority assigned by some
of the countries themselves. Many poor countries
also find it increasingly difficult to retain medical
staff who are attracted by higher salaries in rich
countries.
• The rapid increase in global interconnectedness
has also transformed the face of international
politics. The growing perception of security risks
for high-income countries due to health, but also
the increasing strength of advocacy organisations
in this field and the more active role taken by
developing countries in international fora and
negotiations related to health has changed the
field of international cooperation in health. Many
new institutions have entered the field and the
roles of traditional institutions have changed.
• Private actors have rapidly gained importance
as health becomes a major global market.
Powerful companies and other private for-profit
actors try to defend their strategic position in
a liberalised global trade system ; this includes
food, pharmaceuticals, agricultural products,
insurance companies. Global civil society in turn
has considerably strengthened its advocacy role
and is increasing the pressure on private business
to accept corporate social responsibility for global
health.
Action : “Making globalisation work for everyone’s
health” should be at the core of a <strong>European</strong> strategy
for global health.
14 <strong>European</strong> Foundation Centre – <strong>European</strong> Partnership for Global Health