European perspectives on global health: a policy glossary

3. Europe must assert its role in global health governance
civil society organisations and private foundations in
health and the rise of new organisational forms like
GPPPs in fields where private actors do not supply
important goods which public actors as well are not
in a position to produce ( such as medicines in the
field of neglected diseases ). In general, the retreat of
the state from delivering public goods and services
in combination with the perception of growing
threats has favoured problem-oriented approaches, in
particular strategies to focus on specific diseases.
The politics of fighting HIV / AIDS and other infectious
diseases is a good example of this development.
The recognition of the growing threat from these
diseases has led to a significant increase in financial
and knowledge resources. The creation of the Global
Fund to Fight AIDS, Tuberculosis and Malaria as a
separate organisation outside the UN system and the
increasing importance of private foundations in GPPPs
to the strengthening of R&D activities as well as the
access to available medicines in the field of neglected
diseases constitute important examples of these
tendencies. Private actors ( in particular civil society
organisations ) can also be found at the forefront of
conflicts with pharmaceutical companies and TRIPS on
problems of access to medicines due to the expansion
of patent right systems into developing countries.
Nevertheless, increasingly the lack of transparency,
lack of accountability and the problems of
coordination due to the proliferation of actors in this
field have been recognised and the deficiencies of
national health systems, above all in poor countries, is
again recognised as a major problem. These problems
are also recognised in the more general field of
development cooperation and this context have led
to important agreements like the Rome Declaration
on Harmonisation and the Paris Declaration on Aid
Effectiveness, which contain insights and strategies
that are also important for global health.
On the other hand, globalisation also has increased
the need for binding international agreements,
which has been an element of strengthening WHO
as an international governmental organisation.
The new International Health Regulations and the
Framework Convention on Tobacco Control can be
seen as important indications of this. In addition, the
WHO is asserting its position as the central authority
in global health by initiatives to improve global
understanding on some central issues cutting across
narrow institutional borders and academic disciplines,
for example : the Commission on Macroeconomics
and Health, the Commission on Intellectual Property
Rights and Innovation in Health and the Commission
on Social Determinants of Health.
In the recent past, the <strong>European</strong> Union and <strong>European</strong>
countries have played an ambiguous role in the
politics of global health. On the one hand, they have
defended rather narrow economic interests mostly
in the context of WTO and TRIPS and in relation to
the migration of health workers from the South into
Europe. On the other hand they have contributed
to the increase in resources for international health
activities by giving support for health system
development in poor countries and bridging the digital
divide between Europe and the South and by putting
in general a stronger focus on humanitarian aid and
support for the provision of global public goods such
as health and environmental protection.
Action : The role of Europe in global health politics
should be reinforced by better coordination within
Europe itself, for example by initiating a <strong>European</strong>
global health strategy process to clarify Europe’s
values, strategic priorities, and preferred governance
approaches.
References :
Lee, Kelley. Health Policy in a Globalising World.
Cambridge : Cambridge University Press, 2006.
( Includes chapters by Kent Buse )
48 <strong>European</strong> Foundation Centre – <strong>European</strong> Partnership for Global Health