Journal of Health Communication: International Perspectives
EDITORIALVolume 12, Number 8 Vol. 12, Number 8: Contents | Editorial | Abstracts International or Global Health—Making a Difference The Journal of Health Communication has a subtitle: International Perspectives. While this generally means studies with authors and/or subjects in various nations, it does not truly address the ideas of ‘‘global health.’’ Global health has awakened new passion—meaning thinking globally . . . rather than the pejorative ‘‘international’’ meaning happening somewhere else. Global health seems to be more firmly established, with a variety of organizations, professional publications, governments and foundations increasing the emphasis. Some of the increase in awareness can be attributed to recent concerns of health security— avian flu, SARS, bioterrorism, MDR-TB—as well as the moral imperatives to address the inequalities pervasive in the 21st Century. In the past five years alone, aid for health as more than doubled. Yet, there is a clouded leadership and approach—there is one truly global health organization—the World Health Organization with 191 member states. Yet, there are over 90 global health agencies, 40 bilateral donors, 26 UN agencies, and 20 global and regional funds. Countless foundations and others have entered the fray—some employing evidence informed approaches, with others based on ideology and multiple sources for engagement. The Bill and Melinda Gates Foundation has a budget dwarfing many governments as well as multilateral institutions dedicated to health. The Global Fund for AIDS, Tuberculosis and Malaria and the US President’s Emergency Plan for AIDS Relief (PEPFAR) have helped galvanize and provide funding for specific diseases. Recently, the new UK Prime Minister Gordon Brown launched the International Health Partnership, another initiative to accelerate progress on health globally. The WHO also has a new initiative: in November of 2007 the Intergovernmental
Working Group on Public Health, Innovation and IPRs (IGWG) will develop a
Draft global strategy on public health, innovation and intellectual property While all these efforts are laudatory, global health is not just about aid and support. The recent (July/August 2007) lead article in Health Affairs by authors affiliated with the World Bank, concluded that ‘‘better quality aid and more coordination among donor and recipient countries are critical to improving aid effectiveness.’’ More money alone will not solve the global health challenges. Yet, efficient use of funds and allocation of resources within and by countries would be important advances in global health. For example, since 1981 the idea that a country should spend 5% of its national income on health has been promulgated by the WHO. While spending alone does not translate into health outcomes, the focal point on economics often imperils policy-making on economic rather that moral and ethical terms. What should be the basic essential services provided in health from a local and national government, private and=or global body? What are the basic human rights a government should aspire to in health? Are there different thresholds base upon urban development, economic transitions, political certainty and other variables? In the future—in the multipolar world that moves from concentration of decision making to increased communication amongst stakeholders, the historical axis of the US, Japan and Europe will need to engage and empower different multilateral grouping of national powers. One of the best examples of a transnational campaign for improving health engaged in a ‘‘global health diplomacy.’’ In 1995, during the Civil War in Sudan, former President Carter negotiated a guinea worm ceasefire for 4 months with began Sudan’s onchocerciasis control program. In 2007, the campaign is in its final stage with cases reduced to roughly 25,000 from 3.5 Million in 1986 when the campaign began two decades ago. Such goals and resource deployment can make a difference with perseverance. Global health is at a unique crossroads where multiple approaches have been attempted with modest success. Yet, the challenges of health reform, human rights and efficient use of resources challenge all of us. We have now learned enough internationally, that we can begin to act and think globally. It is with this idea that we will begin to explore modifying the journal subtitle to best advance the ideals for global health for the 6 billion humans inhabiting this planet. _____ |
