Global Health GLOBAL GOVERNANCE SERIES
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Gold Mercury’s Global Governance Series is designed to offer an informative and invaluable insight into how our world works. The series is structured according to Gold Mercury’s Global Governance Model™ which identifies eight Global Governance challenge areas and a number of corresponding subareas. In each area we address where major policy discussion emanates from, who the key actors are, what developments and challenges we can expect the future to present and which actors are making a considerable contribution to finding global solutions to global challenges.
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Global Health
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Towards an Understanding of Contemporary Global Health ‘Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO, 2006a).’ This definition of ‘health,’ provided by the World Health Organisation (WHO) upon its founding in 1948, highlights the idea that global health is a multi-dimensional and complex state of objectivity and human self-perception.
Despite some criticism of this definition of health, on the basis of a potentially unclear distinction between health and happiness (Saracci, 1997) and in light of continued discussions on an improved definition (Radad & O’Grady, 2008), the multidimensionality of health is broadly accepted. Many influences affect our health. Diverse diseases, accidents, hazards or psychological pressures and traumata can have serious impacts on our well-being, to name just a few examples, and are often interrelated. Throughout history, health has always been a main concern for people of every region and every epoch. >
GOLD MERCURY INTERNATIONAL Eight Global Governance Areas: Global Health
Until recent times, dangerous epidemics have always been more threatening to human life than any war in world history, despite crucial scientific and technological advancements. It is estimated that the Black Death in the 14th century, for instance, caused more than 75 million deaths – more lives than both World Wars have cost together. In the 20th century, between 1918 and 1920, an influenza epidemic killed more people than the Great War, that is to say more than 20 million people (Hough, 2008: 165). With the foundation of the WHO in 1948, an International Organization (IO) in the context of the United Nations (UN), a time-window of global desire for international cooperation to prevent dangerous harm against humanity in the aftermaths of the Second World War was utilized. The WHO can be seen as today’s most effective tool of Global Governance in terms of Global Health policies. Since 1948, WHO campaigns have been able to eradicate and reduce several diseases by means of immunization and the use of insecticides. Just the eradication of smallpox alone, in 1978, has saved two million lives per year to date (ibid. 174-177). Owing to the indicated multidimensionality of health, it is interesting to see how physical and socio-economic issues affect our health quantitatively and qualitatively. It is interesting to retrace how and why different kinds of diseases harm human life globally, and by what means we can treat and prevent them. Global Health is a fascinating field due to its age-old importance for humanity, its worldwide significance, and its rich variety of facets.
Physical Impacts on Health A main concern for human health is physical influences. Physical impacts can be understood as concrete, immediate physical impairments that are damaging to a person’s health. Infectious diseases, non-infectious diseases and different kinds of hazardous waste form the main aspects. Infectious diseases Infectious or communicable diseases are caused by pathogenic microorganisms (germs) such as bacteria, viruses, parasites or fungi; the diseases can be spread, directly or indirectly, from one person to another or from an animal to a person in the case of Zoonotic diseases (WHO, 2009b). Infectious diseases range from harmless colds to incurable HIV/AIDS infections and have been the main cause of human deaths per year than any other external influence on human life. Table 1 shows the ten most significant infectious diseases, their root causes and the main geographical areas affected. Many of the diseases listed occur globally, although it is clear that the most affected areas are Less Developed Countries (LDC s), specifically in Africa. Between 14 and 17 million people die each year because of infectious diseases, most of them children in LDCs (Global Health Council, 2009a). Many of those diseases are preventable but particularly poor countries do not have the means to treat their populations. >
Infectious diseases range from harmless colds to incurable HIV/AIDS infections and have been the main cause of human deaths per year than any other external influence on human life.
6 GOLD MERCURY INTERNATIONAL Eight Global Governance Areas: Global Health
TABLE : TEN MOST SIGNIFICANT INFECTIOUS THREATS DISEASE
CAUSE
MAIN AREAS AFFECTED
LOWER RESPIRATORY DISEASES
Influenza and pneumonia virus passed by coughing and sneezing
Global but most deadly in LDCs Global but principally Sub-Saharan Africa
AIDS DIARRHEAL
TUBERCULOSIS
Various diseases carried by waterborne viruses, bacteria and parasites (e.g. cholera, dysentery)
India, China, Sub-Saharan Africa
coughs and sneezes
LDCs, principally Africa and SE Asia The ‘Tropics’
MALARIA MEASLES
Virus affecting children
Global
HEPATITIS B
Virus transmitted via blood (e.g. sharing needles) causing liver diseases
Global but principally Africa and E Asia
TETANUS
Bacterial infection affecting babies and mothers during birth due to unsanitary conditions
LDCs in Asia and Sub-Saharan Africa
PERTUSSIS
Bacterial infection of the lungs
Africa
deadly by human contact
Global but most deadly in Sub-Saharan Africa
MENINGITIS
Source: (Hough, 2008: 167)
Infection can be transmitted through touch, eating, drinking or breathing something that contains germs, through animal and insect bites, kissing and sexual contact. Vaccines, hand washing and medicines can help prevent infections (MedLinePlus, 2008). Hough, who analyses health in the context of globalisation and global security, identifies several determinants with regard to our globalising world that promote infectious diseases (Hough, 2008): ○ Increased travel, migration and trade. History shows us that diseases wandering from one continent to another cost millions of people’s lives. The Black Death came with trade ships from Asia to Europe. Although there will be a global immunity on several diseases in the long term, until then, however, uncontrolled tourists and goods are potential transmitters of foreign diseases into a country. ○ Urbanization, especially in the cities of LDCs, often contributes to the prevalence of unhygienic circumstances that breed infectious diseases like cholera or dysentery. Deforestation steals living space away from natural enemies of insects and leads to closer contact between animals and people. AIDS was transmitted by monkeys to people. ○ Refugees are often weakened and more vulnerable peoples. The movement of Internally Displaced Persons (IDPs) is lightly controlled, they are forced to live in disease-subservient areas and receive less assistance. ○ Owing to overuse of medication and insecticides, more viruses and bacteria are proving resistant. >