What is Global Health and Governance?
When the term ‘Global Health’ is mentioned, what do you think of? The majority of people, me included, immediately think technical expertise. We think science, we think medicine and healthcare providers, we think biotechnology. However, what REALLY should we be thinking about when we discuss Global Health? Think about it…how are health providers able to reach populations where they are most needed? How do breakthroughs in science and technology translate into better health for the world’s populations? It is primarily through governance-the political architecture of the world and of each country of the world. In order to address world health problems, we have to start at ‘the causes of the causes‘. Policies put in place to enable the practice of providing better healthcare are extremely important, as has been demonstrated in the rich nations of the world. It is not that there is anything special about these nations, on the contrary majority of the world’s population is susceptible to the same kinds of health problems. However, the healthcare laws in place in developed countries provide for a conducive environment for monitoring and evaluating health problems. Now shift your focus to underdeveloped and developing countries. One doesn’t have to look too close to see the gaping hole where there should be a sound healthcare system. Why? Because there is a lack of policies not just involving health but also science and education, ALL of which affect health.
So how did we get from national Public Health Governance to this thing called Global Health Governance? Global Health governance is a relatively new and emerging field driven by factors such as the growing interdependence among countries and shared problems like climate change and infectious disease. These shared problems require all nations to engage in a meaningful and collective response. The World Health Organization (WHO) was created, shortly after WWII under the auspices of the United Nations, precisely for this reason.
Who funds WHO?
WHO is a largely successful intergovernmental institution, funded primarily by member states and voluntary contributions. Obviously, this means that richer nations such as USA, Japan, UK and France, as well as NGOs like the Gates Foundation, are able to contribute more towards WHO funding than the poorer nations, and thus have more say over how priorities are set. This, by definition, presents a problem to the less privileged who rely on WHO as the authority on Global Health. A system that is meant to be of an international nature and working for the good of humanity ends up being taken over by the interests of a select few while the rest of the world is forced to fall in line with their agenda. This is in no way meant to condemn rich nations and NGOs for their commitment to global health. It just points out a fact that I am sure many people are aware of. The fact that Global Health is not truly global because it does not give the high need populations any say when priorities are being set.
It is of central importance that WHO remains the final authority of on global health policies and practice. Countries and NGOs who possess vast resources and are deeply involved in the global health domain should make it a point to be properly engaged in broader dialogue on issues of health. Doing this will ensure that they understand and are aware of all aspects of Global Health issues and can act in a more synergized way towards more effective outcomes.