Rethinking the 'global' in global health: a dialectic approach
Tóm tắt
Current definitions of 'global health' lack specificity about the term 'global'. This debate presents and discusses existing definitions of 'global health' and a common problem inherent therein. It aims to provide a way forward towards an understanding of 'global health' while avoiding redundancy. The attention is concentrated on the dialectics of different concepts of 'global' in their application to malnutrition; HIV, tuberculosis & malaria; and maternal mortality. Further attention is payed to normative objectives attached to 'global health' definitions and to paradoxes involved in attempts to define the field. The manuscript identifies denotations of 'global' as 'worldwide', as 'transcending national boundaries' and as 'holistic'. A fourth concept of 'global' as 'supraterritorial' is presented and defined as 'links between the social determinants of health anywhere in the world'. The rhetorical power of the denotations impacts considerably on the object of 'global health', exemplified in the context of malnutrition; HIV, tuberculosis & malaria; and maternal mortality. The 'global' as 'worldwide', as 'transcending national boundaries' and as 'holistic' house contradictions which can be overcome by the fourth concept of 'global' as 'supraterritorial'. The 'global-local-relationship' inherent in the proposed concept coheres with influential anthropological and sociological views despite the use of different terminology. At the same time, it may be assembled with other views on 'global' or amend apparently conflicting ones. The author argues for detaching normative objectives from 'global health' definitions to avoid so called 'entanglement-problems'. Instead, it is argued that the proposed concept constitutes an un-euphemistical approach to describe the inherently politicised field of 'global health'. While global-as-worldwide and global-as-transcending-national-boundaries are misleading and produce redundancy with public and international health, global-as-supraterritorial provides 'new' objects for research, education and practice while avoiding redundancy. Linked with 'health' as a human right, this concept preserves the rhetorical power of the term 'global health' for more innovative forms of study, research and practice. The dialectic approach reveals that the contradictions involved in the different notions of the term 'global' are only of apparent nature and not exclusive, but have to be seen as complementary to each other if expected to be useful in the final step.
Tài liệu tham khảo
Koplan JP, Bond TC, Merson MH, Reddy KS, Rodriguez MH, Sewankambo NK, Wasserheit JN: Towards a common definition of global health. Lancet. 2009, 373: 1993-1995. 10.1016/S0140-6736(09)60332-9.
Fried LP, Bentley ME, Buekens P, Burke DS, Frenk JJ, Klag MJ, Spencer HC: Global health is public health. Lancet. 2010, 375: 535-537. 10.1016/S0140-6736(10)60203-6.
Macfarlane SB, Jacobs M, Kaaya EE: In the Name of Global Health: Trends in Academic Institutions. Journal of Public Health Policy. 2008, 29: 383-401. 10.1057/jphp.2008.25.
Rescher N: Introduction. Dialectics: A Controversy-Oriented Approach to the Theory of Knowledge. 1977, New York: State University of New York Press, xiii-
WHO: Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948. 1946
PHA: People's Charter for Health. 2000, Savar, Bangladesh: People's Health Movement
WHO: Commission on Social Determinants of Health. Report by the Secretariat. A 62/9. 2009
Rowson M, Hughes R, Smith A, Maini A, Martin S, Miranda JJ, Pollit V, Wake R, Willott C, Yudkin JS: Global Health and medical education - definitions, rationale and practice. 2007, Unpublished Work
Kickbusch I, Buse K: Global influences and global responses: international health at the turn of the twenty-first century. International Public Health: Diseases, Programs, Systems, and Policies. Edited by: Merson M, Black R, Mills A. 2001, Gaithersburg, MA.: Aspen Publishers Inc
Brown TM, Cueto M, Fee E: The World Health Organization and the Transition From "International" to "Global" Public Health. Am J Public Health. 2006, 96: 62-72. 10.2105/AJPH.2004.050831.
Board on International Health - Institute of Medicine of the National Academies: America's Vital Interest in Global Health: Protecting Our People, Enhancing Our Economy, and Advancing Our International Interests. 1997
Lee K: Introduction to global health. Global Change and Health. Edited by: Lee K, Collin J. 2005, London: Open University Press, 3-13.
Kickbusch I: Global Health - A definition. 2002, [http://www.ilonakickbusch.com/global-health/global-health.pdf]
Stuckler D, McKee M: Five metaphors about global-health policy. Lancet. 2008, 372: 95-97. 10.1016/S0140-6736(08)61013-2.
Dodgson R, Lee K, Drager N: Global health governance: a conceptual review. 2002, Geneva, WHO Department for Health in Sustainable Development, Discussion Paper No.1
Janes CR, Corbett KK: Anthropology and Global Health. Annual Review of Anthropology. 2009, 38: 167-183. 10.1146/annurev-anthro-091908-164314.
Collier SJ, Ong A: Global Assemblages, Anthropological Problems. Global Assemblages: Technology, Politics, and Ethics as Anthropological Problems. Edited by: Ong A, Collier SJ. 2005, Malden Oxford, Victoria: Blackwell, 3-22.
Deleuze G, Guattari F: A Thousand Plateaus: capitalism and schizophrenia. 2004, London, New York: Continuum, 5
Sassen S: Territory, authority, rights: from medieval to global assemblages. 2006, New Jersey, Oxfordshire: Princeton University Press
Scholte JA: What Is Globalization? The Definitional Issue - Again. 2002. Coventry, Centre for the Study of Globalisation and Regionalisation (CSGR). Department of Politics and International Studies, University of Warwick, CSGR Working Paper 109/02.
Chopra M, Galbraith S, Darnton-Hill I: A global response to a global problem: the epidemic of overnutrition. Bulletin of the World Health Organization. 2002, 80: 952-958.
WHO: Global health risks: mortality and burden of disease attributable to selected major risks. 2009, Geneva, World Health Organization
Hill K, Thomas K, AbouZahr C, Walker N, Say L, Inoue M, Suzuki E: Estimates of maternal mortality worldwide between 1990 and 2005: an assessment of available data. Lancet. 2007, 370: 1311-1319. 10.1016/S0140-6736(07)61572-4.
Fidler DP: The globalization of public health: the first 100 years of international health diplomacy. Bull World Health Organ. 2001, 79: 842-849.
Labonte R, Torgerson R: Interrogating globalization, health and development: Towards a comprehensive framework for research, policy and political action. Critical Public Health. 2005, 15: 157-179. 10.1080/09581590500186117.
Bozorgmehr K, Tinnemann P: The 'global health education' framework: a conceptual guide for monitoring, evaluation and practice. 2009, Unpublished Work
Dahlgren G, Whitehead M: Policies and strategies to promote social equity in health. 1991, Stockholm: Institute for Future Studies
Huynen MMTE, Martens P, Hilderink H: The health impacts of globalisation: a conceptual framework. Globalization and Health. 2005, 1: 14-10.1186/1744-8603-1-14.
Stuckler D, Basu S: The International Monetary Fund's effects on global health: before and after the 2008 financial crisis. Int J Health Serv. 2009, 39: 771-781. 10.2190/HS.39.4.j.
Darnton-Hill I, Cogill B: Maternal and Young Child Nutrition Adversely Affected by External Shocks Such As Increasing Global Food Prices. J Nutr. 2010, 140: 162S-169. 10.3945/jn.109.111682.
Reich MR, Takemi K: G8 and strengthening of health systems: follow-up to the Toyako summit. Lancet. 2009, 373: 508-515. 10.1016/S0140-6736(08)61899-1.
Eastwood JB, Conroy RE, Naicker S, West PA, Tutt RC, Plange-Rhule J: Loss of health professionals from sub-Saharan Africa: the pivotal role of the UK. Lancet. 2005, 365: 1893-1900. 10.1016/S0140-6736(05)66623-8.
Hunt P, Bueno de Mezquita J: Reducing Maternal Mortality: The contribution of the right to the highest attainable standard of health. 2010, Essex, Human Rights Centre, University of Essex
Khan KS, Wojdyla D, Say L, Gulmezoglu AM, Van Look PF: WHO analysis of causes of maternal death: a systematic review. Lancet. 2006, 367: 1066-1074. 10.1016/S0140-6736(06)68397-9.
Thaddeus S, Maine D: Too far to walk: maternal mortality in context. Soc Sci Med. 1994, 38: 1091-1110. 10.1016/0277-9536(94)90226-7.
Labonte R, Spiegel J: Setting global health research priorities. BMJ. 2003, 326: 722-723. 10.1136/bmj.326.7392.722.
Spiegel JM, Labonte R, Ostry AS: Understanding "globalization" as a determinant of health determinants: a critical perspective. Int J Occup Environ Health. 2004, 10: 360-367.
Marcus GE: Ethnography in/of the World System: The Emergence of Multi-Sited Ethnography. Annual Review of Anthropology. 1995, 24: 95-117. 10.1146/annurev.an.24.100195.000523.
Gupta A, Ferguson J: Anthropological locations: boundaries and grounds of a field science. 1997, Berkley, Los Angeles, London: University of California Press
Gille Z, Riain S: Global Ethnography. Annual Review of Sociology. 2002, 28: 271-295. 10.1146/annurev.soc.28.110601.140945.
Conceiving the New World Order: The Global Politics of Reproduction. Edited by: Ginsburg FD, Rapp R. 1995, Berkley Los Angeles: University of California Press
Burawoy M, BLum JA, George S, Gille Z, Gowan T, Haney L, Klawiter M, Lopez SH, Rian S, Thayer M: Global Ethnography: Forces, Connections and Imaginations in a Postmodern World. 2000, Berkley: University California Press
Burawoy M: Manufacturing the Global. Ethnography. 2001, 2: 147-159.
Latour B: Reassembling the social: an introduction to actor-network-theory. 2005, New York: Oxford University Press
Kearney M: THE LOCAL AND THE GLOBAL: The Anthropology of Globalization and Transnationalism. Annual Review of Anthropology. 1995, 24: 547-565. 10.1146/annurev.an.24.100195.002555.
UAEM: Universities Allied for Essential Medicines. 2010, Accessed: 9-3-2010, [http://essentialmedicine.org]
Banerjee A, Hollis A, Pogge T: The Health Impact Fund: incentives for improving access to medicines. Lancet. 2010, 375: 166-169. 10.1016/S0140-6736(09)61296-4.
IGH: Incentives for Global Health. Health Impact Fund. 2010, [http://www.yale.edu/macmillan/igh/index.html]
Kuehls T: Beyond sovereign territory: the space of ecopolitics. 1996, Minneapolis: University of Minnesota Press
Debrix F: Deterritorialised Territories, Borderless Borders: The New Geography of International Medical Assistance. Third World Quarterly. 1998, 19: 827-846. 10.1080/01436599814055.
Appadurai A: Disjuncture and Difference in the Global Cultural Economy. Modernity at Large: Cultural Dimensions of Globalization. 1996, Minneapolis: University of Minnesota Press, 27-48.
Walsh V: Sen after Putnam. Review of Political Economy. 2003, 15: 330-344. 10.1080/09538250308434.
Sen A: The Idea of Justice. 2009, London: Penguin Books, I
Cornwall A, Brock K: What do buzzwords do for development policy? A critical look at 'participation', 'empowerment' and 'poverty reduction'. Third World Quarterly. 2005, 26: 1043-1060. 10.1080/01436590500235603.
World Health Organization Maximizing Positive Synergies Collaborative Group: An assessment of interactions between global health initiatives and country health systems. The Lancet. 2009, 373: 2137-2169. 10.1016/S0140-6736(09)60919-3.
Buse K, Walt G: Global public-private partnerships: part I - a new development in health?. Bulletin of the World Health Organization. 2000, 78: 549-561.
Buse K, Gill W: The World Health Organization and Global Public-Private Health Partnerships: In Search of 'Good' Global Health Governance. Public-Private Partnerships for Public Health. Edited by: Reich MR. 2002, Cambridge, USA: Harvard University Press
People's Health Movement, Medact, Global Equity Gauge Alliance: Global Health Watch 2. An Alternative World Health Report. 2008, Zed Books
McCoy D, Kembhavi G, Patel J, Luintel A: The Bill & Melinda Gates Foundation's grant-making programme for global health. The Lancet. 2009, 373: 1645-1653. 10.1016/S0140-6736(09)60571-7.
Buse K, Harmer AM: Seven habits of highly effective global public-private health partnerships: practice and potential. Soc Sci Med. 2007, 64: 259-271. 10.1016/j.socscimed.2006.09.001.
Ollila E: Global health priorities - priorities of the wealthy?. Globalization and Health. 2005, 1: 6-10.1186/1744-8603-1-6.
Labonte R, Gagnon M: Framing health and foreign policy: lessons for global health diplomacy. Globalization and Health. 2010, 6: 14-10.1186/1744-8603-6-14.
Kishore SP, Tavera G, Hotez PJ: The Global Health Crisis and Our Nation's Research Universities. PLoS Negl Trop Dis. 2010, 4: e635-10.1371/journal.pntd.0000635.
Merson MH, Chapman Page K: The Dramatic Expansion of University Engagement in Global Health: Implications for US Policy. A report of the CSIS Global Health Policy Center. 2009, Washington, DC, Center for Strategic & International Studies
Hotez PJ: Should we establish a North American school of global health sciences?. Am J Med Sci. 2004, 328: 71-77. 10.1097/00000441-200408000-00001.
Edwards R, Piachaud J, Rowson M, Miranda J: Understanding global health issues: are international medical electives the answer?. Med Educ. 2004, 38: 688-690. 10.1111/j.1365-2929.2004.01849.x.
Yudkin JS, Bayley O, Elnour S, Willott C, Miranda JJ: Introducing medical students to global health issues: a Bachelor of Science degree in international health. Lancet. 2003, 362: 822-824. 10.1016/S0140-6736(03)14276-6.
Koehn PH: Globalization, migration health, and educational preparation for transnational medical encounters. Global Health. 2006, 2: 2-10.1186/1744-8603-2-2.
Bateman C, Baker T, Hoornenborg E, Ericsson U: Bringing global issues to medical teaching. Lancet. 2001, 358: 1539-1542. 10.1016/S0140-6736(01)06586-2.
Bozorgmehr K, Last K, Müller A, Schubert K: Cutting-Edge Education - Global Health in Medical Training: Proposals, Educational Objectives and Methodological Recommendations. GMS Z Med Ausbild. 2009, 26:
The Economist: To have, not to hold: the rise of the new philanthropists. The Economist. 2006
The Economist: The business of giving. The Economist. 2006
Economist: The birth of philanthrocapitalism. The Economist. 2006
Srivastava P, Oh SA: Private foundations, philanthropy, and partnership in education and development: mapping the terrain. International Journal of Educational Development. 2010, 30: 460-471. 10.1016/j.ijedudev.2010.04.002.
Oslo Ministerial Declaration - global health: a pressing foreign policy issue of our time. Lancet. 2007, 369: 1373-1378. 10.1016/S0140-6736(07)60498-X.
Kickbusch I, Matlin S: A European council on Global Health. Lancet. 2008, 371: 1733-1734. 10.1016/S0140-6736(08)60741-2.
Kickbusch I: Influence and opportunity: reflections on the U.S. role in global public health. Health Aff (Millwood). 2002, 21: 131-141. 10.1377/hlthaff.21.6.131.
Donaldson L, Banatvala N: Health is global: proposals for a UK Government-wide strategy. Lancet. 2007, 369: 857-861. 10.1016/S0140-6736(07)60327-4.
Erikson SL: Getting political: fighting for global health. Lancet. 2008, 371: 1229-1230. 10.1016/S0140-6736(08)60539-5.
Kickbusch I: Tackling the political determinants of global health. BMJ. 2005, 331: 246-247. 10.1136/bmj.331.7511.246.
Habermas J: Theorie und Praxis. 1974, Frankfurt am Main: Suhrkamp Verlag, 3
Birn AE: Gates's grandest challenge: transcending technology as public health ideology. The Lancet. 2005, 366: 514-519. 10.1016/S0140-6736(05)66479-3.
Nagel T: The View from Nowhere. 1986, New York: Oxford University Press
Smith A: The Theory of Moral Sentiments. 1759, Oxford: Clarendon Press, revised edn, 1790; republished 1976 edn
Pfeiffer J, Nichter M: What can critical medical anthropology contribute to global health? A health systems perspective. Med Anthropol Q. 2008, 22: 410-415. 10.1111/j.1548-1387.2008.00041.x.
Brown TM, Fee E: Rudolf Carl Virchow: medical scientist, social reformer, role model. Am J Public Health. 2006, 96: 2104-2105. 10.2105/AJPH.2005.078436.
WHO: Declaration of Alma-Ata. 1978, International Conference on Primary Health Care
CSDH: Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. 2008, Geneva, World Health Organization (WHO)
WHO: The world health report 2008: primary health care now more than ever. 2008, Geneva, World Health Organization
Backman G, Hunt P, Khosla R, Jaramillo-Strouss C, Fikre BM, Rumble C, et al: Health systems and the right to health: an assessment of 194 countries. Lancet. 2008, 372: 2047-2085. 10.1016/S0140-6736(08)61781-X.
Van Der Bly MCE: Globalization: A Triumph of Ambiguity. Current Sociology. 2005, 53: 875-893. 10.1177/0011392105057153.
Sen A: Inequality Reexamined. 1999, New Delhi: Oxford University Press, 14
Bonnefoy J, Morgan A, Kelley MP, Butt J, Bergman V, Tugwell P, Robinson V, Exworthy M, Mackenbach J, Popay J, Pope C, Narayan T, Myer L, Simpson S, Houweling T, Jadue L: Constructing the evidence base on the social determinants of health: A guide. 2007, Measurement and Evidence Knowledge Network (MEKN)
Labonte R, Schrecker T: Globalization and social determinants of health: Introduction and methodological background (part 1 of 3). Globalization and Health. 2007, 3: 5-10.1186/1744-8603-3-5.
Labonte R, Schrecker T, Sanders D, Meeus W: Areas for further research. Fatal indifference: The G8, Africa and global health. 2004, Capetown, SA; Ottawa: University of Capetown Press; IDRC Books, 222-224.
WHO Task Force on Research Priorities for Equity in Health: Priorities for research on equity and health: Implications for global and national priority setting and the role of WHO to take the health equity research agenda forward. 2009, Geneva, World Health Organization, Discussion Paper, [http://www.globalhealthequity.ca/electronic%20library/Priorities%20for%20research%20on%20equity%20and%20health.pdf]
Martin G, Bird P, Crichton C: Global health: where are our priorities?. British Medical Bulletin. 2009, 91: 23-28. 10.1093/bmb/ldp025.