Public Health Governance: The Challenge of Globalization

Now, we are entering in the new era of globalization where the geographical boundary between the countries is nonexistence. People and goods are free to move between the countries, opening the new avenues of sharing economic, technological, political, social, scientific and cultural values at ease. The globalization is not only boon for inter-exchanging of relation, knowledge, human work forces, information and technologies; it is, however, also a bane for acquiring the public health governance affecting health as well as other aspects of human activity. Its consequences can be either direct, at the level of whole populations, individuals and healthcare delivery systems, or indirect, through the economy and other factors, such as education, sanitation and water supply.

High rate of migration, human work force shifting and population movement are main contributors of intense international contacts and pandemic outbreak of communicable disease in world. Transmission of influenza pandemic in early 20th century and continental outbreak of cholera epidemic in 1990 are just two examples for such incidents. With the explosive increase of travellers, there is also the tendency of shifting vectors to new places and adopting new inhabitation. The well known tiger mosquito, a potential vector for dengue fever virus, was introduced into the United States in the 1980s in a shipment of used tyres imported from northern Asia. When such disease causing microbes travel with the infected human and attack the new host, they are likely to bring some changes on their genetic levels and develop a new drug resistance strain. Tuberculosis Bacilli is the example of such public health nuisance.

Similarly, globalization has helped many multinational companies to expand their trade and made them easy to reach even in the remote part of the world. The world’s popular brand beverage and fast food are now easily accessible. It has replaced the traditional and local nutritional diets with fat and calorie rich diets. Free and uncontrolled trade of alcohol, tobacco and neurotic drugs are creating socio-cultural imbalance, family problems and various psychosocial disorders.

It is not only people, microbes, and material goods that travel from one country to another; it is also ideas and lifestyles. Adoption to sedentary lifestyle, increased exposure to tobacco use, unhealthy diets, and harmful use of alcohol are leading world into the epidemics of non-communicable diseases. According to World Health Organization (WHO), every year, an estimated 14 million people die prematurely in developing countries from preventable heart disease, stroke, diabetes, cancers and asthma, with major negative consequences for socioeconomic development.

On the other hand, globalisation is making the flow of information on health care easier. The inter-countries coherence strategies, international liaison and multinational or globalized efforts have been playing significant role to ameliorate deep problems of poor health in the world. 189 countries have conjointly set a target of millennium development goal by 2015. We are moving ahead to reduce the burden of HIV/AIDS, Malaria and TB and improve the maternal and child health by 2015. Through Framework Convention on Tobacco Control (FCTC), most countries aligned to impose strong control over tobacco use. World Health Organisation (WHO), UNICEF, FAO and ILO are working in collaboration for the betterment of the health of people. Similarly hundred of global health initiatives like global fund to treat AIDS, TB and malaria, global alliance for vaccine and immunization etc intend to promote the health. However, such global efforts are being criticised for increasing dependency over international organisation, insensitivity to local cultures, exclusion and inequality. A part from this, lack of coordination, collaboration, accountability and transparency are still in debate.

Finally, it is an undeniable fact that globalization has myriad negative impacts on public health governance. Nevertheless, it also brings the opportunity to deal with health problems together and establish a mutual understanding and empathy between the countries. Free and fast flow of health information, knowledge and research findings cannot be neglected as well. Collaboration between the countries, national and international organizations and other stakeholders can have an important role in minimizing such challenges through regulations, policy recommendations, advocacy and combined efforts.

My education includes training in medicine, public health, clinical research, biostatistics and health response in complex emergency. I have more than seven years of experiences in health research (Survey, Case control studies, Randomised Controlled Trials (RCT), Health Policy and Systems Research). My areas of expertise also include the project management particularly in health sector. I have also experience and interest to work in health emergency in large population in disaster setting.

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One Response to “Public Health Governance: The Challenge of Globalization”

  1. Dear Dr. Raja Ram,
    Go to find this health blog. Well written.
    Keep it up.


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