Global Health: the need for European action

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Global Health the need for European action

• EFC meeting Brussels
• November 2004
• Prof. Dr. Ilona Kickbusch

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New global mindset

• Implicit in the idea of globalization rather
  then internationalization is the idea that we
  are moving beyond the era of growing ties between
  nations and are beginning to contemplate
  something beyond the existing conception of the
  nation state
• Concept One World
• Peter Singer 2002

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Europe
Koolhas
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Global Health a global public
good

• Those threats to health and opportunities to
  improve health which transcend national,
  generational and cultural boundaries health
  implies physical, mental and social components
  and a view towards the determinants of health
  including issues such as trade, peace, conflict,
  womens development. Many of these are outlined
  in the Millennium Development Declaration and the
  road map of the Millennium Development Goals.  

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Dimension 1

• The growth of epidemics
• AIDS, SARS etc
• Global obesity/tobacco epidemics
• Increasing Global risk factors
• Unhealthy consumption
• The threat of bio terrorism

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Dimension 2

• The lack of sustainable health systems
• Lack of health care coverage of the poor
• Insufficient national capacities for public
  health in rich and poor countries
• The dramatic fall of investment in universal
  health systems.
• Lack of human resources //export and brain drain

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Dimension 3

• The socio-economic-political context
• Unstable world
• New emerging poverty
• People movement 1 bill on the move
• Negative impacts of globalization

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Dimension 4

• The values
• Lack of value attached to human lives in the
  south
• Lack of support for strong public systems
• Lack of support for new global financing
  mechanisms

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Dimension 5

• The international actors
• An ever denser network of actors with lack of
  transparency
• Increasing lack of accountability
• Balkanization of global public health and
  unintended consequences

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Dimension 6

• Systems problems
• Focus on disease
• A world of vertical programs and quick fix
  solutions
• A tendency to invest in technologies and drugs
  and not in social protection, health systems and
  people

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Action is needed now

• Impending crisis needs urgent action at all
  levels
• Opportunity new policies, commission, European
  strategy for health, development, new mechanisms
  , the new budget, new foreign policy,
• revised CAP, new development policy and budget,
  strong new role of European parliament

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Action is needed now

• Common comittment of Europe because of
  enlargement, new members
• Responsibility developed world MDGs mid point
  2005 especially goal 8, global compact
• Impacts of globalization on European health and
  health systems

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The external Objectives of the European Union
upholding and promoting the EU Values and
Interests
Sustainable development of the earth
Security
Respect for the principles of the UN
Charter
Peace
Respect for international law
Solidarity
Global health strategy
Protection of the rights of the child
Mutual respect between peoples
Free and fair trade
Eradication of poverty
Protection of human rights
TF-AU/3
European Commission
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• Health is a determining factor for Europes
  future 
• Not just charity but Geo politics in our interest
  
• major parts of our own security are bound up in
  health/// Break down of social order
• Africa and Russia are our neighbourhood

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3 plus 3 solidarities

• Risk
• Generational
• distributive

• National
• European
• global

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The Millennium Development Goals

• The Millennium Development Goals are time-bound
  and measurable goals and targets to be achieved
  between 1990 and 2015, they include
• halving extreme poverty and hunger
• achieving universal primary education
• promoting gender equality
• reducing under-five mortality by two-thirds
• reducing maternal mortality by three-quarters
• reversing the spread of HIV/AIDS, malaria and TB
• ensuring environmental sustainability
• developing a global partnership for development,
  with targets for aid, trade and debt relief

A global compact
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Goal 8 Partnership for development

• The last goal-global partnership for
  development-is about the means to achieve the
  first seven. Many of the poorest countries will
  need additional assistance and must look to the
  rich countries to provide it. Countries that are
  poor and heavily indebted will need further help
  in reducing their debt burdens. And all countries
  will benefit if trade barriers are lowered,
  allowing a freer exchange of goods and services.

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Commitment to Development Index
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The global

• The global is not just out there
• It is in here part of us and our societies

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In the 21st century Health is.

• Foreign policy
• Security policy
• Economic policy/Trade policy
• Environmental policies
• Demographic development
• Geopolitics

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The health wars.different concepts
Risk
Threat
justice

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International law

• Pooling sovereignty and right to intervene on
  behalf of the global community
• Revised International Health Regulations

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Signing the IFCT
Codes, treaties, conventions
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6 Global Health action areas

• health as a global public good
• Health as a human right
• health as a key component of global security
• health a key factor of global governance of
  interdependence
• health as responsible business practice and
  social responsibility
• health as global citizenship.

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Priorities for action

• Put health in the center of EU policies
• MDGs and goal 8
• Harmonization of aid
• Support , reform and strengthen the UN system
• Be a leader on womens health and ICPD
• Apply the lessons of European public health
  history
• Support a strong civil society movement for
  global health

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Importance of advocacy

• Governance and policy questions have moved to the
  center of the global health debate
• New financing mechanism for global public goods
• Public health advocates and associations will
  have to move their advocacy forcefully into the
  European arena.G8, G20

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ECGH what could it do?

• Develop awareness/disseminate information
• Build partnerships and aim to create consensus on
  a joint (identifiable) and integrative European
  approach to global health based on European
  values
• Strengthen and monitor European commitments to
  global agreements
• support and build global partnerships for
  dialogue and action
• Raise European citizens awareness of the
  relevance of global health issues to their
  everyday lives

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Resources
WHO
Gates Foundation
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Global Ethics From charity to entitlements

• the very values of an enlightened and civilized
  society demand that privilege be replaced by
  generalized entitlements if not ultimately by
  world citizenship then by citizens rights for all
  human beings of the world
• Ralf Dahrendorf

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Global solidarity/human rights
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New global social contract on health