Candidate no: Z26590

Essay for Key Issues in Health Policy

Word count = 1954

Essay Question:

Argue both in support of and against the following claim: globalisation is good for your health. Use
examples to illustrate your claim

Introduction:

The idea of globalisation is not particularly a new one as it was fundamentally a consequence of
industrial revolution and colonisation age. However, with the 1990s came the term Globalisation as
we now know it, it seems to have been the preferred terms used to describe the rise in cross
continent supersized organisation. These organisations operate not just across single countries’
boarders but have a far-reaching operation that extends from one side of the globe to the other.
With some of these conglomerate giants achieving profits larger than some of the developing
countries entire budgets.

With the coming of the information boom and the rise of the internet, globalisation become much
more than simply an expansion tool that services an economical or political agenda. Globalisation
now have a much wider impact globally, as it impacts societies and cultures across the world with
free flow of information, technology and ideology.

All this has led to globalisation becoming this highly complex and multifaceted phenomena. One of
the main areas that globalisation has impacted upon which is equally as complex and multifaceted is
health and population health. With the supersonic rise of the information technology and in
particular social media the world became a much smaller place, this extensive social media coverage
exposed more of the inequalities around the world in different aspects of everyday life. Population
health is one of those areas where there is massive difference between the developed countries,
developing countries those that are underdeveloped.

This essay aims to provide a conceptual framework on how globalisation impact population and it’s
influence on health policies from one country to another as well as internationally. The argument on
whether globalisation is good for health or not has advocates on both sides of the spectrum. In this
essay will review some of those views in attempt to understand the impact of globalisation on heath
policies and population’s health in different countries.

Conceptual framework

There are different conceptual frameworks that can be used to asses the impact of globalisation on
health. Woodward for example focused on the economical drivers of globalisation and their impact
on population health as being the most critical, (Woodward D. et al 2001). While Labonte and
Torgerson build their conceptual framework based on a combination between economic
globalisation and international governance, seeing those two elements as primary influencers on
population health (Labonte R, Torgerson R. 2002). For the purpose of this essay, we agree with
Maud’s school of thought in the sense that for a comprehensive framework on the impacts of
globalisation on health a much wider perspective ought to apply. Hence this essay focuse on a
conceptual framework that links the main features of globalisation, such as global markets, global
communication and diffusion of information, global mobility, cross-cultural interaction and global
environmental changes, with the determinants of health (Maud et al, 2005). Within this conceptual
framework the health determinants are divide into three levels. First, the contextual level and this
includes, Institutional infrastructure, economic infrastructure, social culture, population structure
and geographical distribution, social infrastructure and environment, secondly a distal level and that
focuses on health polices, as well as economic development and trade, third a proximal level which
focuses on the available health, economic and social services available, (Maud et al, 2005). Through
this conceptual framework the essay will review and discuss different examples of globalisation
impact on population health, in a bid to understand and assess these different impacts, and whether
the overall impact of globalisation is more positive or negative.

Example of Positive Impact

The WHO in 2005 established the Commission on Social Determinants of Health (CSDH) as a global
network of policy makers, researchers and civil society organisations. The CSDH purpose was to
provide support in tackling the social causes of poor health and avoidable health inequalities, by
evidencing what can be done to achieve a better and more fairly distributed health worldwide,
(WHO). The commission was given three years to complete its work, at the end of which it produced
the following three overarching recommendations, 1. Improve daily living conditions and create a
social protection policy for all, to achieve these goals it will require civil society, governments and
global institutions to come together. 2.Tackle the inequitable distribution of power, money and
resources. 3. Measure and understand the problem and assess the impact of action to address the
health inequity. This commission was a true testimony of the power of globalisation in bringing
together researchers and practitioners from universities and research institutions, government
ministers, and international and civil society organisations to work together for the bettering of
human health. One can argue that without globalisation none of this would have come about.

Feachem, argues that there is a substantial body of evidence that supports globalisation economical
benefits, for example the development countries that has both increased trade and reduced import
tax have grown much faster than other developing countries, also and perhaps more importantly
their growth was much faster than the wealthy countries that are members of the Organisation for
Economic Cooperation and Development (OECD). Feachem also points out that when discussing
equity and globalisation it is important to concentrate on “absolute poverty of nations and of
households and not on poverty relative to the rich”. In Feachem’s opinion globalisation and
economic growth leads to improvements in health, on the basis that economic growth improves the
poor’s income which in turn improves their health (Feachem BMJ 2001). However, to really
capitalise on the effects of globalisation and economic growths, developing countries must apply the
right public policies to help sustain the ongoing economic growth and extend its benefits in
improving the population health within those countries. Hence being part of a global network like
the OECD can bring not only economic benefits but also health ones.
Globalisation can also influence health policies in low and income countries by applying different
leverages of pressure on these countries governments in return for access to loans or grants. For
example, the implementation of the childhood immunisation programmes, which could have been
due to external support from the Global Alliance for Vaccines and Immunizations (GAVI Alliance).
The formation of the BRICS nations (Brazil, Russia, India, China and South Africa) as a collective of
emerging countries in a bid to influence the global health agenda, is yet another form of
globalisation leverage, that some might argue that it would bring about positive change to those
countries population as well as other countries where the BRICS will be able to positively influence
the health policies. (Buse, Mays and Walt, 2012)

Examples of Negative Impact

Global changes in health care polices, economic development and trade are increasingly influencing
health services in different countries. A reduction in the level of involvement by government in
health care policies has led to a more neoliberal economic view of health, where it is increasingly
perceived as private good, leaving the market to decide on which area of health to invest in based
on profitably (Collins, 2003). This coupled with the change in some governments policies toward
privatising their health care services has led to an increase in the health trade, which some might
argue that it improves consumer’s choice, however a closer look at this changes reveals possible
long-term dangers, like establishing a two tier health system where those who can afford it gets all
the benefits while those who cannot are left with a less than adequate heath care service, also the
migration of health care professionals from the public sector to the private sector, which leads to an
inequitable access to heath care as well as possibly undermining the national health systems, (Hong
E, 2000 & Walt G 2001)

The boom in social aspect of globalisation, namely the internet has led to an increase in people
access to controlled and illegal drugs, which can be found with minimum amount of searching via
any of the internet search engine. This poses a serious health risks, especially in under developed
countries where governments might not be able to monitor and control the internet as effectively,
(Lee K., Collin J. 2001)

Another contentious issue is in relation to Intellectual Property Rights (IPRs), in relation to

pharmaceuticals and how and they manage and protect their rights in the newly developed drugs.
Pharmaceutical companies `make advances in medicine through innovation and research and
development and depends on the markets and IPR mechanisms to ensure that it gets rewarded for
its work and innovation, a classic example is the advancement in HIV drugs and the cost associated
with that, which made it unaffordable option in developing countries simply because they can not
afford to pay it. (Dollar, D.)

Evaluating globalisation impact

Economic growth has been the fundamental driving force behind the overall process of globalisation
over the past half a century, and over the last twenty years this economic growth has gained much
more momentum with boom in the global information technology. This has enabled globalisation as
worldwide phenomena to grow exponentially in volume as well as its ability to dramatically increase
cross boarder flow. These two elements of globalisation might have had the most impact on
population health globally, however they don’t stand alone there are other global elements such
global governance structures, which in recent years has become a key player in global health policy.

The examples used in this essay also reflects some indirect effects of globalisation which can be
equally as important as the direct ones and in order to understand the true deep-rooted impact of
globalisation on public health, these indirect effects have to be taken into account.

To enable a comprehensive study of the impacts of globalisation on public health, there is a

necessity to formulate a conceptual framework that links the main drivers of globalisation, such as
economy and market leavers, information technology, global mobility, environmental policies, and
the cross-cultural fusion, with the determinants of health (Maud et al, 2005). It is also fundamental
to have an analytical framework to enable a reliable assessment of the health effects of
globalisation, the development of a research agenda and to decide on the appropriate policy
responses needed.

Conclusion

The literature review on the impact of globalisation on population health, reflects the current
situation in policy formulation in general and in health policy in particular, in the sense that they are
formulated or enacted in isolation, this represents a key issue in health policy. However there
appears to be a shift in this concept as more and more governments realise that, 1. they are not
alone in their problems, 2. that they cannot work in isolation, 3. and that a more globally
collaborative approach to talking population health problems will probably be more beneficial to all
concerned.

Globalisation may have a lot of notable positive effects on health as seen in the examples in this
essay, however it also has some negative effects that cannot be ignored. Global governance
structures such as the World Health Organisation (WHO), the World Bank (WB) and the International
Monetary Funds (IMF, 2004, and Dodgson et al), will play a major part in in the global health
governance, as they work together to regulate and coordinate global health policies using different
leavers within their power to achieve the Millennium Development Goals, (United Nations 2009)

The evidence explored in this essay support the theory that overall the positive effects of
globalisation exceeds its negative effects. However, the effects of globalisation can only be optimised
when improvements in health and well-being takes central stage in being primary objectives of
national economic policy making and the design and management of international economic system

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