Gilbert Tal, Gilbert Leah
Magdalen College, Oxford, UK.
Health Policy. 2004 Mar;67(3):245-55. doi: 10.1016/S0168-8510(03)00120-9.
This paper reviews some of the multiple influences on health issues in South Africa, placing them in the context of globalisation. By examining the complexity of factors, both domestic and global, which impact on these issues, it questions the extent to which global patterns in areas such as health policy, HIV/AIDS, health care pluralism, and neo-liberal macroeconomic policy have played out in South Africa. The identification of some of the multiple and complex forces in each case reveals a relatively consistent story of global pressures interacting with domestic realities, with some recognizably local results. There is no doubt that a full and nuanced understanding of health in South Africa requires an appreciation of developments in the global political economy, international organizations such as the WHO and World Bank, and forces which operate outside of institutions. In each case, however, the specific opportunities available to actors within the country, as well as the relative power of those actors, should be given their due consideration in analysing their potential impact on health matters.
本文回顾了对南非健康问题的多种影响因素，并将其置于全球化背景下进行考量。通过审视国内外影响这些问题的复杂因素，探讨了诸如卫生政策、艾滋病毒/艾滋病、医疗多元主义以及新自由主义宏观经济政策等领域的全球模式在南非的呈现程度。对每一个案例中多种复杂力量的识别揭示了一个相对一致的情况，即全球压力与国内现实相互作用，并产生了一些可识别的本土结果。毫无疑问，要全面而细致地理解南非的健康状况，需要了解全球政治经济的发展、世界卫生组织和世界银行等国际组织以及机构之外的各种力量。然而，在分析这些因素对健康问题的潜在影响时，都应充分考虑该国行为体所拥有的具体机会以及这些行为体的相对权力。
