Franco-Giraldo Álvaro
Rev Panam Salud Publica. 2016 Feb;39(2):128-136.
This article presents a Latin American vision of global health from a counterhegemonic perspective, applicable to various countries of the world in similar circumstances. It begins by reviewing several concepts and trends in global health and outlining the differences between conventional public health, international health, and global health, but without seeing them as antagonistic, instead situating them in a model that is based on global health and also includes the other two disciplines. It is understood that global factors influenced earlier theories, schemes, and models of classic international health. The article emphasizes the importance of several aspects of world-geopolitics and economic globalization that impose constraints on world health; it also underscores the theory of social and environmental determinants of the health-disease spectrum, which have impacts beyond those of epidemiologic risk factors. The suggested approach is based on cosmopolitanism and holism: global philosophical and political currents that allow for a better interpretation of world phenomena and are more relevant because they give rise to lines of action. Structurally, the theoretical foundations of global health are presented in three analytical areas: global justice and equity, governance and the supranational protection of rights, and holism and a new global consciousness. The article concludes by underscoring the need to construct an approach to the existence and praxis of global public health that is based on the Latin American perspective, an approach that highlights grassroots social movements as an alternative way to secure a new order and global awareness of rights and to redefine the architecture of global health governance.
本文从反霸权视角呈现了拉丁美洲对全球健康的愿景,适用于世界上处于类似情况的各个国家。文章开篇回顾了全球健康的几个概念和趋势,概述了传统公共卫生、国际卫生与全球健康之间的差异,但并未将它们视为对立的,而是将它们置于一个以全球健康为基础、同时也包含其他两个学科的模型之中。可以理解的是,全球因素影响了经典国际卫生的早期理论、方案和模型。文章强调了世界地缘政治和经济全球化的几个方面对全球健康造成限制的重要性;它还强调了健康 - 疾病谱的社会和环境决定因素理论,这些因素的影响超出了流行病学风险因素的影响。所建议的方法基于世界主义和整体主义:这两种全球哲学和政治潮流能够更好地解释世界现象,并且因其引发行动路线而更具相关性。在结构上,全球健康的理论基础在三个分析领域中呈现:全球正义与公平、治理与权利的超国家保护,以及整体主义与新的全球意识。文章结尾强调,有必要构建一种基于拉丁美洲视角的全球公共卫生存在与实践方法,这种方法将基层社会运动作为确保新秩序和全球权利意识以及重新定义全球健康治理架构的替代方式加以突出。