Department of Nursing and Health Sciences, Fulda University of Applied Sciences, Leipziger Strasse 123, D-36037, Fulda, Germany.
Global Health. 2020 May 6;16(1):42. doi: 10.1186/s12992-020-00573-4.
Global Health has increasingly gained international visibility and prominence. First and foremost, the spread of cross-border infectious disease arouses a great deal of media and public interest, just as it drives research priorities of faculty and academic programmes. At the same time, Global Health has become a major area of philanthropic action. Despite the importance it has acquired over the last two decades, the complex collective term "Global Health" still lacks a uniform use today.
The objective of this paper is to present the existing definitions of Global Health, and analyse their meaning and implications. The paper emphasises that the term "Global Health" goes beyond the territorial meaning of "global", connects local and global, and refers to an explicitly political concept. Global Health regards health as a rights-based, universal good; it takes into account social inequalities, power asymmetries, the uneven distribution of resources and governance challenges. Thus, it represents the necessary continuance of Public Health in the face of diverse and ubiquitous global challenges. A growing number of international players, however, focus on public-private partnerships and privatisation and tend to promote biomedical reductionism through predominantly technological solutions. Moreover, the predominant Global Health concept reflects the inherited hegemony of the Global North. It takes insufficient account of the global burden of disease, which is mainly characterised by non-communicable conditions, and the underlying social determinants of health.
Beyond resilience and epidemiological preparedness for preventing cross-border disease threats, Global Health must focus on the social, economic and political determinants of health. Biomedical and technocratic reductionism might be justified in times of acute health crises but entails the risk of selective access to health care. Consistent health-in-all policies are required for ensuring Health for All and sustainably reducing health inequalities within and among countries. Global Health must first and foremost pursue the enforcement of the universal right to health and contribute to overcoming global hegemony.
全球健康日益受到国际关注和重视。首先,跨境传染病的传播引起了媒体和公众的极大兴趣,同时也推动了教师和学术项目的研究重点。与此同时,全球健康已成为慈善行动的主要领域。尽管在过去的二十年中它变得越来越重要,但复杂的集体术语“全球健康”今天仍然缺乏统一的用法。
本文旨在介绍现有的全球健康定义,并分析其含义和影响。本文强调,术语“全球健康”超越了“全球”的领土意义,将地方与全球联系起来,并指的是一个明确的政治概念。全球健康将健康视为一项基于权利的普遍福利;它考虑到社会不平等、权力不对称、资源分配不均和治理挑战。因此,它代表了公共卫生在面对各种普遍全球挑战时的必要延续。然而,越来越多的国际参与者关注公私伙伴关系和私有化,并倾向于通过主要的技术解决方案促进生物医学的简化论。此外,占主导地位的全球健康概念反映了全球北方的固有霸权。它没有充分考虑到主要由非传染性疾病构成的全球疾病负担,以及健康的社会决定因素。
除了预防跨境疾病威胁的弹性和流行病学准备外,全球健康还必须关注健康的社会、经济和政治决定因素。在急性卫生危机时期,生物医学和技术简化论可能是合理的,但存在选择性获得卫生保健的风险。需要制定一致的全健康政策,以确保全民健康,并在国家内部和国家之间可持续减少健康不平等。全球健康必须首先追求普遍健康权利的实施,并为克服全球霸权做出贡献。