The Global Health Landscape

The last few years have been good for ‘global health’. Everyone talks about it. Large amounts are spent on it. Many universities have created departments of global health. The prominence of health indicators among the Millennium Development Goals also shows the ascendancy of ‘global health’ in international affairs. Even Hollywood celebrities fly the ‘global health’ flag. The need to ‘govern’ health at a global level is important for several reasons. For a start, health care itself has become ‘globalised’. Health workers are imported and exported from one country to another. Tele-medicine, medical tourism and the number and size of multinational medical enterprises are expanding. The Severe Acute Respiratory Syndrome (SARS) epidemic, multi-drug-resistant tuberculosis and the threat of a lethal global flu pandemic have further focused attention on global health governance and the need for laws, guidelines and standards to optimise disease control across national borders. Finally, many of the underlying determinants of poor health are global in nature. The effects of the globalised economic system on poverty and nutrition, as well as climate change, all point to the need for strong and effective global health leadership. Meanwhile, a raft of new organisations, institutes, funds, alliances and centres with a ‘global health’ remit have mushroomed, radically transforming the ‘global health landscape’, raising questions about the accountability, effectiveness and efficiency of global health governance.