Steeven Toor - Reading Summaries Jan

18, 2017

The first reading was quite intriguing and was centered around the history of global health and key
moments from history that explores the limitations of contemporary models of global health and health
problems in general. The reading focused one several historical moments such as the Rwanda genocide and
the slave movement in Haiti (international and public health being advanced solely for commercial interest).
Distinction between human rights and citizens right is quite unique, and this example shed light on the
tension between policy and practice. The mergence of epidemic diseases in the 19 th century led to a fear of
such diseases was tied to the commerce of the time. The article also touched on how the creation of the Pan
American Health Organization was rooted in the expansion of international commerce, international
diplomacy and medical advancements. This develops into a rather intriguing discourse on a new concept of
health. Health is not just a individual concept anymore and that being healthy was right of the people and
responsibility of the state. Leads into discussion of WHO as the first global health institution and witnessing
the shift in population health (eradication of small pox). Theres also a transition of focus from
acute/infectious diseases to chronic diseases. Responsibility falls on the international community for
reducing chronic health conditions/increasing health. Social sciences play important role in health as it
raises the concerns in health and trys to create solutions (solutions also rooted politically). The endeavor
towards global health encompasses political rights and power and the history that leads to the creation of
global health.

The second reading focused on the evolution of international health policies (creation of WHO and
Alma Alta conference) reviewing issues on public-private partnership and the creation of a global fund to
fight AIDS, TB and malaria. The WHO was formally established in 1948 as a specialized agency of the UN.
At the Alma Alta conference, the health care problems of the lowest SES countries (also under oppressive
rule) were discussed (promotion of healthcare for all) and access to high level of health is an important
global interest. Reaffirmed the definition of health as the complete wellbeing, not just a matter of absence of
disease. Health systems should focus on the promotion of wellbeing and prevention of disease. Discussion
on selective and comprehensive care eluded to focusing on limited diseases with specific interventions that
are most cost-efficient (vaccines). There were several intriguing examples from the reading but a couple
that stood out to me were the user fees in government structures for promoting insurance systems. Again
with the discussion of the global fund and world bank, it seems to me that before creating health policies
and executing them, funding is a major criterion that needs to be addressed first. For example, the G8
summit approved a creation of a special fund dedicated to HIV, TB, malaria. But theres also and
expectation of results, and although there were several health objectives achieved, there was a decrease in
African health standards in maternal and child health. Shift from a publically funded system to privatized
provision of health. We need mechanism in place that ensure a fair an equitable health system for everyone,
especially focusing on vulnerable populations. The last reading tied in really well with the second reading
on how international efforts to control infectious disease has dominated global health policies and budgets
when they should be directed at chronic conditions. It was interesting to read the PH principles discussed
and the application to infectious epidemics. WHO set out a goal for equitable access to health for all, but
much of its success is infection control, focus is on few high profile problems. Donors typically address a
single disease but not the basic necessities of life such as clean water, air sanitation, disease prevention and
equitable access to health. The goal of the UN should be to establish a effective universal healthcare
system/global health governance that can help establish appropriate priorities, set budgets and execute these
programs where they are needed most.

Discussion Points Several discussion points stem from these readings more me, the main one being who
will decide and set the agenda/mandate for what the most important global health needs are. It seems to me
like there is a tension between governance structures and sources of aid (donors/contributors) and global
organizations (WHO). My curiosity stems from a more local issue with the extensive PHC expenses on the
Steeven Toor - Reading Summaries Jan
18, 2017

rise and the smallest portion of funding is for population health interventions/health promotion. Majority
of the costs on acute conditions is this the case on a global scale when addressing global health issues