AUTHOR: AARON PRITCHARD
Global health offers a lens on the intricacies, dynamics and interdependencies of healthcare systems, disease distribution and susceptibilities to illness on a planetary scale. It is an inherently layered and multidisciplinary field, one which draws together the expansive disciplines of the social sciences; epidemiology, economics, sociology and politics, as well as being informed by and informing clinical and biomedical perspectives. For this reason, global health may be approached as an academic or policy-informing stance on matters of health and health system significance internationally, The facilitation of global health partnerships serve as an example of how this approach can be operationalised, drawing on the insights and expertise of differing geographical contexts to enable and sustain mutual learning, innovation and skills exchange.
Global health as a way of thinking
Whilst global health may be considered an academic discipline of increasing prominence, it can also be perceived as a mindset: a way of thinking about how trends and patterns in human healthcare are unfolding globally. It may prompt us to think about how our interaction with nature and the environment has sequelae far outreaching our own doorsteps, as well as the influences of policy and macroeconomic events on health systems. Global health perspectives stimulate us to think about cause and its inseparability from consequence. In the same way as we may think about a pathophysiological process on a biological level, the multi-factorial intricacies of causality and sequelae apply too on a population scale, often with an equivalently insidious course. Being interested in and astute to these complex relationships brings us closer to appreciating our place in the dynamic social and environmental ecologies of which we are a part, and resultantly better able to respond to the challenges we may face.
Naturally, this presentation of global health may lead us to question its distinction from public health with an international focus (or international public health). International public health has been distinguished from global health by its argued emphasis on communicable disease, maternal and child health in less economically advantaged contexts (1). Congruently, others have asserted the derivation of international public health from tropical medicine with global health representing a more recent evolution of this domain (2). On this basis it may be considered that global health represents an attempt to re-conceptualise traditionally disease-focused or philanthropically-driven interest in tackling disease inequalities globally. Global health is offering less of a medically deterministic view on or of human health, its influences and determinants across the world – it is becoming a way of seeing. Establishment of the seventeen Sustainable Development Goals (SDGs) in 2015, adopted by all UN Member States (3) provide high level leverage for directing the broader fields of health risk mitigation and healthcare provision globally, reflecting the growing recognition of the inseparability of the local from the global.
Applied global health
Extending the concept of global health as a predominantly academic domain, it may also be useful to recognise ways in which thinking globally has directed the establishment and activity of health partnerships between health providers, institutions and facilities, typically between low and middle income countries (LMICs) and comparably higher income countries (HICs). Many such partnerships have made much progress in supporting healthcare initiatives and provision in resource limited healthcare settings (4) whilst drawing on health needs assessments to plan future activity with mutual learning. In order to ensure LMIC healthcare empowerment, ownership and sustainability, it is crucial to consider ways in which partnerships can construct themselves as equitable crucibles of learning and skills exchange in times of ever-pressingly evident healthcare challenges. Such considerations have been clearly articulated in recent work (5) and remind us of the potential within global health, as a disciplinary field, to drive carefully considered and needs-led practice in the execution of applied global health work. The broad framework offered by the UN SDGs offer a valuable platform from which to collaboratively achieve this.
Key learning points
- Global health is an inherently multidisciplinary field drawing on perspectives from social, environmental and health sciences.
- Global health can be challenging to define and has been presented as distinct from international public health
- Global health helps us to understand the complex interdependence of human health in an increasingly connected world.
Further points to consider
- In what ways does the inherently multidisciplinary nature of global health help us to better identify and respond to emerging global health priorities?
- How can the study of global health help us to address the UN Sustainable Development Goals (SDGs)?
- Beaglehole R, Bonita R. What is global health?. Global Health Action. 2010;3.
- Koplan JP, Bond TC, Merson MH, Reddy KS, Rodriguez MH, Sewankambo NK, Wasserheit JN. Towards a common definition of global health. The Lancet. 2009 Jun 6;373(9679):1993-5.
- The Sustainable Development Agenda (UN) available at: https://www.un.org/sustainabledevelopment/development-agenda/#:~:text=The%2017%20Goals%20were%20adopted,plan%20to%20achieve%20the%20Goals. (accessed 28/06/2023)
- Crisp LN. Global health partnerships: the UK contribution to health in developing countries. Public policy and administration. 2008 Apr;23(2):207-13.
- Binagwaho A, Allotey P, Sangano E, Ekström AM, Martin K. A call to action to reform academic global health partnerships. bmj. 2021 Nov 1;375.