Environmental Engineering Reference
In-Depth Information
The Inadequate Governance Response
In the face of such demanding deadly challenges—now reaching crisis proportions in
the sheer volume of avoidable deaths—the global community still struggles to devise
an appropriate and adequate response. the causes and cures of the compounding
global health crisis that come from agriculture, demography, economics, ecology,
security, and technology are well known, but seldom related to health and a health
governance response in a comprehensive or coherent way. through its general
requirements for reductions in public sector spending, the neo-liberal economic
policies espoused by the International Monetary Fund (IMF) and the world bank
have often counterproductively constrained the national governments that borrow
from them and thus made them fail to protect global health (thomas and weber
2004). lack of capacity and an abundance of corruption hamper national governments
around the world. within wealthy countries, there still exists an isolationist mentality
that views the developing South as a reservoir of human disease that can be guarded
against by better medicines, bigger border barriers, and more protective policies at
home (aginam 2004). Yet domestic health policy cannot address the determinants
of health that originate beyond national borders. and the dire poverty in much of
the developing world is still found in abundance inside the developed north itself
(Kickbusch and de leeuw 1999).
Sovereignty, national suspicions, and profit motives compound the challenge.
attempts to harmonise national policies for the purpose of strengthening global
health continue to face fierce resistance from states unwilling to give up sovereignty,
as shown by the recent process of revising the International Health regulations
(IHR) (Gostin 2004). Hindered by conflict over human rights, bioterrorism, and the
political status of taiwan, the success of those regulations depends ultimately on
whether states decide to implement them (Fidler and Gostin 2006). certainly much
of the responsibility can be laid on the doorstep of national governments, as states
have yet to internalise the value of public health as a human right (Fidler 2001).
but other actors share the blame. transnational pharmaceutical companies have had
little financial incentive to invest in the research and development (r&D) of drugs
for neglected diseases such as trypanosomiasis, even though the moral imperative
has always been there (trouiller et al. 2002; t'Hoen 2002).
at the centre of the growing array of actors responsible for governing global
health stands the wHo. this organisation, charged with improving the health of the
world's population, has been limited by political and financial constraints imposed
by its member states. It may indeed need radical reform to do its job in today's
world (Godlee 1994). there is a gap between monies committed and what is actually
delivered (labonté and Schrecker 2004). However, the principal impediment to
improving global health is not merely lack of money but the poorly coordinated
and bureaucratic nature of the disbursement of funds. It is also the tendency of
governments, international organisations, and public-private partnerships (PPPs)
to focus on individual diseases instead of vigorously investing in health human
resources and public health infrastructure and working to reduce social, economic,
 
 
Search WWH ::




Custom Search