ANTH265 Midterm Overarching questions Concepts from lecture definitions Readings and films for examples Know diseases and issues around diseases examples supporting Week 1 What is global health and why does it matter Key questions in the study of global health Global Health IOM Def health problems issues and concerns that go beyond national boundaries may be influenced by circumstances or experiences in other countries and best addressed by cooperative actions and solutions WHO Def Transnational impacts of globalization upon health determinants and health problems which are beyond the control of individual nations Brown Taking into consideration the health of all people beyond concern of particular nations and acknowledging the growing importance of non governmental and intergovernmental actors Why does it matter Human cost lives Equities distribution of resources Direct impact of disease infectious disease spread Indirect impact of disease poverty and political instability Key questions what is the scope of the challenge Ex When People Come First Janira is dying of a heart condition in today s medical age public policy and lack of access to resources are preventing her from existing treatments Week 2 History of Global Health Where did the idea of global health come from What are some of the earlier institutional political and social arrangements from which it emerged Colonial medicine colonization cycle of wealth and poverty Introduction of disease Public health practices served interests of colonial powers Early medicine Greek imbalance of body Filipino cholera blame for disease force drug administration seized bodies Eradication programs malaria some success but rates increased after treatment ended funds ran out Focus on human development and social justice Rx for Survival polio vaccines obstacles of movement and mobile countries muslim refusal and resistance have to deliver to each child Small pox smaller amount of vaccine have to decide who to vaccinate people in immediate vicinity of affects AIDS treatment not affordable for citizens sex workers immune Week 3 Primary Health Care and Neoliberal Policies How did the concept of primary health care emerge What are the debates and meanings of primary health care Primary health care essential health care made universally accessible through full participation First level of contact between the individual and the health system essential care majoring of prevailing health problems managed closest to people Secondary Health care more complex problems dealt with compromise curative services provided by district hospitals 1st referral level Tertiary health care super specialized regional central level institution Emerge Health for All by the Year 2000 Program commitment to global improvements in health reviewed by World Health Assembly Vertical programs disease control program implementation interventions targets implemented Horizontal programs people focus needs relationships care life cycle Debates of Primary Health Care cost effectiveness support of programs whether should be vertical horizontal or both how programs should be Neoliberal limit gov interference in market forces powerful elite and corporations influenced government IMF World Bank World Trade Organization Social Theory and Health policy changes only effective in Asia and East no improvement in Africa reduced gains in life expectancy and increased mortality widened health inequalities Life and Debt tourist perspective compared to native IMF devalue currency expand exports and diminish imports rising debt working on low pay in bad conditions but still lose jobs Week 4 Global Health Governance What is global health governance What are the challenges to global health governance Who is authorized to act on global health issues Governance action and means adopted by a society to promote collective action and deliver collective solutions in pursuit of common goal means of organizing selves local groups or transnational corporations Health governance actions and means adopted by society to organize itself to promote and protect health of population Government type of governance formal authority Challenges of global health governance manage health risks that impact every country address broader determinants of health from a whole government perspective involve broader range of actors and interests bring together actors Coherence between policies public health mortality morbidity global burden foreign policy interests influence security stability trade development aid MDGs poverty reduction human No structured system of global health programs do their own focus economic stability versus health needs unequal distribution overlap and competition Need to understand cooperation define leadership and authority generate resources and distribute appropriately monitoring cannot be achieved on a global scale because of varying ideas and different rights policies Acting on global issues many actors from different parts of society local government civil society private sectors complex packages and agreeing upon means of action resource imbalances and distribution issues because different programs are working at their own pace with their own priorities X Ray of a Human Hospital human tragedy pay as you go spend life savings on treatment or don t and the people die readily diagnosis and prescriptions but treatments not available or too expensive Week 5 Metrics and Values in Global Health How have numbers and techniques of enumeration been deployed in describing prioritizing and shaping response to global health issues DALY one lost year of healthy life gap between current health status and ideal health Universal formula to measure the burden of ill health how much money to spend on controlling which disease how much to spend on disease research Narrow measurement does not take into account ability to cope with disability not including burden on family Standard life expectancy used is high Unethical to value lives with money Timing is off present valued more than future years Restrict analysis only to health interventions clean water reduce morbidity and time spend getting water female education reduce infant mortality and increase contraceptive use Numbers frame issues and categorize people Simplify complex issues and limit solutions Have valuue guided by decisions of variables how to measure Risk factors emphasize individual behavioral determinants Little information on environment