2016 GH Sesi 1 dan Sesi 2 YM Global Health
Global Health
Yodi Mahendradhata
Global Health*
• an area for study, research, and practice that places a priority on
improving health and achieving equity in health for all people
worldwide.
• emphasises transnational health issues, determinants, and solutions;
• involves many disciplines within and beyond the health sciences and
promotes interdisciplinary collaboration;
• is a synthesis of population-based prevention with individual-level
clinical care.
*Consortium of Universities for Global Health Executive Board, 2009
What do we mean by global health?
an area for study, research, and practice that places a
priority on improving health and achieving health equity
for all people worldwide
Koplan et al (2009)
health issues that transcend national boundaries and
governments and call for actions on the global forces
that determine the health of people
Kickbush (2006)
collaborative international research and action for
promoting health for all
Beaglehole & Bonita (2010)
worldwide improvement of health, reduction
of disparities, and protection against global threats that
disregard national borders
MacFarlane et al (2008)
Global health in perspective*
*Kopla , J.P., T.C. Bo d, a d M.H. Merso et al.
Health: New Field or New Na e? Lancet, in press.
. A Defi itio of Glo al
International political economy of health
Quarantine: the birth of global health policy
The birth of tropical medicine
International Sanitary
Conferences
L’Offi e Internationale
d’Hygie e Publique (OIHP)
The League of Nations Health
Organization
Office of Malaria control in war areas
1942-1945
The Center for Disease Control (CDC)
(1946)
WHO Constitution (1946)
The attainment by all peoples of
the highest possible level of health
…Health is a state of o plete physi al, e tal a d so ial well
ei g a d ot erely the a se e of diseases or i fir ity
The 1st World Health Assembly (1948)
WHO functions:
1. Direction and coordination of international health work
2. Normative functions
3. Research and technical cooperation
United Nations International Children Fund –
UNICEF (1946)
The cold war effect: 1949-1956
Global malaria eradication:
1955-1978
Malaria eradication commando: 1959
Small Pox Eradication: 1959
United Nations Population Fund –
UNFPA : 1967
Alma Ata Conference (1978)
The attainment by all peoples by the
year 2000 of a level of health that will
permit them to lead a socially and
economically productive life.
Primary health care is the key to
attaining this goal.
Selective vs comprehensive primary
health care
World Health Assembly voted to freeze
WHO’s udget
U“ withhold o tri utio to WHO’s
regular budget (1985)
WHO Essential Drug Program
(WHA 31.32)
International Code on
Breast Milk Substitutes
(WHA 34.22)
The Washington Consensus
• Privatization
• Reducing public expenditure
• Trade liberalization
The rise of WTO...
UNAIDS enter the scene...
GAVI enter the scene...
Recharging WHO
The Commission for
Macroeconomics and Health
Global development ladder
High income:
1 Milyar
Middle income:
2,5 Milyar
Moderate poverty:
1,5 Milyar
Extreme poverty:
1 Milyar
# extreme poor 1981vs. 2001
900
800
700
600
500
400
300
200
100
0
1981
2001
East Asia
East
Europe
Latin
America
Middle
East
South
Asia
Africa
es
te
La
tin
ad
a
R
e
Af
ri
ca
a
n
As
i
Ja
pa
er
ic
a
Ca
n
Am
US
US
S
ro
p
ro
pe
Eu
Eu
Ex
rn
rn
Ea
st
e
W
GDP per capita 1820 vs 1998
30000
25000
20000
15000
10000
1820
1998
5000
0
Global poverty diagnosis
• Poverty trap
•
•
•
•
•
•
–
–
–
–
–
Demographic
Environmental
Climate shocks
Disease
Price fluctuation
Economic failure
Fiscal trap
Physical geography
Governance failure
Cultural barriers
Geopolitics
Causes of avoidable mortality
• HIV/AIDS, Malaria and Tuberculosis
– 11.4% DALYs Global
– 31.5% DALYs di Afrika
•
•
•
•
•
•
Kematian maternal dan perinatal
Penyakit2x yg bisa dicegah dgn imunisasi
Infeksi saluran pernapasan akut
Diare
Malnutrisi – mikronutrien dan KEP
Tembakau
* Source: Jha et al, 2002
The Birth of GFATM
Bill and Melinda Gates Foundation
Universal Health Coverage
WHA 58.33
The world is now at the start of the
2009 influenza pandemic...
Margaret Chan (DG WHO)
Global economy in crisis
GFATM in crisis
The new world bank
[email protected]
Yodi Mahendradhata
Global Health*
• an area for study, research, and practice that places a priority on
improving health and achieving equity in health for all people
worldwide.
• emphasises transnational health issues, determinants, and solutions;
• involves many disciplines within and beyond the health sciences and
promotes interdisciplinary collaboration;
• is a synthesis of population-based prevention with individual-level
clinical care.
*Consortium of Universities for Global Health Executive Board, 2009
What do we mean by global health?
an area for study, research, and practice that places a
priority on improving health and achieving health equity
for all people worldwide
Koplan et al (2009)
health issues that transcend national boundaries and
governments and call for actions on the global forces
that determine the health of people
Kickbush (2006)
collaborative international research and action for
promoting health for all
Beaglehole & Bonita (2010)
worldwide improvement of health, reduction
of disparities, and protection against global threats that
disregard national borders
MacFarlane et al (2008)
Global health in perspective*
*Kopla , J.P., T.C. Bo d, a d M.H. Merso et al.
Health: New Field or New Na e? Lancet, in press.
. A Defi itio of Glo al
International political economy of health
Quarantine: the birth of global health policy
The birth of tropical medicine
International Sanitary
Conferences
L’Offi e Internationale
d’Hygie e Publique (OIHP)
The League of Nations Health
Organization
Office of Malaria control in war areas
1942-1945
The Center for Disease Control (CDC)
(1946)
WHO Constitution (1946)
The attainment by all peoples of
the highest possible level of health
…Health is a state of o plete physi al, e tal a d so ial well
ei g a d ot erely the a se e of diseases or i fir ity
The 1st World Health Assembly (1948)
WHO functions:
1. Direction and coordination of international health work
2. Normative functions
3. Research and technical cooperation
United Nations International Children Fund –
UNICEF (1946)
The cold war effect: 1949-1956
Global malaria eradication:
1955-1978
Malaria eradication commando: 1959
Small Pox Eradication: 1959
United Nations Population Fund –
UNFPA : 1967
Alma Ata Conference (1978)
The attainment by all peoples by the
year 2000 of a level of health that will
permit them to lead a socially and
economically productive life.
Primary health care is the key to
attaining this goal.
Selective vs comprehensive primary
health care
World Health Assembly voted to freeze
WHO’s udget
U“ withhold o tri utio to WHO’s
regular budget (1985)
WHO Essential Drug Program
(WHA 31.32)
International Code on
Breast Milk Substitutes
(WHA 34.22)
The Washington Consensus
• Privatization
• Reducing public expenditure
• Trade liberalization
The rise of WTO...
UNAIDS enter the scene...
GAVI enter the scene...
Recharging WHO
The Commission for
Macroeconomics and Health
Global development ladder
High income:
1 Milyar
Middle income:
2,5 Milyar
Moderate poverty:
1,5 Milyar
Extreme poverty:
1 Milyar
# extreme poor 1981vs. 2001
900
800
700
600
500
400
300
200
100
0
1981
2001
East Asia
East
Europe
Latin
America
Middle
East
South
Asia
Africa
es
te
La
tin
ad
a
R
e
Af
ri
ca
a
n
As
i
Ja
pa
er
ic
a
Ca
n
Am
US
US
S
ro
p
ro
pe
Eu
Eu
Ex
rn
rn
Ea
st
e
W
GDP per capita 1820 vs 1998
30000
25000
20000
15000
10000
1820
1998
5000
0
Global poverty diagnosis
• Poverty trap
•
•
•
•
•
•
–
–
–
–
–
Demographic
Environmental
Climate shocks
Disease
Price fluctuation
Economic failure
Fiscal trap
Physical geography
Governance failure
Cultural barriers
Geopolitics
Causes of avoidable mortality
• HIV/AIDS, Malaria and Tuberculosis
– 11.4% DALYs Global
– 31.5% DALYs di Afrika
•
•
•
•
•
•
Kematian maternal dan perinatal
Penyakit2x yg bisa dicegah dgn imunisasi
Infeksi saluran pernapasan akut
Diare
Malnutrisi – mikronutrien dan KEP
Tembakau
* Source: Jha et al, 2002
The Birth of GFATM
Bill and Melinda Gates Foundation
Universal Health Coverage
WHA 58.33
The world is now at the start of the
2009 influenza pandemic...
Margaret Chan (DG WHO)
Global economy in crisis
GFATM in crisis
The new world bank
[email protected]