The recent expansion of the deadly Ebola virus in west Africa, has demonstrate the catastrophic impact of such epidemic on the people’s health with numerous deaths but also result in socioeconomic disruptions in the region. However, it also emphasizes the rapid response of international organizations such as WHO to counter such pandemic.
Over the history, pandemic have made a lot of death. One of the deadliest natural disasters in human history was the 1918 flu pandemic which touched almost half of the world’s population and killed over 5 percent of the world’s population between 1918 and 1919 which was worse than the number of death during the entire 1914-1918 world war. This is a reminder of the terrible pandemics such as the black plague of 1348 (killed 1/3 of Europe population between 1347 and 1352), and the 1916 polio pandemic.
Nowadays, despite the apparent progress concerning the medical but also healthcare, we did not manage to eradicate the diseases, as a matter of fact the progress of Globalization and the multiplication of exchanges seems to be an aggravated factor.
The term Health which was defined by the World Health Organization (WHO) in 1948 as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” This vision remains utopic since only small part of the world’s population actually meet this criteria. One of the objectives here is the improvement of the medical conditions and public health. Being able to reduce the risk of transmission of infections and diseases is one of the stake of the globalization. Another aspect might include the transmission of specific medical knowledge (by the standardization of the medical learning in university) to the global community.
I will develop the argument as follow. First, I will briefly review…Then I will review evidence indicating…Next, I will consider… Finally, I will conclude by demonstrating how…
The inequality in the world’s access to health and basic healthcare
The access to the medical system and the quality of the healthcare services highlight well the disparities in development.
A lot of indicators nowadays still demonstrate the difference between the North and the South. The inequality concerning the death is particularly relevant. Even though the average life expectancy at the global scale continued to increase to attain almost 71.4 years old in 2015 (According to the data provided by the WHO, http://apps.who.int/gho/data/view.main.SDG2016LEXREGv?lang=en). This average is however hiding the disparities: 60 years old in Africa against more than 76 years old in America. Even worst, along with the disastrous effect of warfare, HIV/AIDS made the life expectancy plummet for Zimbabwe which was on average 61 years old in 1990 and 51 years old in 2011.
Furthermore, other indicators could be used to demonstrate the inequality in development such has the HDI (The Human Development Index (HDI) is a composite statistic of life expectancy, education, and per capita income indicators)( the HDI are found in the annual Human Development Reports produced by the Human Development Reports Office of the United Nations Development Programme (UNDP)) or the medical staff ratios, the technical quality of the medical materials, or else the childhood mortality (look for numbers and data)
Another sign that highlights these disparities is the phenomena called “medical brain drain”, Although the developed countries of the North are providing aid and medicines to developing countries, they are stealing them by taking their most precious resource: trained doctors and nurses. (Stopping Africa’s medical brain drain). For instance, in Zimbabwe more that 3 quarters of trained doctors and nurses leave their country at the end of their study, usually for South Africa or the United Kingdom.
How to explain these disparities? Health situation depend primarily on the level of development. The access to clean water is thus a primordial thing (ex design thinking: India)
The geography of the malaria highlight this reality: according to a study provided by the WHO, more than 6 % of deaths would be a result of bad quality water (0.5% in the North, more than 20% in Angola). Only the countries from the North possess the capacity to implement public health policies, such as global prevention and treatment. As a result, wealthy people from poorest country tend to go get treated in wealthier country where there is actual healthcare system, emphasizing the failure of the healthcare system in their proper country. Conversely some diseases are only affected developed countries such as Alzheimer or cardiovascular disease due to obesity problem. Besides this stake becomes a primordial issue in emerging countries such as Mexico or China.
According to a study from FAO, Mexico would be one of the most affected country by obesity (more than 32% of the adult population).
Also disparities exist in the North countries; Thus in the countries where there is no real healthcare system, the poorest people have trouble to get access to health and good consumption due to the cost of the medicines, treatment for heavy diseases as well as access to higher quality product.
Even though globalization is a vector of progress, there is still a real medical fracture.
Health, in the center of the globalization process
In the same time, globalization in the domain of pandemic is process which tend toward standardization. In fact, the multiplication of the exchanges, and the migration of population foster the propagation of disease at a larger scale. This was the case for the SARS which appeared between November 2002 and July 2003 in china and reach 37 countries (WHO). These last year, we witness the mutation of several virus such H5N1 (Bird flu) which can be transmitted man to man and led to a global risk of contagion. Similarly, with climate change, and the adaptation of new kind of mosquitoes such as the tiger mosquitoes or chikungunya in France, might be a factor of expansion of new kinds of diseases.
However, disease are not the only challenges of global health. Commercial flaws as well as the propagation of new production techniques might engender new issues. GMOs, hormone beef, and the traceability of food are all issue that resulted from Globalization. Thus, the 2008 Chinese milk scandal which was a food safety incident involving milk and infant formula along with other food materials and components being adulterated with melamine, question on the overall quality of control on food.
Public health is also a major concern, as Dr. Alain Poirier explains in his conference that
health was a major issue in today society with the rise of fast food, malnutrition, and the lack of
physical activity.
In addition, the globalization of economic activities develops new kind of health issue in the world. For example, with air pollution (according to the WHO, air pollution would be responsible for more than 3.2 million of deaths every year), but also the discharge or threat of discharge of polluting product into the see.
All these health tragedies are a reminder that health as an evident economic dimension in the process of Globalization.
Healthcare issue can represent an impediment to the economic dynamism, as the significant plague of AIDS in South Africa where most of the active young population is HIV positive.
Conversely, in some country which benefit from high healthcare quality, a new form of tourism called “medical tourism” is developing such as in Costa Rica, Hungary (where they specialize in dental care) or else Tunisia.
Nowadays, the income that is resulting from the healthcare sector is extremely important. This sector represents a tremendous market: the total revenue from medicines and drugs was 1,668 billions of dollars in 2015 (http://www.statisticbrain.com/health-care-industry-statistics/). This rapidly growing market is still mostly dominated by the countries from the North: Pfizer (USA), Merck & Co (USA), Novartis (Swiss), Sanofi (France).
The cost of research and development and the importance of the sector leads to merger, acquisition and partnership (NIH in the USA) or the creation of big pharmaceutical group such as the Ranbaxy group in India which continue to expand. More and more multinational firm attract researcher from all around the world. However, an important of their production is relocate to emerging countries which possess cheapest cost of production.
The health sector has become a domain in which different actor of the globalization thrives.
The imperatives of global responses to the challenges of health
Health issue are global challenges that need adapted and coordinated responses at the global level.
Despite an effective vaccine, Measles has killed more than 150,000 persons. This health scandal of diseases than can be prevented or healed emphasizes the imperatives of global policy. Numerous progress was accomplished due to world vaccines campaign made by the WHO which has saved many lives. As an example, smallpox was eradicated completely in 1977 thanks to this measures.
Globalization principles can be put at the service of a commune solidarity in the health area. As can be the case in other sector of the globalization, many actors work for better responses to healthcare problems. Thus, many non-governmental organizations such as Bill and Melina Gates foundation work to facilitate the access of medicines and drugs to the poorest country.
However, despite this apparent desire of international cooperation, multinational healthcare corporations continue to seek for higher profit. Investment and research cost constrain these companies to concentrate their research solely on profitable disease, more on cancer than malaria for instance. Consequently, due to this economic logic, the lobbying of the pharmaceutical group put pressure on the internationals organism and developed country to make use of generic medicines more often. One can wonder if the right to healthcare is more important than intellectual property and profit? Despite legal appeal, multinational corporations lost the fight of the international public opinion in the South Africa AIDS controversy(…)
Finally, healthcare and economic challenges are not the only challenges that requires international cooperation. Nowadays, there is a still some threat concerning bacteriological attacks (in spite of the convention of 1972 which was sign by 162 and supposed to prohibited it). The efficacy of such protocol is raising questions, considering the fact that this attack are more easily available. As an example, the Japanese sect Aum launched an attack with anthrax in Tokyo in 1993. Also, we are not protected from terrorist bacteriological attacks.
Besides, financial stakes of the health market attract a lot of desire. Thus we witness the strong expansion of the e-health market which make harder the control on medicines. Furthermore, the risk of creation of an illegal or black market generating all kind of traffic, may multiply and spread.
This is the case in particular for emerging countries where counterfeit drugs represent an important part of the market. In the African market the repercussions of this illegal industry are severe: risk for local population, and loss of earnings for multinational corporations. As a matter of fact, only a massive coordinated fight, lead by actors from the North and the South as well as public and private sectors can overcome this plague. Likewise, the illegal profit generated by such market foster the emergence of the organ traffic, often directed by local mafias to fill the lack of donations of organs from rich country. This type of business in poor country reveal a dark aspect of the globalization.
According to Dr. Poirier, even if we raise awareness on health problems, it would
be insufficient. For example, when he was studying medicine, smoking was allowed in class. One
day, he attended a conference on the dangers of smoking and afterwards, as was the norm, the
lecturer lit a cigarette in front of the students, despite having warned them of tobacco-induced
health concerns beforehand. Consequently, we should find new ways of fighting against bad habits that causes health problem.
How to rethink Health and Healthcare in a globalized world
Conclusion