HLTC24H3 Lecture Notes - Occupational Safety And Health, World Social Forum, Social Forces

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8 Apr 2012
1) What features of contemporary globalization are new?
Promotion of free trade 17th-18th century
Appalling factory conditions 19th century (factory workers)
Communications/transportation revolution 19th century (steam engine)
Transnationalism (colonialism)
New: (Exam Question: What is particularly new about globalization?)
Internationalization of finance (mostly speculative)
o Speculative capital flows
o Moving around money that doesn’t exist
Rate of increase in social inequalities
o South East Asian Crisis
2) What is Neoliberal Globalization?
Neoliberal Globalization:::Promotion of free markets/removal of trade barriers
o Reduction of subsides for the poor
o Cost recovery fees for essential services
o Privatization of public assets
o Weakened role of government
o High military expenditures
o Growing dominance of Western-based transnational capital
- Political order dominated by the logic of the market
3) What are the major pathways thru which globalization affects health?
Globalization influences health and generates health inequities thru 5 major pathways:
1. Trade liberalization and the world trade regime (WTO)
Trade liberalization changes employment patterns in variety of ways;
farmers pushed out by agribusiness, others are deindustralized, others industrialized but subjected to social
stratification heightens exposure/suscept to disease.
trade liberalization unequally affects agricultural workers and small-scale entrepreneurs who have no safety
net, women, and children, jobs for these workers poorly regulated
greater labor mobility of professionals led to their emigration from poor countries
2. Global reorganization of production and labor markets
The global reorganization of production and labor markets has resulted in the exportation of jobs and entire
industries to areas where regulation is lax.
This contributed to a “race to the bottom” in which jobs are lost from industrialized countries (unemployment,
stress, poor hlt outcomes) and are relocated to poor countries where wages are inadequate and labor
organizing is suppressed.
3. Debt crises and structural adjustment of developing country economies
Due to the debt crisis & imposition of structural adjustment policies on many economies of the developing
world, the ability of the govt to invest in public hlt, education, water and sanitation, nutrition been
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High debt-servicing payments limit public provision of social goods, while loan conditionalities have stipulated
decreased food subsidies, reduced state investment in social programs and decreased public sector incomes,
disproportionately affecting women and marginalized communities as a whole.
4. Environmental damage
As commodificationturning nonmarketable/public goods H2O into market commoditiesintensifies under
neoliberalism, the environment suffers
Under pressures of neoliberal globalization, environmental regulation is unenforced or nonexistent in many
5. Financial liberalization
Financial liberalization exposes national economies to the uncertainties created by large and volatile capital
flows and intensifies the effect of inequality on the social determinants of hlt
w/1+ trillion US$ in daily transactions= instability in countries, sudden currency devaluations, evaporating
purchasing power, and undermining livelihoods of millions of people
4) What would happen to health if the WTO did not exist?
Trade affects the determinants of health and disease in variety of ways:
1) Increased fluidity of global production aids transfer of outdated production technologies to poorer countries,
poses hazards to both unprotected employed pop and whole pop
2) Labor market “flexibility” seen in EPZs if often pretense for minimal regulation, anti-union legislation, and unsafe
working conditions, and relaxed trade rules can result in importation of poorly regulated/contaminated goods
3) Leads to increased exposure to infectious diseases thru rapid cross border contamination, disruption of animal
habitats thru rapid urban growth (increasing exposure to disease w/animal hosts SARS) and unregulated food
production and markets (avian flu)
4) Raises probability of developing chronic diseases thru the marketing of unhealthy products like tobacco and
alcohol, thru promo of unhealthy behavs like fast food, and thru increased environmental degradation
5) Can reduce the provision/distribution of health related goods, services, personnel (Ex extended patent
protection lead to decreased access to medical technologies, trade treaties restrict national govts from investing
in/regulating health care)
5) Which WTO agreement has the greatest implications for public health?
1) Agreement
on Trade-
Extended patent protection limits access to essential meds. Higher resulting cost of drugs
drains money from PHC and other determinants of hlt, must abide by patents for a min period
of 20 years
Hurts the producers of generic meds in developing countries and millions who cant afford to
buy patented drugs (S.Africa’s fight for ARVs)
TRIPS inhibits generic drug protection, which lower costs, ensure constant, sufficient supply of
meds. TRIPS prioritizes profits ova human well-being
>>Lrg producers of generics Mexico, India and Brazil
2001, Doha Declaration agreed that TRIPS should be operate in a way that supports the right
of countries to protect public health and promote access to meds for all in times of
emergency/cant prevent membs from taking measures to protect hlt
Some countries use the flexibilities of TRIPS agreement to challenge high cost of patent-
protected drugs, Countries that declare public hlt emergencies can break patent barriers by
getting compulsory licenses or thru parallel imports
EX: Zimbabwe issued licenses for import or local production of ARVs, lead to price
reductions b/w 60-90%.
2) Agreement on
Sanitary and
allows each country to set its own standards for food and drug safety regulations but requires
them to be based on a scientific risk assessment w/o discriminating b/w domestic and
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