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University of Toronto Scarborough
International Development Studies

Chapter 1 Introduction Chapter Key DefinitionsAccording to the WHO Health is a state of complete physical mental and social wellbeing and not merely the absence of disease or infirmity 3oInternational health actors frame international health in terms of disease controloThere is growing consensus on the need to address social determinants of health essential for good health and well being These includeadequate housing access to clean water sanitation nutrition education broad social policies and protections safe working conditions and living wages 94C E A Winslow a public health leader described public health as the science and art of preventing disease prolonging life and promoting physical health and efficiency through organized community efforts 4 There have been several other conceptions of the field of public health includingoSocial medicinerefers to integration of political action and health thefforts developed in the 19 centuryoPopulation healthemphasizes on how various determinants of health interact affecting health egunemployment can lead to social isolation poverty and homelessness with profound effects on health 5developed by the Canadian Insitute for Advanced ResearchoCollective healthemphasizes on people exercising agency thus shaping health outcomes proponents of this view challenge the exclusive role of and reliance on the public sectorInternational HealththoTerm came into use in the 20 century and differs from tropical medicine which addressed the health problems in Europes coloniesand other tropical settings 5oIt was born from interest among countries to address transnational health concernsinparticular it was originated out of fear of the adverse affect ill health had on worker productivity and social unrestointernational health principally covered the problems of health in underdeveloped countries and the efforts by industrialized countries and international agencies to address these problems 6influenced by Cold War rivalries and dominance of industrialized powers over developing countriesGlobal HealthoAccording to the US Institute of Medicine global health is health problems issues and concerns that transcend national boundaries may be influenced by circumstances or experiences in other countries and are best addressed by cooperative actions and solution 6It is different from international health because it emphasizes on addressing health concerns of BOTH rich and poor nations alike because it implies that all people share a susceptibility to experience of and responsibility for health 6oGlobal health has been used to assert US global unilateralism in which the US has dominance on what is considered part of international health agendaoImportant issues and key players of global health governance international agreements and protocols international agencies and NGOshuman rights issues international trade and development of pharmaceuticalsoProponents of the belief globalization of public health is good state the proliferation of technology ideas and altruism brings unity in public health surveillance whereas others believe that the World Bank IMF and WTO dominance neglects to take into consideration the underlying determinants of diseasesoInternational public health refers to the application of the principles of public health to health problems and challenges that affect low and middleincome countries and to the complex array of global and local forces that affect them 8this term alludes to false generalizations about nonindustrialized countries and their inadequate health systemsoNOTE in this book the term international health will be used to refer to political and economic forces creating adverse health conditions anywhereInternational Health continuedointernational health is characterized by activities that are carried out by international bilateral multilateral regional and transnational health organizations and individuals at lower levels like local primary health care workersIH address potential and actual pandemics including diseases like avian flu HIVAIDS malaria and cancer as well as work related deaths or diabetes related to food production and marketing 9Health an indicator of the efficiency of ID political science IR economics and social work hence IH is important to these fieldsIH organizes response to humanitarian disasters and emergencieso2 geopolitical aspects of IH IH has become involved in foreign policy agenda because of concerns induced by health crises eg bioterrorism IH is also intended to protect market capitalism because of realization that disturbance in health has adverse affect on worker productivity commerce manufacturing tourism etcoThe World Bank is a proponent of the belief that health is a function of health care systems 10 and thus financing and organization and health economics should be primary focus of IHThe authors of the book argue the contrary stating political economic and other social factors shape health ergo the health care system is one element that contributes to healthoWhen it comes to developing countries most efforts involving training of people overseas whether locals or foreigners and bringing them to the recipient country based on the belief health crises is a result of lack of resources knowledge and particular tools 10The social justice perspective of IH on the contrary centers on the involvement of people in the region needing improvement through its own representative organizations movements and elected officials 10WAYS OF CONCEPTUALIZIGN INTERNATIONAL HEALTHHumanitarianhuman rightsethical imperativeGlobal public goodSecurity fear of pandemics and exoticdeadly disease social unrest and bioterrorismProtect and preserve marketscapitalism
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