IDSB04H3 Chapter Notes - Chapter 2, 4: World Social Forum, Aga Khan Foundation, International Rescue Committee

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IDSB04 Week 3 Reading
Chapter 4 Global Health Actors and Activities
- The work in global health is not divvied up among relevant actors and instead is based on the current political and
economic order therefore HICs and actors on their side (NGOs, bilateral organizations, philanthropies etc.) are influential
- Social justice actors say that the ultimate aim of global health is for sovereign states to be in a position both economically
ad politiall, to eet thei o people’s eeds
- Global health diplomacy refers to both formal structures of global health decision making in foreign affairs ministries and
multilateral and summit organizations (ex. G20, UN agencies) and the interactions and negotiations among state and non-
state actors
- Definitions (Box 4-1, pg. 2)
Snapshot of Global Health Actors, Agencies, and Programs
Key Questions:
- Who are the major players in global health and what are their roles?
- What political, economic, and ideological rationales guide their policies and activities?
- Table 4-1 Typology of Global/International Health Actors and Programs
United Nations (Multilateral) Agencies
- UN agencies are aimed at aid, technical cooperation, and setting international norms and standards
- These agencies were traditionally funded through member states through the UN directly, the World Bank or UNICEF
- Some autonomous specialized agencies are linked to the UN through specific agreements and help set standards, formulate
policies, and provide technical assistance in their areas of expertise
- Table 4-2 Selected UN Organizations
- The UN sponsors large international gatherings directly or indirectly related to health
- Progress around gender (and health) justice remain uneven
- The UN has no power to implement/enforce resolutions, declarations and programs of action
The World Health Organization (WHO)
- It is the flagship global health organization, founded in 1946
- Mission and functions
o The attaied  all peoples of the highest possile leel of health
o Specific functions (some of them)
Assist governments in strengthening health services and emergency aid
Promote maternal and child health and welfare
Foster activities in the mental health field
Promote research and health training
o Their work is divided into 2 major
Central technical services epidemiologic intelligence, development of international agreements
Technical assistance to governments
- Governance
o World Health Assembly (WHA ats as the WHO’s paliaet hee ee Ma, the set poli pioities ad
appoe WHO’s poga udget
o WHO can only intervene in countries when requested and all resolutions require or urge but never oblige member
states to act
makes routine reports on domestic health conditions
There are representatives in each country where they help help governments in reviewing health needs
and resources
- Budget
o They have a fixed budget made up of contributions from member states they highly rely on voluntary
otiutios that ae’t egulated
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o Extra budgetary arrangements give both the government and private donors the power to determine how their
contributions are used, which leads to funding instability, coordination difficulties
UNAIDS (United Nations Programme on HIV/AIDS)
- Established on the efforts of the UN to prevent new HIV infections and improve the living conditions for people with HIV by
reducing the economic and social impact of the epidemic
- They coordinated with various UN agencies including UNESCO, World Bank, International Labor Organization (ILO) etc.
- They have offices in countries that are most affected by HIV as well as offices in countries that are major donors
UNICEF
- Was established after WWII to provide food and clothing for European children who suffered displacement from the war
- Their work extended globally in 1953
- It is funded only through voluntary donations
- They focus on all issues that are related to the well-bring of the child
International Financial and Economic Institutions (IFIs)
- Most notable the WB, the IMF, WTO these are all involved in setting macroeconomic policy and establishing and
overseeing trade rules and providing sector-speifi gats ad loas ofte use ieties ad oditioalities
o The IMF and WE are independent UN agencies
- IFI policies emphasize free markets, financial liberalization, national and international deregulation of health and
environmental protections, and privatization of public assets and services
The World Bank
- Include two lending institutions for development and a tripartite investment arm
o The International Bank for Reconstruction and Development (IBRD) they provide loans to MICs, their interest
rates are below commercial banks but are still burdensome
o The International Development Association (IDA) provides low-interest or no-interest loans and grants to countries
with annual income of less than US$1215 per capita
o The International Finance Corporation (IFC) promotes private investment in LMICs
- Since the 90s, the WB has been the well-known global health financier but has been displaced because of new players and
initiatives
- A ke oe elated to the WB’s udeoati otig stutue deisios ae ade ad fudig pioities ae goeed
by a group of major shareholders)
Other Development Banks
- Inter-American Development Bank, Asian Development Bank, the African Development Bank, the Islamic Development
Bank etc. these are regional level lending banks that have less capital
The international Monetary Fund
- The IMF is in charge of maintaining the stability of the international monetary system i.e. the balance of payments (the
financial flows of imports and exports, credit and debit among countries) and the exchange rate system
- The poide adie to ee outies o ho to avoid crises, technical assistance training, and temporary financing
- They help indebted economic by proving them with short-term financing to restrain immediate balance-of-payment
problems and minimize instability internationally
- The implement structural adjustment loans (along with the WB)
The World Trade Organization
- It was founded in 1995 to replace the General Agreement on Tariffs and Trade (GATT)
- The administer trade agreements and negotiations, monitors and enforces trade policies, and resolves trade disputes
internally among its 164 members
- The poote fee tade, ope akets, gloal opetitio, ad odisiiatio agaist foeig goods  eliiatig
import tariffs, lowering subsidies, and homogenizing rues and trade concessions
- They claim that their policies have led to increased economic growth in LMICs but critics say that their trade rule have
caused huge loses to local industries and jobs because transnational corporations are privileged over human lives
Critiques of and Alternatives to International Financial Institutions
- Immiserating, exploitation and dependency in LMICs to IFI policies
- Undemocratic decision making structures at the WB and IMF
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- The BRICS (Brazil, Russia, China, South Africa) focus on infrastructure and sustainable development in LMICs, is a capitalist
institution that is created by capitalist countries
- The Grameen Bank (based in Bangledesh) provide microcredit (small loans) to mostly women and they do this to try to
alleviate poverty through small scale economic development
o They have been critiqued for failing to reach the poorest populations
o They have also been accused of furthering capitalism on a large scale in Bangladesh through commercial banks,
private university, hotels and real estate
Bilateral Aid and Development Agencies
- Bilateral donor agencies are official ways of governments of many former colonial powers in Western Europe, North
American and the Pacific they are often in charge of channeling national contributions to multilateral and international
financial agencies
United States Bilateral Assistance
- The US is the largest official development assistance (ODA) donor in the world
- USAID its flagship development office and the State Department carry out and fund many global health programs
o They focus a lot on family planning
- The US government use its enhanced global health platform to push for multilateral efforts around health security to boos
global epidemic response capacity
PEPFAR U“ Presidet’s Eergey Pla for AID“ Relief
- It is administered by the US Department of State, the USAID is involved, and the Centers for Disease Control and Prevention
(CDC)
- Citis said the PEPFAR’s ok as though a etial approach where they hired people from other needed health activities
OECD Donor Comparisons
- The largest percentage of DAC ODA is allocated for health (infrastructure and disease control), population policies and
productive health, and water/sanitation projects (14%)
Military Ators’ Ivolveet i Gloal Health
- The US military is the largest military in the world is also the main military global health actor
- A lot of the health protection efforts revolve around US Army and Navy overseas labs these labs support the Armed
Foes Health “ueillae Cete’s Gloal Eegig Ifetious “ueillance and Response System
- MSOs (medical stability operations) this is where the global health work of the US focuses most on
o Their activities are given priority
- An advantage of humanitarian relief delivered by the military is that they can deploy resources quickly and efficiently
o Many military forces work closely with international and national NGOSs this can affect the neutrality of NGOs
o The design of MSOs are short-te, ad do’t assess o ealuate ad theefoe he the ilita leaes, the
region is unsustainable
South-South Cooperation
- A growing number developing countries are finding ways to help one another
o Their rising economics are allowing countries such as Brazil, India and South Africa to create discussion amongst
South-South countries amongst common positions on international issues
- The bilateral agencies of China, Brazil and India have been particularly active
o China is currently the largest player amongst south-south development assistance where they work in Asia and
Africa in health, population, water and sanitation where a lot of their projects focus on infrastructure and human
resource development
o Citis agued that Chia’s deelopet aid is eause the at aess to atual esoues ad to epad thei
markets for their products
Contract Providers and Consulting Firms
- Many of these providers operate on a for-profit basis while other are NGOs or act as NGOs
- They receive contracts from bilateral and multilateral agencies
- Contractors are intermediaries rather than agenda setter but they often have a role in project evaluation and in
determining which programs are successful by donors
Government Technical Agencies and Research Institutions
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Document Summary

Chapter 4 global health actors and activities. The work in global health is not divvied up among relevant actors and instead is based on the current political and economic order therefore hics and actors on their side (ngos, bilateral organizations, philanthropies etc. ) are influential. Social justice actors say that the ultimate aim of global health is for sovereign states to be in a position both economically a(cid:374)d politi(cid:272)all(cid:455), to (cid:373)eet thei(cid:396) o(cid:449)(cid:374) people"s (cid:374)eeds. Global health diplomacy refers to both formal structures of global health decision making in foreign affairs ministries and multilateral and summit organizations (ex. G20, un agencies) and the interactions and negotiations among state and non- state actors. Snapshot of global health actors, agencies, and programs. Table 4-1 typology of global/international health actors and programs. Un agencies are aimed at aid, technical cooperation, and setting international norms and standards. These agencies were traditionally funded through member states through the un directly, the world bank or unicef.

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