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Promoting Global Health: The Case for Global Health Impact Initiatives

Nicole Hassoun

in Global Health Impact: Extending Access to Essential Medicines

The third chapter presents the book’s new proposal for addressing the access to medicines problem. It suggests that by collecting and analyzing data on global health, people can come up with new ways ... More

The third chapter presents the book’s new proposal for addressing the access to medicines problem. It suggests that by collecting and analyzing data on global health, people can come up with new ways to improve poor people’s access to essential drugs and technologies. It suggests utilizing information about medicines’ global health impact (organized by drug, disease, country, and company) to create incentives for positive change. One possibility is to give pharmaceutical companies with the most impactful drugs a Global Health Impact label to use on all their products. Highly rated companies will have an incentive to use the label to get a larger share of the market. Further, socially responsible investment companies could include Global Health Impact companies in their portfolios. Finally, having a Global Health Impact certification system for pharmaceutical companies would open the door to all kinds of fruitful social activism. One possibility is a Global Health Impact licensing campaign. Pharmaceutical companies rely, to a large extent, on university research and development. So, if universities allow only certified companies to benefit from their technology, companies will have an incentive to abide by Global Health Impact standards.Less

Global Health Inequalities and Justice

Jennifer Prah Ruger

in Understanding Health Inequalities and Justice: Bridging Perspectives for New Conversations

This chapter discusses challenges of global health inequalities in the current global health policy system. It then describes provincial globalism and a shared health governance framework as ... More

This chapter discusses challenges of global health inequalities in the current global health policy system. It then describes provincial globalism and a shared health governance framework as approaches to these challenges. Moral philosophers have for some time argued that global poverty and associated human suffering are universal concerns and that there is a moral obligation, beyond matters of charity, for wealthier countries to do more. Being serious about addressing the problem of global health inequalities requires developing a conception of global health justice. Moreover, addressing global health inequalities requires a reexamination of the norms and principles underlying global institutions in order to offer proposals for a better global health policy. This chapter sketches analytical components of provincial globalism, a framework that takes individuals to be the moral unit in both domestic and global contexts and that improves the prospects of alleviating global health inequalities. Provincial globalism promotes the realization of individuals’ health capabilities and supports a shared health governance that enables institutions to reexamine the objectives, policy goals, and decision-making procedures of the global health architecture. Shared health governance, in turn, provides standards for regulating global and domestic institutions and practices to create the conditions for realizing individuals’ health capabilities.Less

Health: Medicine for Market Failure

Georgia Levenson Keohane

in Capital and the Common Good: How Innovative Finance is Tackling the World's Most Urgent Problems

Looks at the range of innovations that have emerged in recent years to improve financing for global health objectives, and examines various approaches, including global levies like UNITAID and ... More

Looks at the range of innovations that have emerged in recent years to improve financing for global health objectives, and examines various approaches, including global levies like UNITAID and UNITLIFE; an array of market shaping initiatives like prizes and challenges and the GAVI Alliance’s advanced market commitments; a variety of innovations related to debt, including loan forgiveness and ‘debt swaps’ administered through the Global Fund, Pledge Guarantee for Health, the International Finance Facility for Immunization (IFFIm)’s vaccine bonds; and equity investments—impact investment vehicles like the Global Health Investment Fund—that blend philanthropic and commercial capital for drug research and development and other health interventions.Less

Beyond Experimental Political Philosophy: Evaluating Global Health Impact Certification

Nicole Hassoun

in Global Health Impact: Extending Access to Essential Medicines

The sixth chapter suggests that examining the prospects for a Global Health Impact labeling and certification campaign might expand the domain of traditional philosophical inquiry in an important ... More

The sixth chapter suggests that examining the prospects for a Global Health Impact labeling and certification campaign might expand the domain of traditional philosophical inquiry in an important way. It presents a proposal for testing consumers’ willingness to make decisions based on a Global Health Impact label. The basic idea is to put a Global Health Impact label on a few over-the-counter products and to collect data on changes in consumers’ willingness to purchase these products compared to otherwise similar generic versions of the products from sales. The chapter explains how carrying out this test might provide an example of a new kind of experimental philosophy. Although most experimental philosophy has focused on individuals’ intuitions and is modeled on the psychological literature, there is a lot of empirical work in other disciplines, and many useful methods are available for answering important questions experimental philosophers might want to address.Less

Pathways Towards a Framework Convention on Global Health: Political Mobilization for the Human Right to Health

Kent Buse, Lawrence Gostin, and Eric Friedman

in Law and Global Health: Current Legal Issues Volume 16

This chapter focuses on the global initiative—the Joint Action and Learning Initiative on National and Global Responsibilities for Health (JALI)— which seeks to establish a Framework Convention on ... More

This chapter focuses on the global initiative—the Joint Action and Learning Initiative on National and Global Responsibilities for Health (JALI)— which seeks to establish a Framework Convention on Global Health (FCGH). It outlines the JALI’s manifesto on global health justice and a FCGH; discusses how powerful vested interests are vigorously resisting the FCGH; and considers the role of transnational advocacy coalitions. Drawing on a conceptual framework in policy sciences literature—one which explains that policy change results from interactions between ‘interests’, ‘ideas’, and ‘institutions’—the chapter discusses how developments in each of these three streams may influence the strategies JALI and how the movements it fosters, supports, and allies itself can influence future inter-governmental negotiations on a Convention.Less

Covenants in Occupational Health

Igor Fedotov

in Global Occupational Health

The right to a safe and healthy work environment is a fundamental human right. Two organizations within the United Nations system are directly concerned with occupational health: the International ... More

The right to a safe and healthy work environment is a fundamental human right. Two organizations within the United Nations system are directly concerned with occupational health: the International Labor Organization (ILO and the World Health Organization (WHO). In order to achieve this, the ILO formulates international standards in the form of Conventions and Recommendations, dealing with occupational health and safety and other work-related issues and administers the legal framework for occupational health protection in international law. Each covenant and convention is designed to be universally applicable, flexible, viable (feasible) and adaptable as needed. The ILO also develops Codes of Practice in the form of detailed technical specifications that apply to various problems and industries that governments, employers and workers’ organizations can use to determine what should be done. Occupational health and safety standards may be written as guidance for policies, to protect workers from unnecessary risks, to protect workers in certain industries. The WHO investigates the scientific basis for controlling occupational health problems and supports educational programs. Its primary means of doing is the Global Strategy in Occupational Health for All, which is intended to strengthen national infrastructure and services in occupational health and the development of occupational health standards based on scientific risk assessment.Less

Rating Efforts to Extend Access on Essential Medicines: Increasing Global Health Impact1

Nicole Hassoun

in Health Inequalities and Global Justice

Global inequality impacts global health. The rich can, but the poor cannot, access many of the existing medicines they need. This paper considers the prospects for rating pharmaceutical companies' ... More

Global inequality impacts global health. The rich can, but the poor cannot, access many of the existing medicines they need. This paper considers the prospects for rating pharmaceutical companies' efforts to extend access on essential medicines to the poor. It argues that it is possible to design a good rating system – one that rewards highly rated companies for doing things that actually promote global health. It also suggests that practical work on promoting global health can yield interesting philosophical questions and conclusions by highlighting some of the normative choices that are important to address in developing a good rating system.Less

International perspectives

Colin Palfrey

in The Future for Health Promotion

This chapter considers international perspectives in the area of health promotion. It begins with an overview of health promotion as a global enterprise, citing major developments such as the ... More

This chapter considers international perspectives in the area of health promotion. It begins with an overview of health promotion as a global enterprise, citing major developments such as the founding of the World Health Organization (WHO), the Alma Ata Declaration, and the introduction of the notion of the social determinants of health by Thomas McKeown. It then examines the Ottawa Charter for Health Promotion (1986) and the five health promotion areas that it identified for achieving better health: building healthy public policy, creating supportive environments, strengthening community action, developing personal skills, and reorienting health services. The chapter goes on to discuss other international health promotion initiatives, including the Bangkok Charter for Health Promotion in a Globalized World (2005) and the Helsinki Global Conference on Health Promotion (2013). Finally, it analyses the role of the WHO in health promotion, along with the issues of health inequalities and health inequities.Less

Global-Health Impact Labels

Nir Eyal

in Global Justice and Bioethics

This chapter introduces the Global-Health Impact Labels (GHILs), which are a form of accreditation awarded to corporations that have made significant impact on global health. Though the idea is not ... More

This chapter introduces the Global-Health Impact Labels (GHILs), which are a form of accreditation awarded to corporations that have made significant impact on global health. Though the idea is not without its criticisms, it can at least be implemented in the medical tourism industry in order to alleviate brain drain concerns in developing countries.Less

Re-Examining the Ethical Foundations: Behind the Distribution of Global Health

Garrett Wallace Brown

in Health Inequalities and Global Justice

This chapter argues that current theorizing about global health rests on opposing ontological worldviews about what global health should prioritize and that these presuppositions result in ... More

This chapter argues that current theorizing about global health rests on opposing ontological worldviews about what global health should prioritize and that these presuppositions result in distinctively antagonistic normative demands about how we should calculate the distribution of global health. In order to understand these existing antagonisms, this chapter will explore three diverse normative arguments (the proximity/statist thesis, lifeboat ethics and the cosmopolitan approach) regarding why we might have global health responsibilities and to further examine their relationship to distributive principles for the alleviation of global health inequalities. It is through this process of comparative investigation that the philosophical attractiveness of a cosmopolitan approach to global health will be stressed.Less

Translating Aid, Brokering Identity: Malagasy Doctors as Precarious Heroes

Britt Halvorson

in Conversionary Sites: Transforming Medical Aid and Global Christianity from Madagascar to Minnesota

This chapter focuses on the emergence and experiences of Merina and Betsileo Malagasy Lutheran doctors and administrators who act as cultural translators or “middle figures” to the two American NGOs ... More

This chapter focuses on the emergence and experiences of Merina and Betsileo Malagasy Lutheran doctors and administrators who act as cultural translators or “middle figures” to the two American NGOs (cf. Hunt 1999). Rooting this subject position in Malagasy cultural practices of ethnic and regional differentiation, the chapter compares the role of Merina and Betsileo Malagasy physicians in the American aid relationship to the deeper cultural history of Merina-Anglo Protestant alliances well-documented in Malagasy ethnography and history. It examines three cultural activities – narratives that depict Malagasy Christian doctors as keepers of the Christian quality of medical care, medical case studies, and Malagasy doctors’ visits to U.S. Christian global health conferences – through which Merina and Betsileo physicians rework and perform the category expectations of this aid subjectivity, which combines qualities of the medical doctor, humanitarian and foreign missionary. The sum of these parts is a view of aid subjectivities as dynamic cultural formations that emerge from a confluence of factors, compelled into action through the conditions of aid while being rooted in Malagasy cultural histories and worked upon and transformed by both Malagasy and Americans.Less

Neuroethics and global mental health: Establishing a dialogue

Dan J. Stein and James Giordano

in Neuroethics: Anticipating the future

At first glance, neuroethics and global mental health would seem to have relatively little in common; the former is often focused on the use or misuse of novel and specialized neurotechnologies in ... More

At first glance, neuroethics and global mental health would seem to have relatively little in common; the former is often focused on the use or misuse of novel and specialized neurotechnologies in specialized or high-income settings, while the latter is often focused on the scaling up of existing treatments in primary care settings in low- and middle-income countries. On closer examination, however, they have significant overlapping concerns and approaches that may be mutually empowering. They both (1) take a naturalist and empirical approach to their questions of interest, (2) are concerned with both disease and with well-being, (3) embrace human rights and patient empowerment, and (4) hold a deep appreciation for human diversity. This chapter considers each of these areas and argues for the importance of conversation and collaboration between neuroethics and global mental health toward a truly international neuroethics.Less

Introduction: HIV Exceptionalism in Sierra Leone: Christiana’s Story

Adia Benton

in HIV Exceptionalism: Development through Disease in Sierra Leone

The book opens with a case study of a woman who died specifically from “not AIDS.” The argument of the book is primarily that the collection of HIV interventions that aim to mitigate the effects of ... More

The book opens with a case study of a woman who died specifically from “not AIDS.” The argument of the book is primarily that the collection of HIV interventions that aim to mitigate the effects of the disease among HIV-positive people (particularly those interventions focused on modifying disclosure practices, changing sexual behavior, and encouraging visibility) entrench and reinforce HIV’s exceptional status. In addition to providing treatment options for people who meet certain clinical criteria, HIV care and support programs define and shape the process of “becoming HIV-positive.” Learning how to become HIV-positive entails rehearsing disclosure narratives and keeping up “appearances” (in the many senses of the word), which in turn enable and facilitate subjective experiences of exceptionality and hierarchy among the HIV-positive.Less

The HIV Industry in Postwar Sierra Leone

Adia Benton

in HIV Exceptionalism: Development through Disease in Sierra Leone

Chapter 1 describes the “topography” of HIV programming in Freetown and the range of theoretical and conceptual tools for developing a map of the program terrain and its key actors.

Exceptional Life, Exceptional Suffering: Enumerating HIV’s Truths

Adia Benton

in HIV Exceptionalism: Development through Disease in Sierra Leone

Chapter 2 explains how ideas about Sierra Leone’s civil war and various accounting practice (techniques of enumeration and stories of suffering) are produced and circulated about the epidemic in ... More

Chapter 2 explains how ideas about Sierra Leone’s civil war and various accounting practice (techniques of enumeration and stories of suffering) are produced and circulated about the epidemic in Sierra Leone, and how these practices shape HIV-positive people’s claims about their exceptionality.Less

For Love of Country: Model Citizens, Good Governance, and the Nationalization of HIV

Adia Benton

in HIV Exceptionalism: Development through Disease in Sierra Leone

In Chapter 5, I address some of the ways that global HIV/AIDS programming norms shape both the official performances of “good governance” and local expressions of political subjectivity among ... More

In Chapter 5, I address some of the ways that global HIV/AIDS programming norms shape both the official performances of “good governance” and local expressions of political subjectivity among HIV-positive people.Less

Conclusion: The Future of HIV Exceptionalism

Adia Benton

in HIV Exceptionalism: Development through Disease in Sierra Leone

The findings in this book suggest the role that HIV care, treatment, and support are to play in future global health endeavors needs to be carefully considered—and its exceptional status ... More

The findings in this book suggest the role that HIV care, treatment, and support are to play in future global health endeavors needs to be carefully considered—and its exceptional status reconsidered—without losing sight of the immense benefits and successes that have accompanied an intensive focus on HIV. To do so would require an honest assessment of how these programs operate in places where HIV is not the most urgent primary concern, with the express purpose of improving the overall quality of comprehensive health care for those who seek it.Less