Examining the Global Health Arena: Strengths and Weaknesses of a Convention Approach to Global Health Challenges
Structured summary
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This purpose of the report is to contribute towards resolving the challenges related to poor health amongst the world’s poorest and least healthy population.
Key message
In June 2009 the Norwegian Directorate of Health commissioned the Norwegian Knowledge Centre for the Health Services with compiling and analyzing available international research material on the strengths and weaknesses of a convention approach to global health challenges. The following report is a response to this commission.
This purpose of the report is to contribute towards resolving the challenges related to poor health amongst the world’s poorest and least healthy population. As such, it represents an initiative from the Norwegian public administration towards informing national and international governmental bodies of strengths and weaknesses of a global health convention approach to structure the international work on global health.
Key messages of the report:
- Increasing global interdependence makes the health of the world’s poorest and most marginalized people a pressing issue for all nations of the world.
- There are observable weaknesses in the current international frameworks to improve health for the world’s most marginalized people, including shortcomings in the human rights approach to health.
- A global health convention could provide an appropriate instrument to deal with some of the intractable problems of global health, especially:
- clearly define what are basic survival needs
- setting principles for cooperation, accountability, and allocation of resources between stakeholders
- structuring and coordinating the financing of global health investments
- granting rules for access to health services, including setting demands for national priorities with respect to the provision of health services
- Challenges might be to muster international support for supra-national health regulations, negotiate compromises between existing stakeholders in the global health arena, and to gain WHO’s support as a convener of the parties and as a facilitator of the adoption process.
Summary
The article comprises a conceptual framework to analyse the strengths and weaknesses of a global health convention approach to some of the intractable problems of the global health arena. The analyses are inspired by Georgetown Law Professor Lawrence Gostin’s suggested Framework Convention on Global Health. The analytical model takes a starting-point in events tentatively following a logic sequence: Input (global health funding), Processes (coordination, cooperation, accountability, allocation of aid), Output (definition of basic survival needs), Outcome (access to health services), and Impact (health for all). It then examines to what degree binding international regulations can create order in such a sequence of events.
The report also examines the most important rights based instruments within the global health arena, especially health as a human right, and assesses the impact these instruments have on global health disparities.
The report finds that there are observable weaknesses in the human rights approach to health, however that there are good reasons to continue developing and improving global health along the rights based avenue. It also concludes that a global health convention could be an appropriate instrument to deal with some of the problems of global health. Thus, the report argues that some of the tasks preceding a convention approach might be to muster international support for supra-national health regulations, negotiate compromises between existing stakeholders in the global health arena, and to utilize WHO as a platform for further discussions on a global health convention. Also, it shows that sustainable and coordinated funding for health is crucial to better utilize resources both internationally and on country-level, as well as to achieving long-term goals, like the establishment of a stable health work-force in developing countries.