February 15, 2010

 DEVELOPMENT A WESTERN CULTURE

To explain whether development is westernised or not, we need to analyse the assumptions underlying development, practices as well as processes taken in consideration as the means to the end. It is also significant to critically look at the impact it has had on non-western societies that is contrary to the indigenous cultural values

 Development is linked to agreed concepts such as wellbeing, good life, liberalisation, evolution, growth etc. On the other hand it is not natural but inevitable consequence of human activities. Neither is it static nor definite but rather continuously changing process that changes with the needs of man over time.

 It is more associated with change for the better in ways of life and advancement. It is a much localised product of specific historical transformations in both social relations and human interaction with nature. It is often seen as a western concept based on western experiences, theories/theorists, imposed on others as the only mode of change for better wellbeing.

Substantive rationalisation is that in all culture, securing livelihood is the main objective however, the way of achieving it is dictated by cultural values, social and traditional values without any economic laws. the bases of rationalising livelihood is based on more than economic laws, to some it may be for social status, power just as modernisation theories and development ideologies were western

 If development is about human wellbeing/good life, then it can not be defined exclusively of the values of life contributing to the human wellbeing, while Culture is about the way of defining wellbeing including thinking. If that is true, then whatever is theorised is nothing but a reflection of our cultures/way of life. The western cultures/way of living becomes superior and central for development. And for that reason it has been exported else where in the name of development and because culture is evolutionary overtime, so is development which is just western culture

 To the poststructuralists, development is just a cultural discourse that shapes and defined society through representative hegemonic western views that systematically shape and construct identities of the third world people without allowing them to think for alternatives of organising principles for attaining wellbeing (Vijavendra R, et al2004).

 Rostows’ five stages of development is an example of imposing western mode of life as universal and good for every one. However, it becomes western when we ask, who is defining wellbeing? who is measuring development, whose perspective is used, whose experiences, whose theories, what are the assumptions, what were the objectives, etc are some of the questions that prompts one to conclude it is all western culture.

 It can be argued that the pervasiveness of development discourse and ideology denaturalizes the historical and political realities of the development enterprise. Because it had been assumed that development has to take a particular course, the same course taken by the western world makes the indigenous experiences and values sidelined.

What does it mean to say development is westernised? Westernisation can be understood as the reconstruction or reshaping the rest of the world basing on western norms, culture and institutions (Ozay, 1999). The west represents the development model to be followed by third world societies. The central concept of westernisation is founded on the idea of progressive economic development according to market forces of demand and supply. While politically; westernisation rested on democratic forces of one man one vote. Westernisation seeks to universalise markets by reducing what is worthwhile to market determined value (Ozay, 1999)

 Western capitalism has been legitimised as economic growth using international trade as a means of expanding and accumulating more capital. Capitalism is now promoted at global level by converting labour and productive resources into capital in form of technology, ecological assets, human capital, natural resources, converting them to private property motivated by individualism which is western ideology.

 Western theorists also tended to ignore non-western cultures concerning self determination, interpersonal relations, creating superiority of individualism through education. John Stuart Mills’ contention that societies pass through specific stages from savagery to barbarism and finally to development shows the western as the model others have to follow to development.

 The concept of westernisation became more pronounced after the Second World War when the economic order growing out of the European experiences became dominant spreading far to less developed countries in form of colonialism. Colonialism in itself is culture of dominance by the west naming others as underdeveloped, backward, uncultured or barbaric countries who needed redemption from poverty and barbarism. But to meet their objectives of `’modernising’ the ‘non-modern’ could not be done in isolation of importing and legalising their way of modern life which in essence is cultural values.

 Western capitalism goes back to Adam smith (1776) theorising of laissez faire laws. It encompasses both economic and political development (Ozay, 1999). After the WW11, local cultures were dismissed as barriers to development or obstacles to economic development to take place which required to be replaced by superior western culture. Creating binary concepts like traditional verses modern, backward and developed, top down development

 In reference to Karl Marx (1818-1883) assumptions  of universality of all people as being homo-economicus and commoditifying and valuing labour in terms of time spent, while alienating it from the products clearly is western value contrary to labour as a social process prior to westernisation. The alienation of labour was and still is a western value and cultural practices.

 In what ways have these western customs and values have been imposed on others

The poststructuralists or postmodernists and anthropologists argue that through development theorises and strategies that led to dependence and underdevelopment was purely western neo-colonial project of capitalistic expansion that was used to structure inequality to reproduce and maintain the domination of the poorer countries(Vijavendra R, et al2004)

Western norms and cultures can still be widely witnessed in the current economic global development reflecting social Darwin’s theory of evolution of natural selection in survival for the fittest culture. By Darwin asserting that societies develop operates by natural law was intended to rationalise and legitimate the unequal divisions within and between societies by making others dominate the less powerful countries and colonisation of list developed countries.

 In reference to the mode of measurement of development in terms of GDP and income per capital are totally based on western values of what is anticipated to be consumed and has a market value. These western concepts are widely applied in non western countries.

 With specific reference to modernisation theory, it was perceived as western process of development that non western societies could follow as along as they agreed to abandon their traditional cultures and adapt the technologically and western morally superior ways and values(Inglehart et al, 2000)

 Politically, theorists like Aristotle’s ideas of development as good life, in reference to state administration; the ideas of Montesquieu (1689 -1755) of power separation and good governance and rule of law currently being used in third world countries was based on  western models emphasising democracy that promoted the rights of the majority leaving the minority. Political liberalism of equality were purely western values that equality, fraternity and

 Socially:

Socially and culturally we learn that economic thinking and market economic laws are influenced by cultural values. The fact that economic systems were created by man, they can not be free from cultural values. For instance individualism and competition are perceived as western values which are contrary to social communal values especially in Africa. This practice has left most developing countries limited to the production of limited commodities like coffee in order to survive in the diaspora.

 Economically:

Adam Smith (1723-1790) as one of the founders of economics laid down the concepts of free trade and free markets, it had been assumed that people every where had  the same way of decision making and had the same thinking of economising as the western world without acknowledging what people in different societies with different cultures would value. What was considered as economic value did not have the same value to another society. The maximisation and economising principle were purely western and not in the nature of man as theorised and if so , it only applied to them. On realising the significance of culture in influencing economic development, the non western culture had to be suspended.

 In conclusion, if development is about man’s wellbeing and evolution in nature, we can not solely argue that development is a western concept but my argument is that the means to the end is what we can categorise as western. There fore it should be looked at as a means of cooperation than competition.

 References:

Inglehart R and Wyne EB, (2000) Modernisation, cultural change and the persistence of traditional values. American sociological review (65) 19-51. Available at http://www.jstor.org/stable/2657288 

Vijavendra R and Walton M(2004) Culture and Public Action : Anthropological Critique of Development.Stanford University Press. South Asia.

GENDERED DEVEOPMENT

 GENDERED DEVELOPMENT: HOW GENDERED CAN IT BE?

From the presentation, development has had multiple definitions by different theorists as indicated. However it is also noted that development interpretations and definitions are multiple because development its self is not static. We can argue that the different definitions often came one after the other and after some time. From the different theorising of development, different approaches are put forward. In analysing the different stages of development, change of approach often came along with a different conceptualisation condemning the previous as having been inadequate, but are we there yet?. We also note that development does not only have varying conceptualisation, but that development is not universal and neither can there be same approaches for different countries.

 However although this may be valid, we need to see development from the lenses of those experiencing development. Although for instance development varies in definitions, the commonality is the wellbeing of people. But even then wellbeing may mean different things for different people around the world. Therefore what should be in the development basket also varies.

 However instead of concentrating on what should be in the well being basket, I will focus on “who” is included in the basket of wellbeing. It is what we refer to as gendered development. Who really determines who enjoys the benefit of the fruits of the development basket and in what proportions? is what I would like to discuss. The question however is that why the turn point in the 21^st century? Why gender equality now in development? As mentioned earlier development is evolutionary and everything that points to change for the better joins the basket. But the question is what if gendered development does not achieve the MDGs as set marks?

 The arguments for gendered development

 Gendered development is when a particular gender is seen as more appropriate than the other. In development, men’s experiences were so entrenched in development theory and practice that they were generalised as if they applied universally by allowing men to define the inclusion and exclusion of the feminine basing on the socially constructed norms. This exclusion denied women of their productivity and reduced them to domestication and invisibility (Lorrain, 2003). The effects were gender inequality. Women were treated as recipients of development rather than agents in the construction of development strategies. Most of the development projects were offered to men improving male opportunities and technology while reducing women access to both technology and employment. Women were primarily reflected in the process on sex specific or gender terms in the capacities as house-wives, mothers and reproducers of children. while the men entered the process as house hold heads and productive agents( Kabeer 1994) as a result, development became gendered because its mainstream targeted the male population.

 This trend is what states are trying to deconstruct by bringing women aboard in order to meet the MDGs. Am wondering if  this is not instrumentalisation of women as a means and not the end? Is gender equality a requirement for development of women as a gender or is it to meet the “ global targets”. Although development is for the wellbeing of all, it is not realistic and sustainable if the process is still gendered.  Previously, inequality was blamed on the social construction of masculinities and femininities which privileged one over the other in developmental productive sectors of life. If the problem was construction, then the answer should be deconstruction. But the issue is how willing are constructors ready to deconstruct their creation? It is absurd that although gender activities are battling to deconstruct the social constructs of inequality, the constructors have advanced o technology, biology, and scientific research to construct other advanced gendered development. How gendered then can development be? When men and women are developing at different rates in different fields? Whose standards are we supposed to use to measure development? How gendered was the participation, representation and what does this mean to gender equality?

References:

Beneria L (2003) Gender, development and globalisation economics as if all people mattered. London Rutledge.

Kabeer N (1994) Reversed realities : Gender Hierarchies in development thought. Verso, London

Loraine C, (2003) Encyclopaedia of feminist thoughts. Rutledge.

United Nations Millenium Declaration. NewYork, NY United Nations(2000) A/RES/55/2

Available at  http://www2.ohch.org/english/law/millenium.htm

ENVIROMENTAL SUSTAINABILITY AND PUBLIC HEALTH

 

 ENVIRONMENTAL SUSTAINABILITY AND PUBLIC HEALTH

Environmental changes and climate in particular, is highly connected to the basic elements of life such as access to food, water, shelter, and clean air which in turn impacts on the health/wellbeing of the population. The more stable environment is, the high the possibilities of achieving MDGs while the more they are instable, the more it is likely to affect people especially in poorer countries with low coping capacities in exacerbating poverty, mortality due to malnutrition, hunger, diseases etc which also affect MDGs.

 To a large extent, public health depends on safe drinking water, sufficient food, secure shelter, and good social conditions (WHO, 2007) which are also dependent on environmental sustainability (ecosystem services). While degradation of the environment affects weather conditions contributing to further serious effects on human health causing potential fatal illnesses associated with extreme heat or coldness like hypothermia, heat stress as well as increasing death rates.

 Environmental degradation is responsible for extreme weather conditions like floods, heavy rains, drought, hurricanes, all of which have a negative impact on public health of the affected populations. For instance in 1990s, an approximate number of about 600,000 death occurred as a result, with 95% of the victims were from poor countries (WHO,2007), in India in 1999, over 10-15 million people were affected by the floods in Orrissa so was Venezuela. As a result, populations are negatively affected socially, economically, physically as well as impacting on the fulfilment of MDGs.

Environmental sustainability is very essential to the achievement of all the millennium development goals(Melnick et al.2005a). It is a prerequisite and main factor of human health and wellbeing. Good environment is basic for achieving human wellbeing as well as increasing the freedom of choice and action to achieve basic material for a good life, health, good social relations and security.

 The environment comprises of a wide range of ecosystems from forests, grasslands, and agro-ecosystems as well as water systems with each providing a set of benefits that highly contribute to the wellbeing, human health as well as livelihoods ranging from provision of goods to more individual benefits (Melnick et al.2005b).

 In explaining the significance of sustainable environment in public health, I have used UNEP as an organisation to express its efforts in promoting sustainable environment and climate as an environmental factor while focusing more on Sub-Saharan Africa as a region that is most dependent on the natural environment for sustenance of almost all their livelihood. This shall be done by reviewing UNEP reports on environment, videos, press releases, and literature related to the environment degradation and sustainability. This literature shall be used to reflect on how environment can influence global public health in the short and long run.

 Problem  

Climate changes endanger health in many ways, for instance extreme weather, storms, floods, drought or extreme heat affect most of the fundamental determinants of health like air, water, food shelter, as well as increasing chances of diseases. Although these changes may appear natural, human activities have highly exacerbated  the degradation of the environment making some people more vulnerable to climatic changes especially in poorer countries. Climate is currently the overriding environmental crisis with economic, health and safety, food production security, as compared to any other environmental problem (UNEP,2007).

 The environment world wide is continuously being degraded at exceeding high rates ranging from pollution of air, water pollution, dumping of dangerous chemicals, deforestation especially in less developed countries as well as disappearance of forests is reported to range from 10 -15 million hectors per year. For example in Southern Asia, 75% of its original forests as well as 42% of its wildlife species by 2100 will be lost(Melnick et al. 2005)

 Environmental degradation breeds problems of drinking water sustainability or pollution, poverty, spread of diseases in case of contamination of water and land, affects health and wellbeing especially of the women and children, affects local and global climate in ways that affect the public health and wellbeing of the entire population.

 It has contributed to the current emergence and increased dispersal of zoonotic diseases as well as serving as a vector borne diseases. These zoonic diseases are on the increase currently accounting for 75%of the emerging infectious diseases such as SARS, Lyme disease, Ebola, Nipah viruses etc which are very harmful to public health and more are expected as the environment continues to be degraded.

 The current global warming is a result of environmental degradation that has furthered the rises in insect-borne diseases such as malaria, dengue, and filariasis in many parts of the world(Melnick et al.2005).

Unfortunately, there is little accountability, monitoring, investment, political will in ensuring environmental sustainability. There is lack of sufficient investment in environmental management, poor integration into policies, inadequate political will and support, difficulty in international and regional cooperation and partnerships, market influence, limited public awareness.

The role of UNEP in ameliorating environmental changes:

UNEP is an international UN organisation established in 1972 by the General Assembly with the main objective of providing leadership and encouraging partnership in caring for the environment by inspiring, informing, and enabling nations and people to improve their quality of life with out compromising the future generation.

 It does so by promoting international cooperation, providing general policy guidance and coordination of programmes, review the periodic reports on the implementation of environmental programmes, reviewing the world environmental situation and environmental problems of wide significance receive appropriate consideration by governments, promote the contribution of the relevant international scientific and other professional communities to acquire, assess and exchange knowledge , information, formulation and implementation of environmental programs, to continuously review the impact of national and international environmental policies  and measures on developed countries , as well as costs in the implementation

 It is the biggest international organisation that advocates for, educate, and or facilitate, promote natural sustainability of the environment and works with many other international organisations national governments, NGOs, business, media, and civil society to improve our environment and make it more sustainable.

Among many environmental factors, climatic change has been a priority area for UNEP. it is one of most pressing global issue causing heavy rainfalls, heavy floods, prolonged draught and many other ecosystem changes which have directly or indirectly affected public health and general wellbeing of the population in the affected areas in terms of spreading disease like diarrhoea, water born diseases during floods, homelessness, poverty as a result of destructive heavy rains or causing food shortages. This is because most poor countries don’t have the capacity to develop and adopt measures in order to cope with the climatic change.

 UNEP therefore supports developing countries to adopt strategies focusing on the building of sustainable ecosystem and economies that are most vulnerable to climate change. Most less developed or poor countries especially in Sub-Saharan African depend highly on the services of ecosystem and on the natural resources for their whole livelihoods as a source of clean air and water, fertile soils, renewable energy and biodiversity to meet their needs.

 Unfortunately, the environment is rapidly declining  due to the activities of both the rich and poor countries leading to green house gas emissions, driving climatic changes, which are currently threatening human health and ecosystem functioning and biodiversity.

 UNEP has implemented small scale rainfall harvest projects changing the way rainfall is perceived in Africa by working with various countries, governments and local communities suffering from water shortages, like Ethiopia, Kenya, Mali etc to improve their wellbeing. It has done so by extending rain water harvest projects for ecosystem sustenance and improvement in Kenya kajiado, while in Mali; UNEP has been able to implement a project of rehabilitation of lake Faguibine to provide sufficient water and ecosystem.

 In Liberia the 13year civil war that ended in 2003 humanitarian catastrophe had destroyed the water plant supply of drinking water to over 600,000 people in Monrovia leading to spread of water borne diseases and deaths resulting from the destroyed ecosystem by the war. However, in 2005, UNEP developed a long term and sustainable water management policy to guarantee a good quality and sufficient supply of drinking water. UNEP managed to ensure environmental rehabilitation for instance in Liberia in the development and implementation of its water policy through facilitating training workshops for country.

 Why sustainable environment is important to public health

Environment is life sustaining for people and other living things through provision of goods and services which contribute to meeting the basic human needs, health and development as well as quality of life.

 Environmental sustainability becomes important in fighting poverty which has ravaged African countries contributing to poor public health of the people. Most people depend directly on the ecosystem services like agriculture, drinking water, fishing, gathering for a livelihood. Any changes in the climate affects their rate and quality of  production and scarcity of most basics thereby affecting the wellbeing of the majority who can not cope like children, pregnant women/mothers and general health of the population.

 In Africa for instance, the populations are at a higher risk of floods, fires, earth quakes, and lava flows, drought, which increase poverty, thereby exacerbating health problems, as well as hunger, vulnerability and insecurity due to low coping capacity.

 In essence, environmental changes  reduces the living standards  and the ability of the poor to grow out of poverty due to the associated constraints of increased malnutrition among the children, poor housing facilities in case of floods, reduced coping capacities, vulnerability to disease and sicknesses hence creating a vicious circle of chronic  poverty and poor health.

 Poverty does not only affect individuals but also reduce general economic growth of the country and straining of public health services and expenditure like treatment of water born diseases, malnutrition in children,  and access to health services and proper sanitation. Without external aid, most populations in these areas can not fulfil the MDGs.

Economically, Environmental sustainability is very essential for the economy. Although the economy is a pressure on the environment, it is also a victim of environmental change in the sense that over exploitation of resources for economic growth has an effect on the environmental change which in turn has a negative impact on the economic performance directly or indirectly in form of floods, drought, earth quakes, storms, fires, on the infrastructure and property and the people. As a result, it creates economic dependence on other countries/aid for survival.

 In essence, environmental changes affect the economic productivity which has an impact on the wellbeing in terms of costs, expenditures on infrastructure, repairing, resettling, and increase vulnerability of the populations to poorer life standards which also affect their health, access to basic services, seeking aid, scarcity of certain services and goods thereby affecting the livelihood of the people.

Economic insecurity may lead to reduced productivity and production, reduced incomes, reduced purchasing power, increased demand for subsidies, increased indebtedness, need for aid and assistance, hunger as well as health problems due to scarcity.

 It is also very important because most parts in Africa are directly dependent on natural resources of the physical environment; they become more vulnerable to environmental changes and with low coping capacities although all people in the world are vulnerable to changes. For example the 1999 disasters that occurred  in United States , India and Bangladesh, there were 14 times reported deaths in India than US, and 34 times higher death in Bangladesh than in US(WHO, 2007).

Lessons:

From the earlier studies, we note that realisation of environmental sustainability and other MDGs depend highly on the global cooperation/partnerships as well as local communities and governments. Never the less, it has been clear that MDGs can not be achieved in isolation.

 Weather changes cause more deaths and injuries especially for more vulnerable people among others like children and pregnant women as high risk bearers in times of floods, storms, and drought. Floods are often followed by outbreaks of cholera, typhoid, when sanitation services are destroyed. Although disaster may not be selective, men, women and children are affected differently. In essence, because children and women are more vulnerable, it could exacerbate the maternal and infant mortality resulting from diarrhoeal which is currently the 2^nd leading infectious cause of childhood mortality claiming 1.8 million deaths each year (WHO, 2007)

 Health as earlier mentioned is dependent on safe drinking water, sufficient food, good shelter etc. however in poor countries, all these determinant are naturally provided such that change of the climate affects food production, loss of income due to poor productivity causing poverty just as much as insufficient food cause malnutrition especially of the children and pregnant women which also leads to further maternal and infant mortality in poor countries.

 Unhealthy environment affects productivity, leaves population vulnerable to diseases, poverty, malnutrition, and viciously poor. To break this poverty circle requires global intervention of richer countries to provide the basics in emergencies, planning for sustainable environment, financing and implementation of the MDGs since most poor countries do not have the capacity to do so.

References:

World Health Organisation. World Health Report (2007) ISBN 9789241563444.

 Melnick D, Yolanda KN, Mcneel J, Schmidt G, Taob R. The millennium project : the positive health implications of improved environmental sustainability (2005) 365: 723 – 25. Also available at www.thelancent.com. Last visited 5/12/09.

 Melnick D, Yolanda KN, Mcneel J, Schmidt G, Taob R, and Sears RR. UNDP Environment and Human wellbeing: A practical Strategy (2005) ISBN: 184407-228-2

 UNEP, Africa Environment Outlook: Past present and the future prospect ivies. Available at: http://hqweb.unep.org/dewa/Africa/publications/aeo-1/index.htm

 UNEP, Ecosystem management. Available   http://www.unep.org/ecosystemmanagement

 WHO, media centre : climate and health (2007) Available at

http://www.whoint/mediacentre/factsheets/fs266en/index.html

 Garside P, (2006) Gender Plan of Action.UNEP

INVIRONMENT & PUBLIC HEALTH: THE CASE OF ETHIOPIA November 23, 2009

INVIRONMENT AND PUBLIC HEALTH: WATER POLLUTION

Poverty and sickness in poor countries is now associated with poor environment as an exacerbating factor to poor health and disease leading to more poverty. According to the UNDP report (2005), poverty can not be reduced due to the continuous degradation of the environment. While to the World Health Organisation report (WHO, 2006) on estimates of the environmental burden (2006), human wellbeing is highly influenced by the environment. The estimates indicate that a quarter (1/4) of global burden, of disease including a third (1/3) of the childhood burden of disease results from modified environment factors.

 The link below illustrate the effects of environment degradation on public health.  Shows Ethiopia as one of the countries in Africa suffering from water pollution caused by industrial dumping of toxic wastes. People are reported to die from water related diseases like diarrhoea, cancer, liver sicknesses as well as affecting the animals that drink the water or live in it and near by vegetation as well 

http://www.youtube.com/watch?v=eUqgUR4qI98

This problem can be reduced by stopping the dumping of the wastes in the lake through state policies and legislations. Investing in public health facilities and fresh water access and availability. Sensitisation of the people about the effects of drinking toxic water.

 Information is very important to the population about such polluted water. Lastly, environment requires the cooperation of the people and state commitment to promote a sustainable environment. Global influence is also important and extensive research about effects of degrading the environment and informing the public about it.

 Environment is currently a Global developmental issue ((Development Millennium Goals 2000, Goal 7) while the United Nations is the biggest global attempt to promote and make it a state obligation to create a stable environment as a partnership development goal. Target 9, makes it an obligation to integrate the principles of sustainability of environment into country polices and programs to reverse the loss of environmental resources like clean water and sanitation by 2015   (target 10, MDGs

 References

UNDP (2005) United Nations Millennium project Task force on environment and sustainability.

Melnick D, McNeely J, Kakabadse Y, Navarro, Schmidt, Traub, Rsears R( 2005) Environment and Human Wellbeing a practical Strategy. London, Earth scan, sterling.

World health Organisation(2006) Preventing disease through healthy environments: Towards an estimate of the environmental burden of disease

 

INFECTIOUS DISEASES November 15, 2009

Infectious Diseases

There are many infectious diseases World-wide but the most life threatening and  wide spread are Malaria, HIV / AIDS and Tuberculosis with the highest death toll of victims from Sub-Saharan Africa. The high-risk areas and vulnerable people live in low-income countries. Although, there may not be an absolute solution, malaria and TB is preventable and curable. However the prevention or cure is contingent on other factors like access, availability, level of income, level of education, information dissemination, awareness, proper treatment etc.

Some of the preventive methods include:

• Use of mosquito nets especially for children and pregnant women as most vulnerable groups
• Use of insecticides
• In door spaying (DDT)
• Early diagnosis and prompt treatment
• Controlling mosquito breeding areas like potholes, drainage, stagnant water
• Use of appropriate drugs for treatment to avoid drug resistance.
• Training people about preventive measures, symptoms, transmission & treatment
• Campaigns against malaria
• Demonstrations, through drama, music, pictures etc
• Malaria awareness campaigns including media, TVs
• Use of partnership organizations
• Foreign cooperation and assistance
• Access to medical facilities

HIV / AIDS and Tuberculosis (Ruxin et al, 2005) affect poorer populations hardest . TB is contagious and the leading killer of HIV / AIDS patients. In Africa, it kills 80% of patients affected by HIV / AIDS. WHO report (2009) indicates that every second a person is infected by TB, but the good news is that not everybody falls sick not until his immune system is weaken especially with HIV / AIDS. These diseases weaken the economy and retains poor countries in poverty

Measures at the global level may include:

Education, awareness and research of causes, consequences and preventive methods can be taught at all levels including primary schools.

• By Ensuring universal access to full equal treatment of diseases like TB
• Encouraging partnership globally
• Strengthening health systems at local and national level by contributing to health systems at primary health care financing as well as supplies, deliveries and information.
• Encouraging accountability of partners through periodical reports is implementation
• Check corruption tendencies against diversion of resources intended for HIV / AIDS and TB treatment and prevention to other destinations
• Monitoring and evaluation of progress to ensure commitment
• Trainings about prevention measures against transmission
• Campaigns about diagnosis, signs, transmission, cure etc
• Foreign Cooperation in the Fight
• Encourage free frequent testing with or without signs
• Ensuring access and availability of preventive measures like free condoms and testing
• Improve Quality of the services provided to the people already infected
• Encourage victims to talk about it openly
• Encourage health living to reduce the vulnerability
• Networking is very important in disseminating information
• Improve Communication Systems
• Advocate for behavior change  like over smoking, having unprotected sex, over drinking, Which increase the vulnerability  infections
• Encourage legislation for those who intentionally infect others.
• Encouraging research to come up with more knowledge

In conclusion, poverty plays a significant role in influencing health status of the people. If poverty is reduced, people can be empowered to access basic health needs to boost their immunity. Awareness or knowledge about a particular problem is important but not sufficient because it is contingent to availability and accessibility of the required service or measures in the prevention and treatment. For instance, most people who die of malaria in Uganda know about it and its causes but can not afford even a mosquito net or drugs to treat it due to poverty.

 References:

Ruxin J, paluzzi J, Wilson P (2005) Emerging Consensus in HIV / AIDS, malaria, TB and access to essential medicine. Lancet (365) Pp618 – 621

At www.thelancet.com

WHO Report (2009) Global Tuberculosis Control.

http://www.who.int/tb/publications/global-report/2009/pdf/ chapter2.pdf

WHO Malaria Fact sheets

http://www.who.int/media center/ factsheets

WHO Fact sheets on HIV / AIDS

WHO Tuberculosis Fact sheets are

MATERNAL & CHILD HEALTH November 7, 2009

  MATERNAL AND CHILD HEALTH

There are many reasons advanced for the high maternal and infant mortality especially in Sub Saharan Africa and Asia as compared to other parts of the world. UNFPA(2008) indicates that 95% of maternal mortality results from Africa so is UNICEF(2008) report on the infant mortality rates. The main reason by UNICEF and WHO(2008) reports is due to lack of skilled health services during pregnancy and delivery. This is  quite significant in saving women especially those in emergence but not sufficient in itself to explain the big gap between industrial and undeveloped countries.

 According to UNICEF indicators, about half of the children under five die from social economic and unhealthy factors such as poverty, malnutrition, diseases associated with sanitation, clean water, infections, HIV AIDs etc. Implying that there are other factors that have contributed to high mortality rates alongside lack of skilled health services in poor countries.

 However the least addressed problem is family planning. Lack of family planning services renders women to unwanted pregnancies and un-spaced children. This has an impact on the health of the mother who gets pregnant before recovery from birth as well as affecting the health of the new-born. She gets two babies in less than two years. This affects the development of both the infants and the health of the mother leading to high chances of mortality for the under five or the mother.

 Culture should also not be ignored in contributing to high mortality rates. Cultural preference for boys over girls especially in Africa and Asia puts women at a high risk of giving birth so many times in order to get a boy. Culture also encourages young girls to go into marriage before they are well-developed mentally and physically to reproduce and nourish the new-born. This can lead to high death rates of the undeveloped young mother and the baby even if there are health services.

 Gendered poverty is also very important in contributing to high mortality in Africa. Women in some cultures are denied access to and control over resources. Such women find it hard to control their lives and improve their own health and the children. WHO report indicates that a healthy mother often gave birth to a healthy baby, which increases chances of welfare of the child. But to be healthy in pregnancy requires more than medical services to include nutrition, sanitation, clean water etc. But poor women can not afford all that due to gendered poverty.

 To reduce maternal and infant mortality requires education and sensitisation of both men and women about health dangers and signs of ill-health and how to treat especially post natal sicknesses and nutrition of the infants. This also requires formal education of the girls and discouraging gendered cultures that put the health of mothers and children at risk

Health skilled services are a prerequisite especially were complications arise. Services should be available even before pregnancy for consultations, during and after pregnancy.

Sanitation and clean water affects both the infant and the mother and need to be prioritized.

Support services especially for the HIV infected children and mothers are required. This is because infected mothers are often discouraged from breast-feeding their infants to reduce chances of infecting the new-born. But this is only possible if they can afford infant formulae milk for the baby and clean water. As a result the child gets malnourished and may die early. While for the infected mother, if she does not get enough social, economic and psychological support and proper medical care could be more vulnerable to further infection and or early death.

 In conclusion, empowerment of women socially, economically and academically can be helpful for women to actively and successfully fight mortality. This is because women most affected are those who are economically dependent and illiterate.

 Reference:

http://www.unicef.org

http://www.who.org

UNICEF (2008) Why are millions of children and women dying

UNICEF(2008) Monitoring the situation of children and women statistics.

WHO(2008)10 facts on maternal health

WHO(2006) 10 facts on about women’s health

WHO(2008)10m facts on child health

 

November 1, 2009

GENDER, EDUCATION AND POVERTY IN DIFFERENT CULTURES

Gender allocates resources differently to men and women in different cultures. In most cultures, boys are preferred over girls. Education is also a resource that is usually given to boys as a priority especially in African countries. Because girls are culturally seen as mothers in the making, they are denied access to education because education is not seen as a prerequisite in mothering or carrying out reproductive roles in the household, as a result women miss opportunities that come along with education such as job opportunities and end up more impoverished than boys who have access.

 Girls in some culture are a source of wealth if sold into marriage for bride price, this does not happen to boys, as a result these girls are married off at a tender age instead of getting education, they become dependent economically while the boys advance in education to become bread winners. Girls become poorer because of their gender and cultural practices that deny them equality of opportunity.Providing free education is not enough without addressing the social and cultural barriers that obstruct girls from accessing education. Although poverty is one of the reasons, culture is equally a great obstacle to success.

 In conclusion, gender is constructed by culture, and culture is an accepted way of life of a particular society that has been accepted as natural by that society. Culture situates men and women in different places even in education. Even in developed countries, you find more women in social and reproductive related jobs like teachers, nursing, catering, secretarial etc jobs with low wages or salary. While men dominate engineering, doctors, technology, pilots, surveyors etc jobs that are highly paying. Culture therefore influences the kind of education and in the end, poverty among the women prevails.

The state of worlds’ children education(unicef report) October 24, 2009

LITERACY DIFFERENCES AND ITS IMPLICATIONS (UNICEF, 2006 REPORT)

Education is a fundamental human right and very critical to development. it a source of power, wealth, knowledge, opportunities, gender equality, a weapon to poverty and a foundation to development. However all the above also are dependent on the quality of education we attain and the factors that facilitate access to education.

In reference to the UNICEF report, countries with lowest female literacy and least female attendance like Afghanistan, Mali, Niger, girls are almost denied the right to enrol even at the lowest level of primary as well as secondary. The implication is that education is only a right only if enforced. Others include girls in Yemen, Iraq, Pakistan etc countries characterised by Islam as a factor that shows more numbers of boys preference to get education as compared to more Christian ones like Philippine with more girls attending school that boys, others include Ukraine, Venezuela.

 Generally least developed countries indicate the lowest literacy levels especially at secondary levels while the developed countries show the highest literacy levels. The developed countries also show high levels of technology and communication. The implication is that children in developed countries have more access to research, skills, electricity associated with internet and phone operations etc. Their world is more technologically advanced as compared to poor African countries like Mali Ethiopia etc were internet as main medium of communication in the global world is zero. Lack of these services have also increased the education gap between the developed and poor countries.

 The statistics also show that the most developed countries have more gender equality in enrolment of boys and girls at all levels so is the attendance. While in most poor countries it indicates children preference in education where the boys are enrolled more than the girls at all levels of education. Discrimination of girls from enrolment especially in Moslem countries like Afghanistan and Pakistan have the lowest girls enrolment. This  can be associated with either religion or cultures that see girls only as mothers in the making and therefore do not require to go to school.

 Reasons for the differences:

Poverty is one of the reasons why not all children go to school especially girls. For instance in Uganda were primary education is free for all and Secondary education, but still the enrolment is higher at the primary level with high attendance but it decreases at higher levels. This is because children at earlier age are not so required to provide labour than when they grow. This is influenced by culture which socialise girls for domestic work and early marriage than others.

The reason for high rates of low attendance in poor countries is due to lack of enough resources and labour for subsistence. While in developed countries child policies on education and enforcement may be more realistic than in less developed countries were child labour if forbidden.

 The other reason could be the advancement in technology in the developed countries where information and education is supported by technology. In most countries with low literacy also have no internet, this in itself goes beyond technology to suggest that there may not be electricity to support computers and phones. There fore low literacy have factors that go beyond attendance.

 We also note that although enrolment is important at the primary level, retainance is another big issue coupled with inconsistent attendance. This in the end affects performance and quality of education. In comparing mostly East African levels of enrolment and retainance, there is a lot of drop outs of children as compared to developed countries which retain their children in the schools to the end.

 This implies that unless children are enrolled, retained and attend lessons can not gain from the education like getting any qualifications to earn a job to eradicate poverty. Because education is an assurance for better wellbeing and critical for one’s own health living and others,  employment is also possible. For example the UNIPID courses are only done on line, this implies that without the internet you can not have the right to study these courses or if you are computer illiterate. This is the true situation of our friends who don’t have internet and no technology in their countries like Ethiopia the table shows zero internet( UNICEF , 2008)

 

Reference

UNICEF(2006) The state of the world’s children 2007. Table 5

Available at  www.unicef.org

linking gender to poverty & health October 17, 2009

 

POVERTY AND HEALTH:

a) How is Gender inequality linked to poverty and Health In reference to Farmers’ article (2008)?

Summary of the article: Farmer in his article, explores the relationship of poverty and poor health or diseases by looking beyond curative approaches to diseases. He explains the relationship between socially constructed forces which he calls structural violence to the actual effects it has on the spread, treatment, poverty and prematurely death. Some of these social constraints to health access especially are economic, race, social violence gendered, religious and political. These constraints directly or indirectly affect especially the third world population in impairing their normal lives by lowering the possibilities by which they would be accessible.

The relationships arise when these social constrain limit the possible means of earning like lack of education, unemployment, structural violence  which often shape the course of the diseases or the spread. To the poor, some of these diseases have been normalised like malnutrition, natural breast feeding with no supplement, poor sanitation, poor housing, etc all of which in the long run affect their health in terms of immunity, hastening diseases which would otherwise be healed, illnesses resulting from poor water sources, poor environment and providing for other opportunist diseases like typhoid, diathermia etc.

To farmer it is unfortunate that even the medical professions, public health providers do not consider social factors as a contributory factor to most of these diseases. And yet he reports that indeed most of these illnesses are so prevalent because of social factors. Social factors are agencies to these illness, affect the diagnosis of drugs, administration and cure. He insists that indeed social factors determine variable risk of infections. He gives an example of how race affected black Americans from accessing HIV treatment as priority according to race.

He explains that to eradicate poverty is to start by improving health of the poor and ensuring access to health services. however he warns of the tradition that making medicines alone can not realise the goals but rather waste time, because the diseases lies beyond medicine.

Suggests that improvement of social constrains may not in themselves heal diseases but rather lessen the chances of persistent and re-occurrences. Although research indicated that structural violence increases the chances of illness, it is really discussed as an approach to addressing the poverty or health problems. Condemns the distal health approaches which don’t understand the structural violence embodied at the individual, community. And therefore their solutions do not address the cause.

 General Comments: I do agree with Farmers’ observations that vitally , it is very important to examine social factors as well as medical causes of disease especially in poor countries where illness seem to be related to poverty or other shortages of basic needs. Also agree that unless measures are undertaken to include in the medical investigations the social, economic reasons, efforts of cure may indeed be futile. This is because most of the diseases have underlying factors that can either affect the patient psychologically, recovery, accessing the services, or physical and religious constraints.

However, to suggest that medical providers investigate beyond medical causes implies that they be also trained to handle structural violence in treating or providing health care. This would be ideal but unfortunately in poor countries the ratio of doctor to patient is so alarming that if this procedure is considered, then very few people world access such services and it is also very expensive for instance for poor countries to provide social public services for free, free insurance without collapsing the entire economy. Especially where there is a high dependency on donor tired funding and its consequences and terms on where to invest or whom to benefit.

In most poor African countries, the poorest will prefer to take alcohol which is like a drug to make them forget at least their poverty for a day than stay sober in poverty((WHO, 2001). In Uganda for instance, the poor people have many sorts of local brew and spirits where especially the HIV infected would prefer to drink from morning to late in the night just to forget that they are sick. This however does not only affect their health but also their families. Usually these people become so drunk and violent and often fail to think of food or any other basic needs for themselves and families. They become poor because of spending on liquor which is a danger to health and savings. This is a behavioural trend that is accepted in some societies as normal. Increased earning implies increased consumption of alcohol, and increased violence and increased vulnerability to illnesses.

 He suggests that there is no good way to tackle the health crisis in Africa without using both distal and proximal tools. This sound so generalised and portrays Africa as one country with same structural violence problems and require same solutions. Africa is however a big continent with varying social structures and different problems that have affected their health and wellbeing. To one it is genocide, the other drought, floods, wars, race is almost not there apart from few countries like South Africa. All these require a diversity of skills and resources.

The inequalities rather are of class, tribal, political affiliations, language, location, corruption etc These in one way or another affect the end results of health and poverty. The PIH model for instance could not take off especially in countries were corruption is “almost” legalised. What kind of system would Farmer suggest in such a country were peoples’ lives are shaped by forces of corruption and the befits are diverted away from the patients? The case in reference is about the Global fund where millions of Dollars were sent to facilitate HIV patients, provide mosquito nets to prevent malaria, reduce maternal mortality etc but all this money was diverted by a few entrusted people to carry out exactly what farmer suggested, but unfortunately it was all diverted into their private usage. What would farmer suggest in the circumstances?

Farmer’s solutions seem to be more politically achievable, for instance, improving quality of water, education, insurance, security, etc are more of public goods that require state provision or legislation as a check to structural violence. This is true, but there are also their underlying factors that require to be addressed before structural violence is addressed. For instance land reform, trained personnel, functional legal system, political stability, accountability, infrastructures like roads etc

 HOW GENDER INEQUALITY LINK TO POVERTY AND HEALTH? Gender refers to the socially constructed roles, behaviours, activities, attributes that a given society considers appropriate for men and women (WHO).It includes the rights, roles, responsibilities and resource distribution. This is particularly true in the developing world where women are often systematically deprived from having equal access to social services as well as to physical and social capital(Phipps, 3003). Women are allocated roles that are often unpaid for while men are assumed to have more rights than women. women are more domesticated in the private space while the men dominate the public space. Each of these social constructs are dictated by culture, religion or general socialisation and have a negative impact on women.

To farmer, even disease is gendered, as well as poverty. Because women are not as mobile as men affects their access to health facilities. They are not only sick but also have no facilitating resources like transport or formulae for the infants. because women are denied access and control over resources, they can not make strategic life decisions or participate as much as men. Because women have been socialised to be child bearers and home care taker, they spend time taking care of others thus suffer time poverty and forget their own health. As a result, they are disempowered economically causing income poverty (Chamber, 2006), material poverty and capability poverty (laderchi et al, 2006)all of which are linked to poor health or wellbeing.

From the definition we note that these social constructions create inequalities between men and women by influencing who has access over what and why, who is supposed to do what in society. As a result, men and women are allocated duties which affect women and men’s health positively or negatively. In reference to the definition of poverty by UN (1995) gender plays a role by putting constraints in labour markets by making it hard for women to get paid jobs than men and or limiting certain jobs to men like police, night jobs, piloting etc because of the socialisation that women are the week, home takers while the men are tough and bread winners so entitled to pay and work. In the process, women become poorer and can not afford to access health

 Gender related constraints in labour market make it more difficult for women to escape poverty through employment or paid labour as a result they suffer more poverty constrained because they can not afford the basics of wellbeing and as such their health is affected in the long run.

It is evident that Countries with low levels of gender inequality report higher levels of economic growth, while those with high inequality gap levels report high poverty rates (Ehrenprel(2008) In essence there fore the higher the gender inequality the higher the poverty and the lower the health levels.

Because of gender inequality, men are the key decision makers and holders of economic and organisational power and public resources. They may not represent the needs of the women as well as the women would if there was gender equality to make decisions as well. This affects women in that gender-related-priorities-health-needs of women like maternal health, sexual health and reproductive health related services may be ignored. This can lead to maternal mortality, reproductive related diseases and complications as well as infant mortality. Because women already suffer from income and material poverty, lacking these resources could lead to absolute poverty and poor health

Gender also is responsible for the unequal distribution of resource in any society. Women have the responsibility of taking care of others especially when sick but no body takes care of them((Kern, 2001). This makes their own health poorer given the factor that even if they wanted to access medication they may not afford because of lack of resources.

It is also noted that due to reproduction, women especially the poor can not afford to access the basic health services were transport is required. As a result of poverty, their health is compromised. This can not be compared to men as a gender because they are mobile and have lesser domestic reproductive related obligations like taking care of the children and the aged, the sick, breast feeding etc.

Health is however worsened when they are HIV infected. Farmer (2006) reports that these women require ART to be given to the expecting mothers before birth but because of the distance, most of them miss this opportunity putting the life of the new born and that of the mother at a high risk. Because these women are poor, they can not afford formula for their new borne as a requirement to protect the infant from being infected but because they are poor, they end up breast feeding these babies and increasing the chances of making others sick because they are too poor to afford health measures.

Structural Violence therefore makes the victims vulnerable to poverty and forces them to live in unsatisfactory environment without the basic needs by either influencing access to resources, control over, behavioural changes, wellbeing etc directly or indirectly. However not all poor countries suffer the same structural problems although they may all suffer from poverty and ill health. This therefore requires a diversity of approaches in addressing health and poverty issues and support by the poor countries themselves and the victims or communities affected.

 Reffernces:

Ehrenprel D (2008) Poverty in focus: gender Equality. International Poverty Centre Brazil. Available at www.undp.povertycentre.org

Farmer PE, Nizeye, Stulac, Kashavjee S( 2006) Structural Violence and Clinical medicine. PLoS medicine Vol 3(4) at www.plosmedicine.org.Vol

Kern A, (2002) Dying for change: Poor people’s experiences of health and ill health. World health Organisation

 Laderchi C R, Stewart F, Ruhi S (2006) Does the definition of poverty matter: comparing four approaches. UNDP

 Phipps S(2003) The impact of poverty on health: A scan of research literature.  Canadian Institute for Health, Ottawa. Canada.

United Nations (1995) Copenhagen declaration and programme for Action: World Summit for Social Development.

 UNDP (2006) Poverty in Focus. International poverty centre poverty in focus. Brazil. At

www.undp-povertycentre.org

 

 

                POSTED ON 15^TH OCTOBER 2009

 

                 https://hart2009.wordpress.com

why is it important to consider health at global level October 11, 2009

                                       

               WHY IS IT IMPORTANT TO CONSIDER HEALTH AT THE GLOBAL LEVEL?

      INRODUCTION: Health is a concept with varying interpretations depending on the standpoint and knowledge of the one defining. But whatever the definition, determining its importance in global sense depends on how you define it. In this work the WHO(1946) definition has been adopted as well as some aspects of human rights perspectives. This work therefore explores the concept of health, its significance within and beyond boarders and the need for it to be addressed as a globally concern. It addresses the questions of why health should be recognised as important to the whole population, why there is need to  be protection measures against other effects of globalisation, why there is need to promote health living.  How it serves to preserve and provide the benefits to the next generation. Finally concludes with caution about the possibility of dominating the less developed countries and the consequences of dependence on the developed world than the intended interdependence.

 Health:

Health is a broad term defined differently in different disciplines and application. In science it is limited to being free from disease, from the human rights perspective health is a fundamental human right, to the UN millennium declaration (2000), it is an indicator of development, to others it is social wellbeing, to an environmentalist is living in a certain physical environment, and to WHO( Constitution 1946, Dickens et al,2004) it is “a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity”. Implying that health is shaped by a variety of factors ranging from individual factors, physical, social-cultural, economic and political context in which people live (smith et al, 2006). it goes beyond individual wellbeing to the environment one lives in that must be free not only from disease to be health but in terms of factors that influence health through relation with others or the surrounding one lives in which is also dependent on other influencing factors.

Although health is basic to everyone’s wellbeing, it is not enjoyed equally as a right in terms of access or distribution, due to a number of factors that go beyond an individual and national ability to provide, protect, and promote equally to the entire population. This is because health is like any other good with value and cost but least invested into because it does not generate direct profits to attract private investment. It therefore leaves the burden often on the state as the main provider or the victims. Health however is becoming increasingly expensive especially in this globalisation era, where focus is mainly on economic and political security.

Good health per se, has been acknowledged as very important to economic development  and achieving the MDGs (Huynen et al, 2005), but to achieve it requires a diversity of innervations in order to give a more central role to pro poor growth considerations

 by providing the necessary poverty reduction strategies through promoting good health, protecting populations against diverse health effects of globalisation. This is what has been referred to as public health.

Public health:

Public health is a broad and dynamic science, practice, an attitude taken to ensure that basics are met. It is politics, a principle and art of protecting and improving the health of people or communities and preventing disease as well as promoting health through organised and systematic efforts such as education, research, promoting healthy life styles, injury(Kauhanen, 2008, Brown et al, 2006) etc. Public health is more than medicine and more practical system and or infrastructure aimed at ensuring prevention of disease or injury, and protection of the most vulnerable populations for instance from epidemics and affections were individual initiatives can not provide sufficient solutions. It is a field which recognises that health needs can be addressed at multiple level such as interpersonal, community, environmental, political level, while at the same time being informed by a range of disciplines such as epidemiological studies, ethnographic studies, sociological research as well as historical studies, and economic research(Smith et al, 2006). It is characterised with prevention measures rather than curative aspects of health at a population level not individual.

Although public health is essential, it is often very expensive to under take due to the fact that it is a common good and often does not attract private profit motivated organisations neither does it affect only a group of individuals but also across boarders to impact on the globe directly and indirectly.

WHY IT IS IMPORTANT TO CONSIDER HEALTH AT A GLOBAL LEVEL

Basing on the UN Millennium Declaration(2000) and MDGs (2005), it was declared as a principle and the responsibility of all the member sates to uphold human dignity, equality and equity at the global level. It was an obligation of states to fight injustices including ill health as an indicator of under-development at the global level in order to ensure peace, security and a just world (WHO, 2005). This there fore is not a debate as to whether or not to consider health at global level but rather an unprecedented commitment by world leaders and requirement/ duty to bring justice especially to the most vulnerable groups.

From the development point of view, health is the heart/centre of the realisation of  MDGs to reduce poverty, as well as enhance important measures of well being. Out of the eight goals, health is directly represented as central to the realisation of gender equality, eradication of extreme poverty, education and hunger. Therefore from this point of view, it requires health diverse strategies to respond to the diverse health needs of different countries worldwide hence consideration of health at global level for the purpose would be ideal.

From Kickbusch’s(2002) arguments, globalisation  has largely contributed to transfer of health risks changes in nature due to the increased speed and reduced distance and cultural transfer brought about by modern transport and communication as well as economic dependence and interdependence. The implication therefore is that disease travels faster  than ever, harmful cultural practices, pollution, toxic substances and unsafe products. Health at a global level becomes important in such circumstances to provide guidelines, carry out research to establish the impact of such risks to human health and provide measures of prevention, protect the population at risk and to hold those responsible accountable for  their actions for the good of humankind.

 Since calamity or disaster  does not give notice as to when and where to strike, for instance floods, influenza, air borne diseases, earthquakes, wars etc,  implies that any body anywhere can fall victim and usually in such circumstances, there is little or no preparedness to protect such population from heath disaster that comes a long with such calamity. It is therefore important to consider health at global level to address human health needs especially in emergencies.

 From the definition, public health is so broad that it require a lot of diversity of specialisation in its planning and service providence and even advocacy which is easier if done collectively or globally in terms of resource requirement especially in research, education, prevention to ensure responsibility of all and to avoid similar crisis the WHO went through while being financed by individual states than globally(Brown et al, 2006).

 In order to prevent spread of infectious deceases resulting from factors of globalisation process, requires global campaigns through media, professionalism, diversity of appeals which have an economic implication to focus on health education, encouraging people to make health choices , demands , statistical evidence to show the gravity of the matter and the effects  on health to promote health life styles. All require global cooperation and organised system to combat such problems, makes health at global level ideal.

 While for administrative purposes, it is important for instance in creating policies for health, having standard of measure  of improvements  or decline( health indicators) , checking the politics of health, business and science of private health providers in managing fiscal resources needed to deliver effective acceptable services free from exploitation. This could be effective in controlling illegal trade of drugs, restricting production of scientifically proven dangerous products at an agreed global level health standards.

It also creates a link of different nations to one another, this also could lead to accountability of all to the improvement or degradation of health related factor and a collective effort to prevent the reoccurrence and provide a head way to better living for all as a developmental factor as well as checking the health challenges that go beyond national boundary

At global level specialisation is possible in addressing complex emergencies and promoting public health benefits such as public nutrition, food security, research, evaluation etc which would otherwise be expensive for an individual nation to address its problems. It Can ensure accessibility to health services especially of the vulnerable populations, given the fact that there are development inequalities among nations especially the less developed countries who often fall victims of poor health. By focusing on the entire population than individual health, enhances health equity.

Economically, health is a public good with value but has been ignored as a good in the expansion of trade and commerce in global institutions ( Kickbusch, 2004). Because it is a common good with often no profits attached, investment in it is left for those who do not want to make profits and some times it leads to exploitation of others or depletion of the environment. It there fore necessitates the creation of public health models that can take radical approaches to question the very premise of what a private good is at the global level. As well as addressing health issues and challenges beyond national boarders

Health is central to wellbeing as well as an important contributor to development and progress. This is based on the argument that healthier population is more productive in that people who live longer are more productive in terms of human resource and provide market , while poor health population drain the countries resources in terms of providing for social services and providing poor human resource and its associated effects.

Public health as a public good and or service has high demand at national level but limited supply which requires subsidising especially among the poorer nations who are not only indebted to donor countries but also can not afford to provide these goods and services to all their population among others include preventing HIV spread, child mortality, improving maternal health, carrying out research etc. This therefore necessitates global intervention.

Unlike before were states were able to produce what is sufficient for their population, with time, globalisation seem to be the only option to expand markets, commerce, there by creating interdependence between countries in terms of trade, technology, differences in endowment and many other resulting relationships. However this comes along with its own health impacts due to mobility of goods, people and more exploitation of the environment. Generally , global activities creates the need for an overall global body to monitor these activities in relation to the health of the general population.

Addressing health issues at global level enhances social networks of information, knowledge, research, social support thereby inducing changes in social cohesion, integration and interaction to influence social support in a population(Huynen et al, 2005)

This leads to enhancement of knowledge , technology to improve surveillance of the infectious diseases , monitoring , increased speed of response  especially in emergencies  like rapid spreading infections, by using global alerts , specific advisories and monitoring can prevent the spread there by saving the costs of treatment and loss of lives.

Conclusion:

Although there may be many reasons for considering health at global level, this program like any other, comes along with its own global negative impact especially on the poorer nations. For instance, given the big gap of inequality, there is a high possibility of dependence rather than interdependence. However on the other hand, we should ponder on how global is health at that level? What does it take to close the global health gap? Who sets the standards and terms of operation? How sustainable? How participatory are the poor developing countries? How independent is the organisation from the main- founders or funders of the program? Who takes decisions? What are the safety nets to this program? Who determines the beneficiaries? Why do we need global health when we already have the world health organisation?

 References:

Brown TM, Marcos C, Fee E, The world Health Organisation  and the Transition from International to Global Public Health.(2006). American Journal of Public Health 96(1): 62-72.

Dickens BM, Cook RJ and Fathalla MF(2004) Reproductive Health and Human Rights : Integrating Medicine , Ethics and Law. New York, Oxford University press.

Hynen MM, Marten P, Hilderink HBM, The health impacts of globalisation: a conceptual frame-work (2005) Globalisation and health 1 (14) 1-12. health.com/content/1/1/14.Last accessed on 6^th/10/09. available at http://www.globalisationand

Kauhanen J (2008) Introduction to Public Health. Video available at http://www.oppi.uku.fi/opk/video/kansanterveystiede/kauh

 Kickbusch I,(2004) From Charity to Rights: Proposal for five Action areas of Global Health. Journal of epidemiology  and community  health 58 ; 630 – 631. At http://www.ilonakickbusch.com/global-health/global-health.pdf

 Lee JW (2005) Health and the Millennium Development Goals: Keeping the promise. World Health Organisation.

Smith BJ, Cho tang Kwok and Nutbeam D, WHO Health Promotion Glossary: new terms. Oxford University Press ( 2006), 21 (4) 340 -345.

United Nations Millenium Declaration. NewYork, NY United Nations(2000) A/RES/55/2

Available at  http://www2.ohch.org/english/law/millenium.htm . accessed on the 8^th/10/09.

 World Health Organisation Constitution 1946