OVERVIEW OF HEALTHCARE AND INTERNATIONAL RELATIONS Dr M A Tutakne 02 May 2015.

OVERVIEW OF HEALTHCARE AND INTERNATIONAL RELATIONS

Dr M A Tutakne02 May 2015


International Relations: …… International Business

(Business without Relations?)

International Healthcare Business

Diseases & Microbes never respected National Boundaries

Health care is to be provided without discrimination: Hippocratic Oath/ Geneva Declaration Even Ravan’s physician treated Laxman

YetHealth & Healthcare did not figure prominently in International relations



Discipline of International Relations has concentrated on Political Relations.

Dominant aspect:

Territorial Security (Era of physical power) International Trade (Era of Money power)

Has this Changed in era of knowledge power?


Why Health Issues became important?

1. Epidemics HIV, SARS & Influenza &Bioterrorism Considered as security threats

2. Globalization/ Trade in drugs & Health care

3. Governmental responsibility for ‘Right to health’ as a part of Right to life

4. Effect of ill health on economy


Identification of Int. Health Security Issues1. Emerging Diseases like SARS2. HIV AIDS3. Chemical, Biological & Radiation terror4. Humanitarian Emergencies5. Environmental Threat6. Economic Instability (Due to ill health)7. Building Health Security 8. Strengthening Health Systems

(World Health Day 2007)


Health and SecurityThe link between Health and Security:UN – High Level Panel on Threats Challenges and Change 2002

US National Security Strategy (2002) after 9/11 bothered with spread of Anthrax

In UK pandemic influenza features as security threat (2008)


How Human Health has been affected by global interconnectedness

New geographical distribution of vectorsEmergence of novel infectionsIncreased drug resistanceChanging epidemiology of diseasesInnovations in ICT influencing healthChanging pattern of human behaviorGlobal restructuring of Health industryInnovations in collective action on health


In Academics: IR discipline giving importance to health and Health discipline incorporating IR as study topics developing a concept of

Global HealthConsortium of Universities for Global Health (CUGH), which is Washington, based organization of academic institutions has been formed. (One DU in India is a member)


Definition of Global Health“ An area for study, research and practice that places priority on improving health and achieving health equity for all people world wide.”Koplan in BMJ

Health and Policies on health are good areas for study so that soundPolicy could be formulated for more healthy world.

Health and Healthcare Related Issues that could influence IR:

Issues of Disease Prevention (Vaccines) Issues of Health Promotion (social Issues of Sanitation & Environment)

Restoration of Health (Treatment)Health Inequities in world



As per Well known

DEFINITIONS OF HEALTH

For International Business: Public Good

For understanding Importance of HealthHealth is a continuum between life and death. Health prevents approach and overpowering of life by death.


Health and Foreign PolicyG H Brundtland. DG WHO: (Address to Council on foreign relations 1999)Why investing in global health is good politics?

Group of 8 countries (2005 Gleneagles summit): Doubled ODA to Africa to 50 billion $

Other major funding agencies for Global Health:World Bank, UNICEF, WHO, GFATM, Welcome Trust, Bill and Melinda Gates Foundation etc.

(Is it altruism or philanthropy?)

Health & United nationsWHO was formed in 1948Its role was however ‘advisory’ Laying standards, collecting data and researchBut now IHR are obligatory

Millennium Developments Goal adopted by UN in 2000 has 3 health targets: Child Mortality, Maternal Health and Combating major diseases like HIV, Malaria


Economic Instability (Due to ill health)



Center for Disease Control USA‘The most effective and least expensive way to protect America from diseases and other health threats that begin overseas is to stop them before they spread to our shores.’

Hence their Global Health Goals:Improve health around the worldImprove response to infectionBuild public health capacity Maximizing Organi. capacity


Health and International Political Economy

Healthcare expenditure worldwide in 2010: US $ 5.5 Trillion1. Increasing burden of aging population2. IPR issues and supply of life saving drugs3. International cooperation in Clinical Research4. Multinational Companies & generics5. Global restructuring of Blood and Blood products6. Issues of organ transplant & Surrogate pregnancy7. Ethics of emerging technologies


Health and International Political EconomyHealth inequities are not easily accepted

Life expectancy difference:Girl child born today: 45 yrs in some 80 in othersAdult males in Swaziland has 9 times probability of premature death

Access to healthcare depends on individual and national poverty

Even in America sizable population goes without health insurance and hence denial of healthcare


Health and Global GovernanceGovernance is a series of norm, principles and rules accepted by key players involved.

WHO, UNICEF, UNDP etc for pursuing shared health goals Declaration of Essential Drugs listCodes on marketing of breast milk substitutesInternational codes of DiseasesInternational Health Regulations 2005


Health and Global Governance

Success of Health due to Good Global Governance is evidenced by

Eradication of Small Pox and

Reduction of Polio

Control of HIV load

Activists for attaining Health for All:


Hope All healthcare managers work with one aim:Make Health care accessible to maximum

Health for all may be a dream at presentBut

I hope the health care academicians put in efforts to induce governments to realize this dream


Special Thanks

OVERVIEW OF HEALTHCARE AND INTERNATIONAL RELATIONS Dr M A Tutakne 02 May 2015.

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