Global Health

Global health is a dynamic term which is still evolving with the changing world. At
present, the term Global health pertains to an area for study, research and practice that places a
priority on improving health and achieving health equity for all people worldwide. Likewise, it
has been proposed to refer to a collaborative transnational research and action for promoting
"health for all" peoples. Its core is founded on national public health efforts and institutions.
Compared to several countries where public health is equated primarily with population-wide
interventions, global health emphasizes in all strategies for health improvement, whether
population-wide or individually based health care actions, and across all sectors, not just the
health sector.

Global health is better understood by integrating the following key concepts (as
highlighted by Koplan, et al.):

 Collaborative (or collective) highlights the critical role of collaboration in addressing all
health issues and especially global issues having multiple determinants and a wide range
of institutions involved in obtaining solutions.

 Transnational (or cross-national) pertains to the issues transcending national boundaries

despite the effects of global health issues being experienced within countries.
Transnational work is usually based on strong national public health institutions. This
further requires the involvement of more than two countries.

 Research refers to the importance of developing the evidence-based policies which are
multidisciplinary focusing on the effects of transnational determinants of health.

 Action focuses on the importance of utilizing evidence-based information as basis to

improve the quality of health and health equity in all countries.

 Promoting (or improving) pertains to the importance of using a full range of public health
and health promotion strategies in improving health. This includes initiatives toward
underlying social, economic, environmental, and political determinants of health.

 Health for all traces back to the Alma Ata Declaration and places global health at the
frontline of multi-stakeholder approaches to health improvement. Eventually, this leads to
strengthening primary health care at the core of all health systems.

"The widening, deepening, and speeding up of worldwide interconnectedness in all

aspects of contemporary social life. These global processes are changing the nature of human
interaction across a wide range of social spheres including the economic, political, cultural, and
environmental." (Source: HM Government, 2008, p. 5)

Globalization and Health

Globalization has been regarded as a social, cultural, and economic phenomenon. It

primarily involves the evolution of common understanding of ideas, languages, foods, and
popular culture. It is perceived today as the influence of the Internet, Western and Eastern, i.e.,
American and Korean respectively, particularly in media, television, films, and corporations. All
these have been considered as driving forces either impacting positively or negatively.
Furthermore, the global and rampant spread of fast-food outlets and consumption has
significantly revolutionized the lifestyle of the Filipino family and the youth.

Advantages of globalization have been beneficial or a "benign phenomenon." In daily

practice, it had brought further developmental, sociocultural, political, and public health
improvements. For example, global networks of the Internet, worldwide web, and mobile phone
communication have been a driving force in globalization that have already had wide-ranging
health impacts. These technological developments have provided much international health
knowledge and has become more influential in dissemination of health news and information.
Hence, this has become more integral to academic and commercial research and development in
health, geared toward helping physicians guide their patients and their families into making well-
informed decisions to effective treatment options best suited to address patient needs and their
resources.

On the contrary, globalization undermines local economies and cultures, replacing them
with "imported" or foreign elements in culture and society. How is it that despite the increasing
interconnectivities in both virtual via email, Internet, and telecommunications and subsequently
real connections, there still is the evident "digital divide" and disparity among nations and socio-
economically within countries? These barriers still exist regardless of being a devel ped country
such as China, where monitoring or censoring access to various parts of the web and mobile
phone networks persists. Similarly, countries such as Burma and North Korea has been severely
restricting Internet access for most of their populations.

Beyond virtual communications, there is a huge leap of 'real' contacts brought about by
international business, travel, tourism, and long- or short-term migration. These real contacts
may often be beneficial but, of course, a side-effect of any international travel is the huge
potential for affecting human health. Immediate impact of international travel on health is the
spread of contagious and infectious diseases. This further goes beyond acute health issues but
also widespread influence of common culture and lifestyles into various parts of the world.

The sociocultural aspects of globalization have been held variously responsible for drifts
toward Western styles of life, consumption, and morals. Many alleged by-products of such
globalized lifestyles include morals, values, attitudes and behavioral change, environmental
damage, global warming/climate change. Moreover, there are direct health status outcomes such
as widespread obesity, diabetes, and heart disease. More subliminal changes involve those within
societies, such as altered family relations and social contexts for life and morality, as well as
health and welfare of individuals and their families.

The "global" in global health refers to the universal scope of problems instead of location
(Koplan et al., 2009). Global health must, therefore, address he interlinked sociocultural,
behavioral, sociopolitical, and environmental factors related to health change which are referred
to as social determinants of health. These would further include "lifestyle factors," such as
alcohol, tobacco, and other drug Consumption and control; micronutrient deficiencies,
overweight, and obesity; injury prevention, health of migrants, the migration of health workers,
and the health of people affected by political and natural disasters. These lifestyle factors have
likewise greatly influenced our Iocal health profile of the Philippines such that the top 10 causes
of illness and death in the country are largely due to non-communicable diseases due to
unhealthy lifestyle habits and behaviors, which include cardiovascular diseases, hypertension,
diabetes, cancer, and pulmonary diseases.

Philippine Health Profile

In the past years, the Philippines has made significant investments and advances in
health. The rapid economic growth and strong country capacity have contributed to Filipinos
living longer and healthier. Despite this, not all the benefits of this growth have reached the most
vulnerable groups, and the health system remains fragmented affecting gravely the marginalized
sector of the Philippine society.

Some positive developments in the healthcare of Filipinos are the following:

1. Health insurance now covers 92 percent of the population.

2. Maternal and child health services have improved

a. more children living beyond infancy

 b. increasing number of women delivering at health facilities and more births
being attended by professional service providers than ever before

3. Access to and provision of preventive, diagnostic, and treatment services for

communicable or infectious diseases have improved.

4. Several initiatives t to reduce illness and death due to non-communicable diseases

(NCDS)

Despite substantial progress in improving the lives and health of people in the
Philippines, achievements have e not been constant and challenges remain. There is still
persistent disparities and inequities between regions, rich and the poor, and different population
groups. Many Filipinos continue to die or suffer from illnesses that have well-proven, cost-
effective interventions, such as tuberculosis, HIV, and dengue, or diseases affecting mothers and
children. Many people lack sufficient knowledge to make informed decisions about their own
health. Rapid economic development, urbanization, escalating climate change and widening
exposure to diseases and pathogens in an increasingly global world increase the risks associated
with disasters, environmental threats, and emerging and re-emerging infections.

Social Determinants of Health

Social determinants of health refer to the conditions in which people are born, grow, live,
work, and age. These circumstances are shaped by the distribution of money, power, and
resources at global, national, and local levels. These determinants are mostly responsible for
health inequities, such as the unfair and avoidable differences in health status seen within and
between countries. Poverty, social exclusion, poor housing, and poor health systems are among
the main social causes of ill health.

The Philippine Health Agenda for 2016 to 2022 has highlighted that there are many
factors that affect the health of individuals and their communities. Much of the health of
individuals is determined by the circumstances and environment where they live. This would
include social and economic environment, physical environment, and individual characteristics
and behaviors of a human being. Structural determinants refer to those factors which lead to
stratification, such as income, education, occupation, social class, gender, and ethnicity.
Intermediary determinants, on the other hand, are factors that directly define and influence health
choices of individuals. These would include individual lifestyle and outcome affected by the
former such as finances, psychosocial, and behavioral factors (Cabral, 2016).

Sustainable Development Goals on Health

World leaders committed to achieve the 17 Sustainable Development Goals (SDGs) by

2030 in an effort to end poverty, protect the planet, and ensure prosperity for all. SDG 3 covers
the unfinished Millennium Development Goal (MDG) agenda and newer challenges such as non-
communicable diseases (NCDs), health security, tobacco, and injuries.

As stated by the World Health Organization (2019), the SDG 3 aims to "ensure healthy
lives and promote well-being for all at all ages, with the following health targets by 2030." This
SDG targets the following objectives: (1) to reduce the global maternal mortality ratio to less
than 70 per 100 000 live births; (2) to end preventable deaths of newborns and children under
five years of age, i.e., reducing neonatal deaths with a minimum of 12 per 1000 live births and
under-five mortality or deaths at a minimum of 25 per 1000 live births; (3) to cease spread
communicable diseases such as, AlDS, tuberculosis, malaria, and neglected tropical diseases and
combat hepatitis, water-borne diseases; (4) to decrease by a third the premature mortality or
deaths through prevention of non-communicable diseases; (5) to further the promotion of mental
health and well-being and reinforcing the prevention and management of substance abuse, e.g.,
narcotic drug abuse and harmful use of alcohol; (6) to decrease by 50 percent the number of
global deaths and injuries from road traffic accidents; (7) to ensure universal access to sexual and
reproductive healthcare services, particularly family planning, information, and education; and
(8) to attain universal health coverage (UHC), specifically, financial risk protection, access to
quality essential healthcare services including safe, effective, quality, and affordable essential
medicines and vaccines for all individuals, and safety for individuals exposed to hazardous
chemicals and air, water, and soil pollution and contamination.

To address the SDG 3 in the Philippines, the Universal Health Care Act (UHC) or
"Kalusugan Pangkalahatan" was enacted into a law, Republic Act 11223on February 20, 2019.
This law institutes UHC for all Filipinos and prescribes reforms in the Philippine Health Care
System and the funds relating to the implementation health care in the country. It simply
provides every Filipino the highest possible quality of health care which is accessible, efficient,
equitable, appropriately funded, and fairly financed (DOH, 2019). This law ensures that all
Filipinos and their communities is given the necessary quality services which are free from
health threats and financial suffering. This is to be measured by the country's health service
coverage and financial protection.