The COVID-19 pandemic is not our first brush with health crisis that has sounded a call for global action. In 1988, the Global Polio Eradication Initiative was established in response to the ravages of polio outbreaks. Since its launch, there has been more than a 99% decrease in the incidence for this potentially debilitating disease. In 2001, the Stop TB Partnership undertook a similar goal of eliminating tuberculosis (TB) globally. More recently, the United Nations’ Agenda for Sustainable Development has set out to end the epidemics of HIV, TB, and malaria by 2030. These concerted efforts, which extend beyond the scope of nation-specific public health, are necessary in this era of global interconnectedness and interdependence.
Global health is a field that has emerged to address health issues that transcend national borders and interests. Noting the lack of consensus on defining ‘global health’, the Consortium of Universities for Global Health Executive Board have put forward the following definition: an area for study, research and practice that places a priority on improving health and achieving equity in health for all people worldwide. Others have since proposed a more pointed amendment – collaborative trans-national research and action for promoting health for all – to further emphasize the need for action-oriented collaboration.
Research efforts in this field spans multiple disciplines, encompassing biomedical sciences, epidemiology, economics, sociology, among others. This multidisciplinary approach allows for a holistic understanding of health challenges through consideration of different socio-cultural, economic, political, and environmental factors underpinning health inequities.
Take, for example, TB. It is an infection caused by the bacteria M. tuberculosis, which can be cured with antibiotics. Why, then, does it continue to cause 1.6 million deaths yearly? TB is often called a ‘disease of poverty and inequity’. Social and structural factors such as overcrowded living conditions, poor access to healthcare facilities and stigma associated to TB pose barriers to receiving diagnosis and appropriate care. Consequent underdiagnosis of TB can lead to higher mortality rate from untreated cases and spreading to others. Research efforts towards improving case detection are assessing the use of systemic screening interventions in lieu of relying on self-reporting from different perspectives like regional case studies and cost-effectiveness evaluations.
Global health research has been perceived to be limited to challenges predominantly affecting low- and middle- income nations (LMICs). TB along with HIV and malaria do indeed disproportionately affect individuals in LMICs. However, many of the social and structural determinants described above affect those in marginalized communities in high-income countries (HICs), such as Indigenous people and people experiencing homelessness, as well.
Moreover, current areas of priority in the field are wide-ranging, including the mental health crisis, the climate crisis, and the rising prevalence of non-communicable diseases. Non-communicable diseases like cancer and diabetes that were once considered diseases of HICs are becoming more prevalent globally. Diseases simply cannot be contained within geopolitical boundaries.
The ‘health for all’ commitment of global health is undoubtedly an ambitious one that is contingent on us coming together as global citizens.
Citations
- Global Polio Eradication (2023) Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/polio/global-polio-eradication.html.
- Our journey (no date) Stop TB Partnership. Available at: https://www.stoptb.org/stop-tb-partnership/our-journey.
- Koplan, J.P. et al. (2009) ‘Towards a common definition of global health’, The Lancet, 373(9679), pp. 1993–1995. doi:10.1016/s0140-6736(09)60332-9.
- Beaglehole, R. and Bonita, R. (2010) ‘What is Global Health?’, Global Health Action, 3(1), p. 5142. doi:10.3402/gha.v3i0.5142.
- De Cock, K.M. et al. (2013) ‘The New Global Health’, Emerging Infectious Diseases, 19(8), pp. 1192–1197. doi:10.3201/eid1908.130121.
- Global tuberculosis report 2023 (2023) World Health Organization. Available at: https://www.who.int/publications-detail-redirect/9789240083851
- Marais, B.J., Hesseling, A.C. and Cotton, M.F. (2009) ‘Poverty and tuberculosis: Is it truly a simple inverse linear correlation?’, European Respiratory Journal, 33(4), pp. 943–944. doi:10.1183/09031936.00173608.
- Smith, A., Herington, E. and Loshak, H. (2021) ‘Tuberculosis stigma and racism, colonialism, and Migration: A Rapid Qualitative Review’, Canadian Journal of Health Technologies, 1(4). doi:10.51731/cjht.2021.56.
- Zulu, D.W. et al. (2022) ‘Integration of systematic screening for tuberculosis in outpatient departments of urban primary healthcare facilities in Zambia: A case study of kitwe district’, BMC Health Services Research, 22(1). doi:10.1186/s12913-022-08043-w.
- Jo, Y. et al. (2021) ‘Costs and cost-effectiveness of a comprehensive tuberculosis case finding strategy in Zambia’, PLOS ONE, 16(9). doi:10.1371/journal.pone.0256531.
- Lucero‐Prisno, D.E. et al. (2023) ‘Top 10 public health challenges to track in 2023: Shifting focus beyond a global pandemic’, Public Health Challenges, 2(2). doi:10.1002/puh2.86.
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