2Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
Striking disparities in access to healthcare and in health outcomes are major characteristics of health across the globe. This inequitable state of global health and how it could be improved has become a highly popularized field of academic study. In a series of articles in this journal the roles of power and politics in global health have been addressed in considerable detail. Three points are added here to this debate. The first is consideration of how the use of definitions and common terms, for example ‘poverty eradication,’ can mask full exposure of the extent of rectification required, with consequent failure to understand what poverty eradication should mean, how this could be achieved and that a new definition is called for. Secondly, a criticism is offered of how the term ‘global health’ is used in a restricted manner to describe activities that focus on an anthropocentric and biomedical conception of health across the world. It is proposed that the discourse on ‘global health’ should be extended beyond conventional boundaries towards an ecocentric conception of global/planetary health in an increasingly interdependent planet characterised by a multitude of interlinked crises. Finally, it is noted that the paucity of workable strategies towards achieving greater equity in sustainable global health is not so much due to lack of understanding of, or insight into, the invisible dimensions of power, but is rather the outcome of seeking solutions from within belief systems and cognitive biases that cannot offer solutions. Hence the need for a new framing perspective for global health that could reshape our thinking and actions.
Shiffman J. Knowledge, moral claims and the exercise of power in global health. Int J Health Policy Manag. 2014;3(6):297-299. doi:10.15171/ijhpm.2014.120
Lee K. Revealing power in truth: Comment on “Knowledge, moral claims and the exercise of power in global health.” Int J Health Policy Manag. 2015;4(4):257-259. doi:10.15171/ijhpm.2015.42
Rushton S. The politics of researching global health politics: Comment on “Knowledge, moral claims and the exercise of power in global health.” Int J Health Policy Manag. 2015;4(5):311-314. doi:10.15171/ijhpm.2015.47
Ooms G. Navigating between stealth advocacy and unconscious dogmatism: the challenge of researching the norms, politics and power of global health. Int J Health Policy Manag. 2015;4(10):641-644. doi:10.15171/ijhpm.2015.116
Forman L. The ghost is the machine: how can we visibilize the unseen norms and power of global health? Comment on “Navigating between stealth advocacy and unconscious dogmatism: the challenge of researching the norms, politics and power of global health.” Int J Health Policy Manag. 2015;5(3):197-199. doi:10.15171/ijhpm.2015.206
Pinto AD, Upshur REG, eds. An Introduction to Global Health Ethics. London: Routledge; 2013
Brown TM, Cueto M, Fee E. Public health then and now. Am J Public Health. 2006;96:62-72.
Macfarlane SB, Jacobs M, Kaaya EE. In the name of global health: trends in academic institutions. J Public Health Policy. 2008;19:383-401.
Whitmee S, Haines A, Beyrer C, et al. Safeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation-Lancet Commission on planetary health. Lancet. 2015;386(10007):1973-2028. doi:10.1016/S0140-6736(15)60901-1.
Potter VR. Bioethics: Bridge to the Future. Englewood Cliffs, NJ: Prentice-Hall; 1971
Garrett L. The Coming Plague: Newly Emerging Diseases in a World out of Balance. New York: Farrar, Straus and Giroux; 1994.
Benatar SR. The coming catastrophe in international health: an analogy with lung cancer. Int J. 2001;56(4):611-631. doi:10.2307/40203607
McMichael AJ. Planetary Overload: Global Environmental Change and the Health of the Species. Oxford: Oxford University Press; 1993
Benatar SR, Daar A, Singer PA. Global health ethics: the rationale for mutual caring. Int Aff. 2003;79:107-138.
Benatar SR. Moral imagination: the missing component in global health. PLoS Med. 2005;2(12):e400.
Friel S, Butler C, McMichael A. Climate change and health: risks and inequities. In: Benatar S, Brock G, eds. Global Health and Global Health Ethics. Cambridge: Cambridge University Press; 2011: 198-209.
Birn AE. Addressing the societal determinants of health: the key global health ethics imperative of our times. In: Benatar S, Brock G, eds. Global Health and Global Health Ethics. Cambridge: Cambridge University Press; 2011:37-52.
Smart N. Worldviews: Cross-Cultural Explorations of Human Beliefs. 2nd ed. Englewood Cliffs: Prentice Hall; 1995.
Lewontin RC. Science as Ideology: the Doctrine of DNA. Concord, Ontario: Massey Lectures Anansi Press; 1991
Lakoff G, Johnson M. The metaphors We Live by. Chicago: University of Chicago Press; 1980.
Smith MJ, Upshur REG. Ebola and lessons learned from moral failures: Who cares about ethics? Public Health Ethics. 2015. doi:10.1093/phe/phv028