Lately, since COVID-19, ‘global health’ is high on the medical, economic and political agenda worldwide. It will probably stay there for a long period of time and strengthen the further development of a European Health Union. Thus global health will be an additional topic for the EU. Many terms have been assigned to precede definitions for global health. The different characteristics stem from the perspectives of who is using the term. Is it health as the classic definition by the WHO (1946), is it public health, international health, planetary health, one health or is it global health in a new setting defined by the World Health Summit in 2017? Health was seen by this summit as a political choice and strategy, defined by six key areas of global health with a commitment to:
- Strong and reliable Governance.
- Ensure global health security.
- Healthy and resilient cities.
- Responsible approaches to big data.
- Research, innovation and development.
- Innovation and health systems strengthening in Africa.
The epidemiological background is well known and presented in many statistics about the morbidity and mortality in the poorest countries of the world (Sierra Leone, Niger, Mali, Burundi to name only a few). Life expectancy and the literacy rate are indescribably low, whilst the spread of diseases is very high (e.g. malaria, tuberculosis, cholera or hepatitis). In addition to the so-called poverty-privileged diseases there are many neglected diseases (NTDs) such as ebola, corona-virus and other pandemics. Finally there are the many infectious diseases, for example those of the respiratory tract.
Given this initial situation, there are countless essential health services in poor countries to improve the status quo. Indispensable in most of these countries are: basic medical care, clean water, electricity, toilets, contraceptives, training (especially of the mother and midwife), nurses, school education, immunization, vaccination programs, school education, medication, preventive measures and ready-made food health coverage. (See in more detail Hans Rosling et al., Factfulness, 4th edition 2019.)
One may be ashamed of all this data given the health status and the health services in the western world, with its many superfluous amenities. Even small amounts of health expenditures in the industrialized nations would help thousands of people to survive in poorer countries. Nevertheless, the industrialized countries do a lot to help improve the global health of the world population. To a selected list of institutions which support the less developed part of the world belong: Development aid from the richer countries, WHO and the World Bank, UNICEF, G7, G20, the Bill Gates Foundation, churches (Bread for the World, Misereor), Médecins Sans Frontières, the World Food Program, World Health Summit, global alliance for vaccines and immunization Gavi, Official Development Assistance (ODA) and Access to Medicine Foundation.
As we do not have a world government we go continent by continent and country by country; in particular with the help of the WHO, the World Bank and the Global Fund to Fight AIDS, Tuberculosis and Malaria. A long list of the different projects for poor countries is available through ‘Global Health – An investment in the Future’ by the German Ministry of Development Aid (BMZ) 02/2019.
Global health is not plagued by a lack of funds. Following the judgement of the active actors in these programs, a better coordination of their activities would be helpful. As the funds differ between countries and diseases, their allocation is always up for discussion. The money spent often does not confer with a positive outcome.
Apart from the worldwide attempts, there are nations and regions with more decentralized approaches. One of them is the European Union with its 27 member states, organized with a lot of effort through the EU-Commission. The EU4Health 2021-2027 – a vision for a healthier European Union – stems from the European Commission, and is described in detail on the official EU website dated 12th March 2021. Together with the recovery spending (next generation EU) the EU may now start making funds available under the Recovery and Resilience Facility. This is the major EU instrument for Economic Recovery from the COVID-19 pandemic.
Last but not least, the growing population on our planet must be fed in a fair and sustainable manner as the World Food Convention 2021 is describing:
Producing enough food causes new, different problems which harm the climate. On top of that, the COVID-19 pandemic endangers the security of food production and the stability of supply chains, threatening food safety.
Thus climate change will cause the situation to deteriorate, especially in poor countries, even though they did not contribute to the crisis.
- Busse, Reinhard., Blümel Miriam, Franz Knieps und Till Bärnighausen, Germany and health 1, Statutory health insurance in Germany: a health system shaped by 135 years of solidarity, self-governance, and competition. The Lancet, Germany and health, July 2017, S. 5-20 und Ilona Kickbusch, Christian Franz, Anna Holzscheiter, Iris Hunger, Albrecht Jahn, Carsten Köhler, Oliver Razum und Jean-Olivier Schmidt, Germany 2, Germany´s expanding role in global health, S. 21-35.
- G20 Germany 2017, Berlin Declaration of the G20 Health Ministers, Together Today for a Healthy Tomorrow.
- Henke, K.-D., Von der Gesundheitsökonomie zur Gesundheitswirtschaft from Health Economics to Health Economy, in: Perspektiven der Wirtschaftspolitik 2019; 20(1): 23-41.
- Kahr-Gottlieb, D., Die „European Health Union“ – gemeinsam für Gesundheit in Europa, in: Klapper, B./Cichon, I., Hrsg. Neustart! Für die Zukunft unseres Gesundheitswesens Robert Bosch Stiftung, S. 307-321.
- World Health Summit, Science, Innovation, Policies, Berlin, Germany & Digital, October 24-26, 2021 with the M 8 Alliance Declaration 2020: No one is safe until all are safe, p. 14/15.