Chapter 6. Global Health
Dr. Fantu Lombamo Untiso, Public Health Specialist Medical Doctor · St. Paul's Hospital Millennium Medical College
Disease, trade, money, ideas and people cross borders every day. A virus in one forest can reach a capital city in a day; a marketing campaign in one country can change diets in another; a funding decision in a donor capital can close a clinic in a village. This chapter introduces global health as the study of these connections, with the latest numbers.
Chapter 6 of 11 · Week 2 · 4 contact hours
Learning objectives for this chapter
- Describe the spatial, temporal and cognitive dimensions of global change and the forces that drive globalisation.
- Explain how globalisation affects health and health systems, with benefits and harms.
- Interpret the global burden of disease and describe the current global health priorities.
- Identify major global health actors, agreements and initiatives, including recent changes to global health security.
1. Globalisation and the three dimensions of change
Globalisation is the growing interdependence of countries through flows of goods, services, money, people, technology and ideas. Kelley Lee describes three dimensions of global change:
| Dimension | Meaning | Health example |
|---|---|---|
| Spatial | Distance and borders become less important as the world shrinks | Air travel carries an infectious person across continents within hours; international trade in food and medicines |
| Temporal | Speed: events happen faster and information moves instantly | Real-time outbreak reporting; a disease spreads before a response can be organised; 24-hour news and social media |
| Cognitive | Changes in awareness, ideas, culture and values | Shared global health goals; but also global marketing of tobacco and processed foods, and the spread of misinformation about vaccines |
Driving forces include trade liberalisation and global markets; information and communication technology; cheaper and faster transport; global finance and investment; migration and displacement; international governance and norms; and global environmental change, including climate change.
2. How globalisation affects health
| Benefits | Harms and risks |
|---|---|
| Sharing of knowledge, guidelines and research (for example open access evidence) | Rapid spread of infectious diseases; antimicrobial resistance |
| Faster development and distribution of vaccines and medicines (Gavi, Global Fund, pooled procurement) | Marketing of tobacco, alcohol and ultra-processed food; spread of unhealthy lifestyles |
| Funding for disease programmes and humanitarian relief | Unequal access to new products; the effects of intellectual property rules on prices |
| Telemedicine, digital health and remote training | Brain drain: migration of health workers from low-income to high-income countries |
| Remittances and economic growth that fund health and education | Dependence on external funding and sudden shocks when donors change policy |
| Global norms (International Health Regulations, Framework Convention on Tobacco Control) | Climate change and environmental harm from global production and consumption |
Global health is the area of study, research and practice that gives priority to improving health and achieving equity in health for all people worldwide. It emphasises transnational problems and solutions, interdisciplinary work and the whole population. International health traditionally meant help from rich to poor countries, and public health is concerned with the health of the population within a community or nation. In practice, they overlap.
3. Global burden of disease
The Global Burden of Disease (GBD) study measures the loss of health from diseases, injuries and risk factors. Its main measure is the disability-adjusted life year (DALY): one DALY is one lost year of healthy life. DALY = YLL + YLD, where YLL are years of life lost to premature death and YLD are years lived with disability.
4. Current global health priorities
- Primary health care and UHC: 4.6 billion people lack full coverage of essential services and 2.1 billion face financial hardship UHC report 2025.
- Health security: preparedness for epidemics and pandemics; the amended IHR and the Pandemic Agreement.
- Health financing: official development assistance for health in 2025 was estimated at 30 to 40 percent below 2023 levels, and the WHO Assembly in 2025 adopted a resolution on the global health financing emergency Health Policy Watch 2026 WHA78 2025.
- NCDs and mental health: the 2025 UN political declaration WHO NCD 2025.
- Climate, environment and air pollution.
- Infectious diseases: HIV, TB, malaria, hepatitis, neglected tropical diseases, vaccine-preventable diseases; antimicrobial resistance.
- Maternal, newborn, child and adolescent health and nutrition.
- Health workforce, data and digital health, including governance of artificial intelligence.
- Equity, humanitarian crises and fragile settings.
5. Global health actors
| Actor | Role |
|---|---|
| World Health Organization (WHO) | Directing and coordinating authority on international health; sets norms and standards; World Health Assembly; IHR secretariat; technical support to countries (WHO AFRO and the Ethiopia country office) |
| UN agencies (UNICEF, UNFPA, UNAIDS, WFP, FAO, UNEP) | Specific technical and humanitarian mandates; supplies, nutrition, reproductive health, food security |
| World Bank and regional development banks | Financing, loans, health system reform, results-based financing, economic analysis |
| Global health initiatives (Gavi, the Global Fund, Global Financing Facility) | Pooled finance and procurement for vaccines and diseases programmes |
| Bilateral donors and development agencies | Government-to-government aid; the 2025 dissolution of USAID and cuts by other donors changed the landscape |
| Philanthropies and foundations | Funding research and products; for example Gates Foundation, Wellcome |
| Africa CDC and regional bodies | Continental health security, coordination, local manufacturing |
| Non-governmental and faith-based organisations; civil society | Service delivery, advocacy, community engagement |
| Private sector and academia | Products, innovation, research, training, technology |
6. Key agreements and initiatives
- Sustainable Development Goals (2015 to 2030): SDG 3 on health and well-being, and links to all 17 goals (Chapter 9).
- International Health Regulations (IHR 2005): legally binding rules for detecting, reporting and responding to health events. The 2024 amendments entered into force on 19 September 2025; they add a new ‘pandemic emergency’ alert level above a Public Health Emergency of International Concern, call for a National IHR Authority in each country and strengthen equitable access to medical products and financing WHO IHR 2025.
- WHO Pandemic Agreement: adopted by the World Health Assembly on 20 May 2025 to improve prevention, preparedness and response and promote equitable access to vaccines and medicines. It cannot be signed until the Pathogen Access and Benefit Sharing (PABS) annex is finalised; by 1 May 2026 negotiators needed more time and asked the 79th Assembly to extend the mandate WHA78 2025 WHO PABS 2026. Check WHO’s website for the latest status.
- Framework Convention on Tobacco Control (2003) and the Immunisation Agenda 2030; the End TB Strategy; the Global Technical Strategy for Malaria; the global HIV strategy.
- Aid effectiveness and reform: the 2023 Lusaka Agenda calls for global health initiatives to align with national plans and systems.
የኮርሱ አካል: Fundamentals of Public Health
በዚህ ንጥል ላይ ያለ ችግር ሪፖርት ያድርጉ
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እስካሁን በቂ ደረጃ አልተሰጠም።
ጥያቄዎችና አስተያየቶች (0)
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ጥያቄ ወይም አስተያየት ይጻፉ
ለፈቃድ ላላቸው ባለሙያዎችና ተማሪዎች። የትምህርት መረጃ ብቻ ነው፦ ሁልጊዜ የወቅቱን ብሔራዊ መመሪያዎች (የኢትዮጵያ ምግብና መድኃኒት ባለሥልጣን፣ ጤና ሚኒስቴር)፣ የምርቱን መለያና የተቋምዎን አሠራር ይከተሉ።