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GLOBAL HEALTH LEADERSHIP in PRACTICE the Global Health Fernando Ortega MD., MA., PhD. College of Health Sciences Researcher and Professor Universidad San Francisco de Quito GLOBAL HEALTH LEADERSHIP IN PRACTICE This was a conference prepared by Fernando Ortega for the Global Health Program of the Association of Pacific Rim Universities Political Map • 24 Provinces • 17 million people • 7% Self identified as Indigenous people • 10% Self identified as Afro Ecuadorians • 80% mestizo people • 3% white or foreign people • 14 different indigenous (native) cultures • 13 different indigenous endangered languages GLOBAL HEALTH LEADERSHIP IN PRACTICE 1 Concepts: Global, Human Being and Health 2 Health issues in our current globe 3 Global Health leading Institutions 4 Some Sustainable Development Goals 5 Other factors not considered when talking about Global Health THE CONCEPT OF GLOBAL Involving the entire world Worldwide Like global warming The human Being constituents Almost 99% of the human body is made up of: oxygen, carbon, hydrogen, nitrogen, calcium, and phosphorus. But, I wanted to know about the constituents of the HUMAN BEING. Human Being constituents • Physical, somatic, the biologic body. • Social: the person, the mother, the family • Spirit: the values, the believes, the relationships • Environment: physical, psycho socio economic THE HEALTH CONCEPT Health is not perceived in the same way by all members of a community, including various professional groups (biomedical scientists, social scientists, health administrators, ecologists, politicians), giving rise to confusion about the concept of health. • Ecologists view health as a dynamic equilibrium between man and its environment. • Health is related to the human being constituents: biologic, social, psychological, cultural, economic and political elements of the people concerned. • Holistic approach implies that all sectors of the society influence health, those are: agriculture, food, education, housing, public works, industry³ … We all know how WHO defined health (1946). Beyond the exposure to a communicable disease, health status of an individual or of a population is determined by numerous factors, like lifestyle, nutrition, cultural norms, humanitarian or other crises, inequalities, national policies and broader social, economic and environmental conditions. In turn, … […] the health of all peoples is fundamental to the attainment of peace and security”. European Commission https://ec.europa.eu/europeaid/sectors/human-development/health_en # 2 GLOBAL HEALTH ISSUES https://www.intrahealth.org/vital/10-global-health- issues-watch-2018 • The challenge of refugees and migrants. • The effects of violence on health. • Our mental health and well-being. • A changing planet. 1 Refugees and migrants 1/7 of our planetary population is on the move. They become vulnerable being displaced and powerless in a foreign land. They face challenges like cultural differences, language, accessing health care, unfamiliarity with local health services. War, genocide, and famine drive people out, and diseases move with the people. GENOCIDE RWANDA 1994 FAMINE ETHIOPIA 1992 WAR SYRIA 2019-2020 STRINGER REUTERS GETTY IMAGES ALLAE fotos de IPTC 2 The effects of violence on health. In Syria, there were ten attacks on hospitals in the span of ten days. In Irak, only one out of ten children are delivered in a health facility. In Venezuela health facilities have no medicines in stock. The Geneva Convention is not observed. Deliberate, calculated assaults on health facilities kill not only patients but also health workers, so vulnerable health services are devastated. What to say about people's mental health !!! 3 Our mental health Trauma due to natural disasters, gun violence, disease, chronic poverty, political unrest and uncertainty, are some of the current stressors that affect our mental and physical health. 4 Changing climate is a health issue Hurricanes, tornadoes, typhoons, high or low temperature records, fires, droughts, and more powerful storms resulting in flooding, damage, and death tolls. Those tolls do not include other people who died because they needed surgery or dialysis after the power went out, or heart attacks or strokes or heat exhaustion. Chaos and destruction are increasing stress conditions and reducing resistance to common diseases. Extreme weather events are becoming more common, affecting air and water quality and life. We should reinforce our health systems to build the resilience we need to keep providing services in a new, stormier world. # 3 GLOBAL HEALTH LEADING INSTITUTIONS There are many international institutions involved in global health efforts. Some of them have a wide scope of assistance, others are focusing their work to support specific tasks, like to end extreme global poverty, to face emerging pandemic threats, to assist in family planning, maternal and child health, nutrition, health systems strengthening, neglected tropical diseases, HIV and AIDS, malaria and tuberculosis. UNITED NATIONS United Nations is encompassing numerous specialized organizations and agencies, programs and funds, training, research bodies, and service providers. There are also numerous subsidiary bodies, including committees, commissions, boards, councils, panels, and working groups. FAO Food and Agriculture Organization ICAO International Civil Aviation Organization IFAD International Fund for Agricultural Development ILO International Labour Organization IMO International Maritime Organization IMF International Monetary Fund ITU International Telecommunication Union UNESCO United Nations Educational, Scientific and Cultural Organization UNIDO United Nations Industrial Development Organization UPU Universal Postal Union WBG World Bank Group IBRD International Bank for Reconstruction and Development IFC International Finance Corporation IDA International Development Association WHO World Health Organization WIPO World Intellectual Property Organization WMO World Meteorological Organization WTO World Tourism Organization Former specialized agencies Related organizations Multilateral Health Organizations • World Health Organization, WHO • United Nations Children's Fund, UNICEF • World Bank. Bilateral Development Agencies • Agence Française de Développement (AFD) • Australian Aid (Australian Department of Foreign Affairs and Trade) • Canada - Global Affairs - International Development. • Irish Aid (Department of Foreign Affairs and Trade) • Japan International Cooperation Agency (JICA) • Norwegian Agency for Development Cooperation (Norad) • Centers for Disease Control and Prevention (CDC) • United States Agency for International Development, USAID • Other countries have bilateral organizations that perform similar functions. Non-governmental Organizations • Doctors Without Borders/Medecins Sans Frontieres • CARE International • Peace Corps Volunteers • ADRA. OXFAM. MERCY CORPS. • Save the Children. • Good Neighbors International. • Engineers Without Borders And many more, delivering emergency medical aid to people impacted by conflict, epidemics, disasters, or lack access to care. World Health Organization Established in 1948, leads the world in public health statistics, public health policy, emergency response, and research. The most visible in disaster relief and immunization programs. Publish health and wellness guidelines and worked with UN- member states to achieve Millennium Development Goals, and now the Sustainable Development Goals, and other international standards to ensure that progress is made. Multilateral, Bilateral and Non-governmental Organizations All of them are making critical contributions to improved global health. From here, in the middle of the planet . I propose you a reflection on these global health issues, institutions and the Sustainable Development Goals accomplishment. ECUADOR … EQUATOR THE HEALTH OF THE WORLD’S POPULATION IS IN A STATE OF INEQUALITY. “People have vastly different stories to tell about their health depending on their economic status, level of education, place of residence, sex, age and any other potential base for discrimination”. WHO/HIS/HSI/2015.1 The United Nations 2030 Agenda Aspires to accomplish 17 integrated and indivisible Sustainable Development Goals (SDGs). Our world, our current society, is unequally developed. Human inequalities have always been present in most societies. Surprisingly, today, you and myself are interested to understand the reasons for this widely expanded “human” condition: INEQUALITY When talking about strategies to cope with inequalities, we must recognize how difficult is to reach political consensus and commitment on each one of our own countries. # 4 SUSTAINABLE DEVELOPMENT GOALS # 1 to end poverty, # 3 to ensure healthy lives and promote well-being for all, at all ages, # 4 to ensure inclusive and equitable quality education, # 5 to achieve gender equality, and # 10 to reduce inequality within and among countries. It is evident that all of them try to tackle “human made” inequalities. SDG # 1: To end poverty What is poverty? The state of being extremely poor. "thousands of families are living in abject poverty" The state of being inferior in quality or insufficient in amount. "the poverty of our imagination" The renunciation of the right to individual ownership of property as part of a religious vow. “The monks choose to live in material poverty”. Poverty in South America All countries are affected by poverty to some extent. During the first decade of XXI century, poverty dropped from 43% to32%. The countries are trying to reduce poverty, with varying
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