Introduction to Global Health Global Health Governance Legal Frameworks

1. Global Health Governance
Legal frameworks
Introduction to Global Health
Global Health Governance

2. Global Governance
• Comprises institutions, rules and processes
• Operating on a global global level
• Providing a framework within which actors
interact and take decisions.
Introduction to Global Health
Global Health Governance

3. Global Health Governance
The use of institutions, rules, and processes by
states, intergovernmental organizations, and
nonstate actors to deal with challenges to health
that require cross-border collective action to
address effectively (Fidler 2010).
Introduction to Global Health
Global Health Governance

4. Important legal frameworks
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WHO constitution – 1946
Human right to health
WHO Alma Ata Declaration - 1978
Development frameworks
WHO treaties and codes
Introduction to Global Health
Global Health Governance

5. WHO constitution
• Adopted in 1946, in confirmity to charter of
UN
• Strives for the highest attainable standard of
health as a human right
• Health and wellbeing is fundamental for the
attainment of peace and security
• Governments have responsibility for health
Introduction to Global Health
Global Health Governance

6. Objectives and functions of the WHO
• Highest attainable level of health for all
• Directing and coordinating authority on international
health
• Assisting governments plus cooperation with other
agencies
• Proposing conventions, agreements and regulations
• Membership of the organisation is open to states
• Governance occurs via the World Health Assembly
(WHA), Executive Board and Regional Committtees
• Annual meeting of WHA to discuss pressing health
issues
Introduction to Global Health
Global Health Governance

7. Human right to health (1)
• Proclaimed in the 1948 Universal Declaration
of Human Rights (UDHR) and codified in the
1966 International Covenant of
Economic, Social and Cultural Rights (ICESCR)
• “the right of everyone to the enjoyment of the
highest attainable standard of physical and
mental health”—has become a cornerstone of
global health governance
Introduction to Global Health
Global Health Governance

8. Human right to health (2)
The human right to health is mentioned in a range of legal
frameworks:
• Constitution of the WHO (1946)
• Universal declaration of Human rights (1948)
• Human rights conventions
• ICESCR Art. 12 (1966) and the General comment 14 (2000)
• Declaration of Alma Ata (1978, par.1)
• Special rapporteur on the Right to Health (2002): sees how
countries progress
• Outcome document Millenium Development Goals summit (2010,
par.13)
• In 140 national constitutions
• In the European Social Charter
Introduction to Global Health
Global Health Governance

9. Introduction to Global Health
Global Health Governance

10. WHO Alma Ata declaration (1)
• International conference on Primary Health
Care in in Alma Ata in 1978
• In context of the Cold War
• Comprehensive Primary Health Care as basis
of national health systems to reduce health
inequities
Introduction to Global Health
Global Health Governance

11. WHO Alma Ata declaration (2)
• Includes health services, promotion and
prevention
• Participation of people and community is key
• Relies on sufficient and well trained health
workers
• Health for all by the year 2000!
• Calls on cooperation and collaboration of
states, WHO and UNICEF
Introduction to Global Health
Global Health Governance

12. WHO Alma Ata Declaration (3)
Main point:
Comprehensive primary health
care is the key to health for all
Introduction to Global Health
Global Health Governance

13. Development frameworks (1)
• Many frameworks and reports are
produced, in particular after conferences.
• They are not legally binding, but political
commitments from states to work on
frameworks.
Introduction to Global Health
Global Health Governance

14. Development frameworks (2)
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Official Development Assistance (1969)
World bank report – “Investing in health”(1993)
Roll Back Malaria partnership initiated by WHO (1999)
WHO: Commision on macro-economics and health
(2001)
Abuja declaration (2001)
Paris declaration on Aid Effectiveness (2005)
International Health partnership + (2007)
WHO: Commision on Social Determinants of Health
(2008) – “Closing the gap in a generation”
WB/GF/GAVI/WHO: JANS national health plans (2010)
Introduction to Global Health
Global Health Governance

15. WHO treaties and codes
Examples:
• International Code of Marketing of breast-milk
substitutes (1981)
• International Health Regulations (2005) +
Pandemic–Influenza- Preparedness framework
(2011)
• International code of Practice on the
recruitment of health personnel (2010)
• Framework Convention on Tobacco control
Introduction to Global Health
Global Health Governance

16. Framework Convention on Tobacco
control (FCTC)
• Treaty adopted by WHA in 2003
• A supranational agreement that aims "to
protect present and future generations from
the devastating health, social, environmental
and economic consequences of tobacco
consumption and exposure to tobacco smoke"
by enacting a set of universal standards stating
the dangers of tobacco and limiting its use in
all forms worldwide.
Introduction to Global Health
Global Health Governance