Chapter 8: Globalization, Governance and Health
Sarah Payne INTRODUCTION The focus of this chapter is health in a global context – particularly the ways in which globalization aﬀects health and the role played by global health governance in protecting health on a global scale. In recent decades globalization has speeded up, while patterns of health and health inequality, both between countries and within them, have changed. While some aspects of globalization oﬀer the prospect of improvements in health, others increase exposure to health risks. Health governance has a role to play in global health, although the nature of that role has varied over time and the success of global health governance is unclear. We begin with a brief account of recent global trends in health, and a discussion of deﬁnitions of globalization and of global health governance. This is followed by an exploration of the ways in which we might expect globalization to aﬀect health and a more detailed look at the part played by global health governance in promoting health and protecting populations. HEALTH IN A GLOBAL PERSPECTIVE In the last half of the twentieth century global life expectancy increased by nearly 20 years. More developed countries gained an average of nine years, while developing countries with high mortality gained 17, and developing countries with lower mortality gained 26 years (WHO, 2003; Leon and Walt, 2001). This represents a signiﬁcant improvement worldwide, but there continues to be a health gap between richer and poorer countries. Over 1 billion people worldwide have...
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