Traditionally, governments have the ultimate responsibility for assuring the conditions for their people to be as healthy as they can be. In this sense one of the fundamental societal goals of health services may be considered the health improvement of the population served and for which the individual government is responsible. As our understanding of the multiple determinants of health has dramatically expanded, exercising this responsibility calls for a national health policy that goes beyond planning for the personal health care system and addresses the health of communities. Broader issues of political, economic, social, institutional, educational, and environment circumstances, among others, are now seen as important determinants of health. Of particular importance is the issue of equity of access to all these resources within a country.
In the face of this added complexity, countries, especially developing countries and those in transition, face challenges from a number of global health threats. Their national health strategies may be compromised by the effects of globalization and global decision making on issues that affect health. Government leaders must not only address health problems within their borders, but those that come across their borders, whether specific diseases like HIV/AIDS, avian influenza, or the pressures of the global labour market that lead to movement of health professionals seeking better pay and working conditions from the developing to the developed world
After discussing definitions of health in international agreements and the general influences of globalization on health and health equity, the course will explore the roles and responsibilities of national health leadership, primarily Ministries of Health and governmental institutions, in assuring the health of their populations and the different strategies and variable capacities of national governments in developed, developing and countries in transition. The role of regional and local governments, professionals, civil society, communities and individuals, will also be explored.
We will then consider in some depth the role, functions and effectiveness of global organizations affecting health in the UN, NGO and business sectors as well as multilateral and bilateral donors and how they interact with each other and with national leadership. Finally we will look at emerging instruments for global health governance, how they operate and their effectiveness for promoting health action at the country level.