Social determinants of health in the context of globalization and modernization

Globalization had affected all allied fields of public health, such as medicine, ethics and human rights. The relationships among these fields are also evolving in response to the new circumstances, events and experiences created by globalization. Alongside epidemics such as HIV/AIDS, many women’s health issues are also brought to light by “the complex humanitarian emergencies of Somalia, Iraq, Bosnia, Rwanda, and now, Zaire” (Levy & Sidel, 2006). From among several aspects of globalization, three of them assume more significance. Firstly, human rights issues and action have become more closely allied to, and have become an integral part of public health work. Next, new standards of public health ethics have gained acceptance. Thirdly, human rights-related duties and responsibilities of healthcare professionals, including doctors, are receiving increased attention (Levy & Sidel, 2006).

Globalization of agriculture has accelerated with newer technologies in the realm of molecular biology. It has both advantages and disadvantages. On the positive side, this has led to increased food security over the last few decades. As a result hunger and starvation have declined. But the question to be asked is not if hunger and starvation have declined (Kazatchkine, 2007). The significant question is: Have they declined proportionate to the production capabilities afforded by newer technologies. The answer is sadly, no. According to Joachim von Braun,
“The main reason for being extremely disappointed with the progress in food security is that such progress has at best followed past patterns and trends but does not at all correspond to the tremendous opportunities offered by the new global wealth and technology. While globalization has successfully included a significant part of the rural and urban food insecure in parts of Asia and Latin America, this is not the case for most of Africa. As agriculture is a knowledge-intensive sector, the facilitation of access to knowledge through globalization is a promising opportunity. At this juncture, carefully designed policies adapted to regional conditions are called for to foster the potential benefits for people and the ecology, and to prevent risks” (von Braun, 2001)

In the final analysis, it is apt to say that the positive effects of globalization have not reached everyone. In the world of today, with rapid progress in communication and transportation, diseases can travel quickly across geo-political borders. In this scenario, contagious diseases can quickly assume epidemic proportions. Health problems can no longer be segregated into local and foreign. As close to two million people travel across national borders each day, a more comprehensive and inclusive approach to the health of general public is called for. It is relevant to note that modern diseases such as cardiac problems, diabetes and cancer have risen in frequency in the era of globalization. This means that the new economic organization of the world has imposed unhealthy lifestyles on people. But there is nothing inevitable about these negative consequences. If the engines that drive globalization can be efficiently tapped into, they can lead to a more egalitarian and healthier global society (Tabb, 2001).

As an acknowledgement of the injustices and disadvantages induced by globalization, a consensus is emerging within the international community toward the formation of a more equitable global health system. Such conceptions as the international development targets, which were discussed in recent WHO meetings try to deal with diseases of poverty head on. Simultaneously, there has been a growing concern from private corporations to involve themselves in civil society organizations. The global health initiative is a product of these developments. If implemented properly, we may see a more equitable global health system in the not-distant future. But for this dream to be fulfilled, private corporations and government health agencies need to put in concerted and coordinated efforts based on shared values. In these times of radical change to economic organization of the world, the need to build bridges between medicine and public health and between ethics and human rights become all the more important (Lietz, 2006).

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