Global Health, population health and social determinants
Objectives
After this unit, students should be able to:
1. Understand and explain the importance of the events and determinants that contributed to the progressive “creation” of Global Health and the elements and criteria that can contribute to the description of the present state of Global Health. Know the objectives, functions and contributions of the main institutional actors in the field of GlobalHealth.
2. To know the elements of the Planetary Health approach for its understanding in a transdisciplinary perspective. Reflect on the various implications in the 21st century. Understand the dynamics that lead to the development of the main global health initiatives and understand the objectives and impact of some global initiatives.
3. Review known health determinants and the possibilities to modify them to improve health. Understand the difference between population health and individual health and the implications for influencing public and intersectoral policies in different geographical and political settings. Understand the burden of non-communicable and infectious diseases, evolutionary trends, distribution and main determinants such as the socio-economic-environmental and commercial determinants.
4. Realize the importance of trade treaties as well as the role of diplomacy in the negotiation of rights, for example at the WTO. To be able to develop the main lines of an action and negotiation plan with all the actors, including the forgotten actors of Global Health to modify the great challenges for health in the 21st century.
5. Be able to develop the main lines of a plan for universal coverage in a defined context. Assess the impact on public health actions of new knowledge.
6. Interpret critically and contextually publications on global health, populations and socio-economic-commercial and environmental determinants of health.
General characterization
Code
5789004
Credits
3
Responsible teacher
Thierry Mertens
Hours
Weekly - 15
Total - 30
Teaching language
Portuguese
Prerequisites
Attendance of 2/3 of classes is mandatory
Bibliography
• Global Commission on the social determinants of health: Final report, 2008. http://www.who.int/social_determinants/thecommission/finalreport/en/
• Lang T and Caraher M. Influencing international policy. In Oxford Handbook of Public Health Practice. Pencheon D et al Editors, 2005.
• Rose G. Sick individuals and sick populations. Int J Epidemiol.1985 Mar;14(1):32-8.
• Dye C, Mertens T, Hirnschahll G et al. WHO and the future of disease control programmes. Lancet 2013; Vol. 381, Issue 9864, pp. 413-418.
• Biesma, Regien G., Ruairí Brugha, Andrew Harmer, Aisling Walsh, Neil Spicer, and Gill Walt. “The Effects of Global Health Initiatives on Country Health Systems: A Review of the Evidence from HIV/AIDS Control.” Health Policy and Planning 2009; 24: 239–52. doi:10.1093/heapol/czp025.
• Primary Health Care: Now more than ever. The World Health Report. WHO 2008.
• Kutzin J. Bull World Health Organ 2012; 90: 867–868.
• Health System Financing. The path to Universal Coverage. The World Health Report. WHO 2010.
• Smith RD, Correa C, Oh C. Trade, TRIPS, and pharmaceuticals. Lancet, 2009; 373: 684–91. DOI:10.1016/S0140-6736(08)61779-1 .
• Smith RD, Lee K, Drager N. Trade and health, an agenda for action. Lancet, 2009; 373: 768-773. DOI:10.1016/S0140-6736(08)61780-8.
• Jones KE, Patel NG, Levy MA, Storeygard A, Balk D, Gittleman JL, Daszak P. Global trends in emerging infectious diseases. Nature, 2008 Feb 21;451(7181):990-3. doi: 10.1038/nature06536. PubMed PMID: 18288193.
• Kickbusch. I- The commercial determinants of health. Lancet 2016 (4): 895-6.
• Swinburn BA et al. The global syndemic of obesity, undernutrition, and climate change: The Lancet Commission Report. Lancet 2019.
Teaching method
Seminars, theoretical-practical classes, group work and tutorial guidance.
Evaluation method
The final evaluation of the student will have 2 components:
1. Presentation of a scientific article or a scenario such as describing an intersectoral initiative - Specifically, the capacity for understanding, research, synthesis, communication and critical reflection will be assessed. It will represent 45% of the final grade.
2. Elaboration of a final research paper on one of the themes presented during the seminars and classes, which will represent 55% of the final grade.
Subject matter
Through participatory discussions and public presentations of personal work, develop understanding, explanatory and implementation skills and competences related to:
I. The progressive evolution of global health, from the 14th century trade, through colonialism, to the post-1945 "economic and human development" efforts.
II. The evolving concept of planetary health, with concerns about limited resources.
III. Explore ethical issues in global public health.
IV. Analyze initial efforts to document inequalities in Western Europe in the 19th century and the most recent documentation of its global scale. Explore the current concentration of economic powers on several continents.
V. Describe the evolution of the global health architecture, identifying the various categories of actors. Discuss the objectives and contributions of these actors and reflect on how to facilitate more inclusion / participation.
VI. Understand the differences between individual high-risk approaches and the population and use that understanding in your professional practice.
VII. Summarize the known determinants of health and briefly discuss which ones may be influenced? Discuss the challenges of biotechnology for individual and population health.
VIII. Views on the creation of globalization and global health. Progressive commodification.
IX. Critically analyze the global priority burden of disease, its social, economic, environmental and commercial determinants and the links with health inequities between countries and within countries, and climate change.
X. Identify socio-economic and corporate determinants of some non-communicable diseases.
XI. Understand the concepts of infectious diseases, epidemic, endemicity, strength of infection, emerging diseases and diseases with pandemic potential, trends, distribution and factors that determine the global weight of infectious diseases.
XII. Recognize new and emerging diseases, their causes, evolution over time, space and access points and become familiar with the factors used to prioritize emerging diseases and understand the different stages and actions of risk management.
XIII. Recognize the threat of antimicrobial resistance (RAM) and develop a plan.
XIV. Discuss the challenges of transdisciplinary action research and intersectoral coordination for effective public health responses on several continents; explain the need to develop legal, financial, environmental, diplomatic skills and knowledge.
XV. Design the main stages of universal health coverage (UHC). Understanding the challenges of health services and human resources in the context of UHC.
XVI. Explore the time horizon and the challenges of social change, using concrete examples.
XVII. Critically analyze the institutional scenario and the challenges of implementing the MDG-SDGs, global health interventions and bilateral cooperation and national challenges in countries.
XVIII. Address selected methodological and ethical aspects in conducting global health research or implementation projects.