2.Influence of world politics and economics on global health: Analysis of five major cases
Journal of International Health 2011;26(1):1-9
Until recently, many global health policies and programs were developed and transformed under the influence of world politics and economics. One example is the primary health care strategy established in a political and social context to enhance the sovereignty and human rights of developing countries. However, the initial ideal had to be abandoned after implementation of the structural adjustment policy derived from the context of growing neoclassical economics. The Integrated Management of Childhood Illness (IMCI) policy was developed entirely based on economical reviews the World Bank initiated. Childhood malnutrition in developing countries remains unresolved due to the politically unequal distribution of food and the strategic selling pressures of multinational food companies. The universal access policy of anti-retrovirus drugs for HIV infection has been impeded by the economical battle for intellectual property rights for the manufacturing and purchasing of these drugs. The World Health Organization's Framework Convention on Tobacco Control was enacted against the marketing strategies of multinational tobacco companies. This paper aims to measure the effects of the intentions of international financing organizations and multinational businesses on the development of global health policies and to discuss the challenges for global health under them.
4.A review of universality and convergence in the 2030 Agenda for Sustainable Development
Motoyuki Yuasa ; Megumi Kaneko ; Sumire Anzai
Journal of International Health 2017;32(1):17-26
In September 2015, the United Nations General Assembly’s adoption of the Sustainable Development Goals (SDGs), in place of the Millennium Development Goals (MDGs), constituted a historical landmark. Previously, developed nations provided developing nations with substantial aid for the implementation of the MDGs that entailed measurable and limited targets. Among these targets, health was prioritized, accounting for 28.6% of the total targets. The new SDGs, by contrast, entail 17 goals and 169 targets that apply not just to developing nations, but also to developed nations. The proportion of health targets (7.7%) in the SDGs, being a quarter of that in the MDGs, appears to indicate lower prioritization of health. However, health remains central for the achievement of the SDGs, given a total of 23 health-related targets associated with other goals such as no poverty, nutrition, and sanitation. Additionally, a “Health in all Policies” approach can be likely adopted for the SDGs to facilitate the implementation of effective interventions for improving social, environmental, and economical determinants of health. Decision makers may find it difficult to comprehend the objectives of the SDGs because of their ‘universality’ and obscure focus in relation to sustainable development targets. This paper presents concepts and approaches aimed at fostering ‘convergence’ to overcome these deficiencies. Health-related examples of convergence include ‘universal health coverage (UHC)’ and ‘gland convergence (GC)’. A myriad of stakeholders, with contrasting opinions and ideas, participated in the SDG formulation process. This has resulted in the inclusion of diverse contemporary health issues that are socially significant such as non-communicable diseases, mental health, substance abuse, and road traffic accidents. Competing specialists’ claims that prioritize particular diseases, saying “my disease is more important than your disease”, have probably contributed to the diversity of SDG targets. UHC and GC will play crucial roles in the future realization of the SDGs.
5.Recent world activities for health system strengthening
Motoyuki YUASA ; Chiaki MIYOSHI ; Eiji MARUI
Journal of International Health 2009;24(4):309-315
Background
In recent global health developments, attention has focused on health system strengthening (HSS). Behind this move is the realization that HSS is essential for the development of sustainable and effective health care activities required to meet UN Millennium Development Goals and eradicate poverty. Since the publication of the World Health Report (WHR) 2000, the World Health Organization (WHO) has made intensive efforts to promote HSS.
Progress
This paper descibes recent global activities for HSS, based on official WHO documents and related issues, along with the following three phases: publication of the WHR 2000, follow up of feedback on the WHR 2000, and global trends for HSS after publication of the WHR 2003. In particular, we shall clarify progress made after the year 2003 with regards to policy, implementation, and scientific methodology. For policy, the principle of Primary Health Care has been introduced to HSS, and the participation of international agencies has been promoted. With regards to practice, training a health care workforce and financial assistance from global funds are addressed. Finally, for scientific methodology, we refer to instances such as the development of the WHO framework for health systems, the promotion of evidence-based health research, and strengthening of health information systems.
Conclusion
To make vertical health care programmes for acute care, infectious diseases and chronic illnesse etc. more effective, HSS as the lateral foundation is an urgent global health care issue. It is surely necessary that Japan's basic strategy for supporting HSS is clarified as well as attempts to introduce concrete components for HSS into bilateral cooperation and NGO programmes.
6.Global health in the context of world politics/economics and development
Motoyuki YUASA ; Marika NOMURA ; Eiji MARUI
Journal of International Health 2010;25(1):1-10
Global health policies and strategies are influenced by world politics/economics and development. Thus, a clear and accurate understanding of global health requires proper knowledge of the history of world politics and economics. Since the end of World War II, world politics and economics have dramatically changed through the cold war era to the multipolar age. Meanwhile, the direction in which developing countries have progressed has been determined by select international financial organizations such as the International Monetary Fund and the World Bank in accordance with the policy of the USA Presidency.
This paper reviews the history of global health policies and strategies in the context of world politics and economics as well as world development.
7.Application of Health Promotion Strategy to International Health Cooperation of Japan
Motoyuki YUASA ; Junko CHUMA ; Harumi ROYAMA ; Seiki TATENO
Journal of International Health 2007;22(3):127-132
Health is heavily influenced by behavioral, social and environmental determinants as well as the biomedical characteristics of individuals. The World Health Organization announced the Health Promotion Charter in Ottawa, Canada in 1986 as a strategy to enable people to have control over and improve these health determinants. This is therefore essential to prevent disease and illness due to risky behavior as well as unsound social and natural environments. Whereas all developing countries have numerous health issues regarding behavior and environment, they need the Health Promotion strategy. Japan has so far implemented a lot of programs of health education and environment improvement to control over such determinants. Thus, Japan should promote and disseminate the Health Promotion project more in international health cooperation through official development assistance for developing countries.
8.Application of the child-to-child strategy to change health awareness and behavior among school children and community dwellers in Sri Lanka
Hiroshi Kobayashi ; Motoyuki Yuasa ; Tetsuya Mizoue ; Diyanath Samarasinghe
Journal of International Health 2011;26(4):315-321
Introduction
Recently, the increasing prevalence of chronic and lifestyle-related diseases has become the most crucial global health issue, even in low- and middle-income countries. However, current health systems are often unable to address the large burden of such diseases because of their poor capacity. In Sri Lanka, a country facing such issues, we implemented a school initiative project, the effect of which expanded beyond the school to the student's family as well as the local community. The project was aimed at prevention of chronic and lifestyle-related diseases among adults through school children's activities.
Activities
Major interventions such as workshops and regular publication of newsletters including the results of the workshops were implemented at four selected primary and secondary schools in the Southern Province of Sri Lanka. The newsletters the children brought home facilitated their communication with the parents regarding health issues. All the schools conducted health camps, which children planned and managed themselves, and incentive funds were offered to support the children's activities.
Results
Through discussion and learning at the workshops, children's self-confidence and self-reliance might be enhanced, particularly in regard to developing their health literacy. The health camps and incentive funds helped promote children's autonomy and capability. The attendance rate of the students at the four schools has increased since the inception of the project, while a questionnaire survey showed that the proportion of parents who smoked has decreased.
Conclusion
The trial suggested that school children have the potential not only to improve their own health but also to help their parents and the broader community adopt a healthier lifestyle. Application of the child-to-child strategy may be useful to deal with chronic and lifestyle-related diseases of adulthood as it expands to the child-to-parents and the child-to-community approach.
9.A Health Promoting Schools (HPS) program among primary and secondary school children in Southern Province, Sri Lanka: A qualitative study on the program’s effects on the school children, parents, and teachers
Motoyuki Yuasa ; Yoshihisa Shirayama ; Mika Kigawa ; Iresh Chaturanga ; Tetsuya Mizoue ; Hiroshi Kobayashi
Journal of International Health 2015;30(2):93-101
A Health Promoting Schools (HPS) program was conducted among primary and secondary school children in Southern Province, Sri Lanka. The HPS program included implementation of health education and workshops, as well as publication of school newsletters that communicated the material the children discussed and learned in school to their families. The study aimed to determine whether the HPS program had any effects on the health of the school children, their parents and teachers.
A total of 22 adults (nine parents, nine school teachers, and four school principals) were invited for in-depth individual interviews and reported their views on changes after the implementation of the project. The interviewees reported that the school children substantially improved their behaviors regarding dietary habits, basic hygiene, lifestyle, and exercise. They also expressed that the school environment improved. They indicated direct and indirect changes in their own awareness and attitudes, as well as in other family members.
After the implementation of the HPS program, improved health behaviors and subsequent improved health across two generations were observed. Beyond providing students with health knowledge, more emphasis on motivating children to spread their health knowledge in their communities will make a more effective health intervention.
10.Reconsideration and definition on the concept “Public Private Partnership” in the field of international health
Motoyuki YUASA ; Yoshihisa SHIRAYAMA ; Ryoko NISHIDA ; Tsutomu KITAJIMA
Journal of International Health 2018;33(1):27-34
Objectives Recently, a Public Private Partnership (PPP) has drawn attention as an efficient strategy to response toward increasing different needs for health in low-income and middle-income countries under tremendously growing private sectors and restricted public finance. Neveretheless, in the society of international health development, there is no commonly acceptable definition of PPP. To make the targets and purpose of the PPP clear, the study attempted to define the PPP, reconsidering the relationship among five concepts, which have been recently used to solve social issues, such as BOP business, social business, Corporate Social Responsibility (CSR), and Creating Shared Values (CSV) as well as PPP.Methods We conducted scrutiny of definitions of PPP in other literatures using bibliographic retrieval and associated PPP with the other four concepts in order to attempt to define PPP.Results and conclusion We analysed the contents and relationship of the five concepts. Thus, the PPP can be defined as a process in which public and private sectors collaborate to aim to solve a social issue, not only to reply to societal expectation but also to achieve company growth.