Section: Research Groups
Global Public Health Unit
“I’ve got a plan for health care reform. But we’ve had a plan before, under a Democratic president in the ‘90s and a Democratic Congress. We couldn’t get it done because the drug and insurance companies spent $1 billion over the last decade on lobbying.” - Barack Obama
Health systems, whether in developed or developing countries, are under pressure to ensure universal access to health services while improving the quality of provision and its outcomes. At a time when the scope for increasing expenditure is limited in most countries, the task of allocating an appropriate level of resource for health care is a major policy challenge. In many countries, health system reform centres on cost control, with a focus on slowing the growth of (particularly public) health spending, which is often presented as unsustainable. There is now a renewed effort, supported by trans-national actors such as the World Bank and the International Monetary Fund, to improve health system performance through the creation of more competitive environments among providers and insurers – and a more prominent role for the private sector. Our research programme aims to examine these reform efforts in the developed and developing world, and evaluate their consequences against common system goals such as equity, universality, quality and efficiency.
“Increased integration between peoples in the economic domain has not been balanced by commensurate attention to the wider imperatives of fair social development. For this to happen, the architecture of global governance needs to be reformed and extended – opening its forums of policy-making more equitably to all, and setting at the heart of its concerns the equitable health and well-being of all.” - WHO Commission on the Social Determinants of Health, 2008
Driven by wider developments in the global political economy, health governance is undergoing a dramatic transformation. Transborder health risks associated with globalization can transcend the regulatory capacity of nation states and require global responses. Non-state actors and the commercial sector play increasingly important roles in policy development and health service provision. International health policy is now characterised by remarkable degree of institutional pluralism, as the World Health Organization seeks to fulfil its mandate “to act as the directing and co-ordinating authority on international health work” amid co-operation, competition and conflict with multilateral agencies such as the World Bank and World Trade Organization, global health partnerships like the Global Fund and GAVI, and corporate philanthropy epitomised by the Bill & Melinda Gates Foundation. While health enjoys unprecedented prominence within international relations, limited progress has been made in promoting policy coherence between the protection of health and the promotion of other economic, trade and development objectives.
Research within GPHU examines the challenges and opportunities associated with global change, and analyses key innovations within health governance including the WHO Framework Convention on Tobacco Control and the revised International Health Regulations. Current and recent research by GPHU staff includes:
This page was published on 9 December 2010