In the un forums civil society has become recognized

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Unformatted text preview: the UN forums, civil society has become recognized as an important body of actors in global policy-making, as seen at the UN Conference for Environment and Development in 1992, and at the International Conference on Population and Development in 1994, where women's organisations were instrumental in shaping the Programme of Action. Regarding health matters, the not-forprofit sectors of the civil society have played an important role for much longer, most notably in the debates concerning essential drugs, breast milk substitutes, and weaning foods in the 1970s and 1980s. [11]. More recently the public health NGOs have been important, for example, in shaping pharmaceutical policies and emphasising the needs and rights of HIV-infected people. The emergence of new global health policy actors – as a result of new global legally independent public-private Page 1 of 5 (page number not for citation purposes) Globalization and Health 2005, 1:6 entities such as the Global Alliance for Vaccines and Immunizations (GAVI), the Global Fund to Fight AIDS, Malaria and Tuberculosis (GFATM) and the Global Alliance for Improved Nutrition (GAIN) – to address selected health issues at the turn of the century has further diversified the global health policy scene. Furthermore, new challenges in health research have been defined under the public-private partnership umbrella of the Global Forum for Health Research. Development aid to health has continued to grow substantially since 1992 despite the fall in total official development assistance (ODA) since that time. The USA provides about one third of the total bilateral aid to health. Other bilateral donors are substantially smaller. The multilateral agencies provide one third of the total official development assistance to health and of that assistance 80% comes from the International Development Association (IDA) [12]. As a new funding source, the Global Health programme of the Bill and Melinda Gates Foundation (BMGF) has become not only significant in size, but also in setting health policy. The funding from the USA, IDA and the BMGF are of about the same order. The US role in global health policy setting has increased in the 1990s. [13] Traditionally the US AID emphases have been on fostering goals such as privatization and economic liberation, and on ties to US exports and technical assistance [14]. During the past decade, the USA has been active in lifting global health issues in new forums, such as the G8. The USA was also instrumental in the creation of the GFATM, towards which the EU, for instance, was initially more critical. According to Kagan [15], the US foreign policy is less inclined to act through international institutions such as the UN and less inclined to work cooperatively with other nations to pursue common goals, while the European foreign policy emphasis is on multilateralism over unilateralism. T...
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