Trade%20in%20Health%20Services%20%e2%80%a6%202002%20Woodward

Trade%20in%20Health%20Services%20%e2%80%a6%202002%20Woodward...

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Globalization, global public goods, and health David Woodward, 1 Nick Drager, 1 Robert Beaglehole, 1 and Debra Lipson 1 I NTRODUCTION Globalization is one of the characteristics that define the beginning of the 21 st century. Yet, there is no single agreed definition of what it is, and there are widely divergent views of what it means in terms of its economic and social repercussions, including its impact on health. What is clear is that it is a multidimensional process encompassing economic, social, cultural, political, and technological components, and that it defines much of the environment within which health is determined. This paper focuses on economic globalization, which is a key element of the globalization process as a whole, a major driving force behind it, and a critical determinant of its impact on health. It provides a description of the key linkages between globalization and health, as presented in Woodward et al. ( 1 ), and introduces the concept and possible applications of global public goods for health as a pro-health counterpart to the globalization process. T HE GLOBALIZATION PROCESS Economic globalization encompasses three components connected by an essentially circular relationship. The increasing cross-border flows of goods, services, capital, people, information, and ideas have created pressure for the development of international institutions and rules regulating national policies towards such flows. These, in turn, have contributed to the opening of national borders, thus promoting a further increase in the level of cross- border flows (Figure1). This is a dynamic, evolving process. World trade in goods and services grew by 8.6% per year between 1991 and 1999, 3.3% per year faster than output growth ( 2 ). Both figures represent a marked acceleration from the 1980s. The value of trade in commercial services grew by around 6% per year in the 1980s and 1990s and increased its share in total world trade from 15.6% in 1980 to 18.9%, in 1999 ( 3, 4 ). The nature of financial flows to developing countries was transformed 1 Department of Health in Sustainable Development, World Health Organization, Geneva, Switzerland.
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4 TRADE IN HEALTH SERVICES Health care system Individual health risks Household economy World markets National economy, politics, and society Population-level health influences Health-related sectors Cross-border flows International rules and institutions Opening of economies Globalization Health Figure 1. Impact of globalization on health
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5 Woodward, et al . Globalization during the 1990s ( 5 ). Net loans and grants from official sources including the IMF fell by more than half between 1990 and 2000 and net commercial lending excluding bonds fell almost to zero. Over the same period, foreign direct investment made to acquire or add to a lasting interest in an enterprise, equity investment (in shares), and bond issues increased by factors of 7, 13, and 25, respectively ( 6 ). As a result, the proportion of net financial flows going from the public sector in developed countries to the public sector in developing countries
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This note was uploaded on 02/13/2010 for the course ANT 4930 taught by Professor Young during the Spring '10 term at University of Florida.

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Trade%20in%20Health%20Services%20%e2%80%a6%202002%20Woodward...

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