The ‘Equity’ in the definition of Global Health

Written by Harriet Mensah

As described in a previous article, global health is a ‘broad concept’. What global health means and looks has changed over the years. It is a reflection of understanding of ‘health’ and the barriers that prevent populations from being in full health. Typically, within global health there is an acknowledgement of the social determinants of health — the conditions people live in that influence our health(1). These determinants are caused by wider structural and social issues. This post aims to highlight why Global Health should consider ways to tackle the wider issues so that health for all as outlined in the Alma-Ata declaration can be achieved(2).

The many re-brands of global health:

‘Global Health’ as we understand it today is a merging of International Health and Public health (3). Public health, as defined by Winslow, was the” science and art of preventing disease, prolonging life and promoting physical and mental health and well-being” (4). International health — an iteration of its colonial predecessor, tropical medicine — was focused on managing health issues in other countries (generally low and middle income countries)(3,5). Global health as a concept overlaps these definitions and forms its own entity. In the early 1990’s, it was used sporadically. By the early 2000s, it became commonplace (5). Yet, it had not been ‘officially’ defined though it was widely understood in the public health and international health community.

There have been several definitions of global health since the 1990’s. Kickbush defined global health as ‘those health issues that transcend national boundaries and governments and call for actions on the global forces that determine the health of people’(6). It is a pretty vague definition. It is unclear about what the final goal of global health would be and how anyone would be able achieving said goal(7).

The most prevailing definition to date was proposed by Kopland et al. — “an area for study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide”. Though broad in focus, it has a clear goal and an action plan(7). Furthermore, indirectly acknowledges that there are inequalities that prevent people achieving their full health potential. Maybe that’s why it works, but it has all the words.