Globalisation of international health

Lancet. 1998 Feb 7;351(9100):434-7. doi: 10.1016/S0140-6736(97)05546-3.


40 years ago, activities in international health were the domain of WHO, governments (based on bilateral agreements), and non-governmental organisations. This has changed. Today, new players (such as the World Bank and, increasingly, the World Trade Organisation) have an influence on international health. As globalisation of trade and markets takes hold, new coalitions and alliances are forming to examine and deal with the direct and indirect consequences on health. This paper examines the changing context of cooperation in international health, and voices concerns about rising potential inequalities in health, both within and between countries. The question of how such changes will affect the actions of organisations working in international health is also addressed.

PIP: The World Health Organization (WHO) used to be the main directing and coordinating body of international health work. WHO is now, however, just one of many UN organizations concerned with health. The World Bank plays a considerable financial and technical role in the sector, and bilateral agencies contribute significantly to health at both the global and national levels. The private sector is also deeply involved in international health. With regard to foreign aid, about US$55 billion was disbursed in 1996 in bilateral aid compared to only about US$5 billion through the UN system. As the globalization of trade and markets occurs, new coalitions and alliances are being formed to examine and address the direct and indirect consequences upon health. The author considers the changing context of cooperation in international health and how growing inequalities in health both within and between countries will affect the actions of organizations working in the field.

MeSH terms

  • Global Health*
  • Health Priorities
  • Humans
  • International Agencies / organization & administration*
  • International Cooperation*
  • United Nations
  • World Health Organization / organization & administration*