Global health

02.08.2024: Faster and farther towards the abyss: global health accelerators instead of tangible changes

Against the backdrop of the rather modest results of the most recent Conference of the Parties COP 28 held in Dubai, the worrying vaccine nationalism of high-income countries during the COVID-19 pandemic, and the ongoing blockade of the United Nations Framework Convention on International Tax Cooperation by the same countries, it is much more likely that the various accelerators will fail to achieve their goals in a timely manner. The ubiquitous proliferation of accelerators runs the risk of being nothing more than another fashionable trend masquerading as actionism, while once again ignoring the root causes and leaving the upstream drivers untouched. Until this is overcome, the current emergence of accelerators in global health and beyond is unlikely to bring about tangible change and innovative approaches to addressing systemic challenges in global health.

Jens Holst

05.06.2024: JGPOH – a new kid on the block

Guest editorial

Quite a few people will wonder why another journal in the broad field of health is needed. Since the end of 2023, the Journal of Global, Public and One Health (JGPOH) released by the German-based publisher Hans Jacobs has been expanding the wide range of publications dedicated to the topic of health. In view of the increasing fragmentation and siloing, the JGPOH attempts a balancing act between three different areas of discussion that have emerged in the theory and practice of health. There is now an almost unmanageable number of health domains, such as public, international, global, urban, public global, global urban, planetary as well as One Health and most recently brain health. All of these sub- and specialty areas of health focus on a specific health-related issue and strive for independence and demarcation, which has often led to some siloing. But basically, all of these sub- and super-specialisations are always about the same thing, namely to get health out of the disease corner and to anchor it as a (whole) societal challenge. Against the background of this fundamental commonality, the name of the Journal of Global, Public and One Health reflects the thematic focus of these three currently most important approaches to health and health policy. The title also indicates that the editors wish to emphasise the common ground and help overcome the separation of these interrelated disciplines.

Jens Holst

25.03.2024: Gesundheit ohne Grenzen

Krankheiten und ihre Ursachen überschreiten Ländergrenzen – das hat nicht zuletzt die Corona-Pandemie gezeigt. Beim Schutz der Gesundheit ist daher weltweite Zusammenarbeit gefragt. Deutschland spielt in diesem komplexen Geflecht eine wichtige Rolle. Wie stark die globale Gesundheitspolitik aber von Machtverhältnissen und nationalen Egoismen geprägt und der Instrumentalisierung für wirtschaftliche und politische Interessen ausgesetzt ist, zeigte das Gefeilsche um Impfstoffe in der Covid-19-Krise. Auch das deutsche Global-Health-Engagement stößt an Grenzen, wenn die bundesregierung gemeinsam mit anderen Industrieländern die Patentfreigabe für Corona-Impfstoffe und -Medikamente blockiert und damit den Gewinnen der Hersteller Vorrang vor globalem Gesundheitsschutz einräumt.

Jens Holst

09.03.2024: Sacrificing globalism on the altar of decolonization

Rapid response

In January 2024, BMJ Global Health published another attempt to redefine 'global health' with the aim of filling the term with 'greater clarity and precision' in a pragmatic and more inclusive sense. The authors intend '‘to offload colonial vestiges present within the field and terminology of ‘global health’. Their argument, however, turns out to be alarmingly unconvincing and narrow. It is based on data from a single country and, worse still, the field of humanitarian aid. Moreover, the authors reduce global health to health care and healthcare systems, neglecting the social, environmental, political and commercial determination of health, as well as inequalities and power imbalances between and within countries.

Jens Holst

21.02.2024: Salud Global: ¿Cuál es el desafío?

La salud global ocupa actualmente un lugar destacado en la agenda política internacional y desempeña un papel importante en las cumbres de foros internacionales como el Grupo de los 7 (G7) y el Grupo de los 20 (G20). Desde el punto de vista de las ciencias de la salud y la política sanitaria, la creciente importancia política de la salud mundial y su consideración en la escena internacional hace tiempo que deberían haberse producido. Sin embargo, el concepto actual de la salud mundial adolece de una serie de limitaciones conceptuales, ya que el alcance y el contenido del debate no suelen estar a la altura de la complejidad de los retos. Esto contradice en cierto modo la evolución que ha hecho de la salud global convirtiéndose en un importante tema transversal. Es alentador que en los últimos años el contexto global de la salud haya pasado cada vez más a un primer plano. Sin embargo, esto requiere un enfoque de derechos humanos que considere la salud no como un "modelo de negocio" rentable, sino como una aspiración de todo ser humano. La salud mundial también debe abordar las raíces y principales causas del empobrecimiento del Sur global, a saber, el colonialismo, un orden económico orientado a la maximización del beneficio a corto plazo y, en particular, la explotación ecológica de los recursos naturales. Una política sanitaria mundial responsable debe abordar realmente los problemas existentes y no limitarse a restablecer las condiciones que condujeron a la crisis sanitaria mundial y planetaria.

Jens Holst

20.02.2024: Global Health - What is the challenge?

Global health is currently high on the international political agenda and plays an important role at summits of international fora such as the Group of 7 (G7) and the Group of 20 (G20). From the perspective of health science and health policy, the growing political importance of global health and its consideration on the international stage is long overdue. However, the current understanding of global health suffers from a number of conceptual limitations, as the scope and content of the debate is often not commensurate with the complexity of the challenges. The dominant global health discourse often fails to live up to the claim to universalism implicit in the term 'global'. In contrast, global health policy has become an important and complex cross-cutting issue and task. It is encouraging that in recent years the global context of health has increasingly come to the fore. However, this requires a human rights approach that sees health not as a profitable "business model", but as an aspiration of every human being. Global health must also address the roots and underlying causes of the impoverishment of the global South, namely colonialism, an economic order geared to short-term profit maximisation and in particular the ecological exploitation of natural resources. Responsible global health policy must actually address existing problems and not be limited to restoring the conditions that led to the global and planetary health crisis.

Jens Holst

03.08.2023: Distracted and captured by decolonialism

Reply to the critique of Holst, van de Pas & Tinnemann: The Virchow Prize: cementing commodification, coloniality and biomedical reductionism in global health?

Criticising manstream developments is always uncomfortable. The Virchow Prize for Global Health should be such a nice event to celebrate at the Global Health Summit in Berlin. The contradictions between the awarding foundation and prevailing trends in global health, on the one hand, and the legacy of its namesake on the other, are all too easily overlooked. And when someone points this out, as Holst, van de Pas and Tinnemann did in BMJ Global Health in April 2023, they have to be caught in the crossfire. And what better way to do that than to accuse them of anti-decolonisation? In his rebuttal, "Distracted and captured by decolonialism", Jens Holst debunks the criticism of his critique and points out blind spots in the decolonisation debate.

Jens Holst

03.05.2023: The Virchow Prize

Cementing commodification, coloniality and biomedical reductionism in global health?

In the tradition of Rudolf Virchow, any foundation using his name should safeguard his legacy. Taking Virchow seriously will require that future Prize winners (including especially groups, movements and organisations) are predominantly entities with outstanding contributions related to the social aspects of global health, fostering a comprehensive, universal, contextualised and just approach within the remits of the right to health. The first iteration of the Virchow Prize in October 2022, and especially the equinomous foundation behind it require some scrutiny. Virchow believed in social reform to achieve a constitutional democracy by reducing the power of the monarchy and the nobility. A consistent translation of Virchow’s writings into today’s reality would ultimately suggest reducing the power of the financial aristocracy and its philanthropic organisations, which are increasingly dominating global health. Jens Holst, Remco van de Pas and Peter Tinnemann published their critical appraisal of the Virchow Prize in the BMJ Global Health 2023;8:e011240. doi:10.1136/bmjgh-2022-011240.

Jens Holst

18.03.2023: The biomedical securitization of global health

The COVID-19 outbreak has highlighted the continuing menace to humanity of global health issues that had been suppressed and considered under control, at least in the Global North. The massive warfare activities in Ukraine in the third year of the pandemic have reawakened the sense of threat particularly in Europe. Both the pandemic and the war, as well as the escalating climate crisis, have made global insecurity more tangible. The existing and likely crises caused by these unfortunate occurrences – mass displacement, increasing prices for products of basic needs such as food and energy, and the overall severe impact on global economy—will burden people in low-income countries most but not at all exclusively. Especially the fatal effects on future generations understandably reinforce the desire for a safer world. Enhanced security is needed in times of growing uncertainty, threatened ancestral rights and dwindling opportunities for a large part of mankind. The current global order has therefore been aptly described as a world risk society. Even if this need for security is comprehensible, the nature of the security discourse in global health and beyond raises fundamental questions and concerns.

Jens Holst & Remco van de Pas

10.10.2022: Viral Neoliberalism: The Road to Herd Immunity Still A Rocky One

The almost ubiquitous spread of neoliberalism has contributed to shifting the prevailing economic system from one of coordinated market capitalism. Neoliberalism is commonly considered an economic theory but is a rather toxic ideology. The pandemic caused by the neoliberalism virus has been and is actually a public health challenge in itself. The neoliberalism virus has proven to be extremely efficient in both manipulating individuals and societies and blurring analytics. The virus has a double stranglehold on a large part of the media, in terms of both content and the economic framework conditions. Viral neoliberalism has been very successful in concealing the contradiction between economic liberalization and the extension of free markets on the one hand, and the growth in market power and dominance of corporate entities and monopolies on the other.15 In fact, under the rules of the game set by neoliberal strategists, pre-existing inequalities have increased and new ones emerged. This is not at all surprising as the "free play of market forces" did not take place in a space free of domination. Evidence shows that neoliberal reform approaches in the health sector tend to have negative impacts on key global health issues such as equity and fairness.The inequitable global distribution of COVID-19 vaccines has highlighted with unusual clarity the extent to which the symptoms of the neoliberal virus are shaping today's world. While overall global wealth has significantly grownthe socioeconomic gap between and within countries has widened.The inequitable and undemocratic nature of the current economic system is unsustainable because it endangers the planet's possibilities for supporting and reproducing life. To enable sustainable living, it is ultimately inevitable to impose political limits on corporate power, because even broader and stronger mass protest movements will be unavailing as long as governments refrain from tackling and shackling the corporate miscreants.

Jens Holst