7. Health and globalisation
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The complex relationship between globalisation and health occurs via effects of international governance and agreements, globalisation’s impact on economic, social, political and environmental conditions, exposure to health-damaging and health-benefiting commodities and conditions, and access to health care.
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One argument that has been used in support of globalisation and trade liberalisation, deregulation and privatisation is that it will reduce poverty and improve services, and thereby improve health. The evidence for this is weak. Indeed, there is greater inequality between and within countries now than there was twenty years ago. This has raised the question of whether patterns of globalisation have widened health differentials, and has resulted in calls for more pro-poor sustainable development processes, so that development has a positive impact where the health burden is greatest. Concern has also been expressed about the impact of globalisation on the cost of basic services, such as water, and the effects of this on health.
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In the longer term, one needs to ensure that the current pattern of globalisation, that depletes natural resources and increases emissions of industrial toxic substances at an alarming rate, does not bequeath an unsustainable situation to future generations with massive and varied health consequences.
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Although the direct impact is difficult to measure, and some positive effects have been identified, globalisation has had some harmful effects on health, as illustrated in Table 3 below.
| Table 3: Examples of how globalisation can harm health |
- Trade barriers have blocked growth of the economies of poor countries and helped to maintain them as commodity-led exporters, limiting manufacturing growth and domestic enterprise. This has left countries more vulnerable to the full range of diseases of poverty.
- The implications of the use of international trade and intellectual property agreements which are blind to their consequences on the health of people in poor countries has been most explicitly illustrated in the case of drugs for treating HIV / AIDS and other conditions prevalent in the developing world.
- Trade liberalisation, including reduction of excise taxes, has led to increased use of tobacco in low-income countries, with all the concomitant health damage that will occur.
- Erosion of public services has been linked to various consequences of globalisation in some countries. The extent to which this undermines education, supply of utilities and health services will impact negatively on health.
- The “digital divide”, besides its economic impact, blocks access to information beneficial to the health of individuals and communities.
- The high cost of hazardous waste disposal in the developed world has opened the door to widespread unofficial movement of this waste into developing countries, which have poorer safety precautions.
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