The Global in Global Health is Not a Given

Abstract

Abstract. The process of globalization is commonly espoused as a means for promoting global health. Efforts to "go global" can, however, easily go awry as a result of lack of attention to local social, economic, and political contexts and/or as a result of commercial and political imperatives that allow local populations to be exploited. Critical analysis of the processes of globalization is necessary to better understand the local particularities of global projects and confront challenges more transparently. We illustrate the potential adverse impacts of globalization in the global health setting, through examination of international tuberculosis control, global mental health, and the establishment of transnational biobank networks.

Parenting Programs for Underserved Populations in Low- and Middle-Income Countries: Issues of Scientific Integrity and Social Justice

“…Global health can be defined as a set of initiatives that promote the scale up of evidence based interventions to improve the quality of service delivery of mental health services, particularly in LMICs (bayetti & Jain, 2017;Jain & Orr, 2016;White, Gregg, Batten, Hayes, & Kasujja, 2017). The initiatives to expand global mental health care delivery are based on the moral and ethical assumptions that anyone should receive attention and care, regardless of their social determinants of health, including location (Kirmayer & Pedersen, 2014;Mason, Kerridge, & Lipworth, 2017;Patel, 2014), and much progress have been made towards improving the mental health care delivery globally (Patel, Boyce, Collins, Saxena, & Horton, 2011). However, as the field of global mental health grows, it has also been met with a number of critiques and challenges (Bayetti & Jain, 2017;Whitley, 2015).…”

“…As Mason and colleagues (Mason, Jerridge, & Lipowroth, 2017) state: "some of these efforts potentially obscure the social, economic, and political histories of the locations where projects are implemented, as well as the plurality of knowledge and values within and across communities." (Mason et al, 2017).…”

Epidemiology, Outcomes, and Risk Factors for Mortality in Critically Ill Women Admitted to an Obstetric High-Dependency Unit in Sierra Leone

“…23 Although a consensus on obstetric critical care admission criteria would be helpful, this is difficult to define because these are heavily influenced by the conditions of the single institution and country. 24 Specific causes of HDU admission are comparable with other cohorts, 17,19,20,25,26 with hemorrhage (both APH and PPH), severe PE, and sepsis representing the most significant burden. Of note, UR as a reason for critical care referral significantly affected this cohort in Sierra Leone, with one in 10 patients admitted with this potentially fatal condition.…”

Preventive Therapy for Multidrug Resistant Latent Tuberculosis Infection: An Ethical Imperative with Ethical Barriers to Implementation?

“…As clinical research has become more global, bringing with it a requirement to obtain consent in different places where many disparate values are held, the obtaining of valid consent increasingly raises a range of challenges. Consent practices in resource-limited settings may be impacted by time constraints for researchers to provide detailed research information, the lack of familiarity with medical research, traditionally paternalistic doctor-patient power dynamics and communication styles, involvement of family members and community members in the decision making process, conflict of duty of healthcare provider acting as researcher (Cheah and Parker 2014;Nguyen 2016), not to mention the significant cultural dimensions involved in adapting (and asserting) this research practice in settings where it is a foreign concept (Mason et al 2017). Suffice to say that obtaining consent in research on LTBI treatment presents complex issues posed by its research context and clinical practice in addition to the complexities of explaining LTBI to a naïve audience.…”