Global Actors and Health Policies - Essay Example

? Global Actors and Health Policies Global Actors and Health Policies Malawi has a high HIV prevalence rate compared to most countries in Africa. It is the leading cause of death among the people within the reproductive age. In the urban areas, HIV prevalence is almost twice than in rural areas. High rural-urban migration has increased the transmission of the virus. The country has several mobile workers such as truck drivers, migrants, refugees, and sex workers who are the most vulnerable people (UNAIDS, 2001). The government established the National AIDS commission to facilitate cost-effective, high-quality, and accessible counseling and testing. The commission also ensures routine testing for pregnant women to reduce the rate of transmission. The commission oversees the distribution of antiretroviral therapy drugs. This program has been rolled out nationwide at a subsidized price. Patients eligible for ART must be HIV-seropositive, understand the implications, fall under WHO clinical stage 4, 3 and 2, and have less than 250/mm3 of CD4 lymphocyte (Kartikeyan, 2007). The world Health Organization is one of the global actors in antiretroviral therapy eligibility. The patients have to fall under clinical stages 4, 3, and 2. Stage 2 defines people with respiratory tract infections, Herpes, angular cheilitis, oral ulcers, seborrhea dermatitis, and unexplained weight loss. Stage three defines people with tuberculosis, oral leukoplakia, persistent fever, anaemia, severe bacterial infections, gingivitis, severe weight loss and many more. Stage four contains people with extrapulmonary TB, HIV encephalopathy, Kaposi’s sarcoma, isosporiasis etc. the government makes the guidelines for ART eligibility based on these clinical stages. These guidelines help the patients to access antiretroviral drugs at an early stage. Another actor in fighting HIV is Medicans Sans Fronieres (MSF). This is an international body that delivers emergency medical aid to people unable to access health care, affected by war, and natural disasters. In Malawi, it began its operations in 1995. It launched a program to provide HIV/AIDS treatment. The first effort was to provide treatment for opportunistic diseases in Mwanza and Chirardzulu. In 2001, it started providing antiretroviral drugs to Malawi nationals. The ministry of health had to organize for decentralized health care by workers from Chirardzulu hospitals to regional health centers. By 2011, the program had about 27,000 patients with about 18,000 of them taking ARVs. The program admits about 650 people every month. Context A global actor is an organization that participates in international activities and has influence on the international system. The actors play different roles in the social system and have more power and influence than individual leaders or groupings (Bretherton and Vogler, 2006). Their continuing activities have impact on interstate relations and their policies affect the framework of policy making in the country. A global actor makes policies, which are then enacted in several countries. The organizations participate in different sectors such as economic and development funding, health, and security measures. An example is the European Union (EU). It is made up of several European countries and provides funding for economic development and health care provision. According to its charter on human rights, every human being requires access to medical treatment and preventive health care. This requires the health policies of any country to operate beyond the national level and achieve strong global support and recognition. In Malawi the European Union contributes to the Global Fund to fight malaria, Tuberculosis, and HIV/AIDS (European Union, 2010). In the recent years many governments have changed their health policies to include standards set by the EU, WHO, UNHCR and other organizations participating in health programs. This makes these organizations global actors. In Malawi and other countries, the criteria for ART access is defined based on the WHO definitions of clinical stages. The organization also monitors health care provision in the country and reports to the international community. The EU participates in several countries under the European Development Fund. The EDF provides funds for agriculture, development projects, and health care provision. For example in 2005, Malawi blood transfusion project. This project aimed at providing blood for transfusion in central and district hospitals in the country. The commission also oversaw the distribution of those funds, and contributions for combating HIV/AIDS in the country. The national health policy is a government plan outlining the efforts aimed at providing a healthy life for all citizens. The government formulates goals and decisions regarding the national healthcare and formulates plans to achieve those goals. These decisions may be short term, to avert or prevent an epidemic, or long term. The policies are based on the circumstances in a particular country. The policy space accumulates effects on the international and national stakeholders. The policy makers have to consider the international integration within the policy space and its effects on the country. The policy must have an agenda that supports health care provision. The government also determines the funding process and other support groups that can participate in the process. Most of the funds come from taxation. The nationals pay taxes and contributions towards health provision. The policy makers may approach international organizations for donations and grants. These organizations may donate food supplements, money, healthcare professional, or engage in health projects. Such organizations include USAID, EU, WHO, and UN organs (Carrin, 2009). In Malawi, the government has put more emphasis on family planning services. The country has a high birth rate. Following the adoption of Malawi growth and development strategy, the government has put more funds on extending family planning services in the country. Less than half of the married women have access to modern family planning methods. Investments into the project come from the government, and private organizations. Such organizations are ministry of finance and planning, family planning association, university of Malawi, and national statistics office (Government of Malawi, 2010). Combating malaria is another part of the health policy. The government funds a program for indoor residual spraying (IRS) to reduce the number of mosquitoes. For example, the USAID funds the process in Nkhotakota district. The ministry of health sprays about 28,000 homes annually in the district. The ministry of health in collaboration with donor agencies provides about 6.6 million malaria doses annually. These drugs are available in government hospitals at a subsidized price (USAID, 2010). The U.S government donated about 26 million dollars for fighting malaria through the President’s Malaria Initiative (PMI). HIV/AIDS is also a major pandemic in the country. The country has a prevalence of about 14%. Most of the programs have focused on fighting HIV among women and children. The government through the ministry of health has set out funds and plans to fight the pandemic. It supports free voluntary counseling and testing. Antiretroviral drugs are available at a subsidized price in all parts of the country. The U.S government has also provided funds to fight HIV and opportunistic diseases in the country. In 2009, the Malawi government received about 155 million dollars aimed at fighting malaria in the country (MHEN, 2009). Global actors affect the health policy by making laws about health provision, providing funds for health care, and engaging in projects revolving around health provision. The European Union has a charter that entitles all human beings to preventive health care and medical treatment. This charter mostly affects the developing countries. The policy makers of any country have to outline measures and goals for health care provision to attract funding from this organization. The health policy requires funds, which come from global organizations. Malawi receives millions of dollars from EU and USAID to fund malaria and HIV combating projects. These funds hasten the provision of health services. Immunization is vital for children. The world health organization outlines the type and age at which the children should be immunized. These guidelines have to be considered when making the health provision programs. The organization also inspects the effectiveness of these health programs. The government has to ensure the process is effective to attract more support (Knobler, 2006). Non-governmental organizations are also part of the actors involved in health policy making. Partners In Health (PIH) is an NGO in Malawi that supports women empowerment in the country. This organization aims at reducing HIV prevalence among women especially commercial sex workers. Raising Malawi is another NGO involved at improving the conditions of women and children with HIV in the country. Family planning project (FPP) is involved with providing and educating women about modern family planning methods. The agenda setting process involves competing for attention from global organizations. The government has to outline the goals and visions for health provision (Christina, 2007). Preference for programs such as malaria, HIV/AIDS, and tuberculosis fighting has to be stated in the plan. Most global bodies give more support towards these programs. Health care projects targeting women and children also receive preference when it comes to policy making. They receive more recognition by the international community. Resources are allocated depending on the number of affected in the country. In Malawi, millions of people die due to malaria and HIV. The country receives more funds compared to countries like Egypt which has a lower death rate. Global organizations exert power through sanctions and withholding aid. In 2010, the US government withdrew its donations to the Malawian HIV/AIDS project after police killed innocent people. The government responded by launching investigations into the killings. These organizations can also lobby for sanctions against a country due to violation of human rights. These power policies deny patients the opportunity to receive medical care. The government may fall short of funds and fail to provide the necessary resources for health provision. However, there are positive results of these sanctions. The policy makers fight issues such as corruption, human right abuse, and uneven allocation of resources. This is aimed at attracting the funds and the patients receive more medical support. The government also expands the health care provision plan to attract more support. Health policies depend on global actors to a great extent. These actors outline the laws and procedure for health provision, which must be followed by policy makers. An organization such as WHO sets the medical categories for patient requiring different medical attention. The government must device a policy that caters for these patients according to the guidelines of WHO. These actors also provide funds for health provision and projects. They make donations for fighting killer diseases such as HIV/AIDS and malaria. The government must have a concrete framework on how to fight these pandemics to attract funds from these organizations. This affects the policy since it has to cater for these guidelines. The policy must also accommodate other actors such as NGOs and community based organizations aimed at providing health services. References Bretherton, C., and Vogler, J. 2006. The European Union As a Global Actor. London: Routledge. Carrin, G. (2009). Health systems policy, finance, and organization. Amsterdam: Academic Press. Christina, P. M. 2007. Policy Analysis and Decision Making: with emphasis on chronic Non- communicable diseases. PAHO/WHO, 1-17. European Union. 2010. The EU role in Global Health. Communication from the health commission to the council, the European parliament, the European economic and social committee and the committee of the regions. Government of Malawi. 2010. RAPID population and development. Ministry of Development and cooperation. Available at http://www.healthpolicyinitiative.com/Publications/Documents/1065_1_Malawi_booklet_2_23_10_singlepg_acc.pdf. [accessed on June 7, 2012]. Kartikeyan, S. (2007). HIV and AIDS: Basic elements and priorities. Dordrecht: Springer. Knobler, S. (2006). The impact of globalization on infectious disease emergence and control: Exploring the consequences and opportunities : workshop summary. Washington, DC: National Academies Press. MHEN. 2009. Financing Malawi’s Health Service: A policy Brief based on Malawi Health Equity Network’s 2009/2010 Health Budget Analysis Report. Malawi Health Equity Network. UNAIDS Secretariat., Malawi., & Malawi. (2001). The HIV/AIDS epidemic in Malawi: The situation and the response. Lilongwe?: UNAIDS. USAID. (2010). Health, Population, and Nutriton. Available at http://www.usaid.gov/mw/programs/hpn.htm. [accessed on June 7, 2012]. Read More