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What are the different types of major players in global health? (6)

1. Domestic public sector
2. Private sector
3. International (bilateral) Agencies
4. NGOs
5. Foundations
6. Corporate funding


What are ministries of health?

They are a part of government that are responsible for health policy and priority setting, including regulations and oversight, and the distribution funding and resources for health ( both domestic and international funds).


What are some issues with ministries of health?

1. Although they may interact with other ministries (e.g. waster and sanitation), their collaboration isn't always strong
2. Head of ministry is a political appointment -> may not have a background in health
-> there can be high turnover


How are healthcare budgets set by ministries?

Budgets are set nationally and the regional district officers will submit requests for funds


What are regions and districts responsible for?

1. Putting together statistics and health info (e.g. rates of immunization etc.)


What are the levels of health centres?

Health Centres
Health Posts


What are health posts?

typically in a village, maintained villager, maybe 2 rooms, focus on preventive services but can also be trained in the management of illnesses


What are the main public sector global health players?

Ministries of health


What types of private sector health care providers exist? (5)

1. Hospitals
2. Clinics
3. Pharmacies
4. Regulated Providers
5. Unregulated providers


What are regulated vs. unregulated providers?

Regulated: Health services that have laws and regulations surrounding them. In most countries this would include doctors with their own clinic, and pharmaceuticals

Unregulated: Health services that aren't managed by regulations. This often occurs when there isn't capacity to regulate. For example, pharmaceuticals are regulated in most countries, but can’t manage, so there ends up being a huge amount of unregulated providers who end up taking over, and can often be better than the regulated e.g. Drug Shops


What are the 2 types of unregulated providers?

1. Copy cats: try to copy what western and local doctors do as much as possible + are often drug vendors
2. Traditional medicine: Not interested in western medicine


What are the United Nations health agencies?

1. WHO - World Health Organization
2. UNICEF - United Nations Children’s Fund
3. UNAIDS - Joint United Nations Program on HIV/AIDS


What is the role of the WHO today?

- No longer has the influence it used to prior to 2000
- influence dropped with the increased interest in global health and the entry of other major organizations (e.g. Bill and Melinda Gates foundation)


What is the WHO's annual budget?

Roughly 1 billion


Roughly how much is spent on global health annually in total?

roughly 38 billions


What are Multilateral Development Banks & Financial Institutions?

Lend or grant money to countries to promote economic and social development – deal with ministries of health and heads of countries


Give an example of 3 Multilateral Development Banks & Financial Institutions

1. World bank: more focused on health systems funding
2. IMF: focused on loans contingent on implementing certain policies which may affect health (e.g. policies promoting the privatization of health care in the 90s that had negative consequences)
3. African Development Bank


What is an issue with Multilateral Development Banks & Financial Institutions?

Ministries of health in low and middle income countries often do not have the capacity to deal with these large sums of money and this can lead to corruption


What are bilateral agencies?

Who do they work with and what are they in involved in?

The development assistance agencies of developed countries (e.g. Global Affairs Canada, the Australian agency for international development)
-> they work directly with low- and middle-income countries to advance economic and social development
-> Involved in advocacy, knowledge generation, financing


What existed before Global Affairs Canada?

We used to have a minister of foreign affairs, international trade, and the Canadian international development agency – conservative government eliminated these and created global affairs Canada


What are foundations?

Philanthropic organizations that will provide funding for a very specific project of interest to them
-> some focused on specific issue
-> some focused on research


How to pharmaceutical companies contribute to global health?

Beyond their normal profit-oriented activities, they sometimes:
Donate drugs to global health programs
Sell antiretroviral drugs for HIV at discounted prices
Sponsor programs to address diseases such as HIV and TB


What are specialized technical organizations?
Give 2 examples

- Assist with planning and carrying out disease surveillance
- Technical assistance for disease control programs

1. Public Health Agency of Canada
2. Centre for Disease Control (CDC)


What are consulting firms?

- For-profit and not-for-profit
- Address a range of issues such as management, economics, financing, and policy
- Particular areas of expertise, such as supply chain management, nutrition, behavior change communications, or social marketing


What is GAVI?

organization who's main aims are to improve the ability of health systems to carry out immunization, raise rates of coverage in low- and middle-income countries, and promote uptake of underused vaccines


WHat is the Global Fund

organization that provides financing and engages in advocacy for HIV, TB, and malaria with a particular interest in scaling up programs for HIV antiretroviral therapy


How much does Canada spend on healthcare (for Canadians) in a year?

250 Billion (and we are only .005% or the world population)


Who spends the most on total health expenditures in low income countries (list in order top 4)

1. Private from domestic sources, i.e. the people themselves (more than half of spending)
2. Public from domestic sources
3. Public from international sources
4. Private from international sources


What is the Muskoka Initiative?

An initiative by Global Affairs Canada that raised pledges from G20 countries of around 5 billion between 2010-2019 to improve Maternal, Newborn and Child Health in low and middle income countries


What is International Development Research Centre (IDRC), Canada?

For more than 40 years, IDRC has actively developed and nurtured the funding partnerships that give developing-country researchers, organizations, and policymakers the tools and resources they need to build knowledge and innovate.

Every year, IDRC manages more than 800 research projects with 600 institutions, and grant about 200 individual awards.

Multi-sectoral approach and must be locally led

Health expenditures relatively minor (