4/2/2019
1
HEALTH AND GLOBAL JUSTICE
The scope of the problem
• We were discussing global inequality in the context of basic
rights
• It is obvious that having lower SES seriously undermines the
ability of people to address these basic rights
o Life expectancy in Swaziland is half that in Japan (People Facts and Figures:
Life Expectancy 2005).
o A child born in Angola has seventy-three times as great a chance of dying
before age five as a child born in Norway (UNICEF 2000).
o The likelihood of dying during childbirth in southern sub-Saharan Africa is 100
times higher than in an industrialized country (World Health
Organization/UNICEF/UNFPA 2005).
• Again, we can approach the question of health and social
justice by looking at different dimensions:
o Response vs prevention;
o Compatriots vs non-compatriots responsibilities (similar to what we
discussed in migration) BUT
• The global health status would be probably the core
concern
1
2
4/2/2019
2
The scope of the problem
• When we look at global health We may probably
broadly distinct between the range of health relating
social justice problems due to globalization as:
• Discriminatory practices of global corporations &
intellectual property regimes and
• Global arrangements that limit the likelihood of low
income countries to address health concerns
o “Brain drain” in the field of health care is one of the problems that may be
posing the greatest challenge for social justice
Discriminatory practices
• Discriminatory practices of global corporations: unethical
clinical trials
• India:
o The revenue of drug testing companies has grown from $485 million in 2010-11 to
over $1 billion in 2018
o Revenues of pharmaceutical corporations outsources trials are many times higher
o January 2005 – November 2017, 4,967 people died during the course of drug trials
and research
o Some 20,000-odd people have suffered adverse reactions in such trials
• People have to fight for compensations (The National, Sept.
17, 2018)
• India is an example of the current trend where expensive
and highly regulated in high income countries clinical
countries are outsources to low income countries
• In low income countries clinical trials are often the only
opportunity to access modern medication but
• The trials are usually poorly regulated
3
4
4/2/2019
3
Intellectual property regimes
• Intellectual property regimes:
• Approximately 1.6 million Africans died of malaria,
tuberculosis and HIV-related illnesses in 2015.
• Globally, 50% of children under five who die of
pneumonia, diarrhoea, measles, HIV, tuberculosis and
malaria are in Africa (WHO)
• One of the central problems is lack of medication:
o For example, in some parts of Zimbabwe some nurses
give painkillers to sick patients as a “treat-all drug”
• Less than 2% of drugs consumed in Africa are
produced on the continent
Intellectual property regimes
• Constraining factors:
o The Trade Related Aspects of Intellectual Property Rights (TRIPS)
regulation of the World Trade Organization (WTO),
o in force since 1986,
o curtails the right of companies to manufacture generic drugs,
forcing countries to rely on brand-name products.
• The cost of advanced HIV/AIDS medication could be
same as in high income countries (clinical trials are
often done in low income countries)
5
6
4/2/2019
4
Brain drain problem
• We discussed this problem when we were talking about
migration in general
• What happens in the field of health care?
• High income countries vs. low income countries:
• Migration of health care professionals happens in both
high income countries & low income countries
• The social justice concerns are about the implications
• Less severe in high income countries:
o a) more or less working system already exists, and
o b) the number of professionals who remain in the country is more or less
sufficient.
• This is not the case in low income countries, therefore,
negative effect of brain drain is much more pronounced
in low income countries.
Brain drain problem
• Africa (with high health needs and problems): some 23,000
qualified academic professionals emigrate annually.
• Zambia: out of 600 doctors trained in the country since
independence only 50 remained in the country (Bundred and
Levitt 2000: 245–6).
• South Africa: between a third to a half of medical schools
graduates emigrate to high income countries
o “The loss of nurses has been even more extreme – for example, more than 150,000
Filipino nurses and 18,000 Zimbabwean nurses work abroad. A recent report from the
United Kingdom estimated that 31% of its doctors and 13% of its nurses are born
overseas […]. These reported figures are likely to be underestimates as many migrate
unofficially. (Pang et al. 2002: 299–300)”
• Annual loss of nurses in some countries is higher than the rate
of training
• For instance, in 2001 Ghana lost 500 nurses twice the number
of trained that year (The World Bank, American Federation of
Teachers 2003).”
7
8
4/2/2019
5
Brain drain problem
• Cumulative effects:
• Many countries project shortages of health workers
• Yet, effects on sub-Saharan Africa are particularly
adverse:
• Current shortage is about one million health workers
required to meet the Millennium Development Goals by
2015.
• Further loss effects:
• Obvious:
• further loss of health services and decreased levels of
health.
• Less obvious:
• Affected countries can’t utilize available aid – billions of
dollars to address global health problems, such as
HIV/AIDS – due to lack of health care professionals
(British Medical Association 2005).
Brain drain problem
• Reasons for brain drain
• Perception of better economic and professional
opportunities in high income countries
• Aggressive recruitment practices by reps. of high
income countries
o Often recruitment agencies operate on
campuses
9
10
4/2/2019
6
Brain drain problem
• Brain gain phenomenon:
• As we already know we have to use differential approach
towards the issue of brain drain.
• In fact, the effects are country specific.
• For instance, in the Philippines training of nurses for foreign
markets is a strategy in the globalized world
• Trained workers than send remittances back home to support
families, but
• Cases like Filipins are more an exception than a rule
• The effects on vast majority of developing countries is
negative
• African countries are among the most negatively affected:
o “the hemorrhage of health professionals from African
countries is easily the single most serious human resource
problem facing health ministries today” (Sanders et al. 2003).
Distribution of health care
professionals
• From the social justice perspective serious concern is
inequality in the distribution of healthcare professionals
• Current distribution of healthcare professionals:
% of world’s
population
% of world’s health
professionals
Europe and North
America
21% 45% (doctors)
61% (nurses)
Africa 13% 3% (doctors)
5% (nurses)
11
12
4/2/2019
7
Distribution of health care
professionals
# healthcare professionals
per 1,000
Required ratio for basic healthcare provision 2.5
Actual ratio
Europe 10.3
Africa 1.4
# doctors per 1,000 (Sanders et al. 2003)
WHO target 1
Actual ratio
Wealthy countries 2
25 poorest countries .04 (1 per 25,000)
13
Are you busy and do not have time to handle your assignment? Are you scared that your paper will not make the grade? Do you have responsibilities that may hinder you from turning in your assignment on time? Are you tired and can barely handle your assignment? Are your grades inconsistent?
Whichever your reason is, it is valid! You can get professional academic help from our service at affordable rates. We have a team of professional academic writers who can handle all your assignments.
Students barely have time to read. We got you! Have your literature essay or book review written without having the hassle of reading the book. You can get your literature paper custom-written for you by our literature specialists.
Do you struggle with finance? No need to torture yourself if finance is not your cup of tea. You can order your finance paper from our academic writing service and get 100% original work from competent finance experts.
Computer science is a tough subject. Fortunately, our computer science experts are up to the match. No need to stress and have sleepless nights. Our academic writers will tackle all your computer science assignments and deliver them on time. Let us handle all your python, java, ruby, JavaScript, php , C+ assignments!
While psychology may be an interesting subject, you may lack sufficient time to handle your assignments. Don’t despair; by using our academic writing service, you can be assured of perfect grades. Moreover, your grades will be consistent.
Engineering is quite a demanding subject. Students face a lot of pressure and barely have enough time to do what they love to do. Our academic writing service got you covered! Our engineering specialists follow the paper instructions and ensure timely delivery of the paper.
In the nursing course, you may have difficulties with literature reviews, annotated bibliographies, critical essays, and other assignments. Our nursing assignment writers will offer you professional nursing paper help at low prices.
Truth be told, sociology papers can be quite exhausting. Our academic writing service relieves you of fatigue, pressure, and stress. You can relax and have peace of mind as our academic writers handle your sociology assignment.
We take pride in having some of the best business writers in the industry. Our business writers have a lot of experience in the field. They are reliable, and you can be assured of a high-grade paper. They are able to handle business papers of any subject, length, deadline, and difficulty!
We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.
Writing a law essay may prove to be an insurmountable obstacle, especially when you need to know the peculiarities of the legislative framework. Take advantage of our top-notch law specialists and get superb grades and 100% satisfaction.
We have highlighted some of the most popular subjects we handle above. Those are just a tip of the iceberg. We deal in all academic disciplines since our writers are as diverse. They have been drawn from across all disciplines, and orders are assigned to those writers believed to be the best in the field. In a nutshell, there is no task we cannot handle; all you need to do is place your order with us. As long as your instructions are clear, just trust we shall deliver irrespective of the discipline.
Our essay writers are graduates with bachelor's, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.
There is a very low likelihood that you won’t like the paper.
Not at all. All papers are written from scratch. There is no way your tutor or instructor will realize that you did not write the paper yourself. In fact, we recommend using our assignment help services for consistent results.
We check all papers for plagiarism before we submit them. We use powerful plagiarism checking software such as SafeAssign, LopesWrite, and Turnitin. We also upload the plagiarism report so that you can review it. We understand that plagiarism is academic suicide. We would not take the risk of submitting plagiarized work and jeopardize your academic journey. Furthermore, we do not sell or use prewritten papers, and each paper is written from scratch.
You determine when you get the paper by setting the deadline when placing the order. All papers are delivered within the deadline. We are well aware that we operate in a time-sensitive industry. As such, we have laid out strategies to ensure that the client receives the paper on time and they never miss the deadline. We understand that papers that are submitted late have some points deducted. We do not want you to miss any points due to late submission. We work on beating deadlines by huge margins in order to ensure that you have ample time to review the paper before you submit it.
We have a privacy and confidentiality policy that guides our work. We NEVER share any customer information with third parties. Noone will ever know that you used our assignment help services. It’s only between you and us. We are bound by our policies to protect the customer’s identity and information. All your information, such as your names, phone number, email, order information, and so on, are protected. We have robust security systems that ensure that your data is protected. Hacking our systems is close to impossible, and it has never happened.
You fill all the paper instructions in the order form. Make sure you include all the helpful materials so that our academic writers can deliver the perfect paper. It will also help to eliminate unnecessary revisions.
Proceed to pay for the paper so that it can be assigned to one of our expert academic writers. The paper subject is matched with the writer’s area of specialization.
You communicate with the writer and know about the progress of the paper. The client can ask the writer for drafts of the paper. The client can upload extra material and include additional instructions from the lecturer. Receive a paper.
The paper is sent to your email and uploaded to your personal account. You also get a plagiarism report attached to your paper.
GET A PERFECT SCORE!!! 
Delivering a high-quality product at a reasonable price is not enough anymore.
That’s why we have developed 5 beneficial guarantees that will make your experience with our service enjoyable, easy, and safe.
You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.
Read moreEach paper is composed from scratch, according to your instructions. It is then checked by our plagiarism-detection software. There is no gap where plagiarism could squeeze in.
Read moreThanks to our free revisions, there is no way for you to be unsatisfied. We will work on your paper until you are completely happy with the result.
Read moreYour email is safe, as we store it according to international data protection rules. Your bank details are secure, as we use only reliable payment systems.
Read moreBy sending us your money, you buy the service we provide. Check out our terms and conditions if you prefer business talks to be laid out in official language.
Read more