In order to understand the challenges that global governance in health faces, it is essential to define global health itself first. Kickbusch (2006) defines global health as those health issues which exceed national borders and governments and request actions on the global forces and global flows that determine the health. In order to achieve global health new forms of governances at the national and international level are needed. These governances need to include a variety of different actors (Kickbusch, 2006). Global health asks for an acknowledgement of the need to act globally on emerging problems in health, of the importance of cross-border determinants of health and the need for global governance.
The literature suggests three different
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SGH refers to the conditions in which individuals live and work and which influence the likelihood of living a healthy live (Labonté & Schrecker, 2007). Globalization affects SGH by its influence on trade liberalization, economic rearrangement, financial liberalization, the global restructuring of production and labour markets, effects through the physical environment and by changes in health systems made by the global marketplace (Labonté & Schrecker, 2007). It is suggested that trade liberalization positively affects a country’s economic growth, therefore augmenting resources and increase health services and access to other SDH. However, globalization has uneven affects, which are locally isolated (Labonté & Schrecker, 2007). Concerning labor markets and the global organization of production, globalization has led to increased competition, which may decrease a government’s ability to implement labor standards, health and safety regulations and other social policy measures. Furthermore a decline in salary of and demand for low-skilled workers, due to outsourcing, is affecting the deindustrialized, rich countries (Labonté & Schrecker, 2007). Globalization affects natural environments by the increase of demand for marketable resources and ecological services, therefore having a direct impact on the environments health. Finally changes in national health systems are made by the global marketplace. Here transnational institutions as the World Bank have a negative impact on health by promoting market-oriented concepts of health sector reforms, favoring private provision and financing. This leads to an increase of out-of-pocket payments by individuals, making health a private good which is dependent on the free market (Labonté & Schrecker, 2007). Globalization therefore has positive and negative effects on SDH. In order to balance these