Abstract
We are challenged to develop a public health approach that responds to the globalized world. The present global health crisis is not primarily one of disease, but of governance: its key characteristic is a weakening of public policy and interstate mechanisms as a consequence of global restructuring. The response needs to focus on the political determinants of health, in particular on mechanisms that help ensure the global public goods that are required for a more equitable and secure development. A first step in this direction would be to take up the proposal from the recent 6th Global Conference on Health Promotion to explore the possibility of a new type of global health treaty which would help to establish the new parameters of global health governance. National public health associations should take the lead to establish health as a global public good and organize “National Global Health Summits” to discuss the possible mechanisms for the necessary political process. This means putting global health governance issues onto the agenda of other sectors such as foreign policy, as health is critical not only for poverty reduction but for human security as a whole.
Résumé
Nous avons un défi à relever: celui de concevoir une démarche de santé publique adaptée à la mondialisation. La crise actuelle de la santé à l’échelle mondiale n’est pas principalement liée aux maladies, mais aux lacunes de la gouvernance; ses grandes caractéristiques sont l’affaiblissement des politiques gouvernementales et des mécanismes inter-étatiques en raison de la restructuration planétaire. Nos interventions doivent donc porter sur les déterminants politiques de la santé, tout particulièrement sur les mécanismes qui aideront à préserver les biens publics mondiaux nécessaires à un développement sûr et équitable. Récemment, les délégués à la 6e Conférence mondiale sur la promotion de la santé ont proposé un traité « nouveau genre » qui établirait les nouveaux paramètres de la gouvernance mondiale de la santé. Reprendre cette proposition serait un pas dans la bonne direction. Les associations nationales pour la santé publique doivent prêcher l’exemple en présentant la santé comme un bien public mondial et en organisant des « sommets nationaux sur la santé mondiale » pour discuter des mécanismes éventuels du processus politique nécessaire. Il faut pour cela inscrire les questions de gouvernance mondiale de la santé aux programmes d’autres secteurs, comme la politique étrangère, car la santé est indispensable non seulement à la réduction de la pauvreté, mais pour tout ce qui concerne la sécurité humaine.
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Kickbusch, I. Mapping the Future of Public Health: Action on Global Health. Can J Public Health 97, 6–8 (2006). https://doi.org/10.1007/BF03405203
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DOI: https://doi.org/10.1007/BF03405203