Saúde global e diplomacia da saúde

Abstract

The "short" 20th century, as defined by Eric Hobsbawm, was marked by major economic, social, scientific, and technological progress that improved both quality of life and health conditions around the world. Still, in an "age of extremes", to use Hobsbawm's same definition, globalization also created growing international disparities, producing enormous social and health problems, particularly in the countries most excluded from the global economy's central circuits. Declining health conditions in large contingents of the population, food insecurity, and climate changes have raised increasing concerns in the international community. Through various initiatives that serve what are often contradictory interests, the United Nations, agencies of international cooperation from developed countries and some emerging nations, and international philanthropy have approached health as a priority on the international cooperation agenda and in development aid programs. This process has been called "global health diplomacy", that is, the set of negotiations at various levels that define and manage the setting for global health policies and that-ideally-produce better population health results in each country (thus serving the national interests), as well as implementing relations between states and bolstering the commitment by a wide range of stakeholders in pursuit of a common undertaking to ensure health as a human right and a public good (Kickbusch I, et al. Bull World Health Organ 2007; 85:230-2). A key example is the Millennium Development Goals (http://www.un.org/millenniumgoals), a series of commitments set by the United Nations Millennium Summit in 2000. Global health and health diplomacy require new institutional and professional public health mechanisms, thus leading various academic institutions around the world to establish research and training centers dedicated to the issue. A recent example in Brazil was provided by the Oswaldo Cruz Foundation, which created the Fiocruz Center for Global Health (CRIS) in January 2009 with the aim of further consolidating the foundation's extensive international cooperation in the health field. As an emerging global power among the middle-income countries, Brazil has played an outstanding role in health diplomacy in the context of South-South cooperation through what we have referred to as "structuring cooperation in health" (Almeida C, et al. Global Forum Update on Research for Health. Volume 6: Innovating for the Health of All, 2009; p. 199-207), which consists of supporting the development and reinforcement of social and health systems by means of structuring institutions in the key health and human resources training systems, as central strategies for organizing the developing countries' own capabilities. Another Brazilian foreign policy strategy focuses on the establishment of regional blocs, where health has been a central priority. Examples include UNASUL-Health (http://www. unasur-salud.org) in the Union of South American Nations and CPLP-Health (http://www. cplp.org/Saúde...

Twelve Years of the Brazilian Initiative to Create a Network of IRBs for the Ethical Evaluation of Research Studies Involving Human Subjects

“…As Brazil occupies a position of political and economic leadership in Latin America, this experience can be shared with other countries as a model of how to develop an ethical review system and a network of IRBs (Buss and Leal 2009;Ozdemir et al 2009;Kickbush and Berger 2010;Almeida et al 2010).…”

UNASUR Salud: experiencias y debates al final de un ciclo

“…La reunión estuvo organizada por miembros del proyecto RePIR bajo la coordinación de Pia Riggirozzi (ISAGS, 2016a, p. 2). global en salud" y "diplomacia en salud" (Almeida 2013, p. 233;Buss y Leal, 2009;Mazzaroppi, 2016).…”