Health Impacts of Globalization brings together an interdisciplinary group of researchers to analyze specific case studies that provide much needed empirical analysis of the impact of globalization on health. The range of issues covered-AIDS, tobacco control, BSE/CJD, nutrition, cholera, anti-microbial resistance, WTO, global governance-is intended to be illustrative, rather than representative, of the diverse health impacts of global change.

Lee Kelley is at the London School of Hygiene and Tropical Medicine.

List of Tables, Figures and Boxes

xi

Preface

xii

Acknowledgements

xiii

Notes on the Contributors

xv

List of Abbreviations

xix

Introduction

1

(12)

Kelley Lee

Bridging the divide: globalization and health

1

(3)

Globalization and health: finding a conceptual starting point

4

(3)

The structure of the book

7

(6)

Part I The Impacts of Globalization on Health

A Global Political Economy Approach to AIDS: Ideology, Interests and Implications

13

(20)

Kelley Lee

Anthony Zwi

Introduction

13

(1)

The global spread of AIDS

14

(2)

AIDS and the global political economy: an emerging transnational neoliberal order

16

(5)

Orthodoxy and ideology: the discourse of HIV/AIDS

21

(2)

The global response to AIDS: policymaking and the biomedical discourse

23

(3)

The global response to AIDS: policymaking and the neoliberal discourse

26

(3)

Towards an expanded understanding of AIDS: a global political economy research agenda

29

(4)

Understanding HIV/AIDS as a Global Security Issue

33

(14)

Dennis Altman

Introduction

33

(3)

HIV/AIDS as exemplar of a new form of global security threat

36

(4)

The implications of how HIV/AIDS and security are perceived

40

(3)

AIDS and the creation of `global governance'

43

(4)

Far From the Maddening Cows: The Global Dimensions of BSE and vCJD

47

(14)

Kelley Lee

Preeti Patel

Introduction

47

(1)

The emergence of the BSE and vCJD crisis

48

(3)

The global dimensions of BSE and vCJD

51

(2)

The globalization of the food industry

53

(1)

The global nature of the animal feed industry

54

(1)

The global export of blood and other biological products

55

(1)

The global governance of food safety

56

(3)

Conclusions

59

(2)

Think Global, Smoke Local: Transnational Tobacco Companies and Cognitive Globalization

61

(25)

Jeff Collin

Introduction

61

(2)

The promotion of global cigarette brands

63

(3)

Fast cars and cigarettes: tobacco company sponsorship of motor sports

66

(5)

Creating the global smoker

71

(4)

A global contest: dominating discourse, resisting regulation

75

(7)

Conclusions: the global public health response

82

(4)

The Impact of Globalization on Nutrition Patterns: a Case-Study of the Marshall Islands

86

(19)

Roy Smith

Introduction

86

(1)

The Marshall Islands

87

(2)

Existing understanding of unhealthy diets in the Marshall Islands

89

(7)

Global factors contributing to unhealthy diets in the Marshall Islands

96

(6)

Conclusions

102

(3)

Globalization and the Challenge of Health for All: a View from sub-Saharan Africa

105

(18)

David Sanders

Mickey Chopra

Introduction

105

(1)

Mixed progress in world health

106

(1)

A global shift in paradigm: from comprehensive to selective primary health care

106

(2)

The global context: globalization and health in sub-Saharan Africa

108

(7)

Globalization, structural adjustment and health

115

(1)

Conclusions: towards a response to the challenge of Health for all

116

(7)

Part II Towards Global Governance for Health

Globalization and Cholera: Implications for Global Governance

123

(21)

Kelley Lee

Richard Dodgson

Introduction

123

(1)

Globalization and health: a conceptual framework

124

(3)

Cholera in the time of globalization: the first six pandemics

127

(4)

Globalization and the seventh pandemic: mirror, mirror on the wall

131

(7)

Global governance for health: learning lessons once again from cholera

138

(4)

Conclusion

142

(2)

Antimicrobial Resistance: a Challenge for Global Health Governance

144

(17)

David P. Fidler

Antimicrobial resistance as a global public helath problem

144

(3)

AMR as a global governance problem

147

(2)

Global governance and AMR: a global public goods approach

149

(2)

Lessons for GHG on AMR from international environmental law

151

(8)

Conclusion

159

(2)

Assessing the Health Policy Implications of WTO Trade and Investment Agreements

161

(16)

Meri Koivusalo

Introduction

161

(1)

The health policy implications of the World Trade Organization

162

(2)

Agreement on Trade-Related aspects of Intellectual Property Rights

164

(3)

Agreement on Sanitary and Phytosanitary Measures (SPS)

167

(1)

General Agreement on Trade in Services (GATS)

168

(1)

The WTO and health policy: a case-study of Finland

169

(3)

Future challenges for strengthening health policy amidst globalization and trade

172

(3)

Concluding viewpoints

175

(2)

Trade Policy, the Politics of Access to Drugs and Global Governance for Health

177

(15)

Caroline Thomas

Introduction

177

(3)

The political problem: the politics of access to ARV and other drugs

180

(1)

WTO/TRIPS and access to drugs

180

(2)

US power and the issue of access

182

(3)

The role of the pharmaceutical giants in issues of access to drugs

185

(2)

The credibility problem: the market system, public-private partnerships and the challenge of widening access to drugs

187

(2)

Looking forward

189

(3)

Global Health Governance: Some Theoretical Considerations on the New Political Space

192

(12)

Ilona Kickbusch

A new political space and paradox

192

(2)

The search for an analytical framework

194

(1)

A social constructivist agenda

195

(2)

The new primacy of politics

197

(2)

What role for the realist American hegemony?

199

(1)

A power vacuum or a new space?

200

(1)

Constructing a virtuous governance cycle

201

(3)

References

204

(29)

Index

233

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