The initiative is pleased to have the support by several international health experts and advisers, who have kindly provided their comments to these key issues on global health. The Project would like to acknowledge their contributions, as well as to make a summary of their opinions. You are welcome to share on these views and to provide your opinions.

THE IMPORTANCE OF GLOBAL HEALTH

The world is getting smaller and smaller in the sense that we are more affected by what happens to people even living at a considerable distance from us as been shown in epidemics like the SASRS or potential global epidemics like Avian Flu. We speak more and more about the Global Village!

The "International health" indicates health situation in all countries in the world, but "Global health" indicates the health situation of the world as one unit and this emphasizes on the fact that Health threats and opportunities are a global phenomenon and need collective effort. This also shows inter-connection of health situation in different parts of the world.

Global Health means addressing problems that affect (or could affect) large regions of the world, especially those places that lack much medical expertise. Global Health is especially relevant where the greatest burden of disease is in less developed regions and/or countries. The meaning of "International Health" is somewhat different. It is more likely to include health issues that only affect a few nations and/or health issues that are of less concern in developing countries.

A focus on Global Health seems important because (1) countries/regions with the greatest disease burden need the most help from richer countries; and (2) problems that are neglected in such countries (e.g., AIDS, bird flu, SARS, drug-resistant TB) may become problems for the rest of the world in the future.

Global Health means the physical and mental well being of the world population through creating and protecting human friendly environment. Global Health is more broad understanding about health than international health. During the last century whole world becomes inter-dependant from each other due to rapid development of science and technology. So, in other words, we are in a same life-boat. Our wellbeing depends on efforts of each member of the team. Global Health is a priority issue for mankind at this stage of our development.

International health in general includes a variety of subjects such as epidemiology and public health at the international and population-based levels. Public health means principally a primary health care and the mission of the global health activities of the WHO. In contrast,“Global Health” means more modern and advanced concept on comprehensive and integrated international health, including politics, economics, and security closely related with the UN activities. Therefore, international health is how to find out the major determinants of the global burden of disease and concrete interventions undertaken at the community, national and international levels. Global heath is more preventive strategically and politically against disease outbreak and environmental/economical/political burdens.

Global Health, set apart from any dictionary definition, implies:
-Any aspect of individual or public health which transcends borders - e.g. communicable disease, water- or environment related health problems, biological and chemical warfare, torture; The interface between foreign policy and health, which increasingly is more relevant to the new ways of global governance;
-The highlighting of the interdependence of states, e.g. a major HIV /AIDS epidemic in Africa directly affects the developed world, or alternatively the increasingly more important role played by the emerging economies in global health negotiations (e.g. for access to care);

Global health is important because it determines the efficacy of prevention, optimal health system design and management and ultimately can also be used in health diplomacy as a bridge to peace.

Global Health reflects the collective health status of ALL people and what contributes to gains disparities and dangers in health improvement. The sense global inter-dependence for health is dramatized during disasters, pandemics and global violence/wars. They are less evident in the immediate cause effect relationships for deteriorating conditions in the environment, diet and nutrition, chronic violence, mental health and economic downturns.

HEALTH IS A GLOBALIZING PHENOMENON!

Global Health is health from global perspective, and health indicators in view of other emerging global issues including politics, economy, war/ conflicts. Global health is health issues worldwide whereas international health is of health issues/ indices amongst countries and does not usually extent/ composes global issues outline above. The focus on global health is important because it considers health globally; but importantly, global health in view of issues (economy, politics etc.) that contribute or impact on health indicators directly or indirectly.

Global health has no boundary and borders, it deals with various issues related to the health of human beings in the world. International health is more focus on the bilateral or multi-lateral relationship and efforts to uplift the health problems in developing countries. l "Global Health" means the level of health, that people on the globe have or can achieve at present or in the future. "International Health" than would be more related to the process that describes existing differences in health in different populations on the globe.

LIST OF CHALLENGES AND NEGLECTS IN GLOBAL HEALTH

- Climate change and the effects on health
- The need to increase the use of sustainable energy and reduce pollution world wide
- Potential use/ misuse of genetic engineering and threats to human health
- Massive movement of populations and its health consequences
- Global financial crisis and the possible effects on health
- Potential Local/regional ability and expertise in tackling diseases/health treat are not well utilized by international players and donors (especially in developing countries).
- Drug-resistant TB and AIDS- Rapid spread of HIV/AIDS
- Possible avian influenza outbreak and other emerging communicable diseases
- Increased prevalence of non communicable diseases
- Increased air pollution and safety of drinking water
- Increased traffic accident- Massive shortages and migration of health workers
- Scarce attention and investment in health care systems
- including research in this area
- Underinvestment, in general, of governments in Africa and beyond
- in health care
- The colonization of Africa by China and its implications on the health of the Continent
- Health violence, wars and health
- Economic violence and poverty
- Cost of pharmaceutical products (drugs) especially for developing countries
- Sharing of health information, disease epidemics, health awareness programs
-Wars/Conflicts and socio-economic impact on global health
- Illiteracy and health l Waste, drugs and water
- Needs to invest in health (including prevention) but major investments are going to deal with diseases.

SOLUTIONS FOR GLOBAL HEALTH CHALLENGES

1.Solidarity as the only way to reduce the real risk for pandemics. The need for a global force to unify and coordinates the public health approaches to react to global public health needs and demands
2.Health threats/ diseases which may destroy a country's infrastructure been given priority
3.Global surveillance of major infectious diseases and attention to any that are rapidly expanding
4.Mobilizing local resources to protect health of population and keeping already reached level of care and service quality.
5.A Global Health Fund is essentially needed to establish a new mechanism of stabilization and equalization of the WHO. To create a new Global Health Organizations in six regions such as the American, the European, the Mediterranean, the African, the Islam and the Asian regions. The new mechanism should be discussed at the highest level, to pool and use the limited budget for global health issues. The WHO is now only one international organization of the UN on the international public health. It is a good time to discuss more profoundly the necessity of another international Global Health Fund mechanism.
6.Invest in the training and establishment of PEOPLE - health workers for Africa especially
7.Full Implementation of groundbreaking international health treaties - such as the IHR, FCTC, Global Strategy on Diet, Physical Activity and Health
8.To eliminate the waste in military build up: The most impact to gain resources for health would through a Peace Dividend: To cut military expenditure/assistance/sales for multi-sectoral health development
9.To identify cost benefit measures in reducing the burden of disease by minimizing excessive costs on high tech health care systems - Maintaining balance in caring versus curing
10.To invest significantly more on prevention and prevention related research, and to strengthen the preventative health programs particularly in the developing countries. This will enable less disease burden to the curative health services, meaning less cost to country and the donor partners supporting the delivery of health services
11.To consider improving/ strengthening health training/ research programs in countries depending heavily on ODA and further limit the dependence on health expenses for pharmaceutical and consumable products, and more on technical support
12. Strengthen vaccines and food program in a global scale.To invest more into health promotion and disease prevention