What in the world is global health? A conceptual analysis.

Abstract

This article suggests that the concept of global health - and to an extent the field that it designates - is problematic in various ways. Within public health, the concept of the 'public' has been widely investigated. However, "global health" has been introduced in academic, policy, and public discussion with comparably lower level of conceptual, philosophical scrutiny. Thus, while public health ethics addresses the ethical and political issues that the different meanings of 'public' allow to identify, global health ethics tends to leave ethical and political issues raised by the concept of 'global health' implicit and insufficiently analysed. I will briefly present the debate around the 'public' in public health, describing some of the ethical and political questions that might arise, depending on what 'public' is taken to mean. I will then use this discussion as a conceptual map for an analogous analysis of the concept of 'global' in global health. I will discuss what dimensions 'global' adds to the concept of 'public'. In the second part of the article, I will briefly introduce the philosophical debate on the concept of health, before suggesting that its cultural sensitivity makes it ill-suited to be qualified as 'global'. All in all, this article wants to bring to light the ethical implications that the terminology of 'global health' introduces in academic research and public policy that goes under that heading, as a first step towards better defining the ethical contours of this discipline.