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Commercialization and Globalization of Health Care

13 Feb 2008

Dr Johannes Sommerfeld

Globalization affects the disease distribution, transmission rates and, in some cases, the management of tropical diseases, as reviewed in a report published by the Special Programme for Research and Training in Tropical Diseases in 2004 and available on TropIKA.net.

Now, the UNRISD’s research and policy brief focuses on a critical side-effect of globalization, the increasing commercialization of health care. Commercialization drives R&D efforts for neglected diseases and the treatment of infectious diseases is increasingly commercialized in many disease-endemic countries. This policy brief is therefore critically relevant to infectious diseases research and control. An extract from the summary appears below. The full document is available from UNRISD as a PDF (4 pages) here.

Dr Johannes Sommerfeld
Scientist, Research Manager
Special Programme for Research and Training in Tropical Diseases (TDR)

Further reading

Comeliau, C., S. Gillioz, M. Carton, Y. Flückiger, M. Mackintosh and F.-X. Merrien. 2006. Le Défi Social du Développement: Globalisation et Inégalités. IUED and Karthala, Paris.

Mackintosh, M. and M. Koivusalo (eds.). 2005. Commercialization of Health Care: Global and Local Dynamics and Policy Responses. UNRISD and Palgrave, Basingstoke.

Commercialization and Globalization of Health Care: Lessons from UNRISD Research (UNRISD Research and Policy Brief: 7)

“This research and policy brief summarizes findings from two UNRISD projects: Commercialization of Health Care: Global and Local Dynamics and Policy Responses, and the health-related research for a broader project, The Social Challenge of Development: Globalization and Inequality. These interlinked projects brought together researchers from 20 mainly developing and transitional countries to undertake primary research on the extent and differentiated nature of health care commercialization and globalization, its implications for access and inequality, and the scope for effective policy responses to create inclusive, effective and accountable health systems. Within these themes, topics included the strategies of multinational companies and the health implications of global industrial regulation; the impact of transnationalization of health care corporations on middle-income country health systems; commercialization of the public sector of health care itself and its consequences; international migration of health care staff; public-private interactions and health equity; and experiences of universalization of care in commercializing health systems. Primary research was undertaken in Argentina, Brazil, Bulgaria, China, Ghana, India, Lebanon, Malaysia, Mali, Mexico, the Republic of Korea, the Russian Federation, Singapore, South Africa, Switzerland, Tanzania, the United States and Viet Nam. The projects demonstrated that economists and health policy experts can work effectively together within a conceptual framework that treats commercialization of health care as a process to be judged on its merits, rather than a premise on which health policy is built. UNRISD research on health care commercialization began from an understanding of health policy as part of broader social and public policies. Health systems are the institutional expression of these policies, rooted in legal rights, values and political commitments. Health care forms part of wider health systems, which also encompass public health, health promotion and assessment of health implications of other policies. Health services must aim for universal access to care according to need, and solidarity in provision and financing—and have to be judged against these aims. In this framework, commercialization should be evaluated as a means to these ends. “Commercialized” health care means the provision of health care through market relationships to those able to pay; investment in and production of services, and of inputs to them, for cash income or profit, including private contracting and supply to publicly financed health services; and health care finance by individual payment and private insurance. Commercialization thus encompasses and provides a single framework of analysis for understanding a number of intersecting processes such as private sector expansion, market liberalization and privatization of state assets. Commercialization of health care in this sense has been promoted directly and indirectly by economic pressures and international policy leverage since the 1980s, and has been the precondition of international market integration, or “globalization”, in health.”