In a world marked by escalating geopolitical tensions and multifaceted crises, the intersection of politics and health emerges as a critical focal point for global discourse. The Prince Mahidol Award Conference (PMAC) in 2024, held in Bangkok, provided a platform for probing the complexities of this intersection and exploring pathways towards equitable global health.
At the heart of the discussions lie profound realizations about the interconnectedness of geopolitical dynamics and health outcomes. From armed conflicts ravaging nations like the Middle East, Ukraine and Myanmar to economic disparities perpetuating health inequities, the repercussions are far-reaching and multifaceted. While the political landscape shapes policies and resource allocation, its influence extends beyond borders, deeply impacting the well-being of populations worldwide.
Central to the discourse is the recognition of power imbalances, both within and among nations. As superpowers engage in disputes and an arms race looms large, vulnerable populations bear the brunt of conflict-induced hardships. Healthcare systems, already strained, collapse under the weight of violence and instability, leaving communities without access to essential services. The consequences are dire, exacerbating health disparities and perpetuating cycles of poverty and suffering.
Economic imbalances further compound the challenges, widening the gap between the privileged and the marginalized. Self-serving collaborations and punitive sanctions exacerbate vulnerabilities, leaving populations with limited access to healthcare and basic necessities. Inequitable resource distribution undermines efforts to achieve global health equity, perpetuating a cycle of deprivation and inequality.
Amidst these challenges, the intricacies of global governance are brought into sharp focus. Institutions such as the United Nations agencies play pivotal roles in shaping policies and norms. However, the wielding of veto power by permanent UN Security Council members and corporate interference underscore the complexities of navigating global health governance. Striking a balance between national interests and wider collective well-being remains a formidable task, requiring innovative approaches and inclusive decision-making processes.
Soft power, wielded through cultural and ideological channels, emerges as a potent tool to shape national images and influence political agendas. Nations utilize soft power to exert influence and advance political agendas, with implications for global health. While soft power can promote positive health behaviors, it can also exacerbate health problems by fueling unhealthy practices, such as the spread of fast food chains, contributing to rising obesity rates. Understanding the nuances of soft power dynamics is essential for crafting effective interventions that promote health and well-being on a global scale.
Addressing knowledge disparities is another crucial aspect of the discourse. Global education and knowledge production exhibit asymmetries, perpetuating the dominance of high-income country universities. Brain drain and capacity gaps in research and development between high-income and low- and middle-income countries pose challenges to achieving an equitable global health research agenda. Bridging these gaps requires concerted efforts to promote knowledge sharing and collaboration, ensuring that all nations have access to the resources and expertise needed to address pressing health challenges.
Perhaps most insidious are the commercial determinants of health (CDoH), where corporate interests clash with public health objectives. Transnational corporations wield significant influence over policies and regulations, contributing to a third of global deaths annually. From the tobacco industry to the fast food giants, corporate entities contribute to a myriad of health problems, perpetuating inequities and undermining efforts to improve global health outcomes.
Addressing these challenges demands a multifaceted approach that encompasses diplomatic efforts, policy reforms, and collective action. By fostering collaboration over competition, nations can pool resources and expertise. Decolonizing knowledge systems and promoting equitable partnerships in research and development are essential steps towards levelling the playing field and ensuring that all nations have access to the resources and expertise needed to address pressing health issues.
Moreover, sustainable financing mechanisms are crucial for bridging economic divides and promoting resource allocation based on need rather than profit. By advocating for fair trade agreements and innovative financing models, nations can ensure that healthcare systems have the resources they need to provide quality care to all.
In conclusion, the discourse at PMAC 2024 underscores the urgency of addressing geopolitical complexities to achieve equitable global health outcomes. By acknowledging the interconnectedness of political, economic, and social factors, the global community can work together to build a healthier and more equitable world for all. The path ahead may be fraught with challenges, but with concerted effort and collective action, meaningful progress can be within reach.
About authors: Dennis Carroll, PhD, is Chief Scientist for URC, a Distinguished Professor of Faculty of Medicine at Chulalongkorn University, and a Senior Fellow at Tufts University. He has over 30 years of leadership experience in global health and development.
Peter Friberg, MD, PhD, is professor of global public health at University of Gothenburg and former president of the Swedish Society of Medicine. He was also the chair of the health promotion and behaviour panel at the Swedish Research Council for Health, Working Life and Welfare.
David R Harper, PhD, is the Managing Director of Harper Public Health Consulting Limited. He is also Senior Consulting Fellow in the Global Health Programme at the Chatham House Centre, United Kingdom, and has extensive experience working on health protection and health security with WHO and the UK Department of Health.
Churnrurtai Kanchanachitra, PhD, is Emeritus Professor on Population and Social Research at the Mahidol University, Thailand. She has worked on non-communicable disease prevention interventions and participatory approaches in health systems.
Angkana Lekagul, PhD, is a researcher at the International Health Policy Program, Ministry of Public Health, Thailand. She is a member of the Sustainable Development Solution Network, Thailand, and has worked on antimicrobial resistance and emerging infectious diseases.
Timothy D. Mastro, MD, is Adjunct Professor of Epidemiology in the Gillings School of Global Public Health, University of North Carolina at Chapel Hill. He has decades of experience in scientific leadership positions with US CDC and FHI 360 directing research and science-based programs conducted in countries around the world.
Viroj Tangcharoensathien, PhD, is Senior Advisor at the International Health Policy Program and Advisor on Global Health to the Ministry of Public Health, Thailand. He has served in rural district hospitals in Thailand and worked on health systems improvement in the interests of the poor.
Yik-Ying Teo, DPhil, is Vice President, Global Health, and Dean of Saw Swee Hock School of Public Health at the National University of Singapore. He oversees strategic global health engagement and plans at the University’s Office of Global Health, and is a governing board member of the Regional Centre for Tropical Medicine and Public Health Network for Southeast Asia.
The PMAC International Organising Committee (IOC) oversees the coordination, planning, organisation and execution of the annual PMAC conference. Specifically, the IOC collaboratively decides on the overarching theme of the conference, aligning it with current global health challenges and priorities.
Competing interests: None
Handling Editor: Neha Faruqui