The Politics of Medical Language

For many years, health professionals and academics have used the phrase “International health” to describe health practices abroad. Recently, those who work internationally have increasingly used the term “global health” to characterize their profession. In an article by Theodore Brown, Marcos Cueto, and Elizabeth Fee titled “The world Health Organization and the transition from ‘International’ to ‘Global’ public health”, the reader can examine the difference between the two terms. The definition of “international health” is a system that refers primarily to the control of epidemics across boundaries between nations. The definition of “global health” refers to the “health needs of the people of the whole planet above the particular nations. The difference in definition denotes that there are certain political and structural issues to consider in regards to the application of healthcare throughout the world.

In class, we discussed the issue of semantics – whether the wording is specifically important; The International Health Medical Education Consortium thought that the wording was so important that it changed its name to the Global Health Education Consortium (or GHEC). Is this simply to be politically correct or is it another reason?

 Figure 1.1: screenshot from the Global Health Education Consortium
Source: http://globalhealtheducation.org/Pages/GlobalvsInt.aspx

Examining the headlines, global health seems concerned with the greater good from a grassroots perspective, the other day I pulled up an article titled “Global health group seeks to ‘save brains’ as well as lives (see the article here: http://www.reuters.com/article/2012/09/13/us-global-brains-idUSBRE88C09C20120913). Using the same search engine, I typed in international health and it concerned itself with healthcare legislation in poor countries. It begged me to consider, is the reluctance to associate with international health simply because of wording or is it because of its top-down philosophy? International health seems to examine healthcare from the viewpoint of legislation and global health examines healthcare from a bottom-top philosophy. Global health gives a face to the suffering that must be why we are so attached to the image of it. As human beings, our hearts warm to the thought of a small child suffering because of inadequate healthcare. It is an image we are so accustomed to, the image of the scrawny malnourished African child, his frame is instantly medicalized as some sort of sickness. As “privileged” populations, our desire to take action is universal. In a simple google search two separate images come up for global health, the image of the globe encompassed in a stethoscope is the first image for international health. For global health, the image of an African doctor attending to seemingly health patients characterizes the first image. These images are good examples of how simple wording can hinder our understanding.

Figure 1.2 (left): International Health’s first image on google image search

Figure 1.3 (right): Global Health’s first image on google image search

 The Huffington post recently published an editorial from Hilary Clinton, the United States Secretary of State, in the article she detailed the process of healthcare development abroad. She explains that she asked her diplomats and development experts on how to address the issues of how to “advance America’s interests and promote our values around the world”. She explains that America has been leading the “fight” for global health for decades. What an interesting choice of words… a fight for health at a structural level.  She later explains that the need to save others is unquestionable and the United States had to become more efficient and effective. The aim is to use funding from global health aid to global health investments, the problem with this method is that thousands of people living below the poverty line depend on aid and shifting funding will not be condusive to their well-being. This is where the wording of global health and international health becomes complicated, both sides work to help disadvantaged populations but there can be no overlap in their definitions. The interesting thing about this article is that international health isn’t mentioned once; only the word global health is used. (See article here: http://www.huffingtonpost.com/hillary-clinton/saving-more-lives-than-ev_b_1930957.html).

The issue of wording does not seem like an explicit issue. Language evolves and culture changes. In theory, the definitions of global health and international health dictate that the two are completely separate sectors of the healthcare industry but colloquially it seems that these two concepts are used interchangeably. What does this mean for society? I believe it means that global health or international health is the same concept in the real-world. The people who create laws for international aid are thinking of the person in that particular country who is suffering due to lack of healthcare and the person in the field who is working with these populations are involved in preparing statements for lawmakers to consider. What happens when you transcend that line between global and international health? You simply become a healthcare provider, the titles simply get lost in the politics of it all.