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ПОЛИТИКА, ЭКОНОМИКА И ИННОВАЦИИ № 3 (50), 2023 УДК 327.7:614.2
Понния Раджасекар Яжини, студент международного медицинского института Курского государственного медицинского университета, Курск, Россия
Email: dryazhuraj asekar07@gmail. com
Моханрадж Навин Чакраварти, студент международного медицинского института Курского государственного медицинского университета, Курск, Россия
Email: naveen 1 chakravarthi@gmail .com РЕГУЛИРОВАНИЕ ГЛОБАЛЬНОЙ СИСТЕМЫ ЗДРАВООХРАНЕНИЯ
Аннотация: Всемирная организация здравоохранения (ВОЗ) является учреждением Организации Объединенных Наций, которое объединяет страны и людей для укрепления здоровья, обеспечения безопасности в мире и защиты уязвимой части общества
Ключевые слова: ВОЗ; глобальная система здравоохранения
Ponniah Rajasekar Yazhini, student of the International Medical Institute, Kursk State Medical University, Kursk, Russia
Email: dryazhuraj [email protected]
Mohanraj Naveen Chakravarthi, student of the International Medical Institute, Kursk State Medical University, Kursk, Russia
Email: naveen 1 chakravarthi@gmail .com
REGULATION OF THE GLOBAL HEALTH SYSTEM
Abstract: the World Health Organisation (WHO) is the United Nations agency that connects nations and people to promote health, keep the world safe and serve the vulnerable section of the society so that everyone, everywhere can attain the highest possible level of health.
Keywords: WHO; global health system
WHO's work in Health System Governance aims at empowering actors and increasing accountability, transparency and responsiveness of health systems through actions focused on [3].
Support development of comprehensive and costed national health policies and strategies that enable effective implementation of primary health care towards universal health coverage, including health security;
Strengthen and reform health institutions, laws and regulations, including legal frameworks for universal health coverage that contribute to access, quality and financial risk protection;
Establish mechanisms to support and promote the empowerment of people and communities in oversight functions and the representation of citizens in health decision making processes and gender equality; Work with parliamentarians to support laws and budgets for universal health coverage [4].
Support the harmonisation and alignment of cost and financed national action for health security with national health strategies.
Three main categories of stakeholders who interact with each other determine the Health system and its governance:
• the State
• the health service providers
• The citizen.
SALES
■ grant management
■ Disease-specific HSS
■ Salary
■ system-wide HSS
■ Commodities,diagnostic and drugs
■ unclassified
Figurel: Global health initiative investments and health systems strengthening
According to the analysis, 37% (US$ 362 million) of the Global Fund Round 8 funding was allocated to health systems strengthening. Of that, 38% (US$ 139 million) was for generic system-level interventions, rather than disease-specific system support. Around 82% of health systems strengthening funding (US$ 296 million) was allocated to service delivery, human resources, and medicines & technology, and within each of these to two to three interventions. Governance, financing, and information building blocks received relatively low funding. Substantial portion of Global Fund's Round 8 funds was devoted to health systems strengthening. Dramatic skewing among the health system building blocks suggests opportunities for more balanced investments with regard to governance, financing, and information system related interventions. There is also a need for agreement, by researchers, recipients, and donors, on keystone interventions that have the greatest system-level impacts for the cost-effective use of funds. Effective health system strengthening depends on inter-agency collaboration and country commitment along with concerted partnership among all the stakeholders working in the health system [7]. Monitoring the health situation, trends, progress and performance of health systems requires data from multiple sources on a wide variety
ПОЛИТИКА, ЭКОНОМИКА И ИННОВАЦИИ № 3 (50), 2023 of health topics. WHO brings the world's scientists and global health professionals together to accelerate research and development in emergency situations. In order to prevent and respond to catastrophic events like pandemics, natural disasters and the emergence, or re-emergence, of highly pathogenic diseases, it is essential to be able to quickly gather and share the best available knowledge and evidence on diseases, and on potential available countermeasures [5].
General government expenditure on health as a percentage of total government expenditure - This indicator is defined as the level of general government expenditure on health (GGHE) expressed as a percentage of total government expenditure. It shows the weight of public spending on health within the total value of public sector operations. This indicator includes not just the resources channelled through government budgets, but also the expenditures channelled through government entities for health by parastatals, extrabudgetary entities and, notably, compulsory health insurance. The indicator refers to resources collected and pooled by public agencies, including all revenue modalities.
Total expenditure on health as a percentage of gross domestic product (GDP) -This indicator is defined as the level of total expenditure on health expressed as a percentage of GDP, where GDP is the value of all final goods and services produced within a nation in a given year. It provides information on the level of resources channelled to health, relative to a country's wealth. Per capita total expenditure on health - This indicator is defined as the per capita total expenditure on health, expressed at the average exchange rate for that year in US$. It shows the total expenditure on health relative to the beneficiary population, expressed in US$ to facilitate international comparisons [8].
4,8 4,6 4,4 4,2 4 3,8 3,6 3,4 3,2 3
Health Expenditure
2017
2018
2019
2020
2021
2022
Figure 2 -Health Expenditure in Russia
Healthcare in Russia is free to all residents through a compulsory state health insurance program. However, the public healthcare system has faced much criticism due to poor organizational structure, lack of government funds, outdated medical equipment, and poorly paid staff.
Because of this, many expats in Russia choose to take out private medical treatment which is widely available in many areas. Patients access doctors, dentists, and medical specialists through the state system or privately. In recent years, some state facilities have begun to offer private treatment to those with insurance. Some private providers also offer some public healthcare services [9].
Another important part of WHO's work with global expert networks is the Research and Development Blueprint (R&D Blueprint), a global strategy and preparedness plan that triggers the rapid activation of research and development activities during outbreaks. This includes fast-track development of effective diagnostic tests, vaccines and medicines that can save lives and prevent the spread of large-scale epidemics [6]. The most important amongst them is that they also devised various tools to access and analyse data about COVID-19 called the Access to COVID-19 Tools (ACT) Accelerator. It is a ground breaking global collaboration to
ПОЛИТИКА, ЭКОНОМИКА И ИННОВАЦИИ № 3 (50), 2023 accelerate development, production, and equitable access to COVID-19 tests, treatments, and vaccines. The ACT-Accelerator is organised into four pillars of work: WHO launched their Transition Plan in October 2022, setting out adjustments to its way of working, as countries move from managing COVID-19 as an acute emergency to integration into longer term disease control programmes.
Apart from the existing system, several other factors have been instrumented in broadening the health governance agenda:
Health governance is no longer the exclusive preserve of nation states. Civil society networks, individual nongovernmental organisations at international and community level, professional groups, philanthropic foundations, trade associations, the media, national and transnational corporations, and informal diffuse communities that have found evident influence on decision-making that affects health.
The institutional landscape of global health is increasingly complex, incentives that favour the creation of new organisations, financing channels, and monitoring systems over reform of those that already exist risk making the situation worse. This issue is particularly important in relation to health governance in low and middle income countries with many development partners.
From health governance to governance for health: Health Governance addresses many of the issues essentially coordinating, directing and performing internal coherence functions. While governance for health is an advocacy and public policy function which seeks to influence governance in other sectors in ways that positively impact on human health.
Reference
1. Information on WHO : https://www.who.int/about
2. Initiatives of WHO :https://www.who.int/initiatives
3. Role of WHO: WHO's role in the global health system: what can be learned
ПОЛИТИКА, ЭКОНОМИКА И ИННОВАЦИИ № 3 (50), 2023 from global R&D debates? - PubMed (nih.gov)
4. Importance of WHO :The Global Role of the World Health Organization -PubMed (nih.gov)
5. Accelerator: WHO's role in the global health system: what can be learned from global R&D debates? - Science Direct
6. Tools by WHO: WHO's role in the global health system: What can be learned from global R&D debates? | Request PDF
7. Global health initiative investments and health systems strengthening: a content analysis of global fund investments - PubMed (nih.gov)
8. Health expenditure (who.int)
9. The healthcare system in Russia | Expatica
