NHS-FPX5028_GarciaMartina_Assessment1-1

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1 Global Health Organizations and Health Care Model Martina Garcia Capella University NHS-FPX5028 Comparative Models of Global Health Systems Dr. Yvonne Alles October 2023

2 Global Health Organizations and Health Care Model This following executive summary will provide a high-level overview of the missions and initiatives of four major global health organizations, with an analysis of how their efforts align with the core principles defined within the World Health Organization (WHO) constitution. The executive summary will outline the structures and components of the three major health care delivery models employed globally: entrepreneurial, mandated health insurance, and national health service. Finally, there is a review of key performance indicators (KPIs) used to evaluate performance within and across these systems to assess the organization’s ability to effect change and meet their stated goals. Mission and Major Initiatives Initially proposed in 1945 by representatives from Brazil and China to the convention forming the United Nations (UN), the World Health Organization came into being April 7, 1948, through the ratification of its constitution by UN delegates as an agency of the UN. With the adoption of the core principles outlined in the WHO’s constitution preamble, it effectively defined health care as a human right of all people and elevated equitable health as a security issue, equated the importance of mental health to physical health, and prioritized the health of children (World Health Organization, n.d.-a). The following outlines the mission and major initiatives of four major global health organizations: the WHO, the United Nations Foundation (UNF), the World Bank, and the International Monetary Fund (IMF). The COVID-19 pandemic put a spotlight on the strategic challenges facing these organizations in response to a significant health care issue. First, the way in which the organizations are structured in terms of leadership and funding tends to favor wealthier nations; for example, the IMF distributed $228 billion to the seven wealthiest nations to address the pandemic, while only $8 billion to the least developed (Lederer, 2023). Another longstanding criticism of the Word Bank and IMF is that they tend to impose requirements and policies of industrialized nations, rather than working with local

3 nations to develop sustainable strategies reflecting the needs and ideas of the local populations, and often determining health outcomes within the context of economic value (Abbasi, 1999). World Health Organization As the global leader in public health, the WHO has defined the blueprint for holistic health hat has been modeled by public health agencies abroad and within the United States. The WHO’s mission is to “coordinate the world’s response to health emergencies, promote well-being, prevent disease, and expand access to health care. By connecting nations, people, and partners to scientific evidence they can rely on, [they] strive to give everyone an equal chance at a safe and healthy life” (World Health Organization, n.d.-c). The primary functions of the WHO are outlined in Article 2 of its constitution and outlines a comprehensive approach to advancing the health and safety of all peoples. The WHO functions include environmental health, communicable and non-communicable diseases, chronic disease, injury prevention, food and product safety, infant, maternal and child health. It also advances the critical importance of effective infrastructures, health communication and promotion, training the next generations of practitioners, epidemiology, and advancing the knowledge and science through research, innovation, and best practice sharing. Notably, the WHO affirms the importance of health equity and universal access to health care as a fundamental human right and spotlights the importance of social determinants of health, such as housing or food insecurity, discrimination, and economics (World Health Organization, n.d.-c). As part of its current five-year strategic plan, the WHO is focused on its Triple Billion Targets: one billion more people benefiting from universal health care, one billion more lives protected from health emergencies across 13 core domains, and one billion more people leading healthier lives across 16 health indicators, such as suicide prevention, intimate partner violence, safe drinking water and air quality (World Health Organization, n.d.-c). United Nations Foundation (UNF)

4 In 1998, American entrepreneur Ted Turner donated the initial $1 billion to fund the formation of the UNF (United Nations Foundation, n.d.-b). Conceived as a strategic partner to the United Nations in support of its 17 Sustainable Development Goals (SDGs), the organization has been instrumental in mobilizing global responses to climate change and environmental crises, advocating for gender equality and reproductive justice, preserving world heritage sites, and supporting advances to fight malaria, tuberculosis, and HIV/AIDS (United Nations Foundation, n.d.-a). The UNF mission is to “advance human dignity and protect the planet through our work on transformative issues critical to humanity’s shared future” (United Nations Foundation, n.d.-b). The UNF’s current initiatives are distributed across seven domains: climate justice; girls and women; global health; data and technology; UN reform and innovation; peace, human rights, and humanitarian response; and emerging issues. Within the global health domain, focused effort is being placed on COVID-19, health equity, antimicrobial resistance, vaccinations, and family planning. Within the emerging trends domain, the UNF is addressing disparities in COVID-19 vaccination rates and setbacks within the SDGs because of the global pandemic (Roberts, 2022). For example, the rate of people who have received at least one dose of COVID-19 vaccine was 72.8% among high income countries compared to just 28.89% in low income countries (Roberts, 2022). The pre-pandemic global projection for people living in extreme poverty by 2022 was 581 million people; however, post-pandemic, that project was adjusted to 657- 676 million people, with the greatest negative impact on women and children (Roberts, 2022). The World Bank In 1944, representatives from 44 UN member countries met to develop a roadmap for global economic development, cooperation, and reconstruction, resulting in the formation of the World Bank and the International Monetary Fund, to be described later ( World Bank, n.d.-b) The World Bank’s early focus was on infrastructure projects and post-war reconstruction, taking on extreme poverty in the late 1960s as a strategic focus area ( World Bank, n.d.-b) . The mission of the world bank is “to end extreme poverty and to promote shared prosperity” (World Bank, n.d.-b). Five financial institutions

5 comprise the World Bank, using a combination of loans and grants to fund reconstruction, infrastructure, and development projects (World Bank, n.d.-b). Each government participating in the World Bank has voting rights, but additional votes are allocated based on financial contributions (Masters et al., 2023). The United States has the largest share of votes within the World Bank at 15.7% (the next highest is Japan at 7.2%) and the President of the United States is delegated the authority to nominate the president of the bank, requiring ratification by the Board of Governors (Masters et al., 2023). While each of the five institutions that comprise the World Bank set their own strategic agendas, overall, the priorities of the World Bank focus on climate change, debt reduction and poverty, food security, energy, agriculture, conflict and violence, and education (World Bank, n.d.-a). The International Monetary Fund While it was created at the same time as the World Bank and is a sub-set of the United Nations, the International Monetary Fund (IMF) operates slightly differently than its sister financial organization. The managing director of the IMF is nominated by either the Executive Board or a fund director and voted in by the entire Executive Board (International Monetary Fund, n.d.). The IMF mission is to “ achieve sustainable growth and prosperity for all of its 190 member countries … by supporting economic policies that promote financial stability and monetary cooperation, which are essential to increase productivity, job creation, and economic well-being” (International Monetary Fund, n.d.) The three main strategic focus areas of the IMF are economic surveillance and advisory consulting to reduce poverty; financing and lending; and technical assistance and training for member organizations (International Monetary Fund, 2023). The IMF does not provide direct health services but aligns its strategic focus areas to the SDGs outlined by the United Nations, provides resources to support the sustainability of governments, and builds nations’ core economic capacity to provide essential services to their populations to reduce poverty (International Monetary Fund, 2023). Alignment to the Basic Principles of the WHO Constitution

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