The featured theme of this issue is “Noncommunicable Diseases” (NCDs). As editor-in-chief Yanzhong Huang noted in the previous issue of Global Health Governance, what we now need in the present era is an institutionalized and holistic structure of global health governance to handle health challenges such as the ones being addressed in this journal. In light of the current meltdown of global financial markets and the complexity of so many other issues that now bind the fate of nations ever more closely together (e.g., environmental degradation, global warming and worldwide pandemics), the articles in this current issue should be of particular interest to those interested in how economic shifts and sociocultural conditions are impacting health outcomes at both the regional and global levels.
In the first article, “(Transnational) Affairs of the Heart: Political Economy and the Globalization of Cardiovascular Disease,”authors Sandra J. McLean and David R. McLean examine the creation of global networks for the prevention of cardiovascular disease (CVD) and argue that CVD deserves more attention as a social phenomenon. Having analyzed the gap between the role of political economy as a contributing factor to global health problems and the need for public health specialists to seek answers to these issues, they conclude that the cost of health services for the management of chronic diseases such as CVD places a “significant burden on both individuals and society”(McLean and McLean, 2008). Consequently, they suggest that governments and diverse stakeholders must shift their thinking and actions concerning chronic disease prevention and health promotion if they wish to affect substantial gains for both global health and the world economy.
Given that the prevalence of asthma (the most common chronic childhood disease) is increasing in most countries among young children (who also utilize the greatest proportion of health care), the second article highlights asthma as yet another NCD that imposes a substantial economic and healthcare burden on countries around the world. In their examination of four pediatric practices and their approaches to the management of asthma to reduce the rate of hospital admissions, Sheniz Moonie and Robert Strunk found that intervention improved a number of aspects of patient care and patient confidence, but did not decrease the number of hospitalizations. Recommending more work on the integration of guideline care into general pediatric practice, they also call for public policy that will support public health activities for asthma management, not only through more targeted and comprehensive programs, but also through regulation of the threats and environmental factors that trigger asthma attacks.
Another major health issue that has received substantial attention in recent years has been the startling increase in the prevalence rates of autism spectrum disorders (ASD) around the world and possible causes for those increases. In the third article, “Autism and Special Education Policy in Mexico,” Tuman et al. look at the challenges facing families of children with ASD. The study focuses in particular upon the public provision of special education and other support services in Mexico, along with the cost and availability of private services to those with sufficient means. The authors found that although there is a great deal of dissatisfaction among parents and other stakeholders, lack of cohesiveness among advocacy groups impedes improvement in the delivery of public health and special education services for this population.
Although the last article shifts the focus back from NCDs to infectious diseases, Ricardo Pereira’s historical and political analysis of the relationship between Western hegemonic power and the processes of infectious diseases securitization offers us a fascinating look at how the discourses of democratization and the global promotion of human rights promotion have favored the overall development of an international health provision agenda (as exemplified by the Millenium Development Goals). Drawing upon upon Michel Foucault’s writings on the Western polity and nature of liberal power and David Fidler’s work on international health law, Pereira argues that the genealogy of securitization can be traced back to the rise of European liberal political regimes, whose “global expansion and consolidation were favored by international public hygienist surveillance as of the 1830s.” (Pereira, 2008) In agreement with Fidler, who asserted that major epidemiological issues have revolutionized the way International Relations researchers now perceive them (as a current and prominent feature of the post-Cold War human security paradigm rather than a topic of little interest), he counsels us to reflect carefully upon the ethical issues surrounding the biopolitics of the securitization of bodies and societies in the formulation and implementation of global health policies.
Danielle Roth-Johnson
Co-editor