Nerona, Anne Martha A.
BSMT – 1H
INTERNATIONAL AND
NATIONAL HEALTH
SERVICES
MS. PAMIELA M. DEMEC ILLO, RMT, MPH
OBJECTIVES
 To identify and compare key organizations and
institutions, their roles in global health, and the
manner in which they can cooperate to address key
global health issues.
 Discuss organizations that help to shape a
community’s ability to respond effectively to health
– related issues by protecting and promoting the
health of the community and its members.
TYPES OF GLOBAL HEALTH PROGRAMS
 A variety of different activities can fall under the
umbrella of global health services and programs.
 Many global health organizations and agencies
work in several of these areas, while some are
specialized in just one domain.
These areas include:
RESEARCH AND EDUCATION ACTIVITIES
 This is the focus of many disease specific charities:
American Cancer Society and American Heart
Association
CLINICAL SERVICES
 Provided by hospitals, clinics, health centers and
other direct patient care providers.
RELIEF AID
 Are often required after major natural disasters and
during wars.
COMMUNITY DEVELOPMENT PROGRAMS
ADVOCACY
 Ex. Human rights watch work to bring global
attention to human rights violations.
LOGISTICS EFFORTS
 Deliver food, medications, medical equipment and
supplies, and other goods and services to people
and communities in need.
EXAMPLE OF NATIONALLY SPONSORED HEALTH
RESEARCH AGENCIES
 The U.S. Centers for Disease Control and Prevention
(CDC) plays a unique role in responding to
international public health crisis, including outbreaks,
when invited by the country or countries affected;
once known solely for its work to control
communicable diseases.
 The United Kingdom’s Medical Research Council
(MRC)
 The Canadian Institutes of Health Research (CIHR)
 Brazil’s Fundacao Oswaldo Cruz (Fiocruz)
 The Indian Council of Medical Research (ICMR)
 Kenya Medical Research Institute (KEMRI)
UNITED NATIONS
 Founded in 1945 by 51 member states, and by
2011 had expanded to 193 member nations.
GOALS
1. To develop friendly relations among nations;
2. To achieve international cooperation in solving
international problems of an economic, social,
cultural, or humanitarian character.
 Many organizations provide healthy villages
projects at both local or national and international
levels.
 These organizations can be classified as:
Governmental, Quasi-governmental, Non-
governmental.
1
Nerona, Anne Martha A.
GOVERNMENTAL HEALTH AGENCIES
 Part of the governmental structure (federal, state,
tribal, and/or territorial or local)
o Examples: FDA, CDC, Agency for Toxic
Substances and Disease Registry
(ATSDR), Centers for Medicare and
Medicaid Services (CMS), National
Institute of Health (NIH).
 They are funded primarily by tax dollars and
managed by government officials.
 They are designated as having authority over some
geographic area.
 Such agencies exist at the four governmental levels:
International, National, State, Local.
INTERNATIONAL HEALTH SERVICES
WORLD HEALTH ORGANIZATION (WHO)
 Primary health agency of the UN.
 Headquarters is located in Geneva, Switzerland.
 A United Nations specialized agency concentrating
exclusively on health:
o By providing technical cooperation
o Carrying out programs to control and
eradicate disease
o Striving to improve the quality of human
life
 Membership is open to any nation that has ratified
the WHO constitution and receives a majority vote
of the World Health Assembly.
 The work of the WHO is financed by its member
states with assessed and voluntary contributions.
 Each member state is assessed according to its
ability to pay; the wealthiest countries contribute the
most.
 Governed by the World Health Assembly –
composed of one representative from each UN state
which convenes every May to approve a budget,
make policy decisions, and approve conventions,
agreements and regulations.
BSMT – 1H
 Formed on April 7, 1948 – a date we now
celebrate as “World Health Day”.
 WHO fulfills its objectives through its six (6) core
functions:
o Providing leadership on matters critical
to health and engaging in partnerships
where joint action is needed;
o Shaping the research agenda and
stimulating the generation, translation
and dissemination of valuable
knowledge;
o Setting norms and standards and
promoting and monitoring their
implementation;
o Articulating ethical and evidence-based
policy options;
o Providing technical support, catalyzing
change, and building sustainable
institutional capacity;
o Monitoring the health situation and
assessing health trends.
 Worthwhile programs of the WHO:
o In 1979 – global eradication of small
pox
o Led the efforts to contain the outbreaks
of Ebola
o Work with the United Nations Millennium
declaration which set out principles and
values in seven areas
 Peace, Security and
Disarmament
 Development and Poverty
Eradication
 Protecting our common
Environment
 Human rights, democracy, and
good governance
 Protecting the vulnerable
 Meeting special needs of Africa
 Strengthening the United Nations
2
Nerona, Anne Martha A.
o Development and poverty eradication
referred to as the “Millennium
Development Goals”
o Specifically, were aimed at:
 Reducing poverty and hunger
 Tackling ill health
 Gender inequality
 Lack of education
 Lack of access to improved
drinking water
 Environmental degradation
SELECTED ACHIEVEMENTS FOUND IN THE MDG’S
 Extreme poverty has declined significantly over the
last two decades. In 1990, nearly half of the
population in the developing world lived on less
than1.25 US dollars a day; that proportion
dropped to 14% in 2015.
 The primary school net enrollment rate in developing
regions has reached 91% in 2015, up from 83% in
2000.
 Many more girls are now in school compared to 15
years ago. The developing regions as a whole has
achieved the target to eliminate gender disparity in
primary, secondary, and tertiary education.
 The global under-five mortality rate has declined by
more than half, dropping from 90-43 deaths per
1000 live births between 1990 and 2015.
 Since 1990, the maternal mortality ratio has
declined by 45% worldwide, and most of the
reduction has occurred since 2000.
 Ozone – depleting substances have been virtually
eliminated since 1990, and the ozone layer is
expected to recover by the middle of this century.
 Official development assistance from developed
countries increased by 66% in real terms between
2000 and 2014, reaching 135.2 billion US dollars.
SUSTAINABLE DEVELOPMENT GOALS (SDG’S)
BSMT – 1H
 A new universal and transformative post – 2015
development agenda of MDG’s, supported by a set
of 17 goals.
FRAMEWORK CONVENTION ON TOBACCO
CONTROL (FCTC)
 The first global health treaty negotiated by WHO
which details specific measures, such as:
o Increased taxation and comprehensive
bans on advertising of tobacco products.
o To reduce the demand for tobacco and
the supply of tobacco.
UNITED NATIONS CHILDRENS FUND (UNICEF)
 UNICEF is the driving force that helps build a world
where the rights of every child are realized.
 Created on December 11, 1946, originally as the
United Nations International Children’s Emergency
Fund.
 Believes that nurturing and caring for children are
the cornerstones of human progress.
 Advocate for measures to give children the best
start in life, because proper care at the youngest
age forms the strongest foundation for a person’s
future.
 19,000 children die every day from causes we can
prevent
 Promote girl’s education – ensuring that they
complete primary education as a minimum –
because it benefits all children, both girls and boys.
 Act so that all children are immunized against
common childhood diseases, and are well nourished,
because it is wrong for a child to suffer or die from
a preventable illness.
 Work to prevent the spread of HIV/AIDS among
young people because it is right to keep them from
harm and enable them to protect others. They help
children and families affected by HIV/AIDS to live
their lives with dignity.
 Involve everyone in creating protective environments
for children. They are present to relieve suffering
during emergencies, and whenever children are
threatened, because no child should be exposed to
violence, abuse or exploitation.
3
Nerona, Anne Martha A.
 They uphold the Convention on the Rights of the
Child – working to assure equality for those who are
discriminated against girls and women in particular.
 Part of the Global Movement for Children – a broad
coalition dedicated to improving the life of every
child. Through this movement, they encourage young
people to speak out and participate in the decisions
that affect their lives.
UNITED NATIONS DEVELOPMENT PROGRAMME
(UNDP)
 UNDP is UN’s global development network
advocating for change and connecting countries to
knowledge, experience and resources to help
people build a better life.
 Four main focus areas of UNDP:
o Poverty reduction and achievement of
the MDG’s (Millennium Development
Goals)
o Democratic governance
o Crisis prevention and recover
o Environment and energy for sustainable
development
UNITED NATIONS ENVIRONMENT PROGRAMME
(UNEP)
 UNEP is the voice for the environment within the
United Nations system.
 They act as a catalyst, advocate, educator and
facilitator to promote the wise use and sustainable
development of the global environment.
 UNEP work encompasses:
o Assessing global, regional and national
environmental conditions and trends
o Developing international and national
environmental instruments
o Strengthening institutions for the wise
management of the environment
WORLD BANK
 “Working for a World Free of Poverty”
 An international lending institution.
BSMT – 1H
 The World Bank is a vital source of financial and
technical assistance to developing countries around
the world.
 The Philippines has been a member since December
27, 1945.
 An investment bank that makes loans to developing
countries.
 Its primary lending institute is the International Bank
for Reconstruction and Development (IBRD)
 IBRD issues bonds in order to be able to make loans
to middle-income member countries and carry
interest rate slightly above the market rate. They
are usually supposed to be repaid within 15 years.
INTERNATIONAL MONETARY FUND (IMF)
 Provides a structure for international monetary
policy and currency exchanges, and also makes
loans to countries of any income level that have a
balance of payment need and would otherwise not
be able to make payments on their other
international loans.
 To allow countries to rebuild their monetary
reserves, stabilizes their currencies, continue paying
for imports, and create condition for economic
growth and employment rates.
EUROPEAN UNION (EU)
 The EU is a union of twenty-eight independent states
on the European Communities founded to enhance
political, economic, and social cooperation.
 United Kingdom is the first to withdraw from the EU.
 Formerly known as the European Community (EC) or
European Economic Community (EEC).
 Members: Austria, Belgium, Bulgaria, Croatia,
Cyprus, Czech Republic, Denmark, Estonia, Finland,
France, Germany, Greece, Hungary, Ireland, Italy,
Latvia, Lithuania, Luxembourg, Malta, Netherlands,
Poland, Portugal, Romania, Slovakia, Slovenia,
Spain, Sweden, United Kingdom (withdrawn).
Other than the UN organizations, international health
organizations are usually divided into three groups:
 Bilateral donor agencies
 Multilateral donor agencies
4
Nerona, Anne Martha A.
 Non-governmental organizations (NGO’s) or Private
Voluntary Organizations (PVO’s)
BILATERAL DONOR AGENCIES
 Official body for a single country, which provide
aid to developing countries
 Major organizations:
o United States Agency for International
Development (USAID)
 120 recipient countries
worldwide
o Japan International Cooperation Agency
(JICA)
 72 recipient countries worldwide
o United Kingdom Department for
International Development (U.K.DFID)
 27 recipient countries in Africa,
Asia and the Middle East
o Australian Agency for International
Development (AusAID)
o Canadian International Development
Agency (CIDA)
MULTILATERAL DONOR AGENCIES
 Agencies that represent a group of countries. The
term “multilateral” means that the funding comes
from multiple governments (as well as from non-
governmental sources) and is distributed to many
countries.
 Multilateral aid is money pooled from many donors.
 Often in the form of loans rather than gifts.
 Major multilateral organizations are all part of the
UN:
o World Health Organizations (WHO)
o World Bank
o International Monetary Fund (IMF)
o European Union (EU)
o United Nations Children’s Fund (UNICEF)
BSMT – 1H
o United Nations Development Programme
(UNDP)
QUASI-GOVERNMENTAL HEALTH ORGANIZATION
 Have some official health responsibilities but
operate in part like voluntary health organizations –
make important contributions to community health.
 Operate independently of government supervisions.
 Also receive financial support from private sources.
 Examples: American Red Cross (ARC), The National
Science Foundation, The National Academy Of
Sciences
NON-GOVERNMENTAL ORGANIZATIONS / NON-
GOVERNMENTAL HEALTH AGENCIES
 NGO’s are also known as private voluntary
organizations (PVOs)
 For most part, the agencies operate free from
governmental interference as long as they meet
International Revenue Service Guidelines with
regard to their specific tax status.
VOLUNTARY HEALTH AGENCIES
 Created by one or more concerned citizens who
thought that a specific health need was not being
met by existing government agencies.
 Examples:
o Alzheimer’s Association
o “The March of Dimes” – helped to
eliminate polio through its funding of
immunization research; Fights birth
defects; Fights all lung diseases thus the
Tuberculosis Society changed its name to
the American Lung Association.
BASIC OBJECTIVES OF VOLUNTARY HEALTH
AGENCIES / NGOS
 To raise money to fund their programs, with the
majority of the money to fund research;
 Provide education both to professionals and to the
public;
 Provide service to those individuals and families that
are afflicted with the disease or health problem;
5
Nerona, Anne Martha A.
 Advocate for beneficial policies, laws, and
regulations that affect the work of the agency and
in turn the people they are trying to help.
 Most voluntary agencies exist at 3 levels: National,
State, Local.
 At the national level, policies that guide the agency
are formulated.
 A significant portion of the money raised locally is
forwarded to the national office, where it is
allocated according to the agency’s budget. Much
of the money is designated for research. By funding
research, the agencies hope to discover the cause of
and the cure for a particular disease or health
problem.
PROFESSIONAL HEALTH ORGANIZATIONS OR
ASSOCIATIONS
 Are made up of health professionals who have
completed specialized education and training
programs and have met the standards of
registration, certification and/or licensure for their
respective fields.
 Examples: American Medical Association, American
Dental Association, American Nursing Association,
American Public Health Association, Society for
Public Health Education, Inc.
PHILANTHROPIC FOUNDATIONS
 Supports the community by funding programs and
research on the prevention, control, and treatment of
many diseases.
 Examples:
o Bill and Melinda Gates Foundation –
fund global health projects
o Rockefeller Foundation – funded the
development of vaccine for yellow fever
o Ford Foundation – contributed greatly to
family planning and youth sexuality
o Milbank Memorial Fund – funded
projects dealing with disintegration of
people with disabilities
BSMT – 1H
SERVICE, SOCIAL, AND RELIGIOUS
ORGANIZATIONS
 Members of this group enjoy social interactions with
people of similar interests in addition to fulfilling the
groups primary reason for existence – service to
others in the communities.
 Examples: Jaycees, Kiwanis Club, Fraternity Order
of Police, Rotary Club, Veterans of Foreign Wars
 Some NGO’s are faith-based organizations (FBO’s)
sponsored by religiously affiliated organizations.
 These groups contribute through donations of money
for missions for the less fortunate and/or solicit
donations from their members.
 Examples: Catholic Relief Fund, United Jewish
Appeal, Islamic Relief, World Vision, Other religious
support groups provide sponsorship of foodbanks
and shelter for the hungry, poor, and homeless.
OXFAM (OXFORD COMMITTEE FOR FAMINE RELIEF)
 “The Power of People Against Poverty”
 Worldwide, the most important NGO in long-term
international health is OXFAM, International.
 Founded in the UK in 1943, and now has affiliates in
10 other countries including the US.
 Since November 2013, OXFAM has invested $42 M
in the Philippines to help with:
o Clean water supplies, community latrines,
water pumps, cash vouchers for food
and home repairs;
o Fishing boat replacement and repairs;
o Clearing coconut tree debris;
o Setting up sawmills to convert the debris
into lumber for shelters.
CORPORATE INVOLVEMENT IN COMMUNITY AND
PUBLIC HEALTH
 Corporate America is very much involved in
community and public health such as:
o Safety of the work environment
6
Nerona, Anne Martha A. BSMT – 1H
o The use of natural resources and the World Health Health
discharge or wastes Organization (WHO)
United Nations HIV/AIDS
o Provision of healthcare benefits for its Programme on HIV/AIDS
employees (UNAIDS)
United Nations Office of Human Rights
 Many corporations today find that their single the High Commissioner
largest annual expenditure behind salaries and to Human Rights
wages is for employee health care benefits. (OHCHR)
World Food Program Hunger
 Many companies support health-related programs (WFP)
both and away from the worksite such as: substance International Court of Justice
abuse counselling, nutrition education, smoking Justice
cessation, stress management, physical fitness, International Labor Labor
disease management Organization
United Nations National Development
Development
GLOBAL HEALTH PARTNERSHIPS Programme (UNDP)
United Nations Population and
 Non-profit public-private partnerships are currently Population Fund Reproductive Health
working to set and accomplish goals for selected (UNFPA) Issues
global health issues: United Nations High Refugees
Commissioner for
o Foundation for Innovative New Refugees (UNHCR)
Diagnostics (FIND) Food and Agriculture Rural Development
Organization (FAO)
o Global Alliance for Improved Nutrition
United Nations Human Urban Development
(GAIN)
Settlements Programme
o Global Alliance for Vaccines and (UN-HABITAT)
Immunizations (GAVI)
NATIONAL HEALTH SERVICES
o Global Fund to Fight AIDS, Malaria, and
Tuberculosis (GFATM)
DEPARTMENT OF HEALTH (DOH)
o Health Metrics Network (HMN)
 Kagawaran ng Kalusugan; The principal health
o International AIDS Vaccine Initiative
agency in the Philippines.
(IAVI)

o Medicines for Malaria Venture (MMV)  It holds over all technical authority on health, as it is
a national health policy-maker and regulatory
o Roll Back Malaria (RBM) institution.

o Stop TB Partnership (Stop TB)  Responsible for ensuring basic public health services
to all Filipinos through quality health care and
PRIMARY FUNCTIONS OF UNITED NATIONS regulation of health goods and services.
AGENCIES  Provide special tertiary health care services and
technical assistance to health providers and
Agency, Program, Fund, Primary Work Area stakeholders.
Office
United Nations Children  Three major roles in the health sector:
Children’s Fund
(UNICEF) o Leadership in health
United Nations Environmental Health
Environment Program o Enabler and capacity builder
(UNEP)

7
Nerona, Anne Martha A. BSMT – 1H
o Administrator of specific services  The agencies under the DA with food safety
regulatory functions are the following:
 Framework for Health Sector Reform
a. The Bureau of Animal Industry (BAI), for food
Health Care
derived from animals including eggs and honey
Financing production.

b. National Dairy Authority (NDA), for milk

production and post harvest handling.
Health Health Care
Regulation Delivery c. National Meat Inspection Service, for meats.

d. Bureau of Fisheries and Aquatic Resources

(BFAR), for fresh fish and other seafood
Good including those grown by aquaculture.
Governance
e. Bureau of Plant Industry (BPI), for plant food.

DEPARTMENT OF ENVIRONMENT AND NATURAL
RESOURCES (DENR)
 Kagawaran ng Kapaligiran at Likas Yaman; Tasked
to formulate and implement policies, guidelines,
rules and regulations relating to environmental
management and pollution prevention and control.
 Formulate, implement and supervise the
government’s policies, plans and programs
pertaining to the management, conservation,
development, use and replenishment of the country’s
natural resources and ecological diversity.
f. Fertilizer and Pesticide Authority (FPA), for
pesticides and fertilizers used in the production
of plant and animal food.
g. Philippine Coconut Authority (PCA), for fresh
coconut.
h. Sugar Regulatory Administration (SRA), for
sugar cane production and marketing.
i. National Food Authority (NFA), for rice, corn,
and other grains.

 Promulgate and implement rules and regulations

governing exploration, development, extraction,
disposition, the use of the forests, lands, minerals,
wildlife, and other natural resources.

DEPARTMENT OF AGRICULTURE (DA)

Specific responsibilities of the DA:

 for the development and enforcement of food

safety standards and regulations for food in the
primary production and post-harvest stages of the
food supply chain.

 Shall monitor and ensure that the relevant

requirements of the law are complied with by
farmers, fisherfolks and food business operators.

 Pursuant thereto, the DA Secretary shall ensure that

the food safety regulatory mandates and functions
for fresh plant, animal, fisheries, and aquaculture
foods of the DA agencies are clearly defined.