Trade, foreign policy, diplomacy and health

1. Global Public Goods and Health: concepts and issues

David Woodward, Richard D Smith

What may be GPG for health?

  • Knowledge (and technologies)
  • Policy and regulatory regimes
  • Health systems (as key access goods)

What interventions may be classified as GPGs for health?
The scope of potential GPGs is wide, but can be broadly divided between

  • those which address in-country health problems with cross-country externalities (primarily communicable disease control, but perhaps also non-communicable disease control to the extent that it has economic effects),
  • and those which address the cross-border transmission of factors influencing health risks (e.g. food safety, tobacco marketing and international trade in narcotics).
Within each of these categories, GPGs may then be classified in to three broad areas:
  • First, knowledge and technologies. Information per se, such as on health risks and treatment régimes, is in principle both non-excludable and non-rival in consumption, at all levels from local to global. However, in practice, it may not be (eg control of communicable disease relies on countries to produce and to act on information, which requires an effective health infrastructure). Similarly, much of the technology for curative and preventive interventions is embodied in private goods such as pharmaceuticals and vaccines, turning a GPG into a club good.
  • Second, policy and regulatory régimes. The collective nature of policies, whether in health or other sectors, makes them public goods. Regulatory régimes (e.g. for food and product safety or pharmaceuticals) are ‘club goods’, as groups can be included or excluded by a regulation, but once a regulation exists it can apply to one or many.
  • Third, health systems act as access goods. Eg eliminating polio depends on the existence of a functioning health system to deliver vaccines and to identify and treat cases. Health systems may thus be treated as if they were GPGs.