6. Public Health Infrastructure and Knowledge
John Powles, Flavio Comim
Public health infrastructure as "access" goods
- Public health infrastructure provide access to other (global public) goods for health (e.g. CDC requires policy regimes, surveillance and vaccines)
- Spatial dimension of public health infra-structures extends from local to global
- Public health infrastructures contribute directly to final GPGH provision (e.g. sewers) and indirectly (e.g. education)
The more foundational properties of public health infrastructure are in providing access to other (global public) goods for health. Eg control of cross-national communicable disease is a GPGH, but achieved using ‘access goods’ of policy regimes, surveillance and vaccines.
The spatial dimension of the three elements of public health infra-structure, may be envisaged as extending from the local through to global level. However, it is more likely that the national provision of these elements will contribute to global externality effects within the realm of public health. Eg the prevention of international transmission of disease. The global transmission of medical knowledge (both popular and professional public health knowledge) and of organisational solutions to health problems may thus help provide the tools to tackle those tasks, and itself exert an important externality effect in contributing to improved health in countries other than the one in which the relevant disease control methods were developed.
Public health infrastructures may therefore best be seen as 'access goods', because they contribute to the provision of final GPGH. This may be directly, such as through the provision of sewers, but also indirectly, through externality effects. For example, in the case of medical and organisational knowledge, positive externalities may have an international domain, as in the case of the smallpox eradication programme in Africa (1959-1980), which left a legacy of useable and transferable skills for other vaccination and control programs. For practical purposes then, the provision of access goods may be seen as part of the general provision of GPGH.