Influence of globalization and international aid on the health outcomes:African Region

Размещено на http://www.allbest.ru/

FEDERAL STATE AUTONOMOUS EDUCATIONAL INSTITUTION

FOR HIGHER PROFESSIONAL EDUCATION

NATIONAL RESEARCH UNIVERSITY HIGHER SCHOOL OF ECONOMICS

Faculty of World Economy and International Affairs

“Influence of Globalization and International Aid on the Health outcomes:African Region”

BACHELOR'S THESIS

Field of study: International Relations

Degree programme: “HSE and University of London Parallel Degree

Programme in International Relations”

Zvereva Maria Alexandrovna

Moscow,2020

Content

• Abstract

Introduction

• Chapter 1.Theoretical aspects of globalization and international health assistance
• 1.1 Essence, conceptualization and indicators of globalization
• 1.2 Influence of globalization on health: previous research findings
• 1.3 Influence of international organization on health: previous research findings
• Chapter 2. Analysis of the impact of globalization and international assistance for health in the African region
• 2.1. Current state of the African region
• 2.2 Analysis of the impact of globalization on health in the African region
• 2.3 Evaluation of international health assistance in the African region
• Chapter 3. Directions for improving the impact of globalization and international health assistance: African region
• 3.1 Problems of development of globalization and modern international health organizations in the African region
• 3.2 Ways to solve the problems of further development of the African region
• Conclusion
• References

Abstract

Globalization as well as international organizations play a significant role in ensuring the development of the health sector in Africa, as they are able to influence both positively and negatively on the health of the population. On the one hand, they can help reduce mortality and disease rates. On the other hand, globalization and international assistance may not be equally distributed among the people of Africa or they can cause economic risks as chronic budget imbalances or differentiation of incomes of citizens of different countries.

The impact of globalization and the provision of international assistance are most significant for African healthcare, especially since both of them have provided significant support to the development of the African healthcare sector.

The relevance of this topic is due to the fact that the consequences of globalization, including international health assistance in the African region, are currently one of the most discussed issues. Today, the globalization of medical aspects is being monitored by both international and non-governmental organizations in the African region and in other countries. First of all, these issues are of concern to experts of the International labor organization, the world Commission on the social aspects of globalization and the UN Commission on social development. Globalization in the health care system is studied by the world's leading economists and scientists. Special attention should be given to the impact of social factors on population health, combating infectious diseases, especially TB, reproductive health and globalization issues of accessibility of qualified medical care for the population of the African region. It is extremely important to study the functioning of the world market of medical services, ways of its improvement and management, the state of health organization in the African region, the analysis of existing problems in the health system and the impact of globalization processes and individual social problems of society on the implementation of the strategy in the health system.

Introduction

Globalization affect almost all spheres of society: economic, political, and legal. In the second half of the XX century, the processes of modernization of health systems became global. Globalization itself is closely linked with international organizations and institutions, which are mutually complementary variables as they support and force the development of each other. Of course, they both have a significant impact on African health, and this effect can be evaluated from different prospectives.

Influence of globalization on health is ambiguous - can be both positive and negative. Some experts argue that globalization has a positive outcomes on the health of African population, while others claim that globalization effects only in a negative way. Globalization affects the national economies of countries, which in turn has an effect on the health sector, creating increasing competition in the market of medical goods and services, developing the social sphere and decentralizing the health system. The issue of development of the national economy is closely connected with globalization, because the country should be ready to face the effects of globalization and get rid of disintegration and social instability. Moreover, international assistance from various organizations and institutions is very important for the development of such sector as healthcare. The success and level of development of the health sector in Africa largely depends on the actions of international organizations and to the extent that this assistance will be equally distributed across all countries.

Local authorities play an important role, because they should know and understand the local needs of their population and correctly adopt the trends of globalization and distribute assistance from international organizations. The health sector is closely linked to social development not only locally, but also globally, since many international processes and further human development depend on the health of the population. Optimization and development of the health care system should be focused on qualitative changes in the health culture in the whole society. It is not only about the development of local health systems, but also about providing quality equipment, technologies and the knowledge of professional specialists.

Moreover, the health of the population depends not only on medicine and healthcare, but also on various other factors such as the social, political or economic sphere, specifically this work is aimed at analyzing the impact of globalization and international assistance on the health of the population of Africa and answers the question of how these two aspects affect African public health. A healthy population is one of the key aspects of the development of modern society, not only in developing countries, but also in developed ones. In this case, globalization and support from international organizations can stimulate the development of the African health sector, but in some aspects, it can become an obstacle to further growth and create various economic and social problems. Globalization and international assistance from various organizations both are significant factors that have a direct effect on the health sector.

International assistance in the field of health in the modern world is of key importance both at the level of an individual state in Africa and in the system of world economic relations. The consequences of globalization have an impact on all spheres of society, changing the motivation of economic actors at the micro level and changing the macroeconomic environment.

The processes of globalization and integration actively influence the strengthening of humanization and socialization of the economy and society as a whole. According to the World Bank, physical capital in the modern world economy forms 16% of the total national wealth, natural capital - 20%, and human capital-64%.

The global economy is a supranational economy that is based on the Erasure of borders, that is, the liberalization of cross-border operations with goods, labor and capital. The processes of economic globalization are associated with the creation of their own superpower mechanisms.

The most important criterion for human existence on the planet will remain its quality of life. Global issues of social quality of life - education, health, security, and so on-come to the fore. Therefore, the problems of the population, providing them with food and other resources, become priority and most relevant. The population of the planet is constantly growing throughout the existence of mankind. If 256 million people lived on Earth before the beginning of our era, then in 1000 ad - 280 million; in 1500 - 427 million. at the beginning of 1820-1 billion, and in 1927 already 2 billion men. The modern demographic explosion began in the 50-60 years of the XIX century. In 1959, the world's population was 3 billion, in 1974-4 billion, and in 1987 - 5 billion. it is Expected that by 2050, the world's population will stabilize and grow at the level of 10.5-12 billion, which is the limit of the biological population of mankind as a species.

The quality of population is defined as a set of medical-genetic and socio-psychological characteristics of people's lives. The quality of the population is usually characterized by such quantitative indicators as the state of health of the population, the percentage of the population that leads a healthy lifestyle, the level of comfort of life, the growth of spiritual and mental qualities of the population, the number of educational institutions in the state. The main indicator of the population is its number. The continuous increase in the world's population is a real concern. Analyzing historical facts and studying the conditions and features of life of various population groups in previous centuries, experts believe that the quality of population can change from one generation to another, because certain genotypes reproduce more intensively than others. For example, people with intellectual work often create small families. At the same time, statistics on the economic development of states show that each percentage of population growth absorbs several percent of the increase in national income.

Modern trends in the development of the world economic system cause the transfer of regulatory and managerial powers to the interstate or superpower level of international economic activity. States create international organizations to solve problems of cooperation, security and development on a global scale. The activities of international organizations provide for an assessment of the state of economic, social and cultural development of the world economic market. An extremely important aspect of the work of international organizations is to determine the impact of socio-economic factors on the health of the population, the duration and quality of life, because life is the most important value.

International organizations such as the United Nations, the international Monetary Fund, the World Bank group, and the World Trade Organization, which were created solely for the purpose of global regulation and management of global socio-economic development, now provide solutions to all existing problems, including in the field of medicine in the African region. However, under the influence of globalization processes in the economy and international relations, these organizations are not always able to effectively regulate the modern economic system and influence the timely adoption of measures to overcome socio-economic inequality on a global scale. In addition, decisions taken by global regulatory bodies can often, in a number of states, increase the disparity of socio-economic development, and on a global scale, deepen the dysfunctionality of the global economic system.

The United Nations Economic and Social Council (UN ECOSOC) is the Central forum for discussing international economic and social problems of a global and regional nature, as well as developing recommendations to address them. ECOSOC conducts research and prepares reports on a wide range of international economic, cultural and other issues, and coordinates the activities of relevant United Nations agencies and institutions. ECOSOC also regularly discusses issues of global economic and social development, the state of international trade, health and environmental protection, economic and technical assistance to developing countries, population, natural resources and food, planning and mobilization of financial resources, regional cooperation, and so on. Today, ECOSOC has developed the Global Sustainable Development Goals Program for the African region. The process of its implementation is periodically evaluated, which makes it possible to more accurately determine the state of world economic development, population health in the African region, food security, environmental conservation, the impact of industrialization on climate change, the level of education, gender equality, employment opportunities, and other human problems. All this ensures that possible measures are taken in a timely manner to adjust the mechanisms for regulating global economic processes in the African region.

Also, the United Nations Development programme (UNDP) is the largest international project to provide multilateral, technical and investment assistance to the African region. UNDP's projects are aimed at helping developing and poor states to improve their personal economic potential, improve the standard of living of the population, ensure access to medical care, increase production for employment, and promote environmentally sound economic development in the African region. International organizations play an important role in the development of the African region by providing them with appropriate technical, financial, medical, educational and educational assistance.

A significant role in the development of global socio - economic processes, along with world organizations, is played by public non-governmental organizations (NGOs), which currently number about 50 thousand.

Among international organizations, the World Health Organization (WHO) takes a special place in the organization that directly affects the development of the health sector. Its main goal is «to achieve the highest possible level of health for all peoples». The World Health Organization directs and coordinates international health work within the United Nations system.

Moreover, the World Health Organization helps to address both globalizing medical problems, coordinate the activities of governments, various foundations, private medical structures, and public organizations to achieve the goals set in the health system, and promote the implementation of national policies and strategies for the development of the medical sector and strengthen the network of individual medical institutions in the African region. The WHO takes part in many partnerships, including the United Nations and other international donor organizations, and civil society.

The key activities of the World Health Organization in Africa are: strengthening the health of the population of the African region, improving the health system and developing medical services, fighting non-communicable and infectious diseases, epidemiological control and supervision. The WHO defines principles and strategic directions of health policy based on legal and moral principles. This international organization coordinates priority issues to ensure the health of people in the African region, participates in the development of partnerships for joint global health projects, draws up long-term plans for research and development in the field of medicine, stimulates the dissemination and implementation of modern scientific developments in practice, promotes the implementation and application of norms and standards, provides technical support, initiates reforms in health systems around the world, contributes to the development of sustainable institutional capacity. The World Health Organization promotes healthy lifestyles and promotes human health by drawing the attention of society and governments to risk factors: environmental pollution, social and gender inequality, and legal aspects. The organization's activities are aimed at the successful implementation of planned activities within the framework of the 8 Millennium development goals, including reducing of child mortality, improving maternal health and combating HIV/AIDS, malaria, and other diseases.

Today, WHO implements more than 75 programs and projects, including WHO Global Initiative to support breastfeeding, in the field of school health, medical devices and equipment, and others.

In addition, ensuring governments to cooperate remains the long-term priority in the field of healthcare. Nowadays WHO gains more authority and resources than the previous international health organization under the auspices of the League of Nations. Today, almost all countries in the world, including the African region, are members of the World Health Assembly, the governing body of the WHO.

Today, WHO is competing with new international health organizations such as the Global Fund to fight AIDS, tuberculosis and malaria, the Global Alliance for vaccines and immunization, the World Alliance for breastfeeding support, and the Bill and Melinda Gate Foundation. This is the world's largest private foundation with the primary goal of providing global support to the health system and improving population's health and overcome hunger and extreme poverty in the African region.

Over the past half-century, not only the WHO contributed to the healthcare sector, but also the World Bank has played an increasingly important role in creating a global health system. This organization has significant resources, effective access to top managers in Finance ministries, and a staff of technical experts. The World Bank allocates billions of dollars in loans to improve the quality of medical care all around the globe.

Taking into account the complex dynamics of the indicators that WHO distributes, namely the analysis of other macroeconomic indicators that indirectly affect the level of organization of medical and pharmaceutical provision of the population in the African region.

The activities of such organizations illustrate the growing significance of globalization in the modern world and the importance of their activities in the form of international assistance, donors and special development programs for those in need. Thus, the process of globalization implies not only growing communication processes and connections, but also stimulates international aid assistance and the development of international cooperation in the field of interstate healthcare.

Problem setting

This work is mainly concentrated on the events of 21st century. Global processes affect almost all spheres of society and influence all its social institutions, including healthcare. Mostly, these changes have a positive effect on the development of the field of health care: the intensity of the exchange of scientific information, access to effective foreign medical technologies, the latest telecommunications tools that allow the introduction of remote forms of diagnosis, treatment and training of specialists At the same time, there are a number of problems that interfere developing of the African region' healthcare, which can be negatively affected by globalization, following with unequally distribution of international assistance. Some developing countries are not ready to meet the modern trends of globalization and are not able to enjoy benefits of it.

Taking into account such features as transformational processes in the healthcare sector, the scale of changes is determined by the political and economic situation in the country and he strategic significance of the tasks in the field of healthcare. This process is based on taking into account current development trends and those objective changes that are caused by globalization processes.

Summarizing the basic requirements for the creation of health systems defined by international institutions, it is possible to define three areas of cooperation between international organizations and member countries in relation to human rights, governance and finance.

Firstly, international organizations define the requirements for national health systems in terms of the content of the basic principles of democracy, human rights and the rule of law in the African region. All international organizations insist that all health systems must ensure the human right to access health care.

Secondly, among certain international communities and their requirements for health systems, those related to improving governance, including aspects such as transparency, accountability, efficiency, and so on, are important.

Thirdly, international organizations are making significant efforts to find new ways to finance health systems, in particular the use of institutions such as public-private partnerships and investment. At the same time, the principle of solidarity and efficient use of resources in health care in the African region remains mandatory.

The process of globalization is increasingly affecting the functioning of health systems, especially changes in the structure and functions of health institutions. All the achievements of science and technology create challenges not only for the medical sector, but also for the economy to optimize the number, geographical and technological availability. International organizations are an important source of expertise in the search for new ways to shape Africa's health systems.

Research Question

How globalization and the development of international aid affects healthcare in the African region?

Hypothesis

This work will allow us to consider to what extent globalization and international assistance can have positive or negative effects on the health outcomes of the people in the African region. In general, the process of globalization and aid from international organizations has a positive effect on African healthcare and shows positive indicators in many dimensions. It also illustrates the change of paradigms in health policy due to economic globalization.

It can be noticed that the impact of the activities of international organizations and globalization on the health outcomes of the African population depends on whether these processes are accompanied by the development of political institutions and increased state effectiveness.

Research and development of measures to improve international health will serve as the basis for further research to improve the situation in the African region. This will make it possible to build a more coordinated strategy for international organizations in the health sector.

Methodology

Based on a study of the economic and social aspects of globalization and international assistance, this research should determine their impact on African healthcare and assess the prospects for African health development in global integration. The identification of the main manifestations of globalization and the activities of international institutions in the field of health will allow us to identify the positive and negative consequences of their impact on the national health systems of African states, as well as to combine foreign experience with national characteristics in practice.

To assess the impact of globalization and international aid assistance on the health outcomes in African region, we use the method of cross-national analysis on determinants of life expectancy in Africa in order to compare life expectancy levels in different parts of the African region, as well as the reasons and prerequisites that led to such indicators. This method helps us to understand and evaluate in which cases globalization has had a positive or negative effect and has led to an improvement or decrease in the quality of healthcare policies of the region. We will also examine what current healthcare conditions exist in different parts of the African region and how international organizations and their aid assistance influence healthcare indicators. Using a cross-border analysis, the data was broken down into composite units and each indicator of international organizations was studied in detail. It provides us with the comparison of the healthcare policies in different African states and find out reasons why some states have higher indicators in this field, while others do have a lack of enough healthcare conditions for their population.

In order to identity the key trends of globalization' impact and international aid on African states we will use multimethod research design, which can provide us with a distinctive indicators of current situation in the field of healthcare in Africa and estimate preconditions for providing international aid from several international organizations.

Familiarization with scientific observations, which are based on current database of African healthcare sector, has allowed us to obtain objective information about the African region in natural conditions.

The comparison analysis made it possible to identify similarities and differences between activities of the international organizations in the field of health. The measurement allowed quantitative data to be collected and further measured for the study of large-scale phenomena in the African region. The obtained quantitative characteristics helped to identify general patterns and eliminate random minor deviations. Aside from analysis we use synthesis, where disparate elements were combined into a single whole. We use this method to get a general idea of the phenomenon being studied.

Analytical observation allows us to create certain conditions for conducting an experiment or a series of experiments, in which international organizations conduct their activities in the healthcare sphere. Next, we considered observing the effectiveness of actions of the international organizations and focusing the results of experiments in further analysis.

Literature review

Scientific literary sources illustrate that much attention was paid to some aspects, highlighted in the topic of this study.

The theoretical and methodological focus of the study was based on the works of domestic and foreign researchers in the field of international health, such as: Aantjes C., Quinlan T., Bunders J., Frich JC., Brewster AL. and others.

The scientific literature pays great attention to the causes of poor health. It is often called low financing of the industry, considering it as an inevitable consequence of the transition economy. But for such cases, the most recent studies focus on the required quality support of international organizations, not only in the field of healthcare, but also in economic terms.

Scientific studies in this area indicate that the process of globalization is controversial and has different consequences for the development of some countries. Developed countries tend to note the positive impact of globalization in general, while in countries with economies in transition and developing countries, the situation is not as clear as in the developed ones.

1) Positive impact of globalization and international organizations on health outcomes in African region

Scientific literature on the impact of globalization on health development in the African region is largely agreed that globalization is a resource and source of the modernization process and contributes to fundamental changes in the management of the health system, based on the preservation of the basic values of the African region.

In Sheffield's work (2013), the issue of political aspects of the globalization of the medical services market provides for the simplification of the principles of national sovereignty of the African region, which for many centuries has been the main theme of international relations. In addition, the increased activity of international organizations to monitor public health has become an important aspect of the politicization and globalization of the medical industry in the African region.

West (2010) argues that at present, the processes of globalization, both in the economy and in medicine, are modern effective levers for the development of the health system of the African region as a whole, the further development of medical science, the introduction of modern high-tech expensive methods of diagnosis and treatment, which creates new opportunities for providing highly qualified specialized medical care on a large scale. Scientists around the world are working to study the impact of various aspects of globalization on the effectiveness of the health system in the African region. Along with globalization, the activities of international organizations and international assistance make a significant contribution to the development of African health.

Existing studies highlighted that the UN, in addition to those who deal with global health issues, has specialized international UN organizations, namely: the International Labour Organization (ILO), the Food and Agriculture Organization (FAO), the United Nations Educational Organization, and the Scientific and Cultural Organization (UNESCO). The activities of these global organizations, in particular, are related to solving existing problems in the field of health organization, medical science and the globalization of the medical services market.

Another globalization theorist Bardhan (2007), focuses on consequences of globalization such as spreading of information and communication technologies, that eased interaction among countries. This process allows to develop the field of medicine of national states through the expansion of specialized knowledge, technologies and qualified staff, enabling developing African states to implement modern medical methodic.

2)Negative impact of globalization and international organizations on health outcomes in African region.

Specific influence of globalization on African healthcare was identified ,according to Rowson et al.(2012 ) in the political aspect, where erosion of sovereignty is shown in economic and financial issues, as a result of the imposition of specified policies and programs of development by the UN agencies, World Trade Organization (WHO) and International Monetary Fund (IMF).

Since financing and investing in the healthcare play an important role for our research and strategy development for international organizations in the health sector , according to Skovdal (2015) . More important is the fact of emergence the risks of the modern world economy, in particular the chronic budget imbalances, the food and water crisis, the growth of greenhouse gas emissions and the differentiation of incomes of citizens of different countries. The views of Pappas and Hyder(2003) sounded in unison that restrictions on people's rights to decent health care are caused by globalization.

Scientist McCall (2006) considered threats to the internal institutional environment in the African region. In the context of globalization and international aid, competition between countries is increasing, which creates additional competitive incentives for innovation and improving the efficiency not only of the health sector, but of the economy as a whole. For the development of the country, in modern conditions, it is necessary to rely on the health of people, which are especially important in building a new economic order in the state, based on knowledge and information in the African region. Therefore, in the context of the modern, high-productivity economic system, the African region needs to have special focus on areas such as medicine and education.

“Globalization has expanded labour force across national boundaries and facilitated brain drain. It facilitated “brain drain” in developing countries, thus reducing further their prosperity of the human capacity” as argued Mowlena (1998).

According to Ssengooba (2003) , special attention is also paid to the fact that the formation of an effective model of international health in the African region is impossible without taking into account the consequences of globalization, since both foreign and domestic economists, scientists and politicians have repeatedly noted that the degree of its participation in the global space depends on how quickly and adequately the African region can perceive aid and reach a «new level».

In addition, Tendon (1998) stated that globalization does not guarantee the ultimate development of countries, and even in some cases discriminates countries from the possibility of further prosperity, since the country is not ready to face the consequences of global processes.

Further, Mule (2000) views that international assistance from relevant organizations is distributed far unevenly among developing countries. International organizations should take into account the local needs of different parts of Africa and provide support according to specific local problems in order to facilitate the development of the healthcare sector.

3)Economic feasibility of medicine

The social aspect of the globalization of medicine is characterized by the fact that market mechanisms are increasingly developing and spreading in the health system, according to Hughes (2008). That is why the medical service acquires product characteristics, the market for medical services becomes more commercial, and the need and volume of medical care receive a new evaluation criterion - economic feasibility.

The work of Ebrahim (2015) should be mentioned, as he also investigated the economic aspect of market globalization, where medical services are primarily associated with the liberalization of trade in medical services, the growth of consumption of services, and cross-border deliveries of medical services (telemedicine and e-health). The legal aspect of globalization is accompanied by an increase in the volume of transactions related to intellectual property rights for medicines and treatment methods. In modern conditions of the world economy development and functioning of national health systems, the issues of regulating the population's access to medical care and providing them with high-quality medical care are relevant, which require further study.

Globalization has facilitated international trade and commerce in a medical field as well as stimulated foreign direct investment (FDI) and capital flows, while also calling for greater accountability and responsiveness of authorities to their nations. In addition, the African healthcare sector is a completely new direction for the flows of foreign capital investments, according to Sachs (1996).

Expected Outcomes

Summing up the results of the study, we note that the influence of globalization' processes and international organizations on national health systems is gradually increasing, and therefore, their achievements require further scientific research, which will eventually contribute to the formation of recommendations for reforming the African health system.

The scientific novelty of this work is to study the development of globalization and modern international health organizations and to develop solutions to problems in the African region.

In accordance with the set goal of analyzing the impact of globalization and international aid on health outcomes in African countries, tasks were set:

- consider the theoretical aspects of globalization and international health assistance;

- analyze the impact of globalization and international health assistance in the African region;

- explore ways to increase the impact of globalization and international health assistance: the African region.

Chapter 1. Theoretical aspects of globalization and international health assistance

1.1 Essence, conceptualization and indicators of globalization

Globalization has two directions of development:

- territorial or extensive direction

- high-quality, deep direction, which is characterized by an intense sense of development.

Economic globalization in an extensive (territorial, spatial) sense means the existence of certain links between national economies, and it is not easy when, as a result of these links, there is a certain mutual influence between them, and there are additional external effects of influence on other economies that are indirectly or even not related to these economies at all.

In other words, “the spatial actions of world economic relations are expanding, their extensive strengthening is taking place, and they cover an increasing number of countries that previously did not participate in global processes “as ODowd (2006) stated.

The intensive direction of globalization is the entry into world economic relations of a new quality-the strengthening of interdependence and interaction of all spheres and components of international relations (economy, politics, law, culture, health, ecology, religion, etc.).

If at previous stages of internationalization of international relations economic imperatives were recognized as dominant, now the importance of other factors - political, cultural, legal, environmental, religious, etc. - is increasing.

The presented regularities are also manifested in the globalization of the economic sphere of world economic relations. Extensive (territorial, spatial) direction forms the world economy into a kind of global integrity.

Today, opportunities have been created for the development of economic ties between national economies that are heterogeneous in size, degree of development, and other characteristics. There is an increase in the mobility of production factors, which makes it possible to effectively use them on any territory and, if necessary, quickly move them depending on the situation (Willott,2012).

The intensive (qualitative) aspect of economic globalization is manifested in the deepening of interrelations and interdependencies of all spheres and components of world economic relations, which are becoming more complex and intertwined. For example, international trade at the present stage should be considered together with international direct investment.

The globalization of world economic relations is manifested as a dense and stable combination of individual factors that contribute to both its extensive (spatial) and intensive (qualitative) development.

Regarding healthcare sector, the main factors determining the current content of economic globalization are the following:

1. Intensification of external commodity flows. The liberalization of world trade, the deregulation of medical commodity and capital markets, and other forms of economic liberalization that have led to restrictions on protectionism have increased the trend towards internationalization of economic activity and made world trade freer, which in turn provided an opportunity to expand the market for medical goods and services in the global stage.

2. Reduced transport and communication costs as a result of the emergence of a qualitatively new generation of transport and communications, the deployment of the global information technology revolution, the emergence of the Internet, created opportunities for rapid movement of medical resources , specialists and equipment, in order to apply them in the most favorable conditions.

3. Accelerated growth of the manufacturing industry, intensification of international inter-firm cooperation in various forms, especially specialization and cooperation (Klochko,2018). This allows medical enterprises to place their assets in a more suitable location and expand opportunities for cooperation with other medical organizations.

In the second half of the twentieth century, the growth rate of the manufacturing, mining and agricultural industries increased sharply.

Technological progress in the manufacturing industry has created opportunities for dividing production processes into separate stages and placing them in different countries in the most optimal way, which has influenced the deepening of the International Division of Labor (IDL).

On this basis, international production cooperation has also begun to develop actively. The technologically interconnected production of parts, components, and semi-finished health products increased the economic interconnection between countries and continents.

4. Intellectualization of the economy. The acceleration of scientific and technological progress, with the mobility of new technologies and the increasing role of highly qualified specialists, has led to the formation of a “new economy”. In a global world, technology and new information products move almost as fast as capital and natural resources.

5. Transnationalization of production. The concentration and centralization of capital has led to the growth of large companies and financial groups that increasingly transcend national borders. A significant expansion in the scope of TNC activities has occurred as a result of rapid technological progress, increased management capabilities based on new means of communication, and policies of trade liberalization and capital movement.

6. The Struggle for the possession of resources and their distribution. The growth of world production has exacerbated the issue of its resource provision. First of all, this concerns energy resources (oil, gas). The network of oil and gas pipelines and electric power transmission systems, that transfer energy resources from developing countries to developed countries, has become an important factor of globalization (Leshchuk,2017). The situation, regarding healthcare is even more complicated since it is quite problematic to get quality certified medicines and medical equipment. Especially for poor countries in Africa, which often suffer from various diseases and epidemics due to the underdevelopment of the medical sector and also due to lack of finances to ensure an adequate healthcare system.

7. International labor migration. The liberalization of national migration policies has led to an increase in the volume of labor movement between countries. Thus, the main migration flows are related to the movement of unskilled or low-skilled labor from relatively poor countries to developed countries. Thus, leaving developing countries without qualified medical professionals.

8. Globalization of financial markets. Globalization of the global financial market implies:

- growth on a global scale by expanding to global dimensions the spheres, forms and mechanisms of internationalization of capital;

- an abrupt increase in the scale and intensity of its migration between states, especially industrialized countries;

- increasing the concentration and centralization of capital through mergers and acquisitions of companies and banks;

- a sharp increase in the influence of the financial and banking sector, which has reached a very high level of globalization, on material production.

This strengthening of the global financial sector has enabled organizations such as the World Bank or IMF to conduct successful sponsorship and financial assistance programs for countries in need where the level of healthcare remains quite low.

9. Formation of an international infrastructure that creates the basis for the development of the international healthcare sector and includes:

- the international transport system as a set of vehicles and transport communications of the world's countries for the movement of patients and various medical cargo in order to ensure the effective functioning of international medicine;

- international communication, which covers a set of means of transmitting information between countries and provides an opportunity for subjects of foreign activity to actively exchange information, make timely decisions and thus ensure a continuous development process;

10. Development of regional integration. Subsystems of the world economy are regional, local associations and groupings, within which there are national states that have strong trade, political and socio-cultural contacts. The largest regional associations in Africa are:

· Southern African Development Community (SADC)

· Community of Sahel-Saharan States (CEN-SAD)

· East African Community (EAC)

Through African regional integration, it becomes possible to unite chaotic health systems of different countries into a single whole unit and thereby effectively improve the overall health system of the African region, that proposed by Hailemariam (2015).

11. Affirming the global regulatory role of international institutions that create the institutional superstructure of globalization. Global regulation is carried out within the framework of such organizations as the United Nations, the International Monetary Fund (IMF ), the International Bank for Reconstruction and Development (IBRD),the World Bank, the Organization for Economic Cooperation and Development (OECD), the World Trade Organization, annual meetings of leaders of leading countries in the G7 or G8 format, world forums, summits, etc.

12. Harmonization of standards (technological, environmental, statistical, accounting, financial, educational, etc.), which creates conditions for ensuring a sufficiently strong combination and interchangeability of various products and their components, as well as technologies and phases of the reproduction process. This contributes to free competition in the world market of healthcare and the development of various international relationships.

13. Unification of consumer preferences and living standards. Cultural factors of globalization cause the convergence and intertwining of lifestyles and consumption patterns on a global scale and the universalization of consciousness and culture. One of the most striking examples, which confirms the phenomenon of market globalization, is the concept of «world product», that is, there are more and more products that can be said: «made in the world» (Klochko,2018).

14. Formation of the economic ideology of globalism based on the principles of the Washington consensus, which was actively promoted by international organizations and implemented by many countries in the last decades of the twentieth century. The political and economic formalization of the global economic doctrine (the Washington consensus) was the ideology of radical liberalism and neoliberalism (the welfare state). Neoliberal concepts have led to significant liberalization of foreign economic relations, which have led to an increase in the volume of cross-border movements of goods, services, labor and capital. As various organizational, administrative, legal, economic and technical barriers are reduced and even eliminated, most of the states of the modern world are becoming more interconnected and interdependent within the framework of a single economic space, on a global scale.

15. Global integration of socio-cultural spheres, which is expressed in many different aspects, such as the formation of globalized mass media, art, culture; the acquisition of the international status of the English language, which facilitates communication, learning and mutual understanding; overcoming borders in education through the development of distance learning , which allows doctors around the world to accumulate knowledge and apply it in their country, regardless of location (Leshchuk,2017).

The considered factors of development of globalization of the world economy reveal its modern content and contain progressive features that contribute to the further evolution of the world economy, socio-economic progress and universal healthcare.

Due to the influence of the main factors of the development of globalization, the economy is beginning to be formed as a quantitative process of increasing the scale of world economic relations. In the XX century the internationalization of commodity exchange develops into the internationalization of capital and production, receives a significant impetus for development under the influence of scientific and technological progress, improving transport, communications and the internet. There is a sharp deepening of the international division of labor and, as a result, international specialization and cooperation. The volume of domestic markets does not meet the requirements of large-scale specialized production, which transcends national borders and acquires global significance.

Perhaps the further research of the development of globalization processes requires a flexible combination and use of the factors considered. At the same time, these processes and phenomena are quite contradictory and contain many threats that need to be taken into account when developing public health policy, analyzing hypothetical directions for the further development of the globalization of the world economy.

1.2 Influence of globalization on health: previous research findings

Criticism of globalization is heard everywhere. And from the mouths of anti-globalists, and some politicians, who are trying to resist the uniformization of the world. And numerous experts and scientists are not far behind with accusations that the world system model of human development is full of shortcomings. But nevertheless, is it possible to stop progress? Instead, should we take into account not only the positive but also the negative aspects of globalization, its interference with other political, economic, social and cultural processes?

To avoid a meta-theoretical or purely normative analysis of the development of global interdependence, the formation of humanity as a whole (which is in fact globalization), Our research looks at a specific area of policy - health, the area that affects a wide range of people, because we are talking about issues of life and death, a sphere that is traditionally considered the prerogative of the state, at least the one that seeks to ensure the implementation of positive human rights (Aantjes,2019).

The study of health and its protection is no longer a monopoly of physicians. Philosophers, sociologists, economists, lawyers, political scientists, and specialists in public administration resort to research in this area. Currently, health is considered as a complex biomedical, social, philosophical and economic category, a determinant of social development and an indicator of the effectiveness of public administration. Increasingly, health issues are becoming the subject of the political agenda and attract the attention of public policy actors. The search for modern strategies and ways to improve the health situation often takes place at the supranational level, but the implementation of these strategies depends not only on global factors. Such trends in health policy require proper scientific analysis.