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

In general, the effectiveness of the health system in each country is determined by an effective and adequate state policy in the areas of medical care, the achievements of science about health, the state of information and educational work, valeological education of young people and adults. An important factor in the effectiveness of the healthcare sector is the level of its state funding, control over the quality of medical services and training of medical personnel (Lepers,2018).

For the African region, the process of improving the health sector is one of the most urgent and problematic areas of internal political development. The medical sector in the African region is in crisis as a result of commercialization and incomplete reforms, the spread of corruption, low quality of medical services, and limited and increasing inequality in access to modern forms of medical care (Jefferies,2015).

The decline in the quality of life of most social groups, political instability and socio-mental stress in African society caused a significant drop in the level of health of the population in the 1990s. After a period of stabilization and improvement in the 2000s, negative trends in the health of the population began to appear again in 2014, although their causes differ from the previous one - the first crisis stage of the post-Soviet development of African region society. Increasing mortality rates due to increased diseases and disabilities, low birth rates, depopulation (reduction of the country's population), as well as the spread of risky health behaviors are destructive manifestations and consequences of the ambiguous and incomplete social transformations that African region society has been experiencing in recent decades. Existing health problems in the African region, which cause serious concern on the part of specialists, are confirmed by statistical and sociological indicators (Kishore et al,2019).

Statistical indicators of health of the population of African region. Among the health pathologies common in African region society, the first places in their rating are occupied by non-communicable diseases - cardiovascular, neuropsychic, oncological diseases, as well as injuries (Klochko,2018). In 2019, a total of 662.4 thousand people died in the African region, including 440.4 thousand people due to circulatory diseases (66% of the total death rate is the first among the causes of death) and 92.3 thousand people - from oncological pathologies (13% of the total death rate is the second place). About 7% of deaths in 2019 were caused by external causes-injuries in accidents, poisoning and others. The causes of death from these diseases and injuries are unfavorable socio-economic conditions, low level and quality of life, and the spread of unhealthy and risky forms of life practices.

Human health, its protection in the form of medical care and disease prevention are relevant problems of social development in all countries and the world as a whole. The strategy of health saving is reflected in such UN and WHO documents as the «World Declaration on Health» and «Health-21». European region has its own policy framework for achieving health for the whole European Union- «UN Millennium Declaration».

It should be noted that one of the main reasons for increasing the role of preserving health are those manifestations of social progress that have ambivalent consequences for people's lives and health. Thus, as a result of the gradual urbanization of life, the widespread use of vehicles, as well as mechanization, automation of industrial and domestic work, the spread of information and computer technologies in all spheres of life significantly reduces the need for physical effort, physical movements. Under these conditions, a sedentary lifestyle, along with an unbalanced diet, drug use, and Smoking pose increasing risks to people's health and lives. This leads in recent decades to significant changes in the structure of causes and manifestations of the disease - non-communicable diseases have become the main cause of health pathologies and mortality. Thus, according to the UN, at the beginning of the new Millennium, no communicable diseases accounted for almost 60% of the total number of deaths and 47% of the total burden of disease (Youde,2018). These are diseases such as cardiovascular diseases, diabetes (type 2), cancer, and others. In this aspect, the optimal mode of physical activity along with a balanced diet, psychology, overcoming bad habits considered by experts as a major and effective methods of prevention of no communicable diseases, an important direction of the strategy of health care in modern conditions (Adepoju,2011).

In the African region, as in most European countries, the prevalence of chronic non-communicable diseases is a priority public health problem that negatively affects the medical and demographic situation, leading to a significant level of morbidity, disability, mortality, low quality and short life expectancy. Within the framework of the concept of Health System Reform, the successful fight against real threats to public health lies in the plane of a comprehensive integrated intersectional approach on a program-target basis (Brolan,2018). Solving public health problems requires improving its determinants, reducing the prevalence of risk factors, and implementing modern prevention strategies and promoting a healthy lifestyle. It is well known that prevention of non-communicable diseases is 2.7 times less expensive than treatment of patients. At the same time, a healthy lifestyle of the population is 5 times more effective than the medical and diagnostic activities of the healthcare industry related to the preservation and strengthening of public health (Bozorgmehr,2019).

It should be noted that in the society of the African region, as in most countries of the world, none of the institutions of society has formed an effective and effective organizational system for the prevention of no communicable diseases, maintaining a healthy lifestyle, and promoting its values. Institutions related to health care (medicine, sports, recreation) operate more within their institutional space, largely in isolation. Since the preservation of health is a complex problem and a strategy for the development of society, it needs institutional intersectional integration not only within the framework of legal and policy documents, but also in the mode of activity between the relevant institutional structure or institutional complex. Thus, a well-known specialist in the field of valeology, doctor of medical sciences Apanasenko in 2004 at the conference «Health Management» expressed the idea of the importance of creating a new organizational structure that would deal with the prevention of diseases and the formation of a healthy lifestyle culture of the population. Its tasks should not be treatment, but the process of forming and improving the culture of health and a healthy lifestyle of the population (Bozorgmehr,2019).

3.2 Ways to solve the problems of further development of the African region

Four major factors contributed to the development of countries that were moving forward.

Most countries in sub-Saharan Africa, by contrast, are oil importers and have benefited from falling fuel prices. Some countries, such as Cфte d'Ivoire, have benefited from higher export prices (in this case for cocoa) and lower import prices for oil. Similarly, many countries are food importers, and lower prices for rice, wheat and other food products have benefited them. Countries with more diversified exports tend to have a more moderate impact on export prices, while they benefit from imports. As before, the growth rates of Kenya, Mozambique, Rwanda, Tanzania and Uganda are expected to reach 5% or more this year.

Demographic changes are another major challenge. The population of sub-Saharan Africa is projected to increase from 965 million in 2016 to 2.1 billion in 2050. Nigeria's population alone could reach 400 million by 2050, more than doubling the current population. Urban population growth will be particularly rapid, which will create serious problems related to job creation, infrastructure, education, health and agricultural production (Aantjes et al.,2019). However, the demographic changes are also creating opportunities: as history shows, population growth does not necessarily limit growth rates. The growth of the urban population, the increasing share of the working - age population, and the increasing participation of women in the labor force all create opportunities for the growth of manufacturing and services, much as has been the case in recent decades in Asia, especially when investments in infrastructure and education are made.

Overcoming these challenges will test the skills of a new generation of African leaders. However, even in this case, the consequences are likely to be very different: countries with the most diversified export base are likely to be less affected, while countries with a narrow export base and weak public administration will be the most affected. In order to achieve further long-term progress during this difficult period, measures must be taken in four areas.

First of all, it is good macroeconomic management. Growing trade deficits put pressure on foreign exchange reserves and currencies, tempting policy makers to try to artificially maintain exchange rate stability. Parallel exchange rates have started to appear in several countries. However, as commodity prices are expected to remain low, maintaining fixed exchange rates in the future is likely to lead to even more significant and heavier exchange rate adjustments. However, it may be difficult, because countries must allow their currencies to decline in order to stimulate exports, contain imports, and support reserves. At the same time, budget deficits are increasing, and due to limited borrowing options, difficult choices must be made to cover this deficit. Its essence is the ability to attract domestic resources and increase tax revenues, which will allow countries to control the deficit and at the same time Finance critical investments in roads, energy, schools and clinics (Brolan et al.,2018). The amounts in question are considerable: every percentage point of increase in income as a share of sub-Saharan Africa's GDP as a whole brings in an additional $ 17 billion. US $ per year. In some countries, it may be appropriate to increase domestic revenue through loans, especially for priority infrastructure projects. However, the debt burden is growing, interest rates are rising, and spreads on sovereign bond issues in Africa are rapidly increasing, which is holding back further borrowing.

Second, countries should vigorously diversify their economies and get rid of their dependence on commodity exports. Governments should create a more enabling environment for private investment in further agricultural processing, manufacturing and services, which will help increase the number of jobs created, accelerate long-term growth, reduce poverty and minimize vulnerability to price volatility.

The consequences of current commodity price shocks are so great precisely because countries have not diversified their economic activities. Specific measures will vary from country to country, but they should start with improving agricultural productivity, creating more effective educational and Advisory services, building quality roads connecting farms to the market, and ensuring that price and tariff policies do not disadvantage farmers. Investments in energy, roads and water are crucial. These investments must be financed by a skillful combination of prudent borrowing with increased domestic revenue (Hoy et al.,2018). However, the basic costs of doing business in many countries remain high. To help companies compete, governments must reduce tariff rates, reduce red tape, and eliminate unnecessary regulations that hinder business growth. It is time to reduce business expenses and promote competition at the domestic, regional and global levels.

Third, Africa's progress cannot continue without strong education and health systems. The quality of schools suffers from outdated curricula, poor teacher training, insufficient local control, teacher absenteeism, and low teacher pay. Similarly, health systems remain weak, underfunded and overloaded, as evidenced by the recent outbreak of Ebola virus disease. Robust measures are needed to increase access to health facilities, train health professionals, and strengthen health systems in General.

Fourthly, further long-term progress requires strengthening institutions of good governance and deepening democracy. A more effective system of checks and balances of power through more effective legislative and judicial bodies, increased transparency and accountability, and a stronger voice for the people are what is needed to sustain progress. In some undemocratic countries, the situation is good, but most authoritarian governments show disastrous results of public administration (Bitton et al.,2019).

Finally, the international community has an important role to play. Foreign aid has helped to maintain the acceleration of development, and further aid will mitigate the effects caused by the slowdown in growth. Greater long-term commitments are needed, especially in the case of countries with better governance that demonstrate a high commitment to progress. Direct budget support will help, as far as possible, alleviate adjustment difficulties in countries that have been most affected by commodity price shocks. In addition, donor financing of infrastructure, preferably in the form of grants and concessional loans, will lay the Foundation for long-term economic growth and prosperity. It is not yet time for rich countries to lock themselves in and erect trade barriers. Many States, on the contrary, should encourage further progress and economic diversification by reducing barriers to trade in products from the least developed countries in Africa.

The slowdown in the global economy creates serious problems that are not easy to overcome. In the next few years, economic growth in this region is likely to moderate, and the pace of overall development progress is likely to slow. In some countries, especially those that depend on the export of several commodities, the slowdown in growth may be quite significant. Policy makers may not be able to achieve high growth rates immediately, but they can do much to keep the slowdown under control and strengthen the Foundation for sustained progress. As for the longer-term horizon, the dramatic improvements in public administration, capacity-building and the promotion of a new generation of leader's point to a promising future.

With concerted action and bold leadership, it is expected that many African countries will continue to make significant development gains over the next twenty years and will continue to reduce poverty, improve governance and improve well-being.

globalization health international african

Conclusion

Globalization and international assistance can both positively and negatively affect the health of the population of Africa, but despite some negative indicators, the effectiveness and positive impact of global processes and the activities of international organizations stimulate and support African healthcare, helping to combat diseases, reduce their spread and decrease mortality rates throughout the whole African region.

The analysis of threats to the healthcare development of the African region concerns the globalization of the world economy, post-industrialization, financial and economic crises, as well as the activities of modern pharmaceutical TNCs, developing new medical innovations from leading competitive economies, which provides a passive technological breakthrough. Electronic infrastructure is being developed.

Globalization creates great opportunities for maintaining sustainable economic growth and social development in general. The main task of the state is to achieve a balance between new globalization opportunities and risks for the population. The degree of influence of negative factors on the national health system should be correlated with the help of an effective domestic public policy. At the same time, direct borrowing of standards and rules developed in advanced societies is unacceptable, and the development of own institutions and mechanisms is associated with radical transformations of the economy and society that meet the challenges of the time, but at the same time taking into account the historical traditions, socio-cultural and socio-economic characteristics of the country.

Also, globalization has determined the interdependence between forms of international economic relations, which in turn has led to the development of cooperation not only between countries, but also between international organizations.

The review of the influence of international organizations has shown that the issue of health and the functioning of health protection systems of the African region is not only a state interest, but an interest of the whole international community. International organizations have identified key principles and factors that must be taken into account both in the formation and reform of national health systems.

The influence of international organizations can be manifested in their financing of the health system in Africa, sponsoring various medical researches and providing the necessary equipment and qualified staff to the African region. International assistance and various humanitarian programs can contribute to the development of African health, in case that this support from international organizations is equally distributed throughout the whole African region. Promoting the development of the health sector in Africa is an independent area of international cooperation and implies a part of foreign assistance aimed at the development of medicine and health care in the African region.

The effectiveness of international organizations and the provision of international assistance largely depends on the volume of this assistance provided by rich countries to poor countries. This is especially important in the health sector because each country has its own problems and needs, so donors and various humanitarian programs should take into account the local needs of African countries, because basically poor countries finance their healthcare sector through this humanitarian assistance. It should be concluded that international organizations play a significant role in the development of the African region by providing them not only with appropriate specialized medical assistance, but also with social, economic, educational ,technological and many others.

Such assistance forces health improvements and the developments of the whole African healthcare sphere. Although allocation of this aid should be more balanced and equally distributed among African states, especially across disease areas, there are many humanitarian programs by international organizations, which finance expensive medical researches, sponsor the construction of hospitals and necessary medical facilities, and help to ensure proper monitoring of the spread of disease and the health of the population of African countries. Due to such monitoring, international organizations can understand the needs and problems of the population of the countries of Africa, and most importantly, choose a specific strategy for the development and improvement of the health sector.

It can be concluded that health policy is one of the most relevant areas of social development and social governance at the national and global levels. The sphere of health preservation is a sphere of highly professional activity, the role of which is growing and will continue to grow in the future society. At the same time, the health of the population depends and will depend not only on the quality of medical care, but also on a variety of socio-cultural conditions and factors. Therefore, health policy should be an integrative and integrated form of policy and regulation of social relations. This policy, which is primarily based on the activities of the state, needs support from other political institutions - parties, public organizations, as well as the economy and the health industry, institutes of science, education, media, sports, recreation, and tourism. Optimization and harmonization of the development of the entire institutional complex for the preservation of health should focus on qualitative changes in the health culture of modern people and society as a whole. In the context of globalization, this process involves not only improving national medical systems, but also using the best experience of developed countries, strengthening international integration and the role of global management institutions in the field of health preservation and improvement, as well as the development of global science and health industry.

Consequently, health protection issues are increasingly becoming super-individual, institutional, societal and global. Preserving health has become a priority for the development of modern society, and improving it is a strategic goal of sustainable development in all countries of the world. African region needs to go through a difficult path of improvement and qualitative development of the entire health sector in order to improve the quality of life and the level of well-being of people, which is an indicator of health.

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