Global Marketing in Health sector

Global Market
A common market further facilitates trade by lowering regulatory and tarif
barriers
Benefits of Global market

The intensification of global flows of capital, goods, ideas and people

across borders and the institutions and rules established to regulate
these flows.

The rapid flow of information, goods, capital and people across political
and economic boundaries.

The speed of information, people, and capital mobility has changed, and
the global participation has expanded.

Easy for to reach other people anywhere in this world.

Easy to manipulate and access in exchanging and transmitting of

information, knowledge, goods funds and services to the allied countries.

It increases division of labor and productivity

It allows and encourages freedom of movement for all medical products /

Services

There is a large availability and choice of medical facilities.

Health as a Global Public Good

A global public good is one all can share and from which none can be
excluded.
Global Public health goods include:
Health knowledge
Drugs and treatments
Health Systems that protect global health.
Globalization may increase public goods

o By supporting global health solutions, sharing knowledge and enabling

common action but it also leads to a reduction in public goods.
o By taking health resources to where they are required.
o By sharing health knowledge and resources
How does Globalization relate to Health?

Globalization in the context of health may be viewed as a concerted

global efort towards prevention, elimination and eradication of diseases,
and the promotion of human health worldwide.

Globalization has a great impact in health care sector where it is

improving the relationship between personnel and the community, where
the individual and the community is working hand in hand in every
matter pertaining to health.

Increased movement of both goods and people increases opportunities for

the spread of disease around the world.

AIDS, TUBERCULOSIS

CHOLERA

But just as globalization increases the frequency and ease with which
diseases can move around the world, it also can improve access to the
medicines, medical information, and training that can help treat or cure
these diseases.

Drug companies and governments now have the ability to ship drugs to
remote parts of the world afected by outbreaks of disease.

Institutions and professionals seeking to put medicines, or other

treatments, in the hands of needy people can now make use of the
product distribution networks, communications technologies, and
transportation technologies that have promoted globalization over the
past decade.

Market Oriented Health Care

In market oriented health care, the patient is the customer and the
medical care and service rendered by the doctor and the hospital and service
traded in a demand and supply chain.
As a user and client, the patients main desire is to secure the best
doctor, the best medicine, the best hospital facilities and the best
attended and related personal care serices.The patient hopes to purchase all
these at the lowest possible medical cost.
Benefits of market oriented medicine:
1) Being consumer oriented, it is patient centered : - Better health service
where patients receive god value for money.
2) Satisfied customer
3) Competition will encourage medical practice to be more vigilant,
transparent and accountable.
4) Doctors are bound to practice evidence base medicine and hospitals
strive to ensure and maintain recognized standard of care.( An example
of a recognized standard of care is for hospitals to be accredited to the
Joint Commission International (JCI).
Global Trade in Health Services -Globalization of health

Efects of trade liberalisation on public health

Trade liberalisation: removal of impediments to trade in

health goods and services

Public health: organised measures (whether public or private)

to prevent disease, promote health or prolong life of the
population as a whole.

Cross border delivery- telemedicine; e-health (The use of new

technologies, such as the Internet, to provide health services across
borders and to remote regions within countries)

Consumption abroad- patients travelling across borders for diagnosis and

treatment

Commercial presence- establishments of hospitals, clinics through FDI,

joint ventures, alliances, mergers

The increasing mobility of health professionals across borders; for

example, the United Kingdom now actively recruits nurses from
developing countries.

The increasing mobility of health consumers (people); for example,

patients travelling abroad to access medical care.

The increase in private companies, including foreign companies, which

provide health services and health insurance schemes.

Benefits of globalisation of health services:

Wider dissemination of knowledge/technology

Incentives for R&D for diseases of the poor

Resources for efective interventions

New rules to control cross border risks

Global Health Governance - international collective action

Global public goods for health - investments beyond the means or

incentives of any single government - new vaccine development for
neglected diseases.

trade liberalisation on public health

Trade liberalisation: removal of impediments to trade in goods and

services

Public health: organised measures (whether public or private) to prevent

disease, promote health or prolong life of the population as a whole.

Risks of globalisation of health services:

Exclusion from developed markets/economic shocks

Lack of access to knowledge and technology

Cross-border transmission of disease

Marketing of harmful products and unhealthy behaviours

Environmental degradation

Conflict

Implication of globalisation of health services

What policies, regulations should be in place to ensure that trade in

health services increases equity in health and is in the interest of those
in greatest need

What collective action across countries, at regional and global level is

needed to take advantages of emerging global opportunities and mitigate
potential risks : promote policy coherence

Modes of Global Trade in health Sector

MODE

MEANING

EXAMPLE

Mode 1

Trade takes place from the

- Telehealth

Cross-border
trade

territory of country A into

that of B

Passing

of

information by means

Mode 2
Consumption
abroad
Mode 3
Commercial
presence
Mode 4
Movement of
natural

Services

consumed

nationals of

country

by
A

in

territory of country B

- Tourism
-

Consumers

cross

who

borders

to

A service supplier of country

obtain
medical
- Establishment of a

crosses

establish
Temporary

the
and

border

to

private hospital by a

provide

European company in

from

- Doctors moving to

movement

country A to B to supply a

another

country

service

temporarily

to

provide

Mode 1: Cross border delivery of services

Shipment of laboratory samples, diagnosis and clinical consultations

-mail

Electronic delivery of health services

Telehealth- telediagnostic, surveillance and consultation services (USA

hospitals to CA and EM)

Telepathology (India to Bangladesh, Nepal)

E-health - products and services available over internet

Health Implications: Opportunities & Risks of Cross border delivery of

services
Opportunities

Enable health care delivery

-promoting equity

to remote

and underserviced

areas

Alleviate some human resource constraints

Enable more cost -efective surveillance of diseases

Improve quality of diagnosis and treatment

Upgrade skills, disseminate knowledge through interactive electronic

means

Risks

Given lack of telecommunications and power sector infrastructure telemedicine may not be cost efective

Capital intensive, possible diversion of resources from basic preventive

and curative services

Hurt equity if it caters to a small segment of the population - urban

affluent

Mode 2: Consumption abroad

Movements of patients to the country providing the service for diagnosis

and treatment

Movement of health professionals for receiving medical education and

training abroad

Health Implications of consumption abroad

Opportunities
For exporting countries

Generate foreign exchange earnings to increase resources for health

Upgrade health infrastructure, knowledge, standards and quality

For importing countries

Overcome shortages of physical and human resources in speciality areas

Receive more afordable treatment

Risks

Create dual market structure

May crowd out local population -unless these services are made available
to local population

Diversion of resources from the public health system

Outflow of foreign exchange for importing countries

Mode 3: Commercial presence

Establishment of hospitals, clinics, diagnostic and treatment centers

and nursing homes and training facilities through foreign direct
investment -cross border mergers and acquisitions- joint ventures and
alliances

Opportunities for foreign commercial presence in management of health

facilities and allied services, medical and paramedical education, IT and
health care

Health Implications of commercial presence

Opportunities

Generate additional resources

infrastructure and technologies

for

investment

in

upgrading

of

Reduce the burden on public resources

Create employment opportunities

Raise standards, improve management, quality , improve availability,

improve education (foreign commercial presence in medical education
sector

Risks

Large initial public investments needed to attract FDI

If public funds/subsidies used - potential diversion of resources from the

public health sector

Two tier structure of health care establishments

Internal brain drain from public to private sector

Crowding out of poorer patients, cream skimming phenomena

Mode 4: Movement of personnel

Includes doctors, nurses, paramedics, midwives, consultants, trainers,

management personnel

Factors driving cross border movements

wage diferentials between countries
search for better working conditions and standards of living

search for
qualifications

greater

exposure,

training

and

improved

demand and supply imbalances between receiving and

sending countries

Approach towards mode 4 trade in health services by exporting and

receiving countries varies - some countries encourage outflow, others
create impediments

Health implications of movement of personnel

Opportunities
From sending country

Promote exchange of knowledge among professionals

Upgrade skills and standards (provided service providers return to the

home country)

Gains from remittances and transfers

From host country

Meet shortage of health care providers, improve access, quality and

contain cost pressures

Risks
From sending country

Permanent outflows of skilled personnel -

brain drain

Loss of subsidised training and financial capital invested

Adverse efects on equity, availability and quality of services

Global Health Diplomacy

Global health diplomacy brings together the disciplines of public health,

international afairs, management, law and economics and focuses on

negotiations that shape and manage the global policy environment for
health. The relationship between health, foreign policy and trade is at the
cutting edge of global health diplomacy.
The goals of this unit are:

To support the development of a more systematic and pro-active

approach to identify and understand key current and future changes
impacting global public health

To build capacity among Member States to support the necessary

collective action to take advantage of opportunities and mitigate the risks
for health