Global health challenges

The BMA examines key global health challenges, providing analysis and advice on national and international policies affecting health in both the UK and in low-resource settings overseas.

Location: UK International
Audience: All doctors
Updated: Tuesday 13 February 2024
Globe symbol article illustration

Global health refers to issues that transcend national boundaries and governments. Global health trends increasingly impact on the UK health service, affecting doctors, patients, resources - like medicines and instruments - and the social determinants of health.

 

The impact of globalisation on health

Globalisation is creating new patterns of health and disease – increase in global trade, travel, communication and migration have obscured the traditional distinction between national and global health. As a result, activities impacting on health in one country may have profound consequences for people in other parts of the world, with no one country able to insulate itself from the effects.

Countries are increasingly working together to tackle global health issues with the UK playing an important role. The NHS is promoted worldwide as an example of an affordable universal health service and is, in turn, influenced by policies made in other countries.

 

International medical organisations

World medical association

The World Medical Association (WMA) is an international and independent confederation of free professional medical associations, therefore representing physicians worldwide.

The main decision-making body of the World Medical Association (WMA) is the General Assembly, which meets annually. The Assembly comprises delegations from the constituent medical associations, the officers and members of the Council of the WMA, and representatives of the Associate Members (Associate Members are individual physicians who wish to join the WMA).

Commonwealth medical association

The Commonwealth Medical Association was established in 1952. The Association, also known as the CMA, is a non-governmental organization and its main objective is to assist and strengthen the capacities of national medical associations (NMAs) of countries within the Commonwealth to improve the health, well-being and human rights of their countries and communities.

 

​Access to free healthcare information

The importance of healthcare information

Accurate and up to date health information can mean the difference between life and death. Tens of thousands of people die every day in low-resource countries, often for the simple reason that their carer or health worker lacks the information and knowledge they need.

Healthcare information for all

Since 2008, the BMA has supported and been a steering group member of HIFA (Health Information for All). HIFA is a growing global campaign that brings together more than 19,000 professionals from 180 countries. Members communicate via six email forums in four languages, which are free to join worldwide.

The aim of the campaign is to ensure every person and every health worker has access to the healthcare information they need to protect their own health and the health of those they are responsible for. The campaign focuses on the needs of front line primary healthcare workers, especially those who work in relative professional isolation, such as rural health posts and small hospitals.

How to access free healthcare information

Health professionals in low- and middle-income countries, or places where peer-reviewed, evidence-based information is in short supply, can access a number of resources free of charge.

On this page we provide links to some of these resources. Most are in English, but many of the websites also include material in other languages.

Some publishers and websites provide free access to all users, some may ask you to register, but without requiring a fee. Other schemes, such as HINARI (Health InterNetwork Access to Research Initiative), provide free access mainly to not-for-profit healthcare institutions, such as hospitals, health libraries and research organisations. This usually includes all the health staff working there as well.

BMA resources

BMJ: With our publishing arm BMJ (British Medical Journal), we are leading global publishers of medical information. Our resources include:

Low- and middle-income countries can access the site for free, as part of the HINARI initiative.

Other organisations and publishers

BIOMED Central  
Provides access to over 140 open access journals covering all areas of biology and medicine. It is an independent publishing house committed to providing immediate open access to biomedical research.

British National Formulary
Provides healthcare professionals with practical information on the selection and clinical use of medicines. Users are asked to register, but do not have to pay for access.

Cochrane Library 
An electronic publication designed to supply high quality evidence to inform people providing and receiving care, and those responsible for research, teaching, funding and administration at all levels. It incorporates the Cochrane database of systematic reviews; access to free online medical books  and Cochrane's Evidence aid project: Resources for natural disasters and other healthcare emergencies

Free books for doctors
Offers free medical books for doctors.

General Practice Notebook
An online encyclopedia of medicine, aimed at GPs in the UK and internationally. It is updated regularly and consists of over 26,000 pages of information.

Gray's Anatomy of the Human Body - is available free through Bartleby Hesperian Foundation 
A non-profit publisher of books and newsletters for community-based health care. Simply written and heavily illustrated, Hesperian books are designed so that people with little formal education can understand, apply and share health information. The books are available to download online; including the most widely-used health care manual for health workers and educators around the world 'Where there is no doctor'.

Health Books International (formerly Teaching Aids at Low Cost)
Provides access to free and low-cost resources on a range of health subjects.

Health InterNetwork Access to Research Initiative (HINARI) 
Provides free or very low-cost online access to almost 3,000 major journals in biomedical and related social sciences to local, health-related, not-for-profit institutions in developing countries. Over 70 publishers are currently participating in the scheme, which is administered by the World Health Organisation.

International Network for the Availability of Scientific Publications (INASP) 
An internet gateway to useful websites for healthcare providers in developing countries.

National Institute for Health and Clinical Excellence (NICE) 
An independent organisation responsible for providing UK national guidance on the promotion of good health and the prevention and treatment of ill health. 

New England Journal of Medicine
Non-subscribers who register (free of charge) get full access to all abstracts back to 1975 and the full text of all original articles that are more than six months old, back to 1993.

Public Library of Science (PLoS)   
Set up by scientists and doctors to make peer-reviewed research freely accessible online.

PubMed Central (PMC) 
The US National Institutes of Health (NIH) free digital archive of biomedical and life sciences journal literature. This site archives all the open access journals and has agreements with a variety of publishers to give free access after specific periods of time. 

Research4Life
A programme by publishers supporting low- and middle-income countries with valuable online resources.

World Health Organisation
Provides a wide range of material free of charge, including fact sheets (in several languages) on a wide range of diseases and health-related subjects, and free full-text publications on surgery.

Patient organisations

Health professionals working in developing countries may find the resources from UK-based patient organisations helpful, for example Macmillan and British Heart Foundation. A list of UK patient organisations can be found at Patient UK.

 

Access to clean water and sanitation

The impact of poor sanitation

Currently, 884 million people live without safe water and 2.3 billion people live without access to sanitation.

Around one million people die each year from water and sanitation-related diseases. Of these, around 6,000 children die every day specifically from water-related diseases.

The BMA works alongside international health and development experts to highlight this sanitation crisis, which has cost more than 10 million children their lives since the year 2000.

What are we doing?

In 2007, members voted in policy calling on the BMA - together with other stakeholders - to raise awareness of the adverse health impact of poor sanitation.

Further policy in 2008 called on the BMA and wider health sector to lobby for increased funding and access to clean water and sanitation in the world’s poorest regions.

The BMA’s international committee, supported by staff in the international department, are tasked with the ongoing delivery of this work.

End Water Poverty

To achieve these aims, we have joined with End Water Poverty, an international campaign driven by a growing group of organisations calling for immediate action to address the global crisis in water and sanitation. As part of this partnership, the BMA’s head of international sits on the steering group of End Water Poverty.

Through the End Water Poverty campaign, we are calling for:

  • a 'Global Framework for Action' on sanitation and water
  • 70 per cent of aid money for sanitation and water to be targeted at the poorest countries
  • water resources to be protected and shared equitably.

We will continue to lobby world leaders to take decisive action, but there is still a lack of political will needed to push through changes that will benefit the poorest and most vulnerable people.

What can you do?

Members who are part of non-profit organisations that support ending the global water and sanitation crisis can join with us on the End Water Poverty campaign. There is no fee and members can:

  • get the facts
  • take action
  • stay in touch for news and updates.

WaterAid

In 2014, the BMA and other international health and development experts wrote to then UN secretary-general Ban Ki-Moon to highlight the sanitation crisis.

This open letter was coordinated by the international development organisation WaterAid to coincide with World Toilet Day on 19 November 2014.

In the letter, BMA president Baroness Ilora Finlay, and 35 other signatories, raised grave concerns that one in three children did not have access to a basic toilet, contributing to the world's three main killers of children: undernutrition, pneumonia and diarrhoea.​