About the Nossal Institute
The Nossal Institute for Global Health is named in honour of Sir Gustav Nossal and his commitment to translating medical research into health for all. The Institute was established in 2006 to advocate for the public health of vulnerable communities.
The Nossal Institute Ltd, which was incorporated in 1998, is a company within the Institute formed to facilitate the international consultancy work of the Institute.
A better future for all through stronger health systems.
To strengthen the quality, affordability and inclusiveness of health systems in the Asia Pacific through practical research, learning and development responses to contemporary health issues.
- Health equity: equal access to, use of, and payment for health services and other facilities and resources, recognising the role of broad social determinants of health
- Knowledge: being informed by and contributing to evidence based solutions
- Sustainability: long-term advances in health systems and capacity development
- Partnership: partnerships defined by mutual respect and understanding
Find out more about the Nossal Institute, our work, capabilities, research units and view our infographic world map featuring our selected clients and areas of work.
What is Global Health?
The concept of Global Health emerged alongside the rise of ‘globalisation’ in the early 2000s. It incorporates concepts including the cultural, demographic, environmental, and socioeconomic determinants of health. Global Health could be defined as ‘… an area for study, research and practice that places a priority on improving health and achieving equity in health for all people worldwide.’ (Koplan et al 2009). Global Health is:
- Global: it looks at health at a national and international scale, and is not confined by geographic boundaries
- Equity-focused: it recognises there are great inequalities and injustices in health, and that addressing the drivers of social disadvantage must be a part of the solution to health problems
- Interdisciplinary: it is concerned with health and its intersections with other sectors and disciplines such as sociology, economics, politics, engineering and education
Global Health investigates the interconnections between various countries, sectors and disciplines, by contrast, the older phrase ‘international health’ referred primarily to infectious disease in developing countries.
Our definition of a Health System
In 2000, WHO defined the health system as consisting of all organizations, people and actions whose primary intent is to promote, restore or maintain health (WHO, 2000). This is a useful starting point but it probably gives insufficient attention to the need for those whose primary focus is on health to recognise its multiple determinants and include in their systems, organizations, people and actions whose primary intent may be reducing poverty, increasing social justice or improving welfare in other health-related dimensions. At the Nossal Institute, we conceptualise health systems according to the figure below.
The yellow ring consists of those organizations, people and actions which are usually considered the health sector – and typically the responsibility of the Ministry of Health. The green ring consists of organisations, people and actions whose primary intentions may still be health but lie outside the traditional health sector and require engagement with those outside the sector, such as those with commercial interests such as food and beverage manufacturers, and those with economic outcomes at the centre of their missions such as tax authorities and Ministries of Finance and Economics. In the outer, blue ring are the larger social determinants of health. Achieving reductions in poverty, improvements in education and disability inclusion is done with other welfare benefits in primary focus but is critically important for health.
We see the yellow ring as core to the health system and the outer rings as more peripheral but still arguably part of the system itself, thereby conceiving a heath system as one that produces health rather than just health services. As we move outwards from the central to the outer ring, there are both increasingly shared responsibilities across different kinds of actors and a greater diversity of benefits including health benefits and other types of welfare benefits. For example, avoiding rotten teeth and obesity are highly valued outcomes in themselves over and above their health benefits. This is even clearer when considering the range of benefits associated with reductions in poverty and increases in education.
The intention of our conceptualisation is to avoid hard boundaries. It is inherent to an ‘open’ complex adaptive system, which we understand a health system to be, that its boundaries are fuzzy, and that sub-systems can be nested within systems.