The pyramid trap

• Published in: Cadernos de saúde pública Vol. 17; no. 4; pp. 1009 - 1015
• Main Authors: Harzheim, E, Alvarez-Dardet, C
• Format: Journal Article
• Language: Portuguese
• Published: Brazil 01-07-2001
• Subjects: Brazil; Globalization; Health Care Services; Health Policy - trends; Humans; International Cooperation; National Health Programs - standards; National Health Programs - trends; Public Health; Public Health - standards; Public Policy; Brazil
• ISSN: 0102-311X

This paper discusses the impact of globalization on public health practice. Neoliberal supremacy has resulted in both greater interdependence between countries and increasing inequalities. Globalization of health risks and the dependence of local health conditions on external forces precludes the use of local/national solutions for global problems. In this context, the classical organization of public health services in a hierarchical pyramid based on geographically defined areas (from the local to the regional and national levels) no longer makes sense. We thus suggest some characteristics of a different type of organization based on new information technologies: a transnational network, horizontally shaped, more independent from political power, allowing for exchange of information and good practices, promoting dissemination of knowledge and producing "glocal" solutions. Through the creation of work opportunities between health professionals, the model will permit the creation of common strategies and increase the power of their political demands, perhaps allowing for the collective development of a more equitable world.