Global health in public policy: finding the right frame?

One of health promotion's major contributions has been its discursive challenge to biomedical and even behavioural models of health and illness. The concept of social determinants of health is now widely accepted by health authorities in many parts of the world. When health promoters focus on these determinants, however, it is often at local or national scales. Contemporary globalisation demands a more critical appraisal of how many health problems have become inherently global in cause and consequence. In making such an appraisal, it is helpful to consider how global health is presently being framed to determine which arguments are most likely to be health-promoting for the greatest number. This article reviews five such frames: health as security, as development, as global public good, as commodity, and as human right. Most offer some useful argumentation to health promotion, although the rights-based frame, when supported by ethical reasoning (a moral voice), is the most consistent with health promotion's more empowering roots.