Turning point in the retraction of health sovereignty in the global south: In the new world order, states choose progressive affiliation, emphasizing human-centered regulations
Global trust currently on whom is reevaluating. U.S. exports marked a watershed, leading Argentina, Hungary and Russia to reassess their ties. Critics believe that people who are increasingly halted are a neutral health institution, but are influenced by some donors with their own external interests.
Beyond this is a question about the global health system, which often ignores national reality, resists adaptive approaches to policy making, and chooses ideology over real-life consequences. This rigidity poses serious restrictions on a country like India, where 1.4 billion people face various health challenges. India has a known history to find its own path. During the HIV/AIDS attack, it has firmly resisted multilateral pressures to provide affordable generic drugs and conduct redefined global visits. Through its polio movement, it does this through local innovation and community advocacy rather than import models. In addition to developing its digital vaccination platform Cowin, India has pioneered the call for the abandonment of the intellectual property rights of the vaccine (TRIPS exemption) in support of fair access. These are not only stories of public health success, but also examples of health sovereignty.
For tobacco control, global policies have been donor-driven, and there are many cases. Following the U.S. withdrawal, the Bill and Melinda Gates Foundation and Bloomberg Charity have become the largest contributors to global tobacco control (now surpassing the most important state contributors such as China), with funding of $616 million (Gates) and $1.58 billion (Bloomberg) since 2005, forming the realistic scope of these areas globally. time. More than 267 million people use smoke-free and informal products in India, and it is one of the largest, truly diverse people in the world who are addicted to tobacco. But despite the complexity of facts, over the past decade, the country has implemented many WHO framework conventions on tobacco control FCTC policies, often affected by external powers rather than local evidence. The results are still disappointing. India reaches Rs 7.6 crore in tobacco taxes every year, but plans to stop Rs 5 crore in 2024-25. It is frustrating that it shows the gap between the actual problem and the reaction to it. Overall law enforcement is hierarchy, and these support systems are underdeveloped, and even if more empirical evidence supports them, low-risk alternatives are still prohibited. This raises the important question of whether these international tobacco control frameworks meet the public health goals of countries like India, or simply strengthen a standard that favors a few standards and ignores the reality of reality?
As Atmanirbhar Bharat envisions, this will empower India’s current public health policymaking to self-reliance. This means a greater representation of the global South’s voice in setting international health priorities and willingness to consider a flexible agenda for context-sensitive implementation. India should also request that global funding mechanisms be combined with national expertise and evidence rather than replace them. Not only that, serious domestic public health investments are needed, such as tobacco cessation, harm reduction, harm reduction, and structured public-private participation, as well as voices from Indian industry, research institutions, civil society and state health systems to provide context-perception, sustainable solutions based on real Indian reality.
The world and India stand at crossroads at both ends. Not to withdraw from multilateralism; rather to play a leadership role that better portrays who we are and what we want. If the global framework really makes sense for the global South, then they should be created by the people who live and lead. And, there is no better moment (or country) to begin this transition than now and India.
