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King Holmes, MD, PhD. University Consortium for Global Health. Sept. 15, 2009.

King Holmes, MD, PhD. University Consortium for Global Health. Sept. 15, 2009.



King Holmes, MD, PhD. University Consortium for Global Health. Sept. 15, 2009.

King Holmes, MD, PhD. University Consortium for Global Health. Sept. 15, 2009.



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    King Holmes, MD, PhD. University Consortium for Global Health. Sept. 15, 2009. King Holmes, MD, PhD. University Consortium for Global Health. Sept. 15, 2009. Presentation Transcript

    • University Consortium for Global HealthKing Holmes, MD, PhDSept. 15, 2009
    • A Special Time in History
      Governments, civil society, academia, foundations motivated by enlightened self-interest (global health as diplomacy) and by humanitarian interests to do good.
      Universities, institutes, professional organizations have special roles:
      • Developing new knowledge.
      • Education, training, and mentoring of a skilled and motivated workforce.
      • Developing sustainable partnerships that deliver mutual
      and reciprocal benefits.
    • Five Global Health Agendas
      Communicable diseases agenda: the unfinished (and unfinishable) agenda: HIV/AIDS, TB, malaria, NTD, EID, ARI, diarrhea
      MCH and RH disparities agenda: the unfinished (but more finishable) agenda
      Accidents, injury, violence, war: Permanent structural (policy-driven) prevention agendas: 8th Western Regional International Health Conference Seattle, April 23-25, 2009: Global Health and War
      Chronic disease agenda: Aging, nutrition-obesity, diabetes, tobacco smoking, cardiovascular diseases, cancer, mental illness…..
      The future “ECO-Health” agenda: Climate change, over-population, migration, environment, & health
    • Climate Change: mitigation and adaptation “Fiddling while the globe burns”D. Weston 2009
    • Global Health: What Do Developing Countries Need?
      Work Force CapacityMedicine (> 30 specialties, Primary health care)Public Health Specialists (5-10 specialties)NursingPharmacists & Pharmacy TechsDentistsSocial workersCommunity Health WorkersEquitable allocation of funding across Education, Health, Poverty, and Infrastructure SectorsHealth Leadership, Management, PolicyHealth leadership, management trainingIntegrated Health Systems DevelopmentPublic Health SystemsTertiary HospitalsDistrict HospitalsHealth CentersHealth PostsCertified Laboratory SystemAccess through Roads & TransportationLogistics & Supply Chain ManagementFinancial & Material ResourcesReversal of structural adjustment policiesSalaries for public sector health care workersPharmaceuticalsEquipmentDiagnosticsAdequate, Safe Water & SanitationNutrition – adequate, safe food supplyHousing – especially in emerging mega citiesAdaption to climate changeInformation Systems
      Etc., Etc., Etc., Etc.
    • Skilled workforce essential to improving global health
      Est’d shortage of almost 4.3 million doctors, midwives, nurses & support workers worldwide
      57 countries, mostly SSA have critical shortages
      SSA has only 4% of health workers but 25% of the global burden of disease (GBD)
      The Americas have 37% of health workers but only 10% of GDB
    • Nurses Working
      Territory size shows the proportion of all nurses that work in that territory.
      “[they] are also being poached by industrialized countries. There are more nurses from Malawi in Manchester than in Malawi …" Glenys Kinnock, 2005
    • Yesterday: Jobs in NGOs, bilateral and multinational global health and development agencies, foundations (1000’s of jobs)
      Today: Jobs involving global health leadership for all students from and at our partner universities; estimated need for 4.3m health workers globally.
      Tomorrow (i.e., Sept. 16, 2009): Jobs for everyone in health-related professions who seek global competence in a globally connected world.
      What Jobs are Available in Global Health?
    • Public health requirements for rapid progress in global health
      TR Frieden and KJ Henning
      Global Public Health 2009;4:323-37
    • Functions (½ CD-related)Program areas1) Surveillance Vital records, surveys & epidemiology Surveillance: disease, risk factors, lab
      2) Environmental health Water & sanitation, air, nutrition & food, injury, smoke, toxics, vectors
      3) Outbreak/ID detection, Contain specific diseases (HIV, STI, TB), investigation, control risk communication
      4) Immunization Vaccine policy, delivery, production, coverage
      5) Non-communicable diseases Tobacco, food & nutrition, exercise, cancer, screening, alcohol, mental health
      6) Clinical care/case mgmt. Direct provision of services, QI & access
      7) Health education Inform & educate public & providers
      8) Emergency prep & response Outbreak detection; planning; mass immunization & prophylaxis, isolation
      Core Global Public Health Functions
    • Public Health Spending
      Territory size shows the proportion of worldwide spending on public health services spent in that territory. This spending is measured in purchasing power parity.
    • New Opportunities
      • Explosion of interest from academia
      • New technologies
      • New resources from governments, foundations
      • Public – private partnerships
      • Professional organizations go global
      • New strategies
    • Collins Says Global Health is One of His Top Priorities
      New NIH Director Dr. Francis Collins singled out global health as one of five areas he wants to focus on during his tenure, citing it as an example of "soft power" the United States cannot afford to pass up.
      ……a chance to be more of a “doctor to the world” than a “soldier to the world”…..
    • Summary: Global Health - 2009
      Many Problems - 5 major GH agendas
      Many Needs & Challenges - workforce, infrastructure, health systems, economy, population, climate change
      Many New Opportunities - Academia, technologies, resources, partnerships, strategies
      We are beginning to make a difference
      We can make a much bigger difference if we work together, strategically, and systematically
    • How Can CUGH Help Universities Become the Transforming Force in Global Health?
      Build on the inspiration and passion of our students and faculty for global citizenship, especially global health – by giving them the experiences, skills, and innovative problem-solving abilities to make a difference.
      Make the whole greater than the sum of the parts by:
      1) Developing effective interdisciplinary sustainable collaborations in education, science, and service (interdigitation);
      2) Bridging silos and lowering barriers between the boundaries of “ossified academic bureaucracies;” and
      Promoting and evaluating collaborations among universities and professional societies, and other institutions in global health.
    • Second Annual CUGH Meeting
      Seattle, Washington
      Sept. 20-21 or 23-24, 2010
      University of Washington
      Stanford University
      University of California, San Francisco
      Washington State University
      An Invitation