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The Future of Health



Lecture given to Learning Unit 2 students of the Integrated Liberal Arts-Medicine Program of the University of the Philippines College of Medicine, March 12, 2014, Paz Mendoza Building ...

Lecture given to Learning Unit 2 students of the Integrated Liberal Arts-Medicine Program of the University of the Philippines College of Medicine, March 12, 2014, Paz Mendoza Building

Fourth INTARMED batch to experience my interactive session on "Futures Thinking" for health - one of the closing sessions in the subject "History of Medicine"



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    The Future of Health The Future of Health Presentation Transcript

    • The Future of Health Ramon Lorenzo Luis R. Guinto, MD Consultant, International Organization for Migration and Department of Health Member, Lancet-University of Oslo Commission on Global Governance for Health Member, Universal Health Care Study Group, University of the Philippines Manila UP Medicine Class of 2012 (INTARMED)
    • Who am I?
    • Who am I?
    • Who am I?
    • Who am I?
    • Who am I?
    • Who am I?
    • Who am I?
    • Who am I?
    • Who am I?
    • IDC History of Medicine • Lectures, lectures, lectures – from Pre- Hippocratic to Medicine’s Dark Side! • Papers, papers, papers! • Visit at Co Tec Tai Museum • Show and Tell – next week?
    • History • History – “Histoire” – Inquiry • Kasaysayan – “Saysay” – Meaning • Elements of History – 5W’s and 1H • Methods of Studying History • Perspectives in Looking at History
    • Milestones in Global Health Thinking
    • Why Study History of Medicine? • Understand the present • Learn from past mistakes • Gain inspiration •See the future!
    • I Ka Wa Ma Mua, Ka Wa Ma Hope The Future is in the Past!
    • Getting Better: 200 Years of Medicine http://www.youtube.com/watch?v=Qxx14RCxblg
    • Questions • Who or what is instrumental in the achievement of the desired outcome? • What are the drivers of change? Positive drivers? Negative drivers? • What are some of the future issues that the each of the three movements will need to grapple with?
    • Futures Thinking The ability to envision scenarios for a more desirable future
    • Can you see the future? • Are you ready/trained? • Is your society ready? • How does it look to you?
    • How can you see the future? CREATE IT!
    • Predict the future? • Futurists cannot predict the future • They invent preferred futures! • Opening minds to probable and possible futures
    • Futures Thinking: Process • Asking the question – What will the future look like? How far ahead you want to think? • Scanning the world – What are the drivers that will shape the future?
    • Futures Thinking: Process • Mapping the possibilities – There is no ONE future! – The future is WHAT I expect. – The future is BETTER than I expect. – The future is WORSE than I expect. – The future is WEIRDER than I expect.
    • Futures Thinking: Process • Asking the next question – What happens then? • Thinking it through – How will we get there?
    • Seeing Futures – 3 Scales • Future as it emerges – The moment, present – Tactics, flow • Medium Range – Strategy, planning • Longer, imaginable, preferred vision – What Could Be (Novelties) – 50 years? 100 years?
    • Four Generic Alternative Futures • Continued Growth • Collapse • Disciplined Society • Transformational Society
    • Filipinas, Dentro de Cien Años (Philippines, A Century Hence) “We know their present. Now what will their future be? Will the Philippine Islands continue to be a Spanish colony, and if so, what kind of colony? Will they become a province of Spain, with or without autonomy? And to reach this stage, what kind of sacrifices will have to be made? Will they be separated from the mother country to live independently, to fall into the hands of other nations, or to ally themselves with neighboring powers?” - Dr. Jose Rizal
    • Professor Hans Rosling 200 countries, 200 years, 4 minutes - Global Health History from “The Joy of Stats” http://www.youtube.com/watch?v=jbkSRLYSojo
    • Alma Ata, 1978 The International Conference on Primary Health Care calls for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all the people of the world by the year 2000.
    • From Beaglehole and Bonita, 2012
    • Glasgow, Scotland (deprived suburb) 54 India 61 Philippines 65 Korea 65 Lithuania 66 Poland 71 Mexico 72 Cuba 75 US 75 UK 76 Glasgow, Scotland (affluent suburb) 82 Life expectancy at birth (men) (WHO World Health Report 2006; Hanlon,P.,Walsh,D. & Whyte,B.,2006)
    • LEB over 80 years IMR less than 10 MM less than 15 LEB under 60 years IMR over 90 MM over 150 Source: Dr. Ramon Paterno, University of the Philippines
    • • Doctor • Pathologist • Biologist • Politician • First to recognize leukemia • Elucidated embolism • Founded “Social Medicine” Rudolf Virchow
    • Do we not always find the diseases of the populace traceable to defects in society? Dr. Rudolf Virchow Father of Social Medicine Social Production of Disease
    • • Prosperity • Education • Liberty Remedy for Epidemics?
    • Social Determinants of Health • Conditions in the social, physical, and economic environment in which people are born, grow, live, work, and age, including access to health care • Policies, programs, and institutions • Social structure, community factors
    • Globalization • Economic; trade • Cultural diffusion • Knowledge and technology transfer • Global village/family • Interdependence versus inequalities • Globalization of risk factors
    • Champagne Glass of Inequality From UNDP Human Development Report 1992 as cited by http://thesocietypages.org/graphicsociology/2009/05/27/champagne-glass-distribution-of-wealth/
    • Social injustice is killing people on a grand scale. WHO Commission on Social Determinants of Health
    • It is not inequalities that kill, but those who benefit from the inequalities that kill. Vicente Navarro Johns Hopkins University
    • 21st Century Global Health Challenges: Five Trends that Shape the Future 1 and 2: Demographic We are getting older and living in cities 3: Environmental The earth is heating up 4: Economic The economic center is shifting eastward 5: Epidemiologic We are sick with noncommunicable diseases (Center for Global Development)
    • Present Global Health Challenges Emerging infections • Climate Change • Noncommunicable Diseases • Neglected Tropical Diseases • Antibiotic resistance • Impoverishment due to catastrophic health spending
    • Rebalancing society Refashioning aid and NGOs as instruments of change Privileging sustainability above profitability Fair trade to replace free trade Domesticating feral capital Devising better metrics Working with all peoples in all nations, cities, and communities G-20 to replace G-8 on the world stage Recognizing semi-sovereigns Getting serious about urban situations Building solutions within networks Involving women and youth Enabling effective community action
    • Millennium Development Goals
    • Health in the Post-2015 Agenda
    • • Health as a Precondition/Contributor • Health as a Beneficiary • Health as an Indicator Health and Sustainable Development
    • Universal Health Coverage
    • Trade and Health
    • Lancet-UiO Commission on Global Governance for Health Promoting inter-generational dialogue
    • The Future Walks Among Us! “Any useful idea about the future must appear to be ridiculous!”
    • “The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, ind diet, and in the cause and prevention of disease.” Thomas Alva Edison
    • Create one ‘ridiculous’ idea about the future of health in 2040. Submit on Wednesday, March 19!
    • What is your
    • Take Home Lessons: LU 3 and beyond • Remember your history! • Continue being aware of the present – which is history a second later! • Aim to be part of history!
    • “Vision without action is merely a dream. Action without vision just passes time. Vision WITH action can change the world.” Joel Barker
    • Yesterday is history. Tomorrow is mystery. Today is a gift That is why it is called PRESENT!
    • "Health is not everything, but without health everything is nothing.“ Arthur Schopenhauer German Philosopher
    • Thank you very much!