Inaugural talk of the Alumni Lecture Series organized by my alma mater, University of the Philippines Rural High School (UPRHS) last Jamuary 9, 2015. My talk is Part One ("Foundation") of my life's trilogy. Part Two ("Formation") and Part Three ("Fruition") will be delivered on my 50th and 75th birthdays, respectively.

1. My Journey in Global Health:
Part One of the Trilogy
Renzo R. Guinto MD
Class 2005
UP Rural High School

4. My Journey in Global Health:
Part One of the Trilogy
Foundation Formation Fruition

5. SOWING THE SEEDS
Pre-UPRHS (1995-2001)

9. LAYING THE FOUNDATION
UPRHS Years (2001-2005)

37. ENTERING THE WORLD
Post-UPRHS (2005-present)

49. GLOBAL HEALTH
– AN INTRODUCTION

50. WHAT IS HEALTH?
WHAT IS GLOBAL
HEALTH?

51. What is Health?
“a state of complete physical, mental, and social well-
being and not merely the absence of disease or
infirmity… a fundamental human right”

52. Present Global Health Challenges
Emerging infections • Climate Change • Noncommunicable Diseases • Neglected Tropical
Diseases • Antibiotic resistance • Impoverishment due to catastrophic health spending

53. 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)

54. 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

56. Source: Ravi Narayan, SOCHARA, India

57. Source: Ravi Narayan, SOCHARA, India

58. • Doctor
• Pathologist
• Biologist
• Politician
• First to recognize leukemia
• Elucidated embolism
• Founded “Social Medicine”
Rudolf Virchow

59. 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

60. • Prosperity
• Education
• Liberty
Remedy for Epidemics?

61. 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

62. Dahlgren and Whitehead, 1991

64. “Unequal distribution of health-damaging
experiences is not in any sense a ‘natural'
phenomenon, but is a result of the toxic
combination of poor social policies and
programs, unfair economic arrangements
and bad politics.”
WHO Commission on Social
Determinants of Health, 2008

65. TB Deaths in England
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
1838 1860 1880 1900 1920 1940 1960
TB deaths
David Werner and David Sanders, Questioning the Solution: The
Politics of Primary Health Care and Child Survival.

66. Basic question: What good does it do to treat
people’s Illnesses …
only to send them back to the conditions that
made them sick?

67. 70
80,000
Average Life
Expectancy of
Filipinos (in years)
Filipino Babies dying
of PREVENTABLE
causes ANNUALLY
Source: Dr. Alberto Romualdez, University of the Philippines

68. 87% of poorest
quintile deliver at
home
84% of richest
Quintiles deliver in health
facility
71% by hilots 77% by doctors
Disparity among income groups
Source: Dr. Ramon Paterno, University of the Philippines

69. Universal Health Care
Improved Health
especially for the
Poor and Vulnerable
Secure access to
quality care at
facilities
Achieve the public
health MDGs
Provide financial
risk protection
INTERVENTIONS OF CARE
Secondary Prevention
and Primary Care

70. Spectrum of Healthcare Services
Health
Promotion
Disease
Prevention
Treatment and
Chronic Care
Rehabilitation Palliation

72. Qualities of Primary Care
5 A’s 4 E’s Others
Available
Affordable
Accessible
Acceptable
Appropriate
Effective
Efficient
Empowering
Equitable
Quality
Safe
Responsive
Sustainable

73. Globalization
• Economic; trade
• Cultural diffusion
• Knowledge and
technology transfer
• Global village/family
• Interdependence
versus inequalities
• Globalization of risk
factors

75. 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/

76. Incidence of Illness and Injury by
Income Quintile
0
10
20
30
40
50
60
70
80
90
100
Poorest Poorest Middle
Income
Rich Richest
55 51 45 39 34
National Demographic and Health Survey, 2008

77. Social injustice is killing
people on a grand
scale.
WHO Commission on Social
Determinants of Health

78. It is not inequalities that kill, but those
who benefit from the inequalities that kill.
Vicente Navarro
Johns Hopkins University

79. Source: Philippine Health Statistics, various yearsLeading Causes of Disease
For the past three decades, Filipinos have been getting
sick of infectious disease, but chronic hypertension is
rising as a leading cause of illness.
Guinto, 2014 for Curiosity Design Research

80. Source: Philippine Health Statistics, various yearsLeading Causes of Death
While we still get sick of infectious disease, today we
Filipinos die more of chronic, non-communicable diseases
– like heart disease and cancer.
Guinto, 2014 for Curiosity Design Research

82. IFPRI, Global Hunger Index 2010
1 billion undernourished people
in the developing world… but 2 billion people
are overweight

84. The Filipino Diaspora
Source: Commission on Filipinos Overseas (cfo.gov.ph)

85. Mental Health Among OFWs

86. OFWs and HIV-AIDS
Source: National Epidemiology Center, July 2013

90. Human health and the environment are by
design interconnected and inseparable.

92. Coal Plants
19operating
44 in the pipeline

93. Naga City, Cebu
Mariveles, Bataan

94. Limay, Bataan
Masinloc, Zambales

96. # 3 in the World
Risk Index 2013
# 6 in the
Climate Change
Risk Index in 2012

102. Resilience
the capacity to recover quickly from difficulties

103. Ebola Crisis in West Africa

105. Millennium Development Goals

106. Health in the Post-2015 Agenda

107. • Health as a Precondition/Contributor
• Health as a Beneficiary
• Health as an Indicator
Health and Sustainable Development

108. Picture of Presidents in Jakarta
MM2011

114. Lancet-UiO Commission on Global
Governance for Health
Promoting inter-generational dialogue

115. Become the 21st century health professional –
thinking globally, acting locally,
committed to health equity

117. “The doctor of the future
will give no medicine, but
will interest his patients in
the care of the human
frame, in diet, and in the
cause and prevention of
disease.”
Thomas Alva Edison

118. "Medicine is a social science, and politics is
nothing else but medicine on a large scale.
Medicine, as a social science, as the science
of human beings, has the obligation to point
out problems and to attempt their
theoretical solution; the politician, the
practical anthropologist, must find the
means for their actual solution....The
physicians are the natural attorneys of the
poor, and social problems fall to a large
extent within their jurisdiction.”
Dr. Rudolf Virchow
Father of Social Medicine
The Power of Medicine

119. The Power of Young People
“The youth are
the hope of the
Fatherland.”
Dr. Jose Rizal
National Hero of the Philippines

120. Fathers of Social Medicine

121. "Health is not everything,
but without health
everything is nothing."
Arthur Schopenhauer
German Philosopher

122. HEALTH FOR ALL!
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