Gerald Keusch opened up this plenary session by stating that universities can play a key role in improving global health through their strength in promoting research and innovation, disseminating knowledge, and advocating for increased funding. He noted that global health is unique in that it touches on nearly all aspects of university activities, beyond just the health sciences.
Chris Murray posed the question of whether the “golden age” of global health funding is coming to an end as a result of the current economic crisis. He presented an overview of the dramatic increase in global health funding since 1990 to the present, during which development assistance for health rose from $9 billion to $27 billion. (Ravishankar (2009). The Lancet. 373:2113-24). He concludes that global health is still in an expansion phase, but that the realities of the global recession will lead to increasing pressure on governments to justify investments in global health during the next several years. In response to this, there will be increasing demand to show that money put into global health translates into improved outcomes for the world’s poor.
Nils Daulaire opened his comments by stating, “I am from the government, and I am here to help.” He pointed out that although the total percentage of the Health and Human Services budget allocated for global health is only 0.25%, that this still translates into a total dollar amount of $2.5 billion per year. He discussed the role of the Office of Global Affairs a commitment to building long-term partnerships with developing countries, helping to coordinate the activities and agendas of a wide range of federal and international agencies, and working to increase attention to the importance of chronic diseases. He also highlighted the Obama administration’s Global Health Initiative, which has allocated $60 billion dollars over six years to aims to expand upon the previous administration’s commitments to combat AIDS, TB, and malaria, and will promote increasing attention to maternal-child health and the health needs of women.
Roger Glass explained the ways in which the Fogarty International Center provides “early childhood education” in global health. He pointed out the many of the current leaders in global health had their passions for global health ignited by research experiences in low-income countries early in their training. The Fogarty Center seeks to help train the next generation of leaders by supporting similar experiences for health sciences professionals during the formative parts of their careers. He described the Fogarty Center as a “watering can” that can promote long-term, collaborative relationships between investigators and academic institutions in the US and their counterparts in developing countries.
Val Snewin discussed the ways in which the Wellcome Trust seeks to “achieve extraordinary improvements in human and animal health” by supporting global health investigators in the UK and low- and middle-income countries. With a total annual budget of 720 million pounds, the UK-based charity helps to support individual investigators, with the philosophy that they in turn will build strong teams and strengthen local research capacity. She pointed out that although clinical trials are important, the context of global health is broadening to include things like the social sciences and water and sanitation efforts. She highlighted the African Institutions Initiative, which has donated 28 million pounds to promote equitable and sustainable South-South and North-South partnerships. Dr. Snewin stated that ultimately, health research capacity strengthening is about nurturing people, and helping create environments in which research and innovation can take place.
Victoria Marquez-Mees rounded out the session by sharing her experiences working with the Carlos Slim Health Institute in Mexico. She discussed the ways in which this NGO is working to improve health in Latin America, including maternal-child health and chronic diseases such as diabetes. She posed the question of “How do you address a series of weakest links?” referring to the need to improve capacity in multiple areas, including administrative capacity, health care delivery, and medical informatics. The Carlos Slim Health Institute has taken a number of approaches to these challenges, ranging from harnessing the power of genomic sciences and communication technology, to building educational and training capacity, to seeking locally-relevant ways to strength people’s ability to take charge of their own health. “We need to move beyond the physician-based model,” she said, to applause. “Ultimately, the target has to be the health of the people.”
Overall, it was an engaging series of talks by people representing a broad range of approaches to global-health capacity-building.
Prepared by David Roesel, Univ. of Washington