Bachi Karkaria, Consulting Editor and Columnist, The Times of India
Former Senate Majority Leader William Frist tries to make a point during the session on global health care. At right are Helene Gayle of CARE USA and Seth Berkley of the International AIDS Vaccine Initiative.
Moderator Bachi Karkaria, a consulting editor for The Times of India started the session with the statement that "health is everyone′s individual concern, but health with a capital H seems to be no one's concern."
To address this statement, the diverse panel, representing various policy, vaccine and international health organizations, discussed key issues facing global health today.
The challenge of health system capacity building was a major focus of discussion. Leslie Mancuso, president and CEO of JHPIEGO, stated that there is a clear problem in the lack of human capacity development in developing countries, specifically in their ability to take care of and plan for future public health issues. These include the issues of proper education, research and public health deployment in addressing global health issues.
A clear example of the lack of capacity building both in the United States and abroad is present in nursing schools. U.S. nursing schools are not given enough incentives to train nurses locally, she claimed, and instead poach nurses from other countries, thus taking these skilled workers from countries that also need them. Helene Gayle, president and CEO of CARE USA, pointed out that each country needs to build its own system by working with nurses to give them the proper incentives and resources to stay in their home countries. Mancuso added that countries should retain the health-care talent they have and realize that the nurses don't leave for salary reasons alone. For example, some nurses feel that infection control is important; each developing country must look at its own nurses and their issues, and adapt accordingly.
On the issue of whether single organizations can build the appropriate human capacity or whether a global body would be needed to do so, Seth Berkley, president and CEO of International AIDS Vaccine Initiative, argued that the challenge really is thinking that a global body will solve such problems without having solutions that connect to local needs. He emphasizes that both leadership and health-care models much be local to be effective. Gayle added that a global body, such as the WHO, should support efforts of country-led leadership, but not pose the solutions itself.
With the need of capacity building, moderator Karkaria asked what kinds of innovations both financial and technological, have helped to improve global health. Berkeley discussed the importance of developing new connections between public-private practices and stressed that the innovations should focus on speed and efficiency, and not politics. Getting the appropriate people engaged in the issues, he said, would depend on innovation financing mechanisms.
Sen. William Frist, the only physician in the U.S. Senate, gave an example of a technology innovation that has changed the way HIV is dealt with. In the past, HIV test results took too long to obtain and patients who feared the stigma of the disease would leave before the physicians could discuss their results and treatment options. These days, with rapid and nanotechnology, physicians are able to gain a "teachable moment" and provide results in a short period of time. The new technologies, he said, "revolutionize the capacity issue," as patients, even in developing countries, can get their health results easily.
Mancuso added that similar technology advances have improved cervical cancer treatments in developing countries. The next step, she said, is to scale up these technologies for the populations that need it the most. "Ideally we don′t want to treat," added Berkeley, "we want to prevent."
To put into perspective why global health is important from a business aspect, Sen. Frist illustrated what would happen if the United States had an avian flu (H5NI) pandemic. A three-month pandemic would cut the U.S. economy by $675 billion, which is a 5 percent reduction in GDP.
The panelists concluded with the agreement that all leaders need to look ahead and have a truly long-term vision for the future. Berkeley stated that the challenge is to get a whole health system in place that will be sustainable over time. This system would need to make system-wide changes by working with local leaders to address local issues. Only then will global health head toward an integrated system.
Global Conference 2013
Former Prime Minister Tony Blair, philanthropist Bill Gates and Strive Masiyiwa of Econet Wireless discuss advancing prosperity in Africa.
