what is global health delivery?

by Anjali Sastry on October 20, 2010

Global Health Delivery is an emerging field of study into how health care can reach all — in advanced economies and resource-constrained settings.

Here’s how the Gates Foundation frames the need; Harvard’s François-Xavier Bagnoud Center for Health and Human Rights overview.

For a quick video introduction: watch Dr. Farmer’s Remedy For World Health in which Byron Pitts Meets A Man Who Dedicates His Life To Bringing Healthcare To The Poor. From CBS 60 Minutes, May 4 2008. Pair this video with Bill Clinton’s TED Prize talk from 2007 in Posts which he asks for help in bringing health care to Rwanda — and the rest of the world.

some specific needs and opportunities

Inequalities are particularly stark in some African countries. Life expectancy between the world’s richest and poorest countries can vary by more than 40 years, a report shows. The World Health Organization examined primary health care systems around the world, and uncovered huge inequalities and inefficiencies. See warning over health inequalities from the BBC, Tuesday, 14 October 2008. From CNN the same day, the story WHO slams global health care reported that the WHO director calls for universal coverage: health care disparities, she said, makes the world “neither stable nor secure.”

On June 11, 2008, the New York Times’ Nick Kristof asked Are Doctors Screwing Up Public Health? in a piece that considered Josh Ruxin’s argument in Democracy Journal that we need to reward efficient corporate practices among public health practitioners.  Ruxin’s full article is Doctors Without Orders. To improve global health, he argued in Summer 2008, what we need isn’t just Bill Gates’ billions, but Microsoft’s managers.

PIH Medical Director Joia Mukherjee reflects on the past two decades of fighting the spread of HIV/AIDS in One world, one hope, a multitude of voices, January 2008. She notes:

During 2001, our group worked with faculty members from Harvard to publish the “Consensus Statement on Antiretroviral Treatment for AIDS in Poor Countries.” Partners In Health and Zanmi Lasante published the first report of The HIV Equity Initiative in the Lancet and the Bulletin of the World Health Organization.  In these articles, we described 60 and then 150 patients in Haiti on antiretroviral therapy.  We reported on the general outcomes: the patients were doing well and had gained weight; the price of ART had dropped considerably with the entry of generic drugs on the market (thanks to activism by Doctors Without Borders (MSF) and others); and community health workers accompanying patients on ART were the backbone of the program addressing adherence and social support.

These themes are, of course, interrelated. As you’ve seen, the next task–of scaling up–may require management skills and approaches to address needs for basic healthcare globally. Consider the challenge of scaling up healthcare in Rwanda, presented in a newsletter article on Rwanda’s new healthcare model and in talks at MIT’s School of Humanities, Arts and Social Sciences and at MIT Sloan School of Management.

introduction to policy issues

Here’s a readymade debate to start you thinking about some of the policy questions.

The Challenge of Global Health Laurie Garrett, Foreign Affairs, January/February 2007
Thanks to a recent extraordinary rise in public and private giving, today more money is being directed toward the world’s poor and sick than ever before. But unless these efforts start tackling public health in general instead of narrow, disease-specific problems — and unless the brain drain from the developing world can be stopped — poor countries could be pushed even further into trouble, in yet another tale of well-intended foreign meddling gone awry.

How to Promote Global Health A Foreign Affairs Roundtable. In this special Web feature, Paul Farmer, Jeffrey Sachs, Alex de Waal, Roger Bate & Kathryn Boateng, and Laurie Garrett discuss Garrett’s essay “The Challenge of Global Health” and debate how best to help the world’s poor and sick.

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