During the opening session, Peter Piot summarized three big historical trends in how we talk about health issues that transcend national boundaries– first there was tropical medicine,then there was international health, and now, as we talk about global health, a new paradigm for global health is emerging.  This new paradigm,which he calls Global Health 4.0, will include more voices from regions outside North America, both from Europe and low-income countries. Global Health is not a region, an “over there: it is worldwide.  PI ‘s should will be from many countries, and what we now call “research sites” will become Centers of Excellence where joint learning takes place. Also, the infectious disease focus is too narrow, global health must address non-communicable disease as well.  Research will shift is focus, now leaning heavily toward randomly controlled trials, there needs to be more translation and implementation science. While we are still working on what it really means to support the health of populations and not just individuals, we need to also integrate the environment as a third focus of attention.  Finally, “Global Health 4” needs to foster a network of higher education for all.

Fitzhugh Mullan  reported on a study of medical education in Sub Saharan Africa.  They did 10 site visits and a survey of 164 schools, and realized a 72% response rate. Twenty percent of graduates migrate out of the country, and another 20% or so work in NGOs and the private sector.  Less than 10% of faculty do research.  Biggest needs that emerged were to build faculty capacity, develop  infrastructure, forge links to MOH, increase funds for  research, and promote primary care.

Lincoln Chen spoke about education for health professionals in 21st century.  In the spirit of the 1910 Flexner report which reformed medical education, he reported on the work of a consortium that focused on medicine, nursing and public health education. The identified 2400 medical schools globally, 460 schools of public health– they could not accurately assess the number of nursing schools.  Their results, to be included in a forthcoming Lancet Commission report, point toward a new kind of medical education that  links the education system and the health care system.  As the Flexner work brought medical education into the university, and problem-based reform and the rise of academic medical centers  made further improvements, now the 3rd stage should be systems-based reform.  Education must be  informative (expert) , formative (values, professionalism), and transformative (leadership for change).  To realize these goals networks and consortia are critical.

This was an inspiring start with lost of ideas and best practices within the health sciences articulated, but so far they have not mentioned any disciplines from outside the health sciences, such as engineering, agriculture, or education and how they can collaborate for global health.  It makes me feel very fortunate to be at UW-Madison where I have had the change to  work with faculty and students from the health sciences, engineering, agriculture, social work, and even astronomy.

Tomorrow morning the  plenary  meetings start at 6 am Seattle time, with the roundtable at 7 and then Melinda Gates at 8:00.  I hope some UW students will watch some of these and participate in the blog!


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