A career in global health is a peek into all that is right and wrong with the world. There are still so many people in both lower income countries (but even in marginalized communities in higher- income countries) that die from treatable diseases and preventable causes. Well meaning donor entities know this and try to rectify this problem by providing resources to Ministries of Health to sort out these issues. The problem is that the way public health interventions are developed and funded can be more disruptive than helpful and often times unsustainable. In a recent Lancet publication, my co-authors and I describe how the focus on ‘Global Health Security’ functions have become a parallel system that many times diverts funding from the main health system (i.e curative health services) to fund specialized activities around preventing, detecting, and responding to disease outbreaks. I think functions such as these are essential—but they are part of a strong health system and not the health system itself. In this paper we advocate for better strategic coordination between donors, Ministries of Health, and global health governance decision makers to ensure that the way we define and fund health systems is compatible with the way they should operate in real life. This is especially important as WHO, led by the dynamic Dr Tedros, push all countries to work toward Universal Health Coverage.Read More
I originally published this blog post in the Huffington Post on 7 March 2017 under the title: Solving the next global pandemic (probably a bit catchier than this post title...)
In his latest annual letter, Bill Gates warned of the imminent threat of a deadly pandemic to the global community. Yet, while his message also lauds the accomplishments of vaccine coverage, he has consistently lacked the emphasis on a crucial element of global health security: If we truly want to prepare for the next pandemic we need to invest in health systems, not just vaccine development.
Gates is not alone. Vaccines as the solution to major global health problems is emerging as a theme for global health in 2017. A new multi-million dollar initiative, the Coalition for Epidemic Preparedness and Innovation (CEPI), is an admirable solution to build an arsenal of vaccines against diseases that may not turn a profit but would protect thousands of lives. In a global health funding environment with an uncertain future due to President Trump’s plans for budgetary cuts, this could be a wise investment. However, pandemics will not be beaten without the participation of the people most affected. And the critical component currently being overlooked is the value of resourcing health systems in countries most under threat.Read More