Global Health

Recently I've had very engaging conversations about "Global Health" and its identity with some of my colleagues.  The more we talked about this increasingly popular and seemingly "sexy" field, the more elusive it became to me.  Ultimately, I felt that the field's amorphous and somewhat disjoint nature is precisely its beauty as it reflects the state and perspectives of public health around the world.  With that said, I'd be foolish to dismiss certain core values shared among the different thoughts on global health. 


Without referring to formal definitions, I took a moment to brainstorm about what types of issues are often spoken about in relation to global health.


1) Health disparities between populations
2) Human rights and social justice

3) Diseases that are indicators or consequences of health disparities (TB/HIV)

4) Diseases that have potential to transmit beyond borders (Influenza/SARS)

5) Globalization and migration

6) The impact of health on productivity
(and many more...)

In thinking about these divergent issues; we realize that they actually coalesce into a common discomfort of disparities in health across population, a common vulnerability to the effects of globalization, and a common sense of duty to do something about it. 

While our vulnerability and duty unite us, our platforms divide us once again.  How are we to implement "global health"?  By pushing a standard agenda forward in a top-down strategy, or by taking an approach that is more context-driven, and letting each case dictate the solution?  Is there such thing as a panacea for the world's ills?  If not, how much should we doubt universal guidelines?

A recent conversation with Prof. Wafaa El-Sadr was particularly enlightening.  I asked, How are we to promote health across the nations? She answered by emphasizing the importance of identifying those core elements that function cross-culturally, making analogies to the ubiquitous McDonalds franchise.  Pertaining to her own organization (i.e. ICAP*), she referred to the core elements of capacity building initiatives including infrastructural development, training and mentoring, monitoring and evaluations etc.  The catch was that each of the core elements had to, by protocol, engage the context and thereby create a partnership with the community all the while implementing a central strategy.  Basically she advocated neither a top-down or down-up approach, but rather an empirical combination of both, driven by common sense.

I am only beginning to scratch the surface of this field known as "global health".  The academic in me wants to define, theorize, and label concepts and strategies.  But in so much as "global heath" reflects the complex realities of the health and perspectives of the nations, I hope to resist the temptation to theorize and label, but take it at face value with good common sense. 


* ICAP supports more than 1000 HIV/AIDS clinics around the world: http://www.columbia-icap.org/