Getting involved in Global Health Dr Rhona MacDonald The Lancet

Setting the scene people die from preventable,poverty related infectious diseases EVERY DAY Global burden of chronic disease Conflict, arms and trauma ‘ Natural ’ Disasters

Standards and targets Remember? Health for all by the year 2000 WHO ’ s 3 by 5 campaign? Current targets Millennium Development Goals Outcomes from Gleneagles > ALL ABOUT HEALTH!

Millennium Development Goals 1-3 Eradicate extreme poverty and hunger: reduce by half the number of people living on less than $1 (60p) a day and those who suffer from hunger Achieve universal primary education Promote equality between the sexes and empower women: end gender disparity at all levels by 2015

Millennium Development Goals 4-6 the Direct Health Ones Reduce child mortality by two thirds for children aged under 5 years Improve maternal health: reducing by three quarters the maternal mortality ratio Combat HIV/AIDS, malaria and other diseases: halt and begin to reverse the spread of HIV/AIDS, malaria, and other diseases

Millennium Development Goals 7 Ensure environmental sustainability, including integrating environmental sustainability into developing country policies and programmes; reversing the loss of environmental resources; reducing by half the people without access to clean drinking water

Millennium Development Goals 8 Develop a global partnership for development, including an open trading and financial system that is rule based and includes a commitment to good governance, development and poverty reduction; enhanced debt relief and cancellation of bilateral debt; more generous development assistance for countries committed to poverty reduction; working with pharmaceutical companies to provide access to affordable essential drugs in developing countries

Outcome of G Gleneagles The G8 agreed a comprehensive plan to support Africa’s progress including: to boost investment in health and education, and to take action to combat HIV/AIDS, malaria, TB and other killer diseases provide as close as possible universal access to treatment for AIDS by 2010

The Reality- way off track Many barriers to accessing health care Many barriers to accessing medicines ‘Brain Drain’

Wider context Governments in poor countries trapped: economic deficits re unfair trade rules ‘ conditionalities ’ of economic growth imposed by global institutions Bureaucracy and complexity  Unable to meet their own targets of spending 15% of GDP on health care  Aid, Trade, Debt really matters

Access to healthcare User fees: Create and exacerbate poverty Act as a deterrent to accessing healthcare for those who really need it Cause people to seek help from alternative, often inappropriate healthcare providers

Access to Essential Medicines TRIPS (Trade Related Aspects of Intellectual Property) impositions Lack of Research and Development in diagnostic tests, medicines and immunisations for neglected and most neglected diseases

‘Brain Drain’ Global market for providing healthcare: Exodus of healthcare professionals from poor countries to rich ones Balance the rights of the individual to want a better life and the right to health of the patients they leave without a healthcare professional to care for them

Global Health and YOU Why get involved? Because you can-Your training, skills, interests and opportunities to travel, put YOU in a unique position to be interested and involved in global health issues High impact- People will listen to you - YOU are a highly respected and influential member of society

Global Health and YOU cont/d Because you should? Caring healthcare professional who wants only the best for your patients Does it matter that they are in a different country? Does that mean that you should not care for them and want to do something about their unjust situation

What can YOU do (Get off your backside) Get and Stay Informed and Inform Others Get active: Campaign, Lobby, Advocate Get linked: Link with Institutions in Poorer Countries Give Go

Stay informed and inform others So many sources of information (sometimes too much information!) In most, you can sign up to e newsletters in your topic of interest Medsin /SSM? WHO / DFID Most international charity websites Medical Journals (The Lancet)

Campaign, Lobby, Advocate Use this knowledge to campaign and lobby organisations, governments, and individual political leaders. Many organisations and charities run their own campaigns and advocacy schemes. You could individually and /or collectively join up and do their activities

Link The Department of Health and THET International have teamed up to encourage UK hospitals to link with institutions in developing countries > Nag your consultants/ Trust etc to get involved

Give Many charities and organisations are working to reduce global poverty and improve global health Restricted and unrestricted funding Can you give regularly now or in the future? Make sure that you are satisfied with the charity administration

Go Elective In the future? Many organisations to choose from Or you might want to go it alone by organising it yourself > Will the new structure of Doctors training make this more difficult?

Don’t just sit there… There is a massive need Millions of patients throughout the world are being treated very unfairly You can do something about it As a healthcare professional, you SHOULD do something about it >So, what are you going to do?