Turning the World Upside Down The search for Global Health in the 21st Century
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Transcript of Turning the World Upside Down The search for Global Health in the 21st Century
Turning the World Upside Down The search for global health in the 21st century
Turning the World Upside DownThe search for Global Health in the 21st Century
CPSO Annual Lecture, Royal Holloway4th November 2010
Nigel Crisp
Turning the World Upside Down The search for global health in the 21st century
The Search for Global Health•Interdependence•The unfair health trade•Turning the World Upside
Down•Co-development•Transition between paradigms
Turning the World Upside DownThe search for global health in the 21st century
The unfair health trade
•Health workers•Health systems•Pandemics•Resources•Trade, Aid and FDI
Turning it Upside Down
•Training and education•Learning and understanding•Rights•Equity•Transparency
Turning the World Upside Down The search for global health in the 21st century
20th Century successes
The 20th Century paradigm•Greater professionalism•Scientific discovery•Commercial development•Growing funding
Turning the World Upside Down The search for global health in the 21st century
Health Wealth SocietyNew drugs Minimum wage HASAW
Surgery Liberalisation Education Clean air Consumerism Equalities Access Employment WelfareAnaesthetics Pensions Franchise Professions Industry
Labour/capital
Turning the World Upside Down The search for global health in the 21st century
21st Century disruptions
Life has changed•Diseases and conditions•Patients and the public•Science and technology•Health becomes global
Turning the World Upside Down The search for global health in the 21st century
This model is now part of the problem
Turning the World Upside Down The search for global health in the 21st century
New ideas from elsewhere•Pioneers•Other industries•Poorer countries•Young people •Disability and rights groups
Turning the World Upside Down The search for global health in the 21st century
Turning the World Upside Down The search for global health in the 21st century
Health in poorer countries
• Poverty, social issues and internal and external power relationships
• Shortages of resources and health workers
• Non-communicable as well as communicable diseases
The distribution of HIV/AIDS• Refreshment and personal
development• Greater cultural awareness• Learning specific skills and
practices• Challenging our long-held ideas• Shaping the future together
Turning the World Upside Down The search for global health in the 21st century
Non- communicable disease• Independence – bringing together
patients, health and social workers• Rebalancing of health systems between
care, population health and costs• Quality improvement and performance• Health worker training and re-design• Interdependence and co-development
Turning the World Upside Down The search for global health in the 21st century
Turning the World Upside Down The search for global health in the 21st century
Innovation
• HIV/AIDS• Specific conditions • Policy initiatives• Product development• Telemedicine• Identified by GE , McKinseys
14
Innovation in health care delivery is taking place around the world
SOURCE: McKinsey analysis
PDA: Social marketing
(humorous) for reproductive
health
5
Integrated care solution
20
50 global locations: social marketing for killer diseases
17
Co-operative medical system
22
Veteran’s Health Administration
21
Mini clinics in retail stores
16
Remote triage/referral
1
Remote chronic disease care
15
Low-cost eye-care solution
11
High-volume, low-cost heart
surgery hospital
14
Midwife led, low-cost maternal
care
2
6
Mauritania complete low-
cost obstetric care
Valencia: Integrated HC
8
Integrated primary care
units
18Weighing children
to predict and prevent diseases
9
Real-time weighing and
diagnosis
19
Low-cost eye-care solution
3
Training for reproductive health clinics
10
Social marketing
program of PSI
4
Franchise network of stores
for deadly diseases
7
Innovative emergency
response model
13
Remote advice and mobile care
solution
12
Turning the World Upside Down The search for global health in the 21st century
Turning the World Upside Down The search for global health in the 21st century
An emerging tradition
• Community, family and women• Health, education and work• Social enterprises• Public health and clinical medicine• Train for the job not the profession
Independence
•Seeing world in terms of peoples’ lives not our services
•“Getting our lives back”•Living a life we have reason
to value
Turning the World Upside Down The search for global health in the 21st century
Co-development
•Top down development - western experts
•The invention of international development
•Understanding Global Health
Turning the World Upside Down The search for global health in the 21st century
Benefits of co-development for poorer countries• Country led and owned• Culturally sensitive and respectful• Able to draw on all traditions • Avoids the faults and weaknesses of
richer countries• Recognises the shifting balance of
power
Turning the World Upside Down The search for global health in the 21st century
Benefits of co-development for richer countries• Refreshment and personal
development• Greater cultural awareness• Learning specific skills and
practices• Challenging our long-held ideas• Shaping the future together
Turning the World Upside Down The search for global health in the 21st century
A movement of people and ideas
Turning the World Upside Down The search for global health in the 21st century
A new paradigm
Professionalism, scientific discovery, commercial development and funding
added to by Interdependence, independence and rights
Turning the World Upside Down The search for global health in the 21st century
Accelerating the change
•Make it visible and coherent•Health worker education and
training •Experience and exchange
Turning the World Upside Down The search for global health in the 21st century