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Global Health Leaders Reflect on 40 Years of Advances in the Field
The Mailman School has been active in the global health field for four decades. In 2005, the School launched a Global Health Track that embraces a multidisciplinary approach to teaching and training. To commemorate faculty involvement in the field and to welcome new students in the Track, the School held a panel discussion led by Pamela Collins, MD, director of the Global Health Track, on Wednesday, September 6, entitled "Reflections on the Past, Directions for the Future."
Several visionaries in the field were present for the day's first panel discussion, including Allan Rosenfield, MD, dean, Mailman School of Public Health; Zena Stein, MD, professor emerita, Department of Epidemiology; Martin Gorosh, DrPH, special lecturer, Heilbrunn Department of Population and Family Health; Roy Brown, MD, professor emerita, Heilbrunn Department of Population and Family Health; and Nicholas Cunningham, MD, DrPH, professor emerita, Heilbrunn Department of Population and Family Health. Each presenter expounded upon early global health fieldwork, ideological approaches to the work, and advances in the field over the past four decades.
"In the very early days, we implemented family, training, and policy programs with a heavy focus on the interface between global and domestic activities," said Dr. Rosenfield. "This led the School to be globally involved in a range of areas and set the stage for it to evolve into one of the major global health groups-one with a steady balance between global health and domestic issues." Dr. Rosenfield explained that a balance is important and programs in each area influence programs in the other.
Drs. Gorosh (left) and Brown
According to Drs. Gorosh and Brown, "Health conditions do not observe country borders." Problematic issues in the U.S., such as the need for healthcare, nourishment, and employment, are similar to those experienced abroad. Providing underserved populations with programs to alleviate healthcare problems can be easier to address in foreign countries, and later can result in new methods introduced to the U.S.
Not all healthcare methods can be exported or imported, however. Dr. Stein cautioned students to be wary of exporting rules from their culture. When deciding what to take, she advised students to have humility in relation to what can be done and for whom, and to consult with local healthcare providers when introducing a foreign concept.
Drs. Cunningham (left) and Stein
Dr. Cunningham argued that an effective approach to care is one that integrates curative and preventive programs. By establishing trust with a patient, healthcare professionals can introduce methods for the long term. The debate is a controversial one, as many successful initiatives focus primarily on curative care.
The second panel focused on funding for global health initiatives. Participants included: Marilyn Aguirre-Molina, EdD, professor of clinical Population and Family Health and director, Dominican Exchange Program; Neil Boothby, EdD, professor of clinical Global Health in the Heilbrunn Department of Population and Family Health and director, Program on Forced Migration and Health; Wafaa El-Sadr, MD, professor of clinical Epidemiology and director, International Center for AIDS Care and Treatment Programs, Lynn Freedman, JD, associate professor of clinical Population and Family Health and director, Averting Maternal Death and Disability Program; and, Joseph Graziano, PhD, associate dean for Research, professor of Environmental Health Sciences and Pharmacology, and director of Columbia University's Superfund Basic Research Program.
Drs. Aguirre-Molina (left) and Graziano
Dr. Aguirre-Molina began by noting that the private sector responds to advocacy. Nonetheless, Ms. Freedman added, "there is a large gap between what donors want and countries need. Donors use corporate lingo and are driven by what is cost-effective. Mortality is a key unit of measurement."
To capture the funding and appeal to donors while controlling the direction of a project or program, Dr. El-Sadr suggested that students employ "opportunistic" methods. Said Dr. El-Sadr, "Funding drives initiatives; it shapes the agenda. Be creative, responsive, push the envelope, and broaden the agenda."
For more information about the panelists and their work, and to listen to an audio feed of the panel discussions, please visit the web page for the September event.
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