Getting involved in Global Health Dr Rhona MacDonald The Lancet

1. Getting involved in Global Health Dr Rhona MacDonald The Lancet

2. Setting the scene • 35 000 people die from preventable,poverty related infectious diseases EVERY DAY • Global burden of chronic disease • Conflict, arms and trauma • ‘Natural’ Disasters

3. 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!

4. Millennium Development Goals 1-3 • Eradicate extreme povertyand hunger: reduce by half the number of people living on lessthan $1 (60p) a day and those who suffer from hunger • Achieveuniversal primary education • Promote equality between the sexesand empower women: end gender disparity at all levels by 2015

5. Millennium Development Goals 4-6 the Direct Health Ones • Reducechild mortality by two thirds for children aged under 5 years • Improvematernal health: reducing by three quarters the maternal mortalityratio • Combat HIV/AIDS, malaria and other diseases: halt andbegin to reverse the spread of HIV/AIDS, malaria, and otherdiseases

6. Millennium Development Goals 7 Ensure environmental sustainability, including integratingenvironmental sustainability into developing country policiesand programmes; reversing the loss of environmental resources;reducing by half the people without access to clean drinkingwater

7. Millennium Development Goals 8 Develop a global partnership for development, includingan open trading and financial system that is rule based andincludes a commitment to good governance, development and povertyreduction; enhanced debt relief and cancellation of bilateraldebt; more generous development assistance for countries committedto poverty reduction; working with pharmaceutical companiesto provide access to affordable essential drugs in developingcountries

8. Outcome of G8 2005- 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

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

10. 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

11. 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

12. 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

13. ‘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

14. 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

15. 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

16. 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

17. 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)

18. 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 collectivelyjoin up and do their activities

19. 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

20. Give • Many charities and organisations are workingto 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

21. 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?

22. 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?