Global Health Ideas for Change – My Thoughts
Let me start off by saying that I have nothing to do with the ideas for change selection of this site. It's based on how many votes each idea gets. The topic editors have no special say in which ideas move forward and which don't. So this is my opinion on each of the three ideas in the Global Health category, but I don't have any extra weight in the voting. Don't take my word for anything; go check each idea out for yourself before you do any voting.
Idea # 1 - Peace Care -- Bring Together Peace Corps and Resident Physicians to Impact Global Health
Summary: Peace Care would have Peace Corps volunteers partner with an American residency programs to do exchanges. The goal is to build long-term health system capacity in developing countries.
I strongly agree with the premise of this idea. Global health disparities are severe, and health systems in developing countries are in desperate need of support. Additional staff and training would be of real assistance.
However, I am not convinced that Peace Care would be the best way of achieving that outcome. Exchanges are always expensive. Airfare, housing, and insurance add up fast. It might be better to use the funds you would have spent flying a resident to support local master trainers in training physicians, or some other project to improve health system capacity. Secondly, it is very hard to maintain the impact of exchange programs. Once participants pass through the program, their efforts are often lost. Lastly, I really can't tell for sure what the residents are bringing to the table. How exactly will they build local capacity?
Idea #2 - Invest in health workers to improve the health of the poor
Summary: The US should increase investment in human capital for global health, by creating a corps of physicians, nurses, pharmacists, lab technicians and computer specialists and deploying them to hard-hit countries lacking health infrastructure. The US should also support the training and employment of community health workers in these countries.
Once again, I agree wholeheartedly with the premise here. Human capital for improving global health is an extremely important issue. Health care providers are an key part of improving human health, as are health systems.
I have concerns, though, about the ability of a few individual advisors to change entire health care systems for the better. Systemic change takes money and political will. The idea does not mention budgets for these advisors to spend, and I think that people who stay in a country for 1-3 years will not be able to develop the political traction to bring about change. This idea is similar to both the Liberia Fellows program, and the USAID global health fellows program. We could look to their experience to see if this one would work.
As for the second part of the idea - I love training community health workers. I am totally on board with that. And working through existing funding mechanisms is the fastest, most efficient way to do it.
Idea #3 - Save Children from Preventable Diseases
Summary: Fight preventable causes of child death by supporting low cost interventions, and do more research on ways to reduce child mortality.
Overall, I think this idea is great. There are so many things we can do to save children's lives - water filters, vaccinations, oral rehydration salts. These are proven to work, and don't cost much. Several of them have been included in the Copenhagen Consensus. We can protect vulnerable children using tools that actually work. We should do so, immediately.
My concern about this idea is that it is so broad. It includes vaccine research, water filters, vaccine research, and more. That is a lot to implement and to track and evaluate. Focusing on one aspect or child mortality might be a more effective way to go.
All in all, I think each of the three ideas represents some serious thought about global health and how to make it better. We've got something to learn from all three.
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