What can European universities do for Global Health?

Professor of Infectious Disease Epidemiology

Co-director Institute for Global Health, UCL

Anne M. Johnson

Global health -a multidimensional concept-

• Transition from national Public health to Global Health occurs ‘where the determinants of health or health outcomes circumvent, undermine or are oblivious to the territorial boundaries of states and this beyond the capacity of individual countries alone to address through domestic institutions.’

Lee K, Collin J eds. (2005) Global Change and Health Term applied in context of:• Global Health Diplomacy• Global Health Security• Global Health Policy• Global Health vs International health vs Public Health

What is global health?

Global health is... “an area for study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide. Global health emphasises transnational health issues, determinants, and solutions; involves many disciplines within and beyond the health sciences and promotes interdisciplinary collaboration; and is a synthesis of population-based prevention with individual-level clinical care.”

CUGH –USA Koplan et al. (2009)

Colonial Cold war Development aid

Globalisation

1.0Tropical medicine

2.0International health

Global health 3.0

Global health 4.0

Source: Peter Piot Global Health 4.0 CUGH Seattle 2010

Global health.... A concept in evolution

3.0 4.0

• High income countries• PI = North Am/Europe• Study sites• Largely biomedical • Infectious diseases

• Clinical trials, epidemiology, implementation

• Worldwide• PI = diverse• Centres of excellence• Multi-disciplinary• Broad health issues and

disparities• Full spectrum of

translation from discovery to implementation science

Source: Peter Piot CUGH Seattle 2010

UCL Institute for Global Health & the Grand Challenge for Global Health

www.ucl.ac.uk/global-health/

ActivitiesWithin UCL:• initiating and enhancing discipline- and department-specific

programmes, research and teaching • stimulating interdisciplinary discourse across the university • enabling the development of activity to make possible effective

large-scale multidisciplinary approaches and interventions.Beyond UCL:• creating real and virtual spaces for academic discourse, in the

public-policy arena and international political processes • exploring partnerships with other universities, government,

industry, funding bodies, trusts and charities, UK and international agencies to support our research, education, advocacy and public-policy initiatives

• positioning UCL as the key informant to governments, business and the community about matters relating to global health

www.populationfootprints.org

Universal and equitable access to quality health care depends on global and national forces

Source: Goran Tomson Global health Europe 2010

New challenges and contexts

• Growing economies (BRIC)• Global population growth, changing demography• Challenges to energy, food, and water security, • Demographic growth and ageing• Growing impact of non-communicable diseases • Migration and social movements• Acceleration of and new communication

modalities• New technologies

New challenges and contexts 2• Growth of ‘health industry’ in eg BRIC

countries- pharmaceuticals, health professional, manufacturing, 3y education

• Equitable Partnership not ‘paternalism’• Equitable and sustainable capacity

development (Iy education needs 3y education)• New models of teaching and learning• Multidisciplinary problem-solving (water,

energy, vaccines, epidemic control)

‘As global health becomes an increasingly hot field, there is a risk these well-intentioned efforts are creating a 21st-century scramble for Africa by US universities’

Source: Johanna Crane Lancet 23rd April 2011 commenting on Consortium of Universities for Global Health (CUGH)

European Academic Global Health Alliance (EAGHA)

European Academic Global Health Alliance (EAGHA)

• 50 Members in 23 countries in Europe

“A forum for interested academic institutions with involvement in Global Health to exchange views and ideas, so as to develop a European voice on Global Health issues and influence

relevant policies”

Where are the member institutions located?

Member of Alliance

Member of Alliance/ASPHER Member

EAGHA Country-level partners by institution type

67.5

15.9

7.9

6.3

2.4

University/college

Government agency (Minis-try, national institute)

hospital/medical centre

research centre

country office of interna-tional partnership

Diversity in type of partnership

– Capacity building • Through joint research projects, setting up PhD, MsC,

MPH programs; exchange programs, hospital management programs

– Policy development • Health System development, improving stewardship and

regulation at a national level

– Infrastructure strengthening • health information system development

– Research partnerships on specific diseases, health systems and target groups

EAGHA Global Partnerships

50%

19%

7%

8%

11%

4% WHO Africa Region

WHO Region of South-East Asia

WHO Region of the Ame-ricas

WHO Eastern Mediter-ranean

WHO Region of Western Pacific

WHO European Region

Objectives

• To advocate for evidence-based policies and increased resources for global health in the European Union and other relevant bodies; to influence EU policy on research and development for global health; to support the implementation of the EU research agenda.

Objectives

• To develop guidelines for partnerships between European institutions and their counterparts in low- and middle-income countries (including the issues of intellectual property and data sharing); to learn about effective partnerships from case studies and to promote the implementation of such guidelines.

Objectives

• To contribute to strengthening capacity in partner institutions in low income countries in response to their priorities, including supporting areas such as research, teaching, administration and infrastructure.

Objectives• To foster exchange of ideas and, where

appropriate, collaboration between European global health institutions on research, teaching, and capacity building;

Objectives

• To encourage and to support the evaluation of investments in global health to ensure they have the desired effects.

Objectives

• To raise awareness of the challenges and opportunities of global health in medical, nursing, public health and allied health professions, as well as the wider public.

Objectives

• To undertake horizon scanning in order to identify new and emerging topic areas, and share knowledge of potential impacts on teaching and research programmes as well as on policy and practice.

change in North America."

Objectives

• To encourage the formation of similar collaborative networks in other world regions and to forge links with those that already exist; to ‘globalize ownership of global health’ and promote more coherence in global health actions across regions through supporting the development of a ‘World Federation’ of like minded associations.

EU Global Health Policy

• Advocating for a sustainable European commitment to global health

• Promoting synergy between the policy spheres of public health, foreign policy, development and research for health

• Promoting effective and fair financing of research that benefits the health of all people