Why is interest in global health booming? The Community and Global Health concentration is one of the most popular programs at Macalester, and the topic of the college's 20th annual International Roundtable is Global Health: Promoting Equity Within and Across Borders.
To answer that question, we spoke with Christy Hanson, dean of the Institute of Global Citizenship. She also serves as Roundtable co-chair with biology professor Devavani Chatterjea and geography professor Eric Carter.
What is global health and why should we care about it?
Christy Hanson: Since 1948 the World Health Organization (WHO) has defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” I would agree; health is central to who we are and how we function. Many member states of the United Nations signed on to Article 25, which says:
Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.
Everyone deserves an equal opportunity for health, but when you look around the globe, you see unjust disparities. Health disparities represent a preventable and solvable global injustice. The world community has so many tools to make people healthy today, allowing them to contribute to their families and their communities. We still need research and development to make health affordable, accessible, and more appropriate for everyone, but there is much that can be done right now.
How would you describe the state of global health?
CH: When I began working in the field more than 20 years ago, we had to make the case to governments for the importance of health. Health needs were seen as a black hole, for which endless money wouldn’t make a difference. Happily, there has been a shift since the mid-1990s. The unprecedented progress we’ve made has gone far to convince governments that health is essential to economic development. Since 2000 the Millennium Development Goals have offered a razor-sharp focus on health as a central element of reducing poverty and developing society.
Of course, there is more to be done, but we have made great progress. According to WHO:
- Annual deaths of children under 5 fell from 12.6 million in 1990 to 6.6 million in 2012.
- Worldwide, the number of people newly infected with HIV dropped 21 percent from 2001 to 2011.
- Since 2000, 1.1 million deaths from malaria have been avoided.
- Tuberculosis treatment saved 20 million lives between 1995 and 2011.
It’s a really exciting time in global health. With success comes more interest and more willingness to invest—it’s a positive cycle. Even so, less than 1 percent of the U.S. budget goes to international development assistance, including health. Where we invest overseas, opinions of America are more positive. It’s called “medical diplomacy” and it gives a political justification to a humanitarian aim.
What is your philosophy about global health?
CH: What I tell my students is if you’re going to intervene in someone else’s health and welfare, be sure you understand their priorities and the root causes of their health disparities before you anticipate solutions. Learn their language, ask questions, and listen. Don’t do anybody any “favors.” I’ve worked with international agencies, government, and NGOs alike. Regardless of platform, I’ve always believed that my role is to provide a voice for the voiceless. Behind any economic model, evaluation, health program or policy I have designed or implemented, a few images of communities and individuals provide my internal compass. They don’t fail me and I try not to fail them.
We have a popular Community and Global Health concentration. Why involve the whole college in global health issues?
CH: Health is so central to who we are that it’s inherently interdisciplinary. Solutions may be medical and involve biologists and chemists, but we also need anthropologists to understand the social dimensions, economists to understand the economic impacts, computer scientists and mathematicians to find big data solutions, writers and artists to advocate, and political scientists to implement change. To understand health issues, we need everyone’s perspectives and skills to find the most appropriate solutions.
What impact can Macalester students have on an issue like Neglected Tropical Diseases?
CH: Here is an example. In 2012, right here at Macalester, the World Health Organization held a task force meeting to explore the impact of using preventive chemotherapy for Neglected Tropical Diseases (NTDs). Our students wrote background papers summarizing the global evidence base related to the impact of NTDs on socioeconomic status, education, health, and water and sanitation. They discussed their findings with WHO’s international experts and jointly identified future research that could help countries manage these diseases.
At the conference’s end, WHO asked us to chair a working group on the subject and asked the students to stay involved, saying “We need your generation, your ideas.” In collaboration with WHO, a group of computer science students is now developing a web-based platform for a research consortium that will match students around the world with the analytical needs of disease-endemic country governments. It will be exciting to see where students take this.
There are so many ways in which Macalester students can contribute. They can intern at nonprofits, with government, at hospitals. They can conduct research and present papers at conferences. They can study abroad and do community-based research.