Q&A: Taking a new perspective on global health

Last month, representatives from 58 U.S. universities gathered to talk about the accomplishments and challenges associated with the global health initiatives on their campuses. Cynthia L. Haq, professor in the School of Medicine and Public Health and director of UW–Madison’s Center for Global Health, and Karen Solheim, clinical professor at the School of Nursing, attended this inaugural meeting of the Consortium of Universities for Global Health.

UW–Madison’s Center for Global Health was founded in 2005 by five units (the Division of International Studies and the schools of Medicine and Public Health, Veterinary Medicine, Nursing and Pharmacy). Its programs also incorporate faculty and curricula from disciplines such as anthropology, environmental studies, public policy and law. Since 2006, the center has offered an interdisciplinary graduate-level Certificate of Global Health to students and professionals.

These interviews were conducted separately.

Q: Why focus on global health when we have so many health crises such as obesity, AIDS, the flu — not to mention the health care system itself — in our own country?

Haq: It’s not either/or, it’s both/and.

By examining how people deal with health issues elsewhere, we can gain new perspectives on how to handle and promote health in our own backyard.

An example of the intersection between global and local health is my work in Milwaukee, where I am designing educational programs to train doctors for health care in the inner city. Many of the skills that I am using here are the same ones I used in my work in Uganda.

It’s about training medical students to be aware of their context, and to recognize the impact of culture and poverty on health outcomes. A powerful way to learn these lessons is to have global health experience which can enable you to return home with new skills and perspectives.

Solheim: Today, what we do at home has an effect on people across the globe and what they do has an effect on us. You can’t separate the local from the global anymore, they are interdependent. Whether we are talking about the spread of disease like the H1N1 or the availability of resources, we have to think about them within a global context and not just within our local environment.

Q: Do people agree on what “global health” actually is?

Solheim: Global health is an all-encompassing topic. There is a real diversity on what people chose to focus on within it: from the analysis of infectious disease to the sociological and political issues that surround global health.

For example, one of the professors at the meeting was focusing on the global health impact of war. The fact is that global health extends into many of the diverse challenges we face as a world today.

Q: Do you see greater interest in global health developing?

Haq: Yes, and I think one of the reasons is the millennial generation. This new generation of students is more aware of the world and how interconnected it is because of their access to instantaneous information from around the world, detailed images and sounds that put the world at their fingertips. This generation can see disparities in health outcomes and they want to do something to address these challenges. Universities can help prepare this generation to reduce health disparities.

As for the enthusiasm of my colleagues in medicine and public health, it is growing. More and more faculty are interested in matters of global health. But the numbers of faculty who are actively engaged in global health is still relatively small.

The hardest step is often to assist students and faculty to gain their first experience in a global health; once they’ve completed that first experience, and they have found they can learn and contribute, they are often eager for more.

Q: What do you see as the major challenges that global health initiatives like yours will face in the next 10 years?

Haq: There is a challenge to go deeper in building long-term commitments and partnerships with other countries around the world. Right now, many students complete an introductory global health field experience, but few are able to engage in longer-term projects. The challenge is to make these experiences more than superficial glimpses and to establish programs of exchange like the new Twinning Center Partnership we have in Ethiopia. These types of programs make a difference and an impact on students and on global health outcomes.

It’s also a challenge to make sure that we develop partnerships with mutual benefits. Americans are notorious for behaving as if we know how to solve others’ problems. But we don’t have the solutions to problems in radically different contexts. We need to learn to be a good passenger, rather than always needing to be the driver.

Another challenge we face is that interest in global health has accrued—we need to figure out how to manage the high level of student interest in our programs and to increase their capacity while we improve the quality and ensure positive impacts of the programs. Right now we have so many applicants to our programs that we must turn half of them away. To increase the capacity of our programs we need more resources both financial and human — we need funding and faculty to lead new programs.

Solheim: One of the biggest challenges that I see for university centers like UW’s Center for Global Health is the ability to provide quality affordable experiences for students in global health. Many students who are interested in global health are not able to engage in experiences abroad because they lack the funds necessary to travel or live there. We need to make it possible for all students who are interested in global health to become engaged in it and leave a friendly footprint somewhere in the world.

We need to continue to develop and foster exchange not only with other countries and regions but within our own university. We have a vision of global health here at UW as particularly interdisciplinary which is something that makes our university different from others. We need to continue to develop this vision, which makes us unique.