A few months ago, Ebola was the big story. Now it’s Zika. Is our approach to global health a comprehensive strategy or a series of reactions to the threat du jour?
For today’s Humanosphere podcast, we’re talking with Christine Sow, director of the Global Health Council based in Washington, DC. We wanted to get Dr. Sow’s take on the current state of global health because the field appears to be in a fairly critical, transitional period.
Sow has what you might call global health street cred. She worked for more than 15 years in Mali on health projects, often focusing on women and children’s health. Sow witnessed the roll-out of the US government’s massive response to the AIDS crisis in Africa, Pepfar (President’s Emergency Plan for AIDS Relief). That project, championed by President George W Bush, saved millions of lives by getting people with HIV on life-saving drugs.
But such massive, well-intended strategies can cause other problems – such as focusing the very limited health systems of poor countries mostly on fighting one disease or health problem rather than bolstering the health system in general. The world has taken many approaches to ‘global health’ over the last century or so, dubbed tropical medicine or international health. The fight against diseases of poverty was first carried as a feature of colonialism, mostly of improving worker productivity, or of keeping Western militaries healthy overseas. Fighting disease was (and is) also a favorite method of community engagement for religious organizations seeking converts overseas. But it is only really in the last 15-20 years that the field of global health has grown to such magnitude and scope.
So what is global health, really? Do we all agree on what it is, and what it is supposed to accomplish? Is it changing? Sow walks us through the history, some of the huge successes we’ve made against some big killers like AIDS and malaria. And then we dig into what needs to change if we are going to continue the trajectory of progress against diseases of poverty – systems changes that are focused on equity and cost-effectiveness.
As usual, KPLU’s Gabe Spitzer and Humanosphere’s uber-journo (not to imply he’s so poor he doesn’t own a car) Tom Paulson talk about some of the big news of the past few weeks, including scientific confirmation of the link between ZIka viral infection and fetal birth defects. Author Lisa Nikolau notes that this fairly unsurprising finding doesn’t resolve questions about relative risk or which stage of pregnancy puts women and babies at most risk. In a related story, Tom Murphy reports on the US government shifting some $500 million put aside to respond to the Ebola crisis over to Zika (see lede sentence re risk du jour).
We also note the revelation in the so-called Panama Papers that the rich and powerful send their money overseas to avoid taxes (we are shocked!) and how Humanosphere will be watching for stories that illustrate how these tax havens contribute to poverty and inequity worldwide. Finally, we discuss Lisa’s report on the challenges complicating peace talks between Colombia’s government and rebels.