Sustainable Development: the Holy Grail of Global Health€¦ · Sustainable Development: the Holy...
Transcript of Sustainable Development: the Holy Grail of Global Health€¦ · Sustainable Development: the Holy...
Sustainable Development:the Holy Grail of Global Health
Stephen Berman, MD, FAAPDirector, Center for Global Health, Colorado School of Public HealthProfessor of Pediatrics and Public Health, University of ColoradoEndowed Chair, General Pediatrics, Children’s Hospital Colorado
Stephen Berman has no relevant financial relationships to disclose
or conflicts of interests
Tales of 2 Global Experiences
• Mountains Beyond Mountains– Biography of Paul Farmer by Tracy Kidder
• Three Cups of Tea: One Man’s Mission to Promote Peace…One School at a Time– Autobiography of Greg Mortenson
Lessons Learned • Passion• Perseverance• Principles IntegrityCredibilityFairness and a sense of social justice
Reflections on My Personal Global Health Journey
Cali Colombia: 1976-78 Study of ARI in 5
community health centers with blood cultures and viral culturesDirector of the Universidad Del Valle Emergency DepartmentCase history of a boy presenting with a rigid abdomen
Reflections on My Personal Global Health Journey
WHO 1980-1990• WHO Case Management of Acute
Respiratory Infections• Program Implementation
Philippines Brazil Egypt
• Research Infant pneumonia Respiratory rate thresholds Otitis media studies
• Global Burden of disease (ARI and Otitis)
Reflections on My Personal Global Health Journey
BOSTID 1987-1988• Research: clinical coordinator
for 12 country etiology study of pneumonia Data on pneumococcal
serotypes
What is Global Health?
Health care issues and concerns that transcend
national boundaries and are best addressed by cooperative
actions and solutions.
Global Health and “America First”How do we benefit?
New therapies developed and tested abroad: ORS, HIV therapies
New vaccines developed and tested abroad:Rotavirus, Pneumococcal, Ebola, Dengue
Understanding emerging diseases:Zika, Ebola, Dengue
International Health
• Excessive Morbidity and Mortality• Low Income Countries
Global Health
• Sustainable Development• Low and Middle Income Countries
Planetary Health
• Planetary Ecosystems • Human Race (all countries)
Perspective• MDGs• SDGsTargets
• Family• Community/country/region• Human race
Population
• Lifetime• Generations• Millennium
Time
Millennium Development Goals - 2015
Maternal mortality Child mortality HopelessnessViolenceCorruptionPolitical instabilityConflict
Water Sanitation
Food InsecurityNutrition
InfectionHealth care access
Environ-mental
conditions
Disaster preparedness and response
Gender Inequality
Family composition
Education
Jobseconomic
growth
Extreme Poverty
Dysfunctional community-based systems
(size)
MDG 1
MDG 2
MDG 3
MDG 4,5
MDG 6
MDG 7
MDG 8
Sustainable Development Goals
September 2015 UN General Assembly ratified 17 goals with 169 proposed targets
Sustainable Development Goals
StarvationEpidemicsDisastersViolence
Political instabilityConflicts
Failed StatesRising mortality
Rising oceans/ flooding
Decreased useable land
Decreased soil nutrients
Expanded vector borne disease areas
Melting glaciers
Land degradation
Water Scarcity
Decreased Biodiversity
Global Warming
FisheriesExploited
Ocean Acidification
Social Justice and Fairness
Disproportionate Burden of Global Warming
Commoners (LMICs) versus Elites (HICs)
Women and their children and families
IN 2011
Promote the comprehensive improvement of health and human development of the population in El Trifinio region
• Large agribusinessenterprises for crop export
EL TRIFINIO REGION
• SAN MARCOS
• RETALHULEU• QUETZALTENANGO• Lack of community
cohesion• High migration
Timeline of the UCD-CHCO Trifinio Guatemala Site
June2011
RNAOct2011
Child developmentAnd growth studies
July 2012-13Clinic Opening
March 2014
The Trifinio Guatemala Project:Implementing the SDGs at the Community Level
• Community nursing program: home and group visits for pregnant women, neonates, and children to age 3 years
• Family clinic• Dental clinic• Birthing Center• Research programs• Education programs• Community Development
Trifinio Clinic2014
Care groups: teaching mothers to help their children grow and develop
“The greatest capital that you can invest in is human capital, and, of that, the most important component is the mother.”-James Heckman, Nobel Laureate, Economist
Research• Surveillance of Dengue, Chick, and Zika• Neurodevelopmental impact of post-natal Zika
infection• GIS mapping of the community• SMS text messaging for immunizations• RCT of new product to treat diarrhea• Child development studies
Education• Students, residents, fellows from medicine,
pharmacy, nursing, dental, and public health schools.
• Trifinio nursing, pharmacy and laboratory staff• Sex education programs in the schools• Youth leadership school program