(January 2008) In the last five years, interest in global health education has surged.

But what should this education look like? What does a person need to know to be literate in global health? At a recent Population Reference Bureau policy seminar sponsored in part by the National Institute of Child Health and Human Development, a panel of experts* gathered to discuss their ideas and vision for global health education.

Richard Riegelman is professor of epidemiology-biostatistics, medicine, and health policy and founding dean of The George Washington University's School of Public Health and Health Services. He has been part of a team of educators affiliated with educational associations that aim to help U.S. students become engaged in global health. Dr. Riegelman noted that a 2003 National Academy of Sciences' Institute of Medicine report recommended that all undergraduates be given access to public health courses.

About 100 colleges in the United States offer a public health school or program and related courses for college students, but 1,900 other bachelor's degree-granting institutions are not attached to such a college or program. Thus, a vast majority of U.S. undergraduates are unlikely to have access to a public health classes of any kind.

As a supporter of the push to add global health studies to the curricula of colleges and universities' schools of arts and sciences, Riegelman endorses a core curriculum of three courses: Public Health, Epidemiology, and Global Health.

Maurice Middleberg, vice president for public policy at the Global Health Council, contended that global health education should focus on improving the health of the poorest of the poor, those living on less than $2 a day. The target students would include those in developing countries who will be responsible for managing their own countries' health programs.

According to Middleberg, the content of global health education should address alleviating the greatest burden of disease based on epidemiological data. The curriculum should go beyond just teaching about diseases to explore how health systems pose major obstacles to progress and to examine health equity issues, including financing. Middleberg also called for management training to be part of the public health curriculum so that people who are otherwise academically trained learn skills that will help them mobilize others.

Joanne Carter, associate executive director and legislative director of RESULTS, an international grassroots advocacy organization, built a case for adding political advocacy to the public health curriculum. "Our greatest challenges are more political than scientific," she said. Some of the most ancient diseases such as TB and malaria have yet to be eradicated, she pointed out, due to a lack of political will. Some $2.9 billion has been spent on fighting HIV vs. $150 million on TB, she noted. Ultimately, whether efforts are made to scale up prevention or eradication will depend on a political decision. "It's a question of what's a priority," said Carter, "not what's possible."

Along similar lines, Robert Eiss, senior public health adviser at the John E. Fogarty International Center for Advanced Study in the Health Sciences, a branch of the U.S. National Institutes of Health, noted the persistent gap between research and practice. If known interventions were deployed, he said, child mortality could be reduced by 60 percent.

Several guests who joined by video commented on global health developments at their institutions. Global health is gradually being integrated into medical and graduate programs. Kristian Olson, an inpatient clinical educator at Massachusetts General Hospital, noted how the hospital is trying to integrate global health training into residencies. A hospital seminar series now includes global health topics. Overseas training with mentors is also an option.

Similarly, William Markle, author of an introductory text on global health and clinical associate professor of family medicine at the University of Pittsburgh's School of Medicine, mentioned how some residents in the Department of Family Medicine can opt to spend part of their residencies in international programs in developing countries.

Another guest was Thomas Novotny, professor in the department of epidemiology and biostatistics at the University of California, San Francisco (UCSF) and director of international programs at the UCSF School of Medicine. He noted that it's possible for medical students at UCSF to "minor" in a global health concentration. In addition, a one-year master's degree in global health sciences is under development and scheduled for launch in 2008.

*The panel included Richard Riegelman, Maurice Middleberg, Joanne Carter, and Robert Eiss.


Sandra Yin is editor at the Population Reference Bureau.


For More Information

www.teachpublichealth.org
This website on undergraduate education in public health offers resources and curricular materials to teach introductory college-level courses in public health.

www.teachprevention.org
The Prevention Education Resource Center (PERC) is a repository of teaching materials related to prevention and population health at the graduate and undergraduate level.

www.ianphi.org
The International Association of National Public Health Institutes aim to improve public health service delivery and decisionmaking globally by helping low-resource countries strengthen or develop national public health institutes.