Foundations of Global Health Learning Objectives

Actors, Foundations & Careers • Identify changing face of global health actors "Demand that your government • Describe the benefits and concerns related to pays more attention. It's immoral that people in die like flies Global Health Initiatives of diseases that no one dies of in the United States. And the more • disease there is, the more political Identify contributions to global health from a unrest there will be, leading to more Darfurs, which the U.S. will variety of actors and foundations have to pay to fix." ~Former U.S. President Bill Clinton • Identify global health challenges and career paths to meet these needs

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Global Health Challenges Traditional Actors

• Complexity of global health • Intersection of multiple actors, NGOs, United Nations, national governments • MDGs require basic improvements (water, food, , education etc) • Weak infrastructure in developing world • Need to strengthen existing health systems

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New Actors Global Health Initiatives

• Emerging trend in global health • Programs targeted at specific diseases – Bonus: resources support other health efforts, too • Between 1998 – 2000, launch of 3 major global health initiatives: – Roll Back – Stop TB – GAVI

Roll Back Malaria

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1 Roll Back Malaria Malaria Global Action Plan • Partnership launched in 1998 by WHO, UNICEF, • Objective: Scale-up interventions to reach 80% of populations UNDP and the World Bank at risk • Estimate that 4.2 million lives could be saved by 2015 • Coordinate global response to reduce deaths from in 20 highest burden African countries malaria – Current annual funding: $1 billion • Increased access to: – Funding Needed: ~$6 billion (gap of $5 billion) – Effective treatment • Level of coverage – Prevention tools (bed nets) is far below target • Responds to malaria – 66.2 million outbreaks bed nets provided – 730 million needed • Assists in development of new products for the to achieve prevention and treatment target

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GAVI GAVI Stats • Global Alliance for Vaccines • 5.4 million deaths and Immunization prevented (2001-2009) • Private/public partnership launched in 2000 • 43% of vaccines are • Strengthen childhood produced by drug immunization programs, companies in especially in developing developing countries countries • Committed $4 billion • Innovative approaches to countries through (AMC) 2015

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Global Health Partnerships: Benefits GHP: Concerns

• Increased profile of target diseases • Poor coordination and duplication • Large-scale new funding • Additional training needed for • Greater civil society and private sector implementation participation • Variable country ownership • Use key technical and operational strategies • Poor alignment with country processes • Accelerated progress • Health system capacity/human resources • Supported global public goods problems • Secured economies of scale • Low or uncertain sustainability • Led innovation

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2 Examples of Multi-lateral Organizations The Global Fund

• United Nations • Global Fund to Fight AIDS, and Malaria – WHO • International financing – UNAIDS institution (just handles the money- others – FAO implement it) – UNFP, etc • Created in 2002 to increase resources for 3 diseases • Global Fund to Fight AIDS, TB, Malaria • Support large-scale • prevention & treatment World Bank measures in 144 countries • $19 billion in total funding

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Global Fund Stats Examples of Global Health Actors • HIV/AIDS: • Tuberculosis – 2.8 million people on ARV – 7 million new cases detected treatment and treated • Past Presidents (USA) – 120 million HIV counseling and – Supported programs for 48% of testing sessions TB cases globally • Foundations – 930,000 HIV+ pregnant women • Malaria • Rich & Famous People received PMTCT treatment – 122 million bed nets distributed – 142.4 million drug treatments • Students! delivered

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Past Presidents The Carter Center • Former US presidents raise awareness & • Founded in 1982 with Emory funding for global health issues University in Atlanta – Jimmy Carter • (Carter Center) Supports Peace & Global – Bill Clinton Health Programs (Clinton Foundation) • $87 million annual operating – George W. Bush budget & 160 employees (PEPFAR program) – “Graduated” over 2000 • Very influential in student interns international community • 2002 Nobel Peace Prize

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3 Carter Center: War on Diseases Clinton Foundation

• Focus on neglected tropical • Established in 1997 to raise funds for presidential library and variety of programs diseases • 7 global initiatives– all related to health & poverty • Base for International Task • NGO with 1,100 staff and volunteers in more than 40 Force for Disease countries • Does not grant money to other programs- funds its Elimination (ITFDE) own projects – Guinea worm – Lymphatic filariasis – River blindness – Trachoma

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Clinton Global Initiative Rockefeller Foundation • Founded in 1913 • Founded in 2005 – Mission: To promote the well-being of • Hosts annual meeting to coincide mankind throughout the world with UN General Assembly • First grant: $100,000 to American Red • Membership is by invitation only Cross to establish headquarters in DC – Fee $20,000 (most tax deductable) • Builds & endows first schools of • Commitments to Action Public Health in the United States • Private sector mixes business & • Developed Yellow Fever Vaccine philanthropy • Agricultural engineering & green revolution • CGI University • Co-founds Children’s Vaccine Initiative & IAVI

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The Bill & Melinda Gates Foundation Bill & Melinda Gates Foundation • Originally formed as the William H. Gates Foundation (1994), then renamed BMGF (1999) • Principle that every life has value • Named Persons of Year in 2005 by TIME • Apply business techniques to giving

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4 Foundation Stats Gates & MDGs • Headquartered in Seattle • Recent trend to address • 874 employees underlying causes of • $68 billion endowed poor health – Dispersed ~$24 B • New emphasis on • Grants support work in maternal/child health over 100 countries • Infectious diseases– still priority– with $10 billion committed to vaccines

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Grand Challenges in Global Health Grand Challenge Explorations • Gates has spent over $450 million to • Launched in 2008 encourage innovation for unsolved problems – Open to everyone (students, too!) • Aims to develop new tools to improve health – Open to any organization – colleges, non-profits, in developing world government labs, etc • People that think “outside of the box” • Must have a cool INNOVATIVE idea • Variety of disciplines: engineering, chemistry, • No preliminary data & short 2-page application statistics, business & medicine/health • $100k to start – If it works, up to $1 million

http://www.grandchallenges.org/Pages/default.aspx 27 28

Warren Buffett

• Rich, American investor • lead singer and activist • • Co-trustee of Gates Co-founder of DATA organization (Debt, AIDS, Foundation Trace & Africa) in 2002 • Pledged to donate most of • ONE campaign to end his wealth to charity – Has committed $30 billion in • RED campaign to fund shares to the Gates HIV/AIDS Foundation • $150 million – One catch: Foundation must "It is extraordinary to me that you can find $700 contributed spend money in same year billion to save Wall Street and the entire G8 can't find $25 billion to save 25,000 children to The Global • who die every day of preventable disease and $600 Billion Challenge hunger.“ ~Bono Fund

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5 Jeff Sachs Students

• American economist • You can be powerful force for positive change • Co-founded the Millennium Villages Project • Volunteer time, skills and enthusiasm • Director, The Earth Institute at Columbia • Raise money & University awareness for • Special Advisor to the organizations United Nations (support fundraisers) • Future leaders in global health

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Important International Experience Global Health Career Paths

• Many global health jobs require (or strongly • Consider MDG targets recommend) international experience – Maternal & child health, poverty reduction, infectious • How do I get experience? diseases, environmental sustainability.. • Opportunities for public health professionals • INTERN or VOLUNTEER for overseas duty (epidemiologists, community health workers, health – 1000s of NGOs working internationally scientists…) – Grassroots Organizations • Health service delivery: doctors, nurses, dentists, – Faith-based Organizations physician’s assistant, EMTs.. – Peace Corps – Public Health Coursework • Program support: program managers, statisticians, (international field experience) communications, IT service, engineers, economists, etc

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Potential Employers Key Training Opportunities • In-country field consultants • USAID: Global Health Fellows • Disaster relief organizations Program/Internships • Immigrant/refugee health organizations • The Corps: Peace Corps, Global Health Corps, • Research and academic institutions US PH Commissioned Corps • International agencies Check out the WEBSITES in • CDC: EIS Officers, Public Health Fellowships, • Other NGOs Recommended Career Resource folder in Week 15. It includes Internships (assignment locations based in • Multi-lateral agencies (such as LINKS to current public health United States) WHO, UNICEF, World Bank) job openings, fellowships, internships and training • NGOs: PIH, MSF, RedCross • Governmental agencies (USAID; opportunities!! in-country Ministry of Health…) • Carter Center

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6 Future of Global Health Practice Questions

• Funding • Contrast traditional vs. new actors in global health. • Sustainable development • Define Global Health Initiative • Weak public health and/or health system • Compare and contrast Presidential foundations infrastructure hampers an effective program • What famous American investor has pledged most of • Tremendous progress & awareness in recent his fortune to charity, particularly Global Health? years • Name 2 health services careers in global health. • Globalization & technology will contribute… Name 2 public health careers. • Greater involvement of private citizens and • Name 3 potential global health employers. grassroots organizations

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Foundations of Global Health

Hope you enjoyed the course!

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