Written by Amrita Sankaranarayanan
Edited by Sinéad O’Ferrall & Helen Myrr
The Copenhagen School of Global Health hosted the 2015 Summer School in Global Health Challenges, a two week summer course seeking participation from 85 students from 27 different nationalities. The atmosphere was as vibrant as it could get with experts and beginners from various different strata, with backgrounds in medicine, engineering, law and politics to name but a few. The Danish sun also decided to show up to justify “the summer” in “summer” school.
Dr Flemming Konradsen, Director of the Copenhagen School of Global Health, gave an introductory talk on various job opportunities within the field and how to achieve a career in global health. This talk was followed by Dr. Alessandro Demaio, who highlighted the density and enormity of global health challenges in the 21st century. He talked about the complex landscape of the influences of the actors, the unprecedented opportunities for a transformational change, and highlighted how 2015 is an important year in global health. He put a special focus on climate change’s relation to global health and the growing concern about NCDs.
Dr Fiona Lander led the day forward by discussing the major actors in global health today, laying special focus on the structure and working of The Global Fund, Bill and Melinda Gates Foundation, World Health Organization, PEPFAR and the World Bank, civil society organizations and national governments. She also discussed state and non state actors and private vs. public actors and the way they work in unison. The takeaway message from this session was that goal setting and funding of initiatives do not necessarily reflect the needs or priorities of the recipient country.
Fiona’s energy and positivity, continued as day 2 began with a more serious lecture on Human Rights and clarifying concepts related to it. There was an interactive session on what human rights actually meant to each participant with ranging answers such as right to life, right to play, right to health, right to education, right to a fair trial, freedom of speech and freedom from torture. The session also involved a more extensive discussion on women’s right to abortion.
Alessandro then continued with an eye opening talk on NCDs, ascertaining that NCDS are not just diseases of the lazy, not just diseases of the rich, not just diseases of the aged and do not just affect men. There needs to be a focus and attitude shift for NCDs in terms of prevention strategies and early childhood education. He also gave quite an animated explanation for whose responsibility is it to prevent NCDS, suggesting the government, the individual, and consumer companies. He asserted that food literacy is fundamental to navigate a healthy lifestyle.
The advent of technology was indeed used to the fullest as the day proceeded with two lectures over Skype. The first one was by Dr Gauden Galea, (Director of division of Non Communicable Diseases, WHO-EURO), on transitions in health. He explained reports from WHO and World Bank from 1993 to 2015 and their (lack of) focus on NCDs. He raised important questions such as why is there a system which neglects NCDs, why is there a lack of investment in NCDs and is it a zero sum gain on investing in NCDs?
This was followed by another e-lecture by Dirk Christiansen focusing on epigenetics and NCDs explaining the double burden of under and overnutrition. He explained the effects of foetal malnutrition giving the examples of the Dutch famine, sub Saharan Africa, Ethiopia and Somalia. He also mentioned about the correlation of intrauterine nutrition and the development of Type II Diabetes. His catchy take home message was “Stay in your local environment and you will not get diabetes!”
‘Food for thought’ dinners with some of the key speakers were arranged where the participants got involved in more in-depth discussions in smaller groups around a dining table filled with delicious foods..
Day 3 began with lecture from the mighty Ib Bybjerg with a very detailed pathology and public health concern of infectious diseases – HIV, Malaria and Tuberculosis. This was followed by an inspiring interview session.
How do you keep the drive after so many years? With his charming smile, he just pointed out to us, and mentioned that it’s the students and patients that keep him going. He mentioned that his first trip to India in his 20s proved as turning point in his transition in career from a clinician to a global health practitioner. Although he continued his clinical practice, global health and in particular malaria always interested him.
The afternoon was a fun session (periodically in the bright sun!) by Dr. Genevieve Bios who shared her experiences on political advocacy and lobbying. We had a simulation session where the audience was divided into groups and given a case study of a particular country, with a focus on coming up with country plans to control smoking and obesity. Each team seemed so very responsible for their own country and passionately designed a program.
Day 4 was opened by Siri Tellier on public health demographics, explaining the 6 megatrends affecting demography- fertility, mortality, migration, growth, age and sex. This was preceded by a simulation exercise where the student had to find alarming figures in demography of six countries with data from 1950, 2010 and an “estimated” numbers in 2050. The afternoon session was a peppy talk by James Michiel on social media and m-health and exploring its creative uses as tools in public health. A simulation exercise was carried out where students figured out health campaigns using technology and came up with some interesting examples.
The last day of week 1 was a thought provoking lecture by Peter Furu on the impact of climate change on global health. Addressing climate change is the biggest global health threat of the 21st century. But also the greatest global opportunity! He explained the in detail consequences of climate change on health shedding focus on infectious diseases, NCDs and the effect of migration to vulnerable populations and regions. He summarised the main projected trends of health effects related to climate change as malnutrition and related diseases, injury in extreme weather events, malaria, diarrhoeal diseases, heart and lung mortality and morbidity, dengue and deaths from cold.
Siri Tellier continued the day explaining the impact of disasters on public health. She explained the consequences of both man-made and natural disasters in terms of demographics and disease trends.
With renewed energy and enthusiasm, week 2 began with Britt Tersbol’s lecture on women’s and child health. She began by asking questions asserting the importance of women and child health. Are women more fragile? Do men not experience illness, or sexual abuse, forced prostitution, socio economic inequality, educational and nutritional neglect, lack of access to quality life and knowledge, poorer care seeking behaviour?
Jo Jowell then gave his insight on the threats and opportunities of globalization in health especially in food and nutrition. He acquainted us with terms such as “Coca-colonization” and “Mc-donaldization” which are major global drivers of our eating behaviour. He also gave an insight how the government can support healthy food preferences. The following day, Andreas Bjerrum discussed about Universal Health Coverage and its economic challenges in the globalized world. Alarming statistics was flashed to us that the developing countries have a disease burden of 90% but only contribute to 12% of all health spending.
We then had a great panel discussion on careers in global health where a lot of questions were answered for us young aspirants. Absolutely motivating and valuable advice given such as follow your heart, keep applying, grab the opportunity that gets your way and don’t be afraid to get your hands dirty in the field. At the end of the day Maureen Wilkinson touched the sensitive topic of mental health affected by migration and asked us situational questions which put up the whole audience in awe and high in emotions.
Day 3 was no less in action packed. Nicolai Lohse lectured us on how drug companies think, how they act and what should be their role in global health? Who is responsible for making quality treatment affordable, accessible and available to patients? We had mixed reactions from the audience on do Pharma companies really care about global health or are they only interested in making profits? The industry must not only stick to development and manufacturing of newer and better drugs but must also continue to influence policy making, advocate public health issues and collaborate on the ground with public health programs.
This was followed by a great panel discussion on access to medicines where critical questions such as do we need a new incentive system than patenting for Pharma companies? What are the new ways of risk sharing while developing a new drug? Why should companies manufacture essential medicines which have no scope of profit making but are for the betterment of millions devoid of its access? Maja Pleic then gave a broad overview on the social determinants of health and presented us with case studies concerning policies in different situations.
The penultimate day (we couldn’t believe the amazing two weeks were almost coming to an end), Jeffrey Lazarus gave an energetic take on health systems in a global contexts and the challenges it faces as we move from MDGs to SDGs. He questioned the WHO framework of the health system and where is the common man in this health system? A great discussion followed, on the need for a people centered health system where the patient (and the healthy) must be kept in focus.
Mike Rowson continued the day ahead with a lecture on health and development and explained the Preston curve and its implications and making us understand concepts such as GDP. The last day was also led by Mike explaining health care in poor markets and global health dilemmas. The afternoon comprised of case studies on is it feasible for the Tanzanian government to invest in and undertake local production of pharmaceuticals followed by an important topic discussion on human resources in health.
The blasts of information and different perceptions of lecturers and participants from an array of different backgrounds and experiences was no lesser than a joy ride. Activities ranging from a swim at Islands Brygge, to exploring Christania, to movie night at Faelledparken kept the spirits high even during the evenings. When the weekend arrived, most participants got around the beautiful city of Copenhagen, said a little hello to the Little Mermaid and visited the majestic castles! It was two weeks of fun.
For just the second round since its inception, the program was perfectly placed, well managed and had no eye closers. The group seemed very energetic and well-read to throw questions at speakers, and wouldn’t settle for anything less than a perfect explanation. Focus was laid on various country contexts, often with real life experiences which indeed helped to shed light on real time global health challenges. It also seemed quite a challenge to leave behind the bright sun and to stay indoors for lectures, but it was completely worth it!
Great experience! Greater global challenges to address!