Making the university a transforming force in global health

Background

In 2005, Dr. Gerald Keusch invited leading university global health programs from the US and Canada to meet at Boston University to discuss whether universities active in global health should form some kind of alliance. Although there was enthusiastic response on the part of the universities, there were no funds or sponsorships available at that time to further develop the idea. On September 23-25, 2007, Dr. Jaime Sepulveda chaired an international conference of global health experts in San Francisco, co-hosted by the University of California, San Francisco (UCSF) Global Health Sciences (GHS) and the Bill and Melinda Gates Foundation (BMGF). The conference was entitled "Global Health Sustainability: Focusing on the Workforce." That meeting resurrected the concept of a North American university consortium for global health. In 2009, CUGH was established with initial funding from The Bill and Melinda Gates Foundation and the Rockefeller Foundation, and the vision and leadership of Dr. Haile Debas.

Defining "Global Health" and Coordinating Resources

The last 20 years has seen an unprecedented interest in global health among faculty and students in North American universities. The universities’ response could not keep pace with the level of enthusiasm and demand and this gap highlighted significant deficiencies that need to be addressed. Among them are:

  • No agreed-upon definition of global health.
  • Absence of standardized curricula and competencies.
  • Chaotic field experiences as a consequence of inadequately prepared students and faculty for international field placement and undefined criteria and conditions for placement in host institutions.
  • Little coordination among these universities to develop administrative and operational systems, avoid duplication, and promote collaboration.
  • Absence of true partnership principles upon which relationships between resource-rich and resource-poor institutions can be built and sustained.

Key Needs for the 21st Century

Ten recommendations from the Workforce Sustainability Conference of September 23-25, 2007 in San Francisco provide the philosophical and tactical foundation for CUGH:

  1. Medicine and public health must respond to changing conditions as a result of advances and innovations in technology, an increased focus on human and civil rights, globalization, and the growing passion among students, faculty and professionals to address global health.
  2. The emerging discipline of global health must be defined, reflecting major global health challenges with a focus on "interdependence;" including disciplines beyond health to include law, engineering, agriculture, social sciences and business.
  3. Make the academic enterprise a transforming agent in global health, recapturing the University as part of the community, not an "ivory tower." Ensure that academic training in global health emphasizes capacity building and the training of leaders and managers.
  4. Expand academic exchange programs through mutually beneficial "academic twinning" between academic institutions in the developed and developing countries.
  5. Develop regional consortia of global health centers in North America, Asia, Africa, Europe, and Latin America.
  6. Accelerate and improve training of human resources for health at all levels.
  7. Address the "brain drain" problem and the strategic ways it might be managed.
  8. Develop research capacity in developing countries, emphasizing the "Bench-to-Burkina Faso" principle, i.e., translate discovery to implementation.
  9. Support innovative approaches to policy and financing.
  10. Initiate "Flexner 21" report for the 21st century, examining the human resource needs for health and how they relate to global health, medicine, public health, health systems, and country competitiveness.

Inaugural Meeting

Supported by a grant from the Bill and Melinda Gates Foundation, this meeting was held on September 7-9, 2008 in San Francisco. Its outcome is summarized in the Inaugural Meeting Report.

Representatives from over 20 university global health programs gathered to learn what universities are currently doing and define a shared vision of the role of universities in global health. This meeting validated the need and support for this consortium.