September 9, 2020
Global health needs to be coordinated, supported and sustained, with countries, multilateral organizations and academic institutions working in partnership on efforts that meet pressing needs and that benefit everyone.
That’s according to Dr. Matt Dasco, associate professor of internal medicine at The University of Texas Medical Branch and director of Academic Partnerships for UTMB’s Center for
Global and Community Health.
Dasco provided the College of Community Health Sciences’s David and Natica Bahar Memorial Lectureship in August. His talk was titled “Challenges and Opportunities for Academic Global Health in the Post-Covid World.”
“Global health has become more relevant in this pandemic, ant it’s exacerbating inequity,” he said. “Goals are great, but we need money to get there, and this is where countries, foundations and other organizations can push their own agendas.”
Dasco, who spent time in Botswana in Southern African working to mitigate HIV, tuberculosis and other chronic diseases and assisting the University of Botswana in establishing its first internal medicine residency, explained that equity and equality are not the same. “The world is not a level playing field. Some areas of the world need more. The question is how to redistribute resources when wealth is profoundly concentrated in the hands of a few.”
Dasco said there is agreement on “sustainable development goals” for global health – eliminating poverty and hunger, clean water and sanitation, good health, quality education, good job and economic growth, and reducing inequalities.
And there is significant financial support for global health, which comes from countries; multilateral organizations like the United Nations, World Health Organization and International Monetary Fund; donors like the Bill & Melinda Gates Foundation and private industry; implementing partners like academic institutions and local governments; and communities.
The United States is currently the largest provider of global health funds, followed by the Bill & Melinda Gates Foundation. The U.S. earmarks nearly half of its contributions to reducing HIV, while the Bill & Melinda Gates Foundation puts the bulk of its donations in work to eradicate HIV and Malaria. But with the U.S. threatening to pull funding from the World Health Organization, the Bill & Melinda Gates Foundation will become the largest funder of global health initiatives. What’s more, the World Health Organization currently allocates 20% of its spending to polio eradication, but there are only three countries in the world where polio is present, Dasco said.
“You have to follow the money and then you can ask why we have inequalities and why gaps still exist,” he said. “Of U.S. global funding, 75% went for specific diseases.” He said neither the U.S. nor the Bill & Melinda Gates Foundation included money for important global health initiatives like workforce training and poverty elimination – “instead efforts are largely disease specific.”
Dasco said global health also includes security component in the form of prevent, detect and respond. “There are always emerging threats and, again, this needs to be about equity. ‘Let us help you control your diseases, so they don’t spread here.’”
Pandemics, like the current COVID-19 pandemic, show “our global interconnectedness and that health equity is both a global and a local issue, and that a coordinated public health response is important,” he said.
The David and Natica Bahar Memorial Lectureship was established in 1987 by the late Dr. David Bahar in memory of his wife. The lecture seeks to promote the quality and practice of internal medicine at the UA College of Community Health Sciences.