Global health programmes aimed at specific diseases fail to meet the broader health needs of the local communities they have been set up to help, according to the Director of the JMSC’s Master of Journalism programme.
“The same children who need to be vaccinated against polio also need to be reached by other immunization programmes, receive bed nets from the malaria program, and benefit from nutrition and safe-water initiatives. It is cold comfort to save a child from polio if the child later succumbs to malaria or diarrhea from dirty drinking water,” says Thomas Abraham, who runs the Health Risk Communication programme at the JMSC and is writing a book about the worldwide effort to eradicate polio. Abraham’s warning appeared in an op-ed piece in the New York Times on November 19.
Abraham was the team leader for the Communications Department in the Director General’s Office of the World Health Organization during the swine flu pandemic in 2009, and is the author of Twenty-First Century Plague: The Story of SARS (HKU Press, 2004). He said in an interview that a single-disease focus is typical of NGOs and governments because that is how they raise money. Each disease becomes a brand that is easier than overall health to market to donors.
“The amount of money, the number of vaccines, the number of people vaccinated – donors fund projects on this basis”, Abraham said. “And it is far easier to administer because it creates clear chains of command, clear outcomes, deadlines, targets. They can set deadlines for the eradication of a disease and then measure the progress”.
Since each programme has different goals and deadlines, integration is difficult. And while many members of the global health community agree that their efforts need to be more closely aligned, there is little initiative to actually make it happen.
“There is a lot of dysfunction in global health programs”, he said, “but their target is the same – healthy people. So surely there must be a way that they can be integrated to be more effective, and made to address all of the health problems in a region, not just one. There needs to be a more comprehensive way of thinking. Hopefully it won’t take a large scale health crisis to get it”.
Abraham first became interested in health issues while living in Hong Kong during the SARS outbreak in 2003. “SARS made me realize that health is more than illness and sickness and medicine”, he said. “It is really fundamental to the way we conduct our lives. The way that we fight a disease is a key element in the way we organize our society…How we see health issues is something that’s reflected in who we are and how we do things”.
Abraham’s blog on polio and information on his forthcoming book about the Global Polio Eradication Initiative may be found here.