The Challenge of Global Health

The Challenge of Global HealthDesign and Health Africa 201125th October 2011Nigel CrispTurning the World Upside DownThe search for global health in the 21 st century

Global Health• Interdependence• The unfair health trade• The wider determinants of health• Strengthening health systemsThe Challenge of Global HealthNigel Crisp

Turning the World UpsideDown• The changing balance of power• The 4 disruptions• Co-development• Reform and mutual learningThe Challenge of Global HealthNigel Crisp

The distribution of HIV/AIDS• Refreshment and personaldevelopment• Greater cultural awareness• Learning specific skills and practices• Challenging our long-held ideas• Shaping the future togetherThe Challenge of Global HealthNigel Crisp

Non- communicable disease• Independence – bringing togetherpatients, health and social workers• Rebalancing of health systems betweencare, population health and costs• Quality improvement and performance• Health worker training and re-design• Interdependence and co-developmentThe Challenge of Global HealthNigel Crisp

The unfair health trade• Health workers and knowledge• Aid, trade and FDI• Rights• The changing balance of power• The economic transitionThe Challenge of Global HealthNigel Crisp

Health and health systems• Integrated into development plans• The 6 building blocks – delivery,financing, governance, workforce,information systems and supplymanagement• Systems thinkingTurning the World Upside DownNigel Crisp

The future - 4 disruptions• Diseases have changed• Patients and the public have changed• Science and technology aredeveloping• Global interdependenceThe Challenge of Global HealthNigel Crisp

Turning the World Upside Down158214Remote chronicdisease careValencia:Integrated HCMidwife led, lowcostmaternal careHigh-volume, lowcostheart surgeryhospital212031013Veteran’s HealthAdministrationIntegrated caresolutionLow-cost eye-caresolutionTraining forreproductivehealth clinicsInnovativeemergencyresponse model16412Mini clinics inretail storesSocial marketingprogram of PSIRemote advice andmobile caresolution15Remotetriage/referralPDA: Socialmarketing(humorous) forreproductive health2211Co-operativemedical systemLow-cost eye-caresolution17691819750 globallocations: socialmarketing for killerdiseasesMauritaniacomplete low-costobstetric careWeighing childrento predict andprevent diseasesIntegrated primarycare unitsReal-time weighingand diagnosisFranchise networkof stores for deadlydiseasesSOURCE: McKinsey analysisThe Challenge of Global Health9Nigel Crisp

Emerging health systems• Social enterprises• Women, family and communities• Prevention and treatment• Health, education and society• Training for the job and not just theprofessionsThe Challenge of Global HealthNigel Crisp

The Challenge of Global HealthNigel Crisp

The future - reforms• Service re-design – across boundaries• System redesign – health as part of widerlocal system - independence to live a lifeyou have reason to value• Staff restructuring – trans-professionaland team based• Interdependence – and learning fromelsewhereThe Challenge of Global HealthNigel Crisp

Democratising Global Health• Interdependence• Co-development and mutuallearning• Democratising global institutions– from health to trade and energyto migrationThe Challenge of Global HealthNigel Crispp

Some design implications• Treatment and prevention• Integrated across boundaries• Part of wider development• Transformed staff and facilities• Co-development and mutuallearningThe Challenge of Global HealthNigel Crisp