Vector Volume 11 Issue 2 - 2017

Editor’s Note- Turning up the heat
Global health is intrinsically linked to the changing social,
economic, cultural and political environment. Political leaders
powerfully shape responses to global health, whether in a
positive or negative way. Historically, when health issues
have risen on the political agenda, they received greater
media attention, and importantly, funding – the HIV/AIDS
epidemic exemplifies this. The change in leadership in the
World Health Organization under the new Director-General Dr
Tedros offers new opportunities to advocate for issues such
as universal health coverage, women’s health and rights, and
climate health.
However, like many others, I find myself disappointed
by the lack of political will to assist refugees and people
seeking asylum. This is an ongoing problem, in Australia with
the recent welfare cuts to refugees, described by Sibella
Briedahl and Jasmine Sekhon (pg 2) , and internationally,
with the plight of the stateless Rohingya people fleeing
persecution in Myanmar, in a feature article by Jumaana Abdu
(pg 50).
Over the past year, controversial policies have dominated
public health discourse on both a national and international
scale. Non-communicable diseases continues to rise on
the agenda. A tax set to cut sugar-sweetened beverage
consumption takes a step towards tackling Big Sugar in the
footsteps of movements against Big Tobacco, as covered in
a review by Saiuj Bhat (pg 29).
In Australia, we have also seen pushes for safe injecting
rooms and pill testing at festivals. Does this reflect the
global shift in attitudes from criminalisation towards harm
minimisation, with decriminalisation in Portugal providing
successful proof-of-concept? Raquel Maggacis overviews
drug control approaches worldwide, arguing that Australia
should adopt a harm minimisation approach (pg 34).
Global health does not obey borders, and health policies
have far-reaching effects. Infectious diseases certainly
require no passport to spread from country to country,
and Madeleine Marsland and Dunya Tomic highlight the
importance of strong regional surveillance systems and
prevention strategies (pg 38) Moreover, so long as one child
has polio, all countries remain at risk, as described by Jeanine
Hourani (pg 19). However, polio eradication in Pakistan, one
of the last remaining polio-endemic countries, is incredibly
complex due to political instability and competing agendas.
Local policies certainly have broader international
consequences, and Keyur Doolabh and Emily Feng-Gu
explore issues around commercial surrogacy such as
exploitation in countries where surrogacy is cheaper or
poorly regulated (pg 10). Similar to drug control approaches,
a harm minimisation approach may offer a better alternative
to regulate processes and protect the rights of parents and
children.
Other contentious topics in Australia include the Adani
coal mine and the postal vote for same sex marriage. These
will have significant implications both now and in the future.
With the recent postal vote, the mental health and wellbeing
of LGBTIQA+ people could not be of more relevance.
However, as Salwa Barmaky and Alex Lee write, LGBTIQA+
people also face barriers in access to healthcare, including
discrimination from the medical profession itself (pg 5).
Aboriginal and Torres Strait Islander people also
experience discrimination within the health care system,
as Narawi Foley-Boscott explains (pg 44). So what then is
the way forward for such issues? Both authors emphasise
the importance of educating medical professionals to be
culturally sensitive, to be open to learning, and to be aware of
the structural factors that contribute to discrimination.
Evan Morgan (pg 21) argues that the Adani coal mine
endangers our health and the environment and is a poor
investment for tax-payers. It hinders Australia’s ability to fulfil
its global commitments under the Paris Agreement to reduce
carbon emissions and temperature rises.
Divestment offers a solution to climate change: take money
away from the fossil fuel industry. We, as medical societies
and the future medical profession, have an important role to
add to this social movement, as thoughtfully argued by Tara
Kannan (pg 17) The title of her article, “Turning up the heat”,
captures the energy that connects the articles in this issue, a
panoramic range of contemporary and controversial issues.
It calls on us to take action and to challenge the paradigm of
seeing health as purely a biomedical issue, but one inherently
connected to regional and international social and political
forces.
As medical students, we are well-placed to educate
and upskill ourselves to contribute to global health in the
future. Attend conferences (Australian Indigenous Doctors’
Association, pg 44 World Congress of Public Health, pg
47. Take elective placements in developing countries, and
prepare yourself with pre-departure training (Nicholas Snels,
pg 26 ). As yourself, what can we do about these global health
issues? (Helena Qian, pg 54)
One of the statements that left a lasting impression on
me from this year’s Global Health Conference was from the
AMSA Global Health Chair, Liz Bennett: “It is not enough to be
inspired... We do not have the luxury of apathy and you cannot
afford to waste time thinking that you are too small to make
a difference.” (pg 52).
I am continually amazed and grateful to the incredible
work of the authors, editorial team, peer reviewers and
Advisory Board. It has been a privilege and a half to lead
Vector Journal this year and hope that this issue inspires you
and challenges you to take action.
Carrie Lee
Editor-in-chief, 2017
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