Program in Global Medical Education and Social Change

Joia S. Mukherjee, MD, MPH, Program Director

Program Background
This is a very exciting time in Global Health. Just prior to the year 2000, the movement to provide HIV treatment to all and the drafting the Millennium Development Goals (MDGs) by the United Nations highlighted the need to address the social determinants of ill health (such as poverty, malnutrition and lack of education and) and to deliver both preventive and curative health care directed at the burden of disease. In the ensuing decade it has become increasingly clear that there are few trained health professionals who can administer these programs: what we are facing today in developing countries has been called the “Health Care Worker Crisis.” In fact, the movement to address the AIDS pandemic and other infectious disease as well as the goals of achieving the MDGs has laid bare the inadequacies of the existing health workforce in resource poor settings to meet the vast health care needs. Developing countries bear 90 percent of the global burden of disease, yet only 12% of all health expenditures are going to stem this tide ($351 billion out of a global total of $3.2 trillion.) Africa is home to only 3% of the global health workforce who are paid with less than 1% of global health expenditures. 

The Program in Global Medical Education and Social Change, housed within the Department of Global Health and Social Medicine at Harvard Medical School seeks to forge long-term academic partnerships to support the education of health professionals and to create a culture of teaching and training in public sector facilities in resource-limited settings that will serve as the nexus of teaching and scholarship for the emerging discipline of global health for decades to come. Thus, the program offers opportunities for students, residents, fellows, and faculty from resource-limited settings to be trained side-by-side with students, residents, fellows and faculty from Harvard University and other academic medical centers around the world. Embedded in these programs is a rigorous evaluation of quality of care, capacity of the practitioners, and the capacity of the training programs to produce health care professionals that remain committed to the areas of greatest need. We believe that the growing interest in global health among students and faculty at Harvard and other academic institutions can--and should--be channeled to achieve the highest quality of training for those shouldering the burden of global health delivery. The cornerstone of the curricula developed by the Program in Global Medical Education and Social Change is “accompaniment”--that is the art of working with local governments and partners, and of responding effectively to priorities outlined by them though a combination of direct patient care, clinical innovation, training, research, and policy work.

References
Pablo Gottret & George Schieber, Health Financing Revisited: A Practitioner’s Guide (The World Bank 2006).

World Health Report 2006, Working together for health (WHO, Geneva, 2006).