This week, an open letter to the healthcare and public health students of the world – written by Harvard Fellow Dr Alessandro Demaio, for the 2013 Global Health Conference of the Australian Medical Students’ Association.
In his speech to the World Health Assembly this year, World Bank chief Dr Jim Kim boldly stated we are at a crossroads in global health.
“Together, we face a moment of decision,” he said, “The question is not whether the coming decades will bring sweeping change in global health, development and the fundamental conditions of our life on this planet. The only question is what direction that change will take.” And of course, who will lead us.
Well I believe there is no group better equipped to choose a healthier future and a fairer trajectory than you. Young, driven, intelligent, articulate and, most powerfully, informed. This is a big responsibility. Taking on the problems that were created and challenges unmet by the generations above you. But as young global health advocates and budding healthcare professionals, you are our white knight. Our secret weapon in global health. As I see it, for three key reasons.
Our White Knights.
First of all, because you can. You are a generation that is globally connected like never before – across time zones, borders and economic divides. You are native to technologies that older generations will likely take years, maybe decades to master. You are driven and desperate for change and best of all, you combine the traditional knowledge of health and medicine, with a deep sense of social justice and an appreciation of non-health determinants.
Second, because you must – time is short. With the world rapidly speeding along deeply concerning environmental, economic and social trajectories, you must be the generation that rises above the rhetoric, moves beyond shallow, aspirational targets and political short-mindedness. Put simply, we have just a few more decades to get this right, and you are our best chance of realigning the direction the global community is heading in, to ensure a more sound, safe and sustainable future for our planet.
Finally, because no one else will. I am a realist and, having worked in global health for a few years now, I realise that change is not going to come in the form we need and in the timeframe that is crucial, from the generation you will replace. This is on you, like it or not. It might seen daunting, even unfair, but trust me – with your skills, your insights and your innovative thinking, a better world is well within reach.
This year, I co-founded a global social movement to address the world’s leading cause of death: non-communicable diseases. In a few months, NCDFREE crowd-funded more than US$60,000 and through crowd-sourcing, drew video from smart-phones around the world to encourage societal and political change through short films and personal narrative. Harvard, Oxford, ANU, the University of Melbourne, C3 Health, PLOS, BMJ and many others have come on board (financially and morally) and joined our movement, including the World Health Organization, who will host a specially-commissioned film at their July Ministerial Meeting. The success of this campaign, albeit it in its infancy still, has taught me a few key things I want you to hear.
The Support is There.
Although I outlined some pretty big challenges above, you have support to bring this change. The world is expecting big things from your generation, and they’re willing to back you in making them happen. They know what you’re capable of, and they’re poised to catalyse your solutions. Be bold, think big and don’t compromise. Others will be inspired by your passion and rally with you.
I also stress the need to continue to look beyond the clinic. A classic flaw of us medical doctors is to lose sight of the world outside. Exams, patient lists, rounds… Don’t forget to look outside the window and remain globally connected and responsible. Being a public health or healthcare professional is noble and I commend you for dedicating your life to the health of others, but it is not enough. Remember the global challenges which may lay outside your daily routine, but for which your voice can be powerful – even game-changing.
Look Beyond Health.
Finally, I am going to use the “M word” – multidisciplinarity. Before you switch off or roll your eyes, I want to appeal to you – remember to have humility. Whether reflecting back or looking forward, the biggest gains in global health, and even healthcare within nations, have and will be made by innovations from outside the clinic and even medicine.
HIV, TB, NCDs… These are all driven by and interlinked with factors we call Social Determinants. The greatest gains in addressing these diseases will come from doctors working with other sectors, within other industries and ministries. Communicators, urban planners, lawyers, designers, anthropologists, economists – the list goes on. Inspire them and be inspired by them, work together and we will achieve much more for many more.
So once again, the challenges are large but there is no group better equipped to rise to meet them. Remember: don’t be afraid of thinking big. Don’t let fear stop you from getting off the conveyor-belt that is healthcare training and tackling some of the bigger picture issues.
Above all, don’t be afraid of failure. The only failure, would be to never try.
Dr Alessandro Demaio
Alessandro is a Australian-trained Medical Doctor (MBBS, MPH) who has recently completed a PhD in Global Health and NCDs. He currently holds a Postdoctoral Fellowship at the Harvard Global Equity Initiative, Harvard Medical School and is Assistant Professor at the Copenhagen School of Global Health. Connect with Sandro on Twitter via @sandrodemaio.