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Richard Smith: Dragging global health from the 19th to the 21st century

29 May, 13 | by BMJ

Richard SmithLast week the World Health Assembly adopted some tough targets for NCD, including reducing deaths among those under 70 by 25% by 2025. The rhetoric is that a “whole of government, whole of society” approach will be needed, but in fact the agenda is dominated by health bodies. The Young Professionals Chronic Disease Network is keen to break out of this straitjacket and modernise global health, and earlier this week Alessandro Demaio, an Australian doctor who has just completed a PhD in global health in Copenhagen, told a C3 breakfast seminar how they intend to do it.

Demaio is frustrated by many policy makers continuing to think of NCD as a problem of rich, fat, old, white, lazy American men rather than poor, black, young Asians, including women. It is a problem for both groups with rates rising among those in low and middle income countries. He’s also fed up with a “nerdy, theoretical, jargonistic” largely biomedical presentation of the problem. We need a way to reach ordinary people and inspire them to action.

The young, he believes, are the people to do it. They have advantages. They are “driven and desperate for action,” globally connected through technology, desire involvement and change, genuinely multidisciplinary in the way they think and behave, native to emerging technologies, and have more to gain and less to lose than the old farts.

So how are they going to do it? (Or “we” if you are young, and I’m proud to be perhaps the oldest member of the Young Professionals Chronic Disease Network.)

Clever use of social media is going to be one of the main ways. Academic communication needs to be reinvented. Demaio pointed out that his PhD protocol has been read by 2000 people, whereas his blog has reached 50 000. Leaders in global health—like Jim Kim from the World Bank and Helen Clark from United Nations Development Programme—are using blogs, Twitter, and other social media, but generally, Demaio believes, academics and those interested in global health are lagging behind the rest of the world—and certainly behind global corporations.

Demaio has a great advantage, a brother, Giuseppe, who is an expert on using social media for branding and promoting causes.

So together they developed the idea of NCD Free, a website that will be used to create a social movement “to make NCDs globally understood and start a wave of social and political change.” It will work “more through moral imagination than moral obligation,”  concentrate less on “lone heroes” and more on the grass roots,  and not just tell stories but “unleash storymarkers”—that could be you.

They started with a multidisciplinary team of five and raised some $60 000 in 45 days through crowdsourcing (which means small amounts from lots of people and some organisations). WHO, Harvard Medical School, C3, and others all contributed ( I did too).

Moving forward in a very concrete way, they have two initial objectives: to make three inspirational films, and to hold global launches in Vienna (July), Boston (23 September), and Melbourne (5 October).  The first film will feature a young female cardiologist from Mongolia, and the second a young man in Northern Ghana who has been given responsibility for NCD by the government.

The meeting in Vienna is a WHO Europe meeting with ministers from all 53 countries attending. NCD Free together with WHO Europe is producing a crowdsourced film to be shown at the meeting. This is your chance to contribute. You need to film a 10 second version of yourself in your environment and then go to the NCD Free website, upload the film, and answer three questions.

The meetings in Boston and Melbourne will include 12 “TED style” (that is, short, arresting, and fun) talks by “changemakers” (a good thing to be), including urban planners retrofitting cities to make them more healthy, rappers, comedians, city farmers, and street artists, including a group called “Dump the Junk.”

The movement will use simple language everybody can understand,  concentrate on social determinants with a focus other than health, think globally, encourage collaboration between high and low income countries, look across diseases, recognise the links with sustainability and urbanisation, and importantly move beyond health, medicine, and academia to branding, art, design, and communication.

The aim is to change the game, bring a much broader and interesting group into global health, move global health from fusty, 19th century academia, to 21st century colour and action—and, of course, to improve the health of the people, all people.

Instead of reading this rather stodgy, old fashioned blog, you can see Demaio’s presentation here  and visit the NCD Free site to contribute your film and ideas for the ministerial meeting in Vienna.

Richard Smith was the editor of the BMJ until 2004 and is director of the United Health Group’s chronic disease initiative.

Competing interest: RS is an unpaid trustee of C3, contributed some of his own money to NCD Free, and is a member of the Young Professionals Chronic Disease Network.

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  • Richard Smith

    Sandro has asked me to make clear that he didn’t use the potentially offensive term “old fart.” Christine Hancock, one of the oldest farts, used it at the meeting, but I use it regularly as well. Being an old fart myself, I regard it as a term of affection, but I recognise that some old farts may be offended by the term. I’m unconcerned by that, but Sandro, a gentler creature, is.

  • hilary standing

    Fantastic blog Richard. Sometimes it feels as if global health institutions and the rest of the world live in parallel universes…

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