A Global Health Workforce Through a One Health Framework: A Public Health Perspective. Traditional Subjects in Schools of Public Health

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Kristopher Summers
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1 A Global Health Workforce Through a One Health Framework: A Public Health Perspective Laura H. Kahn, MD, MPH, MPP Institute of Medicine Global Forum on Innovation in Health Professional Education April 24, 2015 Traditional Subjects in Schools of Public Health Biostatistics Epidemiology Health policy and management (hospitals and health insurance) Population and Family Health Sociomedical Sciences (applied social sciences) Environmental Health (human health risks carcinogens, toxic waste, etc.) 1

2 Challenges We Face in the 21 st Century That Impact Global Health Increasing Populations/Megacities Massive Waste Production Human and animal Water and Food Contamination Potential Food Shortages Antibiotic Resistance Environmental Degradation Mental Illness Public Mistrust of Vaccines Emerging Infections Climate Change Extreme Weather Events, Droughts, Floods Emerging Infections and Climate Change Arthropod borne diseases Dengue West Nile virus Chikungunya Lyme disease Rocky Mountain spotted fever Malaria Yellow fever Non arthropod borne diseases Rabies Nipah Ebola SARS MERS Influenza Q fever 2

3 Emerging Zoonotic Diseases The One Health concept: Human, animal, environmental health are linked. Global health must be viewed with a One Health lens. Public health education typically focuses solely on human health. 21 st century challenges requires a reassessment of this approach. Professional Education and Training in One Health Zoonotic diseases Entomology Parasitology Virology Bacteriology Food safety and security Global health and agriculture Water purity Sanitation and hygiene Human and animal (domestic and wild) health Ecosystem health One Health policy 3

4 One Health Education Team based (Analogous to business schools) Case based Problem solving Interdisciplinary Cross cultural Qualitative Quantitative Core Competencies for Public Health Professionals Analytic/Assessment Skills Policy Development/Program Planning Skills Communication Skills Cultural Competency Skills Community Dimensions of Practice Skills Public Health Sciences Skills Financial Planning and Management Skills Leadership and Systems Thinking Skills The Council on Linkages Between Academia and Public Health Practice. Core Competencies for Public Health Professionals June

5 Mandatory (Team based) Fieldwork Projects Local Regional National International Health Policy Courses Health policy courses typically focus on healthcare delivery (hospitals, clinics, insurance) Minimal (if any) education in health policy focusing on disaster preparedness, biodefense, food security, etc. Students must be taught how to critically evaluate public health programs as well as responses to crises and develop strategies for improvement. Need creative thinkers and problem solvers. 5

Global Health Workforce Shortages In 2006, WHO identified a minimum density of 22.8 skilled health professionals per 10,000 population to provide basic health coverage.

6 Global Health Workforce Shortages In 2006, WHO identified a minimum density of 22.8 skilled health professionals per 10,000 population to provide basic health coverage. 83 countries fall below this threshold. 100 countries fall below density threshold of 34.5 skilled health professionals per 10,000 population. Acute shortages of doctors, nurses, and midwives in sub Saharan Africa. Global Health Workforce Alliance and WHO. A Universal Truth: No Health Without a Workforce. November Distribution of Health Workers by Level of Health Expenditure and Burden of Disease by WHO Region Source: WHO The World Health Report 2006 Working Together for Health, page

7 Global Veterinary Workforce Behind human health workforce in defining basic education requirements and workforce needs. World Organization for Animal Health (OIE) is advocating for people working in veterinary services to have defined education and skills with minimum competencies.* OIE World Animal Health Information Database (WAHID) has veterinary and paraveterinary workforce data available but spotty. Quality is questionable. *Sabin EA and Dehaven WR. Veterinary education: a basis for good governance leading to effective Veterinary Services. Rev. sci. tech. Off. Int. Epiz. 2012; 31: OIE World Animal Health Information Database (WAHID) Total Veterinary and Paraveterinary Personnel 2012 Argentina Australia Bangladesh Brazil Congo Denmark Egypt Guinea India Indonesia Liberia Malaysia Mexico Nigeria Russia Zimbabwe India, Liberia, Malaysia, Russia list no data 7

8 Global Environmental or Ecosystem Health Workforce? Not able to find data. Global Health Workforce Education: Much Room for Improvement Educating health professionals using a One Health framework could fill many gaps. One Health professionals would have education and training to assess the entire milieu in which people live and work. Focus must expand beyond hospital/clinic walls and include animal and environmental/ecosystem health. 8

9 One Health Initiative pro bono team: Bruce Kaplan, DVM Tom Monath, MD Jack Woodall, PhD Lisa Conti, DVM, MPH 9

Prominent U.S. and international individual and organizational One Health Endorsements (multidisciplinary) June 2011 to July 2015

Prominent U.S. and international individual and organizational One Health Endorsements (multidisciplinary) June 2011 to July 2015 http://www.onehealthinitiative.com/ One Health is the collaborative efforts of multiple disciplines working locally, nationally, and globally to attain optimal health for people, animals, plants and our