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Turning the World Upside Down The search for global health in the 21st century
Turning the World Upside DownThe search for Global Health in the 21st Century
Hong Kong Health Authority Convention 2011
7th June 2011
Nigel Crisp
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The Global context
� Interdependence�The unfair health trade� Shifts in power� Sourcing innovation�Co-development
Turning the World Upside Down The search for global health in the 21st century
20th Century successes
The 20th Century paradigm�Greater professionalism�Scientific discovery�Commercial development�Growing funding
Turning the World Upside Down The search for global health in the 21st century
Health Wealth Society
New drugs Minimum wage HASAW Surgery Liberalisation Education Clean air Consumerism Equalities Access Employment WelfareAnaesthetics Pensions Franchise Professions Industry Labour/capital
Turning the World Upside Down The search for global health in the 21st century
21st Century disruptions
Life has changed�Diseases and conditions�Patients and the public�Science and technology�Health becomes global
Turning the World Upside Down The search for global health in the 21st century
This model is now part of the problem
Turning the World Upside Down The search for global health in the 21st century
New ideas from elsewhere
�Pioneers�Other industries�Young people �Disability and rights groups�Low and middle income countries
Turning the World Upside Down The search for global health in the 21st century
Turning the World Upside Down The search for global health in the 21st century
Low and middle income countries
� Poverty, social issues and internal and external power relationships
� Shortages of resources and health workers
� Non-communicable as well as communicable diseases
The distribution of HIV/AIDS
� Refreshment and personal development
� Greater cultural awareness� Learning specific skills and practices� Challenging our long-held ideas� Shaping the future together
Turning the World Upside Down The search for global health in the 21st century
Non- communicable disease
� Independence � bringing together patients, health and social workers
� Rebalancing of health systems between care, population health and costs
� Quality improvement and performance� Health worker training and re-design� Interdependence and co-development
Turning the World Upside Down The search for global health in the 21st century
Turning the World Upside Down The search for global health in the 21st century
Innovation
� HIV/AIDS� Specific conditions � Policy initiatives� Product development� Telemedicine� Identified by GE , McKinseys
12
Innovation in health care delivery is taking place around the world
SOURCE: McKinsey analysis
PDA: Social marketing
(humorous) for reproductive health
5
Integrated care solution
20
50 global locations: social marketing for killer diseases
17
Co-operative medical system
22
Veteran�s Health Administration
21
Mini clinics in retail stores
16
Remote triage/referral
1
Remote chronic disease care
15
Low-cost eye-care solution
11
High-volume, low-cost heart surgery
hospital
14
Midwife led, low-cost maternal care
2
6
Mauritania complete low-cost
obstetric care
Valencia: Integrated HC
8
Integrated primary care units
18
Weighing children to predict and
prevent diseases
9
Real-time weighing and diagnosis
19
Low-cost eye-care solution
3
Training for reproductive health clinics
10
Social marketing program of PSI
4
Franchise network of stores for deadly
diseases
7
Innovative emergency
response model
13
Remote advice and mobile care
solution
12
Turning the World Upside Down The search for global health in the 21st century
Turning the World Upside Down The search for global health in the 21st century
An emerging tradition
� Community, family and women� Health, education and work� Social enterprises� Public health and clinical medicine� Train for the job not the profession
Independence
� Seeing world in terms of peoples�lives not our services
��Getting our lives back��Living a life we have reason to
value
Turning the World Upside Down The search for global health in the 21st century
Co-development and collaboration
�Top down development - western experts
�Understanding Global Health�Not �them and us� � we can all
contribute
Turning the World Upside Down The search for global health in the 21st century
4 reforms in the NHS
� Service redesign� System redesign� Job redesign�Technology and science
Turning the World Upside Down The search for global health in the 21st century
Turning the World Upside Down The search for global health in the 21st century
Benefits of co-development and collaboration� Refreshment and personal
development� Greater cultural awareness� Learning specific skills and practices� Challenging our long-held ideas� Shaping the future together
Turning the World Upside Down The search for global health in the 21st century
Accelerating the change
�Make it visible and coherent�Health worker education and
training �Experience and exchange
Turning the World Upside Down The search for global health in the 21st century
Everyone has something to teach and everyone has something to learn
Turning the World Upside Down The search for global health in the 21st century