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VISUAL

REPORT Institute for Global Health Equity and Innovation, University of Toronto

Creating a Pandemic of Health !

The MaRS Centre - Toronto, ON November 3-5, 2014

Creating a Pandemic of Health: Global Health Equity and Innovation Summit

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About the Summit !The University of Toronto’s Dalla Lana School of Public Health

hosted the Global Health, Equity and Innovation Summit at

the MaRS Centre in Toronto November 3-5, 2014. Throughout

the 3-day event, 750 thought leaders and participants from

around the world came together to imagine ways in which

health could be created and spread. The purpose of the

summit was to forge alliances, identify opportunities for

innovative research and harness the collective talent and

creativity of the participants in order to initiate a global

pandemic of health.

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Host Sponsor Lead Sponsor

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Partner Academic Partner

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Gold Sponsors

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Silver Sponsor

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The G. Raymond Chang School of Continuing Education and Faculty of Community Services, Ryerson University

Bronze Sponsors !

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!!Other Financial Contributions

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In Kind Support

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Thank you to all of our Summit Partners and Sponsors.

DAY 1: Summit Opening

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The Summit was opened with a welcome from

Dr. Howard Hu (Dean, Dalla Lana School of

Public Health, University of Toronto (U of T)). Dr.

Hu gave an overview of the summit

proceedings and discussed some of the

challenges that prompted the creation of the

Summit. He emphasized the need to work

interdependently and holistically to overcome

these growing challenges (see left).

!Paul Dalla Lana (Dalla Lana School of Public

Health benefactor) discussed the Dalla Lana

School of Public Health’s pioneering efforts to

promote health, and congratulated

participants on being part of a new and unique

approach to looking at health. Paul also

announced that he and his wife Alessandra

would be doubling their endowment to the

School (see left).

Dr. Howard Hu opens the summit

Paul Dalla Lana gives his remarks

Goals for the Summit: Creating a Pandemic of Health

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Summit agents Dr. Alejandro (Alex) Jadad (Canada Research

Chair in eHealth Innovation), Dr. Ross Upshur (Head, Division of

Clinical Public Health, Dalla Lana School of Public Health), Dr.

Abdallah Daar (Professor of Clinical Public Health and Global

Health, Dalla Lana School of Public Health) and Dr. Rani Kotha

(Senior Strategist, Global Health and Innovation Initiatives,

Munk School of Global Affairs, U of T) discussed their goals for

the Summit and the conversations that inspired the Summit

theme ‘Creating a Pandemic of Health’. They emphasized the

importance of education, prevention and

‘salutometrics’ (measuring health) in creating a global

movement (see right).

Dr. Ross Upshur, Dr. Abdallah Daar, Dr. Rani Kotha and Dr. Alejandro Jadad discuss the goals of the Summit

Visual Summary: Summit Opening and Goals for the Summit - Whole View

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Cluster 1- Setting the Scene for the Summit: Creating and Spreading Health

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The scene was set for the summit with a keynote

address from the Honourable Marc Lalonde (Past

Member of Parliament, Officer of the Order of

Canada).

!Marc reflected on how things have changed since

the publication of “The Lalonde Report, New

Perspectives on Canadian Health” 40 years ago. He

shared that today he would place more emphasis

on the impact of environment on health, and that

his one wish would be for a better social and

economic regime to promote ‘well-fare’ (see left).

Cluster 1- Setting the Scene for the Summit: Creating and Spreading Health

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Following the opening keynote, Dr. Natalia Pace

(Family Physician and Staff Coordinator in the area of

Health Promotion, Hospital Italiano Health System,

Buenos Aires, Argentina), Dr. Adalsteinn (Steini) Brown

(Dalla Lana Chair and Director of the Institute of Health

Policy, Management and Evaluation , U of T), Dr.

Kwame McKenzie (CEO, Wellesley Institute), and Dr.

Paula Rochon (Senior Scientist, Women’s College

Research Institute) shared their unique perspectives on

creating and spreading health. They explored themes

such as shifting the focus from disease to wellbeing,

equity, keeping people healthy in the community and

co-creating health.

Dr. Natalia Pace, Dr. Paula Rochon, the Honourable Marc Lalonde, Dr. Alex Jadad, Dr. Kwame McKenzie and Dr. Steini Brown celebrate

the 40th anniversary of the Lalonde Report

Visual Summary: Cluster 1- Setting the Scene for the Summit: Creating and Spreading

Health - Whole View

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Cluster 2 - Preventing the Preventable, Treating the Treatable, Transcending the Inevitable: What is the Gold Standard for Health Systems?

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Dr. Julio Frenk speaks about the ideal health system

The panel discusses four unique health systems

Key vector, Dr. Julio Frenk (Dean of the Faculty, Harvard School of

Public Health) spoke about the notion of an ideal health care

system. He talked about the complexity of modern health systems

and the importance of fair financing (see above).

!Then, panelists Dr. Kibrom Hagos (Medical Director, Amanuel

Psychiatric Hospital) from Ethiopia, Dr. Jose Carlos Prado Jr.

(Municipal Secretary of Health, Rio de Janeiro) from Brazil, Dr.

Xiaolin Wei (Assistant Professor, School of Public Health and Primary

Care, University of Hong Kong) from China and Dr. Malabika Sarker

(Professor, James P. Grant School of Public Health) from

Bangladesh described the health systems in their countries and

reflected on lessons learned (see chart on page 13).

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Visual Summary - Cluster 2 - Preventing the Preventable, Treating the Treatable,

Transcending the Inevitable: What is the Gold Standard for Health Systems? - Whole View

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Cluster 2 - Concurrent ‘Outbreak’ Sessions

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3) What Does the 21st

Century Health Care

Provider Look Like? !

1) Strengthening

Collaboration Within

Health Systems !

2) Building Strategic

Alliances !

4) Ability, Inclusion,

Participation and its Place

in the Design of Health

Systems !

Outbreak group discussing the question, “What does the 21st century health care provider look like?”

Global Health Summit Dinner

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At the end of Day 1, delegates gathered for a dinner and presentations at the Shangri-La Hotel.

DAY 2: Cluster 3 - Urbanism, Health, and the Growth of Megacities: When is More, More? Segment on Metrics

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Cluster 3 explored innovative solutions to complex urban problems impacting population

health around the world. This portion of the agenda was divided in to two segments, the

first on metrics and the second focused on resilience.

!The segment on metrics was led by Dr. Patricia

O’Campo (Director, Centre for Research on

Inner City Health, St. Michael’s Hospital) who

spoke about rising inequalities around the world

and the need for more diverse input from

citizens about what needs to be measured to

progress towards reducing inequalities (see left).

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Cluster 3 - Concurrent ‘Outbreak’ Sessions

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4) Resilient Cities - metrics

appropriate for capturing

dimensions of “resilient”

and “smart” cities

1) Clean Air - generating

metrics to track a path

towards cleaner cities

3) Technology -

leveraging the strengths

of a specific technology

for better urban metrics

2) Violence - What are the

right opportunities to

provide youth to keep

them from engaging in violent crime?

Outbreak group discussing the topic of clean air

Cluster 3 - Urbanism, Health, and the Growth of Megacities: When is More, More?

Segment on Resilience

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In the segment on resilience, panelists Dr.

Sandro Galea (Gelman Professor and Chair of

Epidemiology, Mailman School of Public

Health, Columbia University), Jeb Brugmann

(ICLEI USA Past Board President), Stephen

Verderber (Professor, John H. Daniels Faculty of

Architecture, Landscape and Design, Institute

of Heath Policy, Management and Evaluation,

Dalla Lana School of Public Health, U of T), Chris

Buse (Doctoral Candidate, Social and

Behavioural Health Sciences, Dalla Lana School

of Public Health, U of T) and Dr. Blake Poland

(Associate Professor, Dalla Lana School of

Public Health, U of T) discussed the current shift

to thinking of cities as concentrators of health,

the emergence of urban wellness districts,

architectural design for crises and regenerative

cities (see right).

Visual Summary: Cluster 3 - Urbanism, Health, and the Growth of Megacities: When is

More, More? - Whole View

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Cluster 4 - Achieving Convergence: What Kind of Life Should Future Generations Experience?

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Dr. Dean Jamison (Professor Emeritus, Global Health) presented the findings of the Lancet

Commission report, that envisions “the possibility of achieving dramatic gains in global health by

2035 through a grand convergence around infectious, child, and maternal mortality; major

reductions in the incidence and consequences of NCDs and injuries; and the promise of universal

health coverage.” He spoke about the universal health coverage goal of coverage for everyone,

with little or no fee and stated that grand convergence (a reduction in the burden of infections and

Reproductive, Maternal, Neonatal and Child Health (RMNCH) disorders in high-mortality, low and

middle-income countries down to current rates in the best performing middle-income countries)

could be possible by 2040 (see chart on page 21).

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Dr. Zulfiqar Bhutta (Co-Director, SickKids Centre for Global Child Health) challenged Dr. Jamison by

identifying some of the issues that the Commission did not take into account. He pointed out that

there are prerequisites that must be met in order for the Commission’s vision to be realized. Dr.

Bhutta focused on the need for equity and the establishment of a level playing field to truly

transform the global health landscape (see chart on page 21).

Dr. Srinath Reddy (President, Public Health Foundation of India) spoke further about convergence

and bridging inequities across health indicators globally. He emphasized the need for multi-

disciplinary learning to develop ’T-shaped’ individuals with depth and breadth of knowledge, to

bring a well-rounded perspective to the health issues being faced around the world. Dr. Reddy

made the distinction between health insurance and health assurance, submitting that there are

many factors that need to be in place to create the conditions for health assurance (see chart on

page 21).

Visual Summary: Cluster 4 - Achieving Convergence: What Kind of Life Should Future

Generations Experience?

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Cluster 4 - Achieving Convergence: What Kind of Life Should Future Generations Experience? (continued)

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The session on Achieving Convergence continued with a talk show

style panel discussion hosted by Dr. Alex Jadad. Dr. Jadad explored

the subject of convergence by posing a series of questions to

panelists Dr. Dean Jamison, Dr. Srinath Reddy, Dr. Ophira Ginsburg

(Scientist, Women’s College Research Institute), Dr. Daniel Sellen

(Associate Dean, Research, Dalla Lana School of Public Health

Professor, U of T), and Dr. Arjumand Siddiqi (Assistant Professor,

Divisions of Social and Behavioural Sciences and Epidemiology,

Dalla Lana School of Public Health, U of T). The conversation, which

included much audience participation, encompassed topics such

as income disparity and potential solutions, reconciling pathogenic

and salutogenic approaches, bringing policy down to effective

action, cultivating public health literacy and participatory and

interdisciplinary research (see chart on page 23).

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Visual Summary - Cluster 4 - Achieving Convergence: What Kind of Life Should Future Generations Experience? (continued)

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DAY 3: Cluster 5 - Politics, Privilege and Power: What Really Determines Global Health Inequities?

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Day 3 opened with a brief review of Day 1 and Day 2 from Dr. Hu. He also invited

participants to take time throughout the course of the day to do a gallery walk of

the graphic recording charts that had been created during the summit. They

were then asked to propose a specific idea for an action item for the University’s

Institute for Global Health, Equity and Innovation via the Poll Everywhere live

audience response tool.

!Dr. Jennifer Prah Ruger (Associate Professor of Medical Ethics & Health Policy,

Department of Medical Ethics and Health Policy, University of Pennsylvania School

of Medicine) discussed the most significant ways that politics, privilege and power

influence health inequities and what should be done about it. Dr. Ruger focused

on global health governance asymmetries, how the control of resources

contributes to health inequities and the need to empower women and create

equal opportunities for women and men. She asserted that we can do better and

discussed a shared health governance approach, which is transparent,

Afterwards, panelists Dr. Janet Smylie (Research Scientist,

Centre for Research on Inner City Health, St. Michael’s

Hospital), Dr. Walter Flores (Director, Centre for the Study of

Equity and Governance in Health Systems), Dr. Lisa Forman

(Assistant Professor, Dalla Lana School of Public Health) and

Solly Benatar (Emeritus Professor of Medicine, University of

Cape Town) were asked to respond to the question, “What

are the most important ways that power, privilege and

politics influence health inequity and what should be done

about it?” A common theme that emerged was the need for

a shift in thinking in order to make real progress towards

global health equity (see chart on page 25).

Politics, Privilege and Power panelists

Keynote presentation by Dr. Jennifer Prah Ruger

Visual Summary: Cluster 5 - Politics, Privilege and Power: What Really Determines Global

Health Inequities? - Whole View

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Cluster 5 - Concurrent ‘Outbreak’ Sessions

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3) What does the

Ebola outbreak

response reveal

about the ethics and

politics of public health

emergencies? !

4) What is the role

of theory and

methods in studying

power, privilege and

politics?

5) What does a power,

privilege and politics

lens mean for

Canadian global

health researchers?

1) Why does good

governance

matter for health

equity?

2) A tipping point in human

history: What, if anything,

can be done to redress

the prevailing distortion

of values?

Cluster 6 - Global Big Data: How Can Big Data Accelerate Global Health Progress?

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After lunch, participants heard diverse perspectives

on how big data can accelerate global health

progress. Panelists Dr. Prabhat Jha (Director, Centre

for Global Health Research), Dr. Zhengming Chen

(Professor of Epidemiology, Nuffield Department of

Population Health, University of Oxford), Dr. Rumi

Chunara (Instructor, Harvard Medical School) and Dr.

Dennis Ross-Degnan (Department of Population

Medicine, Harvard Medical School) shared their

experiences working with large data-sets from four

sources: verbal autopsies in resource poor settings,

biobank data from China and the UK, data acquired

from the analysis of social media and health

insurance program data (see chart on page 28).

!The Global Big Data discussion continued after a

break with presentations by Dr. Leslie Roos (Professor,

Community Health Science, Faculty of Medicine,

University of Manitoba) and Dr. Zhengming Chen. Dr.

Roos emphasized the importance of the human

touch and cultivating relationships when working

with the government to access data. Dr. Chen spoke

about the need to link databases (via electronic

medical records) to provide more detail and

improve the effectiveness of managing health data

(see chart on page 29).

Dr. Prabhat Jha discusses verbal autopsies Dr. Zhengming Chen speaks about biobank data

Dr. Rumi Chunara shares her social media experience

Dr. Dennis Ross-Degnan talks about health insurance program data

Visual Summary - Cluster 6 - Global Big Data: How Can Big Data Accelerate Global Health

Progress?

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Visual Summary - Cluster 6 - Global Big Data: How Can Big Data Accelerate Global Health

Progress? (continued)

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Creating and Spreading Health: Triggering a Pandemic of Health, Together - Reflections and Making the Links

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To wrap up the Summit, rapporteurs reflected on the great moments shared over the three days, and summarized the key messages

from each of the clusters (see above). Dr. Hu closed by thanking everyone for their participation. He reminded participants that,

though many ideas were shared and connections made, the journey to creating a global pandemic of health has just begun.

Appendix: Graffiti Walls

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Throughout the course of the summit, participants were asked to share their views on four “tough ‘askable’ questions” by writing or drawing their

thoughts and ideas on graffiti walls (see pages 32-35). After the Politics, Power and Privilege session on Day 3 another graffiti wall asked the question,

“What really determines global health inequities?” (see page 36).

Participants contribute ideas to a Graffiti Wall Reception and Graffiti Wall area Participants reflecting on the Graffiti Walls

Graffiti Wall - Tough ‘Askable’ Question #1

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Graffiti Wall - Tough ‘Askable’ Question #2

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Graffiti Wall - Tough ‘Askable’ Question #3

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Graffiti Wall - Tough ‘Askable’ Question #4

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Graffiti Wall - Politics, Privilege and Power

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About Get The Picture

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