Broadening Our Global Health Vision

The job of biomedical research is far from over. Given the changing nature of the global health landscape, we must act now to broaden our vision even further.
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Over the past few decades, global health research has primarily focused on the "big three" diseases: AIDS, TB and malaria. And, thanks in large part to biomedical innovation, we today have better ways to treat these dreaded, infectious diseases and lower the risk of transmission -- advances that have saved millions of lives and promise to save countless more.

However, the job of biomedical research is far from over. Given the changing nature of the global health landscape, we must act now to broaden our vision even further. First, we need to apply the power of scientific innovation to more health problems. Secondly, we need to recognize that developed nations are not the only source of such innovation.

While infectious diseases remain a significant problem, low-income nations face many other serious health challenges. In fact, the fastest growing causes of death and disability in the developing world are injuries, such as those caused by traffic accidents, and non-communicable diseases, such as cancer, heart disease and diabetes.

It will be no easy task to identify and implement the right tools to tackle this formidable -- and potentially very costly -- array of problems in resource-poor countries. To succeed, we will need the brightest minds in all parts of the world, including those from both the public and private sectors, to work together in new and highly creative ways.

As an example of such an approach, the National Institutes of Health (NIH) and the Wellcome Trust, a global charity based in London, recently formed a partnership to support population-based studies in Africa of common, chronic disorders, as well as infectious diseases. That effort, called Human Heredity and Health in Africa (H3 Africa) project, will enable African researchers to take advantage of new research approaches to understand both genetic and non-genetic factors that contribute to risk of illness. Not only will this help people living in Africa, but, since Africa is the cradle of humanity, what is learned about genetic variation and disease likely will have an impact on the health of populations around the globe.

The H3 Africa project also illustrates the second way in which we need to broaden our vision of global health. Rather than seeing biomedical innovation as something that flows from developed nations to low-income nations, we need to start viewing innovation as a two-way street from which the entire world stands to benefit. As global health advocate Lord Nigel Crisp so aptly puts it: "Innovation is happening everywhere."

Recently, some of the most creative -- and cost-effective -- strategies for medical products and procedures have arisen from research that reflects the needs and ideas of people living in poorer countries. Such innovations include: a quarter-sized microscope that can transmit high-quality images via a mobile phone, lower cost intraocular lenses for cataract surgery, non-surgical methods for treating clubfoot, a high-performance prosthetic knee joint for amputees that costs only $20, a cheaper way to deliver IV fluids to children and an inexpensive, non-electronic device to warm premature babies. While some of these innovations are tailored to the specific needs of developing nations, others may come in handy in the United States -- particularly in remote areas or low-resource settings.

So, as a nation, let us renew and strengthen our commitment to biomedical research aimed at improving the health of the world's poorest peoples. It just might improve our own.

Francis S. Collins, M.D., Ph.D., is Director of the National Institutes of Health. He will be speaking at the Partnering for Global Health Forum in Washington, D.C. on June 27.

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