Talking global health awareness with UMN

Bill Stauffer

On April 13, 2019, the Center for Global Health and Social Responsibility at the University of Minnesota will celebrate Global Health Day. This event brings together those engaged in global health at the University of Minnesota to foster the exchange of knowledge around global health topics.

Bill Stauffer, MD, MSPH, with the Center for Global Health and Social Responsibility and University of Minnesota Medical School answers questions on the status of global health today and what is done to keep global and local communities healthy.

Q: Generally speaking, how is global health commonly defined?
Dr. Stauffer:
I can share a little bit about the history of the phrase “global health.” Historically, the field was referred to as “international health” and was primarily used to describe doctors and other health care providers from wealthy countries who would travel to resource-poor countries to do direct clinical care, or public health projects.  Over time, however, issues with sustainability and capacity of the workforce in other countries emerged as major faults in the traditional “international health” model. In the early 2000s, to create a new vision of this area of work, “international health” was re-branded by many to “global health.” However, in reality, at the time, for most, this still focused on “over-there” (overseas programs in resource limited settings).  

The University of Minnesota has been unique in that for decades, the programming I have been involved in has been truly “global” in nature.  In other words, there has been recognition that global travel, migration, and trade have tremendous impact on our local communities. In my vision, “global health” is less about geography and more about social determinants of health and access to resources. For example, someone who is upper middle class in Nairobi, Kenya likely has the same health risks and issues as someone who is upper middle class in Minneapolis, while, someone living on White Earth Indian Reservation here in Minnesota may have health issues more similar to someone in rural Tanzania.

Q: What are current global health risks and outbreaks?
Dr. Stauffer: Current global health risks and outbreaks are a function of how dramatically the world has been changing, particularly within the last 15 to 20 years. World population has been exploding, approaching 8 billion people, and access to cheap and fast travel modalities has increased, primarily air travel, with more than a billion and a half international border crossings last year. In addition, more than 60 million people have been forcibly displaced by civil strife and environmental and climate disasters, largely related to climate change. These factors have led to a myriad of global health consequences. The world has seen an increase in infectious disease outbreaks such as Ebola, and Chikungunya, and resurgence of others such as Dengue and cholera. Antimicrobial resistance has spread through human travel at a dizzying speed.  Vectors and vector borne diseases (e.g. mosquitoes, ticks, and fleas) are on the rise worldwide. All of these global health threats are made worse by shrinking public health budgets and national commitments in combination with an undermining of international bodies and authorities involved with infectious disease control and outbreak response.

Q. How does the international community address these outbreaks and prevent future ones?
Dr. Stauffer: It depends on the scale and geography of the outbreak. Initially, the first to respond is the Ministry of Health or similar entity of a country affected by an outbreak. If a country needs assistance with responding or if the outbreak crosses an international border, intergovernmental organizations such as the World Health Organization (WHO) or the Pan American Health Organization (PAHO) will become involved. Various non-governmental (NGOs) may also respond depending on the type of crisis. Interestingly, the United States Centers for Disease Control and Prevention (CDC) can only become involved in responding to outbreaks when/if the CDC is invited by the country to assist. One of the main roles of the CDC is to try to prevent diseases of public health significance that may be imported, including when there is an epidemic (e.g. Ebola).  This is the mandate of the CDC Division of Global Migration and Quarantine, where I act as a medical advisor.

Q: In your work, what are ways you are advancing health worldwide?
Dr. Stauffer: I’m involved in attempting to advance health worldwide in a number of ways. First, as an educator of medical students, medical residents, masters and doctoral students and other health professions. With a philosophy that the “local is global” I strive to improve the lives of those most marginalized and vulnerable, whether in Tanzania, Uganda or rural Minnesota. The health education system has been slow to respond to the changing realities of how human mobility is affecting health. Health care providers in Minnesota need skills to care for a more diverse populations, and to recognize, diagnose, and treat diseases that may not have been common in U.S. populations in the past. This is important both for the individuals Minnesota clinicians serve, but also for the health and wellbeing of our communities.

Likewise, in my role as the Director of Human Migration and Health at the Center for Global Health and Social Responsibility (CGHSR), I am involved in the upcoming Humanitarian Crisis Simulation. The May 17 to 19 simulation is an immersive learning experience where participants learn the foundations of humanitarian response. Also through CGHSR, I am leading a partnership between the University of Minnesota and the UN Migration Agency - also known as the International Organization for Migration (IOM). The IOM performs health screening and health assessments for US-bound refugees and refugees resettling to other “third” countries through humanitarian projects. The University of Minnesota is working with IOM to meet agency workforce capacity and training needs by leveraging UMN areas of expertise through international trainings, domestic visits, online-learning, and expert clinical consultations.

I also work in research to better define problems and solutions.  For example, I am the co-Principal Investigator for a CDC-funded grant to prevent the importation of malaria into the U.S. through returning travelers.

Finally, I serve as the lead medical technical advisor to the Immigrant, Refugee and Migrant Health Branch at CDC’s Division of Global Migration and Quarantine. In this role I develop guidelines for health screening and medical treatment for refugees prior to coming, and following arrival in the U.S.  I assist with disease surveillance, outbreak investigations and in developing and sharing best practices in refugee health.

Bill Stauffer is a professor of medicine and pediatrics, and Director of Human Migration and Health for the Center for Global Health and Social Responsibility. He is an expert in travel and tropical medicine working in clinical medicine, surveillance and policy development. He serves as the lead medical advisor to the Centers for Disease Control and Prevention, Division of Global Migration and Quarantine (Immigrant, Refugee, Migrant Health Branch). His research areas have included infectious disease surveillance, malaria diagnostics and neglected tropical diseases.

Anyone interested in learning more about global health activities at the University of Minnesota, including research by students and faculty, should attend Global Health Day on Saturday, April 13.

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