In the name of global health: trends in academic institutions.

This paper explores recent trends by predominantly high-income-country academic institutions to expand their research focus from international health and/or tropical medicine to global health, re-branding themselves in the process to take advantage of the considerable interest in global health issues that has been generated in recent years.

The debate between what is appropriately considered “global health” and “international health” continues unabated, and it is unlikely to be resolved anytime soon (please see ref {1}, on which I am an author). Nevertheless, the term “global health” has generated a considerable amount of interest in recent years, so much so that many policy makers, development specialists, health professionals, and, yes, even academics have attempted to jump on the bandwagon claiming global health gains. Indeed, just looking at the proliferation of international actors, humanitarian initiatives and projects, academic courses and qualifications, and conference titles could leave someone with the mistaken impression that there is little else left to do. The bulk of international collaboration and technical capacity, however, continues to remain located in Western developed countries {2}. As other studies have revealed, even in cross-country research this has lead to disproportionate representation by high-income-country authors -- especially authors from the United States and the United Kingdom {3}.

The starting point for this article examines this very theme, notably the proliferation of “global health” research centres and academic institutions. Using statistics derived from PubMed searches, the authors attempt to quantify the move by higher education institutions towards broadening their research focus from international health and/or tropical medicine to global health, with their results revealing some very interesting trends. Their study reveals, for example, that 87% of authors using the term “global health” in their affiliation with an academic institution were based in North America. Extending their study further and drawing upon the Fogarty International Centre Global Health Framework Program funding results, the authors conclude that there has been a similar proliferation of teaching in US-based institutions that adopt a “global health” syllabus. While it is acknowledged that similar content may be taught in European higher education facilities, Europeans, in contrast, appear less likely to alter the name of their academic institutions to include the phrase “global health”, although the authors go on to speculate this may be due to the fact that distinctions between international health, tropical medicine, and global health remain unclear. What does become apparent from this paper is that many academic institutions are using the phrase “global health” to re-brand themselves, offering new options for students such as “in-country” study electives and courses, in an attempt to enhance their reputation and appeal in an internationally competitive market. It is also apparent that many are also seeking to take advantage of the new funding that has become available for global health initiatives. The authors subsequently conclude the paper with a call to US and European higher education institutions to directly assist their neighbouring developing countries' bids for research grants and development contracts to advance their research expertise and technical capacity. Yet, while the sentiment expressed is admirable, the key weakness of the paper is that it fails to address how this can be realistically accomplished in what the authors acknowledge has become a highly competitive market for research funding. Certainly, there is a need for more developing country-initiated evidence-based research, and a number of funding bodies have attempted to redress the existing shortfall by only funding initiatives that adopt a collaborative approach with lower-income country researchers. Much more can and should be done, however, and the findings presented in this paper arguably provide a solid foundation from which the agenda can move forward.

References: {1} Lee et al. "An introduction to global health policy". In: Health Policy in a Globalising World. Lee et al. (eds) Cambridge: Cambridge University Press, 2002:4-5. {2} Frenk and Gonzalez-Block, J Public Health Policy 2008, 29:449-58 [PMID:19079303]. {3} Gonzalez-Block M, Health Res Policy Syst 2006, 4:7 [PMID:16928275] .