Reinventing Global Health

By: Yann A. Meunier MD
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  • Summary

  • This podcast is a package of ten one-hour episodes (seven in English and three in French) with eminent experts having multifaceted backgrounds in the private and public healthcare sectors in the U.S., Canada, and France. It aims at answering the following questions regarding global health, in their respective areas of expertise and based on their vast experience: What is the status? What are the trends? What are the challenges? Would you please give a few examples of projects that were successful or failed,explaining why? What are some solutions, in particular, what could be scaled? It was created and is moderated by Yann A. Meunier, MD, Global Health Expert based in Silicon Valley, California and former Director of International Corporate Affairs and Business Development for Stanford Hospital and Clinics.
    Copyright 2023 All rights reserved.
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Hygiene & Healthy Living Physical Illness & Disease Political Science
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Episodes
  • Global Health from an African Perspective - with Joachim Kapalanga, MD

    Global Health from an African Perspective - with Joachim Kapalanga, MD
    Feb 11 2023

    Main points

    • Definition of global health in the context of Africa
    • Primary problems in quantity and quality in human resources confounded by the multiplicity of stakeholders
    • Lack of harmonization of partnership and funding channels and modalities are different for stakeholders
    • Lack of tracking of resources by governments
    • Weak point: no direct government oversight of the project: no political will and/or no mechanism to harmonize the projects
    • International programs often lack sustainability. Example: H3Africa Program (Human Heredity and Health in Africa)
    • Competition for the same skilled workers to carry out international programs who are thus diverted from provided healthcare to local populations. It also participates in the brain drain (example: H3Africa)
    • No prioritization of the programs in the interest of home countries (medications, tests, equipment). Example in South Africa: patient genetic difference between California and Africa
    • Accountability: No separation between politics and judicial systems. As a result, there is no prosecution when waste or corruption occurs in many cases. Example: SASA conference
    • Successes: H3Africa with sickle cell and genetic diseases / Training of workers skilled in global health / Help in rural areas
    • To counter the brain drain, two examples: (1) Brain Circulation, (2) Carnegie Foundation (cross appointments)
    • Rural areas. The situation has improved in the last decades but they are still underserved particularly regarding access and distribution. Moreover, facilities are underdeveloped, understaffed, and lack diagnostic tools. Example in Tanzania for the training of healthcare workers but it has plateaued. Priority: mother and children healthcare
    • Collaboration between African countries: despite African Union’s efforts there is little collaboration. No continent-wide standards for healthcare
    • Current Ebola outbreak in Uganda (date: 10/3/2020)
    • Disproportion between funding and priorities: HIV/AIDS, TB, malaria are well funded at the expense of other diseases like neglected tropical diseases and chronic diseases
    • Deciders for best ROI: African governments but external players like the Bill Gates foundation have their own projects.
    • Political consequences if programs fail: no mechanism holding anybody accountable
    • Influence of academia on decision-makers. Difficulty in developing policies to advise governments. They have problems on their own: insufficient funding, low salaries, lack of academic freedom, nepotism and lack of competent leaders and staff, lack of equal access to academic institutions
    • High cost of tuition deprives African countries of bright students
    • Advice for people wanting to get involved in global health in Africa:

    - Despite of challenges, follow your heart

    - Work in rural settings. Personal examples (1) in Tanzania, (2) McMaster University, (3) Distributed medical education

    • Advice to fix what is not working in global health in Africa: (1) Training level: Expand distributed medical education nationally or internationally in Africa, (2) More collaboration between academic institutions promoting global health creating guidelines
    • Good example of a successful program that can be scaled: In Tanzania a training program initiated by a foundation in the Netherlands and taken by the Fogarty foundation
    • Good example of program successful for sustainability: Nutritional program started by Oxfam against kwashiorkor and marasmus
    • Example of good collaboration between anglophone and francophone countries: Rwanda and Uganda and DRC (Democratic Republic of Congo) regarding Ebola

    BIO

    Dr. Kapalanga is a physician-scientist and educator who received his medical education from Yale University, the state university of New York, queen’s university and the university of Guelph.

    He is currently professor of paediatrics at the Schulich school of medicine and dentistry and the South Western Ontario academic health network - knowledge translation group, Canada.

    His scholarly and research pursuits are in the epigenetics of neurodevelopmental disorders and exploration of shared endophenotypes in neurobehavioral disorders.

    https://www.linkedin.com/in/joachim-kapalanga-62a64551/?originalSubdomain=ca

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    59 mins
  • The Future of Global Health. The Main Healthcare Systemic Challenge: Prioritization with Yann Meunier, MD

    The Future of Global Health. The Main Healthcare Systemic Challenge: Prioritization with Yann Meunier, MD
    Feb 11 2023
    Main points Speaker introduction (international experience and expertise / pharmaceutical industry and corporate background) Presentation goals (road map for reaching maximum efficiency and efficacy in providing healthcare across the globe / providing food for thought to frame issues)Global and healthcare challenges: The African exampleThe Clinton foundation as an example of unreliable fundingOne requirement to face multiple challenges: PrioritizationAnalogy: Medical emergency departmentTriage processCriterion #1 for global health: ROI with several dimensions (medical, financial, societal, political, moral, and personal)First concrete example: Acute vs chronic disease (tetanus vs HIV/AIDS)HIV/AIDS situation descriptionHIV/AIDS age distributionHIV/AIDS treatment yearly cost (for life)Maternal and neonatal tetanus situation description2022 study: Vaccination coverage of mothers in East Africa The financial calculus The question: Why is the choice not made in favor of the tetanus vaccination?ConclusionFear: Resurgence of historical diseases with COVID-19 is in the news (TB, cholera, polio, HIV/AIDS, malaria) Second concrete example: Prevention vs cure (the tetanus example)Conditions for success (avoiding bureaucracy and making the hard choices)Solutions Priority #1: Good healthThree values (equity / solidarity / liberty)One need: One accepted and respected leadershipOne urgency: A general political consensusTwo sub-priorities: Nutrition and educationOne must: Erasing the African debtThree strategies: A new and serial approach / Thinking locally and acting globally / Consolidating global health Six suggestions: Mergers, coordinating superstructure, drastic limitation of face to face international conferences and congresses, the right to interfere in countries for healthcare reasons (particularly transmissible diseases) and the creation of global health blue helmet brigades, having poverty as the #1 risk factor for many diseases) The past and the futureFood for thoughtVisionConclusion BIO Dr. Yann Meunier is an international and multifaceted healthcare professional and a pioneer in academia, healthcare provision (in clinical settings and public health programs), research, and business. During his education, He studied medicine at Paris V University (France), the Federal University of Rio de Janeiro (Brazil) and The George Washington University (USA). He holds specialty degrees in emergency medicine (Paris XII University), and tropical diseases (Paris VI University), a certificate from the ECFMG, a certificate from Harvard University in internal medicine and two certificates from Stanford University in communication. During his career, In Academia He was Assistant Professor in Tropical Diseases and Public Health (Paris VI University), Adjunct Assistant Professor of Medicine (The George Washington University); Lecturer (The George Washington University Center for International Health), Director (Stanford Health Promotion Network), Manager in Health Promotion (Stanford Health Improvement Program), Mentor (Stanford Medscholars Research Fellowship Program), and Instructor (Stanford Health Improvement Program) He is widely published in the international medical literature and is the author or co-author of nine books on global health and tropical diseases (Oxford University Press and Springer published two). As Healthcare Provider Clinically He was (1) Private General Practitioner in France, Singapore (only European Private General Practitioner in the country), New Caledonia (first and only Private General Practitioner on the island of Lifou), and Nigeria (only European Private General Practitioner in Lagos), (2) Tropical Diseases Consultant (at the Pitie-Salpetriere hospital in Paris, France), (3) Chief Medical Officer for Chevron Oil Co. in Papua New Guinea (PNG), (4) Corporate Physician in Cameroon (for Cellucam), Nigeria (for Spie-Batignolles and Schlumberger), and China (for EDF), (5) he was the team Physician during corporate trips in Gambia and Egypt (for Bosch), and Congo-Brazzaville (for a timber consortium), and (6) he worked as Emergency Medicine Specialist for SAMU 94 (at the Henri Mondor hospital in Creteil, France). In Public Health He (1) created a public health program for about 10,000 Kutubu-area villagers in the Southern Highlands province of PNG, (2) wrote a report on public health priorities in Lifou, (3) conducted public health programs and epidemiological surveys in Senegal (for USAID), China, Papua New Guinea, Haiti, and New Caledonia, and (4) created and delivered health promotion and preventive medicine tools at Stanford University for the Stanford University staff and the San Francisco Bay area population and corporations, in particular several located in Silicon Valley. As Researcher He led or participated in clinical trials providing new treatments for HIV/AIDS, tropical (malaria, intestinal nematodoses, amebiasis, giardiasis), cardiovascular, hematological and respiratory...
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    27 mins
  • What is Wrong with Global Health in 2022? What are the Solutions? - with Alain L. Fymat, PhD, PhD

    What is Wrong with Global Health in 2022? What are the Solutions? - with Alain L. Fymat, PhD, PhD
    Feb 9 2023
    COVID-19 has underlined the current poor state of global health. In this podcast, I have tried to identify the underlying problems that were evidenced, at least in part, by the root causes of the pandemic. My remarks were largely based on my published book “Pandemics: Prescription for Prediction and Prevention”*, especially its Chapter 18. To summarize: We live in an unruly, not easily managed world of ~ 8 billion people that is constantly growing. Notwithstanding the plethora of international, regional, national, and other organizations, there are glaring inequities among nations, principally between developed and poor ones. In particular, within the context of COVID-19, the prime organization among them, the World Health Organization (WHO), has been dilatory, at times issuing contradictory recommendations, and deferring to those powerful nations that fund it most (in this instance, China). In this context, humanity has again proven to have a short memory of past epidemics/pandemics, not having even clearly identified what are their root causes. It is therefore no wonder that these events will continue to haunt us till the end of times ... unless we are able to devise appropriate strategies for predicting/preventing them such as the one I have proposed. For this purpose, I have identified ten important measures: Highlight global health security; Create and strengthen necessary mechanisms; Promote multidisciplinary engagement; Strengthen multisectoral coordination; Emphasize the importance of financial preparedness; Improve early warning and detection; Collect and share data in a timely manner; Conduct laboratory testing; Develop joint outbreak response capacities; and Take appropriate science-based actions. I have also identified ten intertwined cardinal factors that are the root causes of pandemics that need to be simultaneously tackled and remedied: Rapid growth of global human population; Increased globalization; Environmental degradation and destabilization of ecosystems; Creation of new urban or agricultural ecosystems; Economies of scale and monocultures in agriculture and dysfunctional agrifood systems; Loss of land and ocean biodiversity; Water scarcity; Human-induced climate change; Societal inequities; and Irrational mass denialism of hard-won facts of science (vaccinations, antimicrobial overuse). Some of the above factors could be correlated with the United Nations (U.N.) Sustainable Development Goals (SDG). In the same book, I have offered a blueprint for a 6-level strategic pandemic prediction and prevention program that should herald the beginning of the end of pandemics: Creating of a new “World Environment Organization”;Shifting the current health paradigm to a “One-World/One-ecoHealth paradigm” that will be grounded by a new “International Pandemic Treaty” and other international laws;Involving international, intergovernmental, regional, and national health organizations;Incorporating the “Global Human Virome Project”;Actively developing models (epidemiological, climate-type) with their enabling technologies and databases: andFolding-in the development of vaccines & therapeutics and the corresponding research. The value and success of the proposed approach will be gauged by four measures: Reducing causes of new infectious diseases; Preventing outbreaks and epidemics from becoming pandemics; Preparing for potential future pandemics that could not be prevented; and Ensuring that the causing virus does not re-emerge thereafter (e.g., by sustaining itself in domestic animals). Within that blueprint, I truly believe we can reach a stage where pandemics could at long last be predicted and prevented. *Book (hard cover and paperback): Pandemics: Prescription for Prediction and Prevention: https://www.amazon.com/Pandemics-Prescription-Prediction-Alain-Fymat/dp/0228867215 BIO Dr. Fymat is a medical-physical scientist and an educator. He is the current President/CEO and Professor at the International Institute of Medicine and Science with a previous appointment as Executive Vice President, Chief Operating Officer and Professor at the Weil Institute of Critical Care Medicine. He was educated at the University of Paris-Sorbonne and the University of California at Los Angeles. He was formerly Professor of Radiology, Radiological Sciences, Radiation Medicine (Oncology), Critical Care Medicine, and Physics at several U.S. and European Universities. Previously, he was Deputy Director (Western Region) of the U.S. Department of Veterans Affairs, Veterans Health Administration (Office of Research Oversight), and Director of the Magnetic Resonance Imaging Center and for a time Acting Chair of Radiology at its Loma Linda, California Medical Center. He has extensively published (~ 425 publications including patents, books & monographs, book chapters, refereed articles). As invited/keynote speaker and member of organizing committees of international congresses and symposia...
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    1 hr and 3 mins

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