A GLOBAL HEALTH “PEACE CORPS” FOR CHANGE
Michele Barry, MD, Yale University School of Medicine
"What our country does best is health care and health care research. U.S.-funded global health research is our mechanism for partnership and global health diplomacy."
Michele Barry, MD, wants to set a precedent for global health programs. For the past six years, Barry has been working with the Institute of Medicine and her District Representative, Rosa DeLauro (D-3rd, CT) on legislation to implement a Global Health Service Corps. Similar to the Peace Corps, this program would send U.S. medical experts abroad to help respond to the health problems in poor developing countries and to provide the education and training needed to establish a sustainable foundation for their own independent health workforce. "We currently export doctors, nurses and other health experts abroad, but they don't stay," says Barry. "While they generally ‘tackle' many of the health problems of underserved countries, they don't stay or give the people something to work from. There is no partnership, coordination or education. For the lasting impact we all want, we need to also export training and education."
The proposed legislation seeks to strengthen health systems overseas by providing a mechanism for partnerships with developing countries, essentially partnerships in "global health/research diplomacy." These partnerships would connect U.S. hospitals, universities, and medical institutions with those overseas. Barry explains, "We are a globalized world. We need to be more socially responsible about a complex, globalized workforce that will not only improve the health in the countries which need it the most, but will improve our health here in the United States as well."
While the Global Health Service Corps will provide only modest salary to participating physicians, it will help them pay back loans incurred during medical school-for each year of service, they will receive $25,000 toward their debt. Barry sees this as a win-win situation. "Not only will this revolutionize the way we care for the health of those abroad, but this will strengthen our own health workforce here. We can learn how to better recognize, treat and care for diseases that are, or could be, present in the U.S. By utilizing experts in many different fields - information technology, engineering, health management, we strengthen our own knowledge back home."
Not surprisingly, throughout her career, Barry's work has focused on global health policy and the study of how globalization has affected health in poverty-stricken countries. "Globalization has severely hit the health of poor, developing countries. For example, the poorest people end up paying the price when the United States implements sanctions. Groups like the tobacco industry heavily target low-income countries. And now many of these individuals are facing new epidemics of chronic diseases caused by the western influence on diet and lifestyle. These things have resulted in poorer health for people who are already suffering in countries which lack the knowledge or internal systems to treat disease."
Barry also wants to see better oversight and strengthening of American programs which provide relief to countries to deal with health problems. One of the United States' largest initiatives is PEPFAR (President's Emergency Plan for AIDS Relief), which provides the largest investment of any country to care for HIV/AIDS patients in areas with high infection rates. "To be sure, this is an extraordinary investment by the U.S. As rightful stewards of this funding, the U.S. also has a vested interest in the oversight on how the money is being spent. If we provide assistance without also providing education or training, then the gains are not sustainable and the investment is essentially wasted. A Global Health Service Corps could provide this oversight and continuity, and thereby transition emergency relief into sustainable global health partnerships."