“Global health is difficult to define – and yet we know it when we see it.”
Gretchen Birbeck, BMC Medicine 2013, 11:72
Thanks to the efforts of numerous researchers and physicians from a wide variety of disciplines and countries, awareness regarding the main challenges of global health has been increasing over recent years. BMC Medicine has launched a Medicine for Global Health article collection, with guest editors Gretchen Birbeck and Raymond Hutubessy, with the aim to explore public health initiatives, health care policies, health economics, and research into the control and treatment of communicable and non-communicable diseases that have strong implications for global health. The launch includes contributions from Raymond Hutubessy, James Giordano, Charles Wiysonge and Kathryn Maitland and colleagues.
In an Editorial for the launch of the collection, Gretchen Birbeck discusses the increasing relevance of medicine in resource-limited settings, highlighting that simple interventions may help to lessen the global burden of disease. Gretchen Birbeck, who is based in southern Africa for half of the year, has first-hand experience of managing epilepsy in resource-limited settings, and in an interview with BMC Medicine, she talks about her personal experiences in this area, and highlights that economically developed settings are not immune to healthcare disparities amongst people suffering from epilepsy.
Raymond Hutubessy, based at the World Health Organization (WHO), is a health economist who specializes in economic analyses underlying decisions on whether or not to introduce vaccines against, for example, human papillomavirus (HPV). In a Q&A for the launch of the article collection, he discusses why this is of particular importance in resource-limited settings.
In an interview, also available as a podcast, James Giordano discusses some of the most significant ethical issues associated with global health research, and he highlights that although low- and middle-income countries are often the ones in most need of modern medical care, there is an asymmetry between research needs and research funds.
Often, the main concern is whether or not the intervention or research required is sustainable in the host country. This subject is touched upon in a bibliometric analysis by Charles Wiysonge and colleagues. They find that since the onset of the Expanded Program on Immunization, vaccine research productivity in Africa has skewed towards those funded by private means.
The article collection also includes a research paper by Kathryn Maitland and colleagues, who previously published surprising results from the Fluid Expansion as Supportive Therapy (FEAST) study. Here, African children with severe febrile illnesses given the intervention of rapid fluid bolus exhibited excess mortality compared with controls – the opposite to what was expected. In a secondary analysis of this data published in BMC Medicine, the authors explored the mechanisms behind the excess mortality, finding that it was due to cardiovascular collapse rather than fluid overload. Clarifying the mechanisms behind death in this population of patients has implications for fluid resuscitation practices in other populations of critically ill patients, an issue that is further emphasized in a commentary by John Myburgh and Simon Finfer.
The collection highlights some of the most significant medical concerns affecting global health – and we will be adding further articles throughout the year that offer novel insights into public health initiatives, health care policies, economics, and research into the control and treatment of communicable and non-communicable diseases.
The complete list of series articles:
Global challenges of epilepsy management – Gretchen Birbeck
Ethical considerations in the globalization of medicine – James Giordano