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It is understandable that meaningful reform of the U.S. health-care system is front and center on the minds of legislators, business leaders, health-care professionals, and the millions of people across the country who voted for the kind of reform outlined by the Obama campaign. The need for this reform in the near term is undeniable. However, I believe the next few decades are also critically important to making progress on the global-health front.
Leading academic medical centers like Duke's have a unique opportunity to exercise leadership in extending the scope of global-health initiatives. These will include not only improving the treatment of disease, but also training health-care providers and conducting research that can be effectively translated and applied for the benefit of people around the world. I, and others, including Michael Merson, a physician and director of the Duke Global Health Institute, believe a number of factors will drive a greater focus on the importance of global health over the next few decades.
First, we'll see a growing conviction that people everywhere should have access to life-saving medicines. Nowhere has this become more evident than in the provision of anti-retroviral drugs for people with HIV/AIDS around the world. Some estimates suggest that, owing to collective international funding of programs that provide access to medication, millions of lives have been saved and a major impact has been made in preventing maternal-fetal transmission of the disease. With the real and emerging threats of global pandemics, I believe this conviction will grow stronger in coming years, along with a greater sense of urgency in the response of government and industry to the need for medicines and vaccines.
The importance of global research collaborations will become increasingly evident, providing the greatest opportunity for academic medical centers to take leadership roles. Duke Medicine, which is on the verge of some exciting, mission-based research collaborations with strong and respected partners in Asia, Africa, and elsewhere, is in an excellent position to be one of those leaders.
The rapid growth of clinical studies being conducted globally is an indication that clinical research is undergoing the same globalization process that can be seen in other enterprises. It is also clear that the intellectual and scientific firepower that can be accessed through broader collaborations with investigators worldwide will have far greater yields than limiting collaborations within a given country or region. And, unless the U.S. Food and Drug Administration makes fundamental changes that modernize and streamline the clinical-trials process, I would look for Asia to become the hub for clinical research.
Finally, foreign governments that recognize that economic and social development cannot occur without a healthy population will increase global-health research and care-delivery programs. At the World Economic Forum meeting in January, which I attended as a Governor for Healthcare Industry, it was clear that concern is rising around the world about the economic and security threats posed by an unhealthy population. It is becoming more widely understood that cardiovascular disease, obesity, diabetes, hypertension, and other chronic diseases are on the rise globally, especially in India, China, Latin America, and in urban centers in sub-Saharan Africa. Add to this an aging global population, health risks associated with poverty and gender inequity, and emerging infectious diseases, and the need for greater investments in health-care infrastructure abroad is obvious.
With poor health becoming a security risk and a barrier to economic growth, I would look for countries to become more aggressive in seeking strategic partnerships with the health-care industry, academic medical centers, and others that can identify and pursue improved public-health and disease-prevention strategies. At Duke, we are already working on public-private partnerships to address these issues.
The world is changing at a pace that almost defies belief. And, as threats to the health of people around the globe increase, so do the opportunities to have an impact. No doubt, as we look to the future at a time of financial upheaval, significant investments in global medicine carry great risks, but the setbacks that will result from inaction are too great to ignore.
