From the Dean: Doing the Right Thing

From the Dean: Doing the Right Thing

In recent years, we in public health have rather selfishly framed global public health as: “What happens ‘over there’ happens here.” We remind people that in the United States, we’re no more than 14 to 18 hours away from anywhere in the world, and as we saw last year with Ebola, a disease that breaks out in one country can reach our shores in hours.

All this is true, of course. But there are far more noble reasons for engaging in global public health, chief among them that it’s the right thing to do. We in the so-called “developed” world have solutions, technologies, and approaches that can save lives, and it’s our obligation to help where we can.

At the same time, just because we’ve got the latest whiz-bang technology doesn’t mean we should apply it. This school’s deep heritage in community-based partnering makes that clear, and it’s one reason U-M SPH is a durable partner with colleagues around the globe. We understand that global public health requires cultural humility, sensitivity, and trust, and that perhaps more often than not, we need to sit back, listen, learn, and allow our global partners to lead.

In my role as dean, I’ve been in many less-advantaged communities. One thing I’ve seen time and again is that poor people are resilient, they’re resourceful, and they’re innovative. We need to incorporate that wisdom into our thinking.

We can be the most precise, sophisticated, and innovative scientists, and be precisely and innovatively wrong in the implementation of our solution—either because it’s too complex or it’s impractical. It’s one reason we now have so much innovation and social entrepreneurship activity in the school, so that our students can learn to innovate smartly. It’s not enough to have a brilliant solution—the solution has to be intuitive enough for people to adopt. And it’s got to be “sticky,” so they’ll keep adopting it and make it a habit.

Solutions to global health challenges can also be found in approaches we’ve already implemented, or in lessons we’ve already learned. Too often, we’re driven by a mania to find ever more novel and innovative approaches. I would argue that public health ought to spend at least as much time reflecting on past interventions—both successes and failures—and drawing ideas from that solid foundation.

Again, the solutions we need won’t necessarily come from the “developed” world.

Many solutions require larger, more systematic approaches. For example, malaria is a global issue, and one might think it’s primarily about getting rid of the bug and getting a better medicine. But it’s really about harnessing rainwater and fresh water supplies, channeling them into systems that provide potable water, and eliminating the breeding grounds for mosquitoes. That’s not to say we don’t need better medicines for malaria, but we ought to be simultaneously thinking about vaccines and about the kind of engineered environment that would prevent the problem from occurring in the first place.

The same principles apply in Flint, Michigan, where a switch in the city’s water supply in 2014 resulted in widespread lead contamination. What happened in Flint is a sobering reminder that safe, potable water is a fundamental human right—one that is too often denied the world’s most vulnerable populations. As we work now to address Flint’s water crisis, we must dedicate ourselves to devising solutions that are sustainable, cost-effective, socially responsible, and just plain right.

Flint has much in common with other water-constrained places on the globe, and in this Flint is also a reminder that public health is inherently global. The term “global” may, in fact, be superfluous, because health is the bottom line everywhere, whether we’re talking about Flint, Michigan, or Accra, Ghana, or rural Afghanistan or Mexico City. It’s about access not just to health care but to fundamental resources, chief among them safe, secure supplies of water, food, and air.

One of the deep lessons I’ve learned from sitting in the back seat of bumpy jeeps, sometimes next to SPH students, is that at its best, exposure to global public health has great value even if you end up working in a windowless office here in the U.S. And that’s because we live in a globalized system of markets, supply chains, goods, resources, and, on the negative side, pollution and disease. Understanding one’s role in a globalized economy is ever more important, and it’s why as many of our students as possible should experience international work during their years at SPH. Otherwise, in our efforts to do the right thing, we stand little chance of getting it right.

Martin Philbert
Dean and Professor of Toxicology{