Adams Lisa V, Wagner Claire M, Nutt Cameron T, Binagwaho Agnes
Center for Health Equity, Dartmouth's Geisel School of Medicine, 1 Rope Ferry Road, Room 219, Hanover, NH 03755, USA.
Union for International Cancer Control, 62 Route de Frontenex, 1207, Geneva, Switzerland.
BMC Med Educ. 2016 Nov 21;16(1):296. doi: 10.1186/s12909-016-0820-0.
Among academic institutions in the United States, interest in global health has grown substantially: by the number of students seeking global health opportunities at all stages of training, and by the increase in institutional partnerships and newly established centers, institutes, and initiatives to house global health programs at undergraduate, public health and medical schools. Witnessing this remarkable growth should compel health educators to question whether the training and guidance that we provide to students today is appropriate, and whether it will be applicable in the next decade and beyond. Given that "global health" did not exist as an academic discipline in the United States 20 years ago, what can we expect it will look like 20 years from now and how can we prepare for that future?
Most clinicians and trainees today recognize the importance of true partnership and capacity building in both directions for successful international collaborations. The challenge is in the execution of these practices. There are projects around the world where this is occurring and equitable partnerships have been established. Based on our experience and observations of the current landscape of academic global health, we share a perspective on principles of engagement, highlighting instances where partnerships have thrived, and examples of where we, as a global community, have fallen short.
As the world moves beyond the charity model of global health (and its colonial roots), it is evident that the issue underlying ethical global health practice is partnership and the pursuit of health equity. Thus, achieving equity in global health education and practice ought to be central to our mission as educators and advisors when preparing trainees for careers in this field. Seeking to eliminate health inequities wherever they are ingrained will reveal the injustices around the globe and in our own cities and towns.
在美国的学术机构中,对全球健康的关注大幅增长:从各个培训阶段寻求全球健康机会的学生数量,以及机构间伙伴关系的增加,还有在本科院校、公共卫生学院和医学院新设立的用于开展全球健康项目的中心、研究所及倡议活动。目睹这一显著增长,健康领域教育工作者应反思当下为学生提供的培训与指导是否恰当,以及在未来十年及更长远的时间里是否依然适用。鉴于20年前“全球健康”在美国还并非一门学科,我们能预想20年后它会是什么样子,又该如何为那个未来做好准备呢?
如今,大多数临床医生和实习生都认识到,真正的双向伙伴关系和能力建设对于成功的国际合作至关重要。然而,在实际执行这些做法时存在挑战。世界各地都有正在践行这种理念并建立了公平伙伴关系的项目。基于我们对当前学术性全球健康领域的经验和观察,我们分享关于参与原则的观点,强调伙伴关系蓬勃发展的实例,以及作为全球共同体我们做得不足的地方。
随着世界超越全球健康的慈善模式(及其殖民根源),显然全球健康伦理实践的根本问题在于伙伴关系和对健康公平的追求。因此,在培养该领域的实习生时,实现全球健康教育和实践的公平,应成为我们作为教育工作者和顾问使命的核心。致力于消除任何根深蒂固的健康不平等现象,将揭示全球以及我们自己城镇中的不公正之处。