Global Health
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Research at the Earth Institute is organized into nine themes. Global Health is one of them.
Featured Projects and Centers:
Center for Global Health and Economic Development
Center for National Health and Development in Ethiopia
The International Advisory Panel (IAP) on the National Rural Health Mission (NRHM) of India
Global health is greatly affected by factors such as changes in global and regional climate, water resource quality, food growing capacity, and ecosystem health. Poor human health in turn affects the capacity of the global population to deal with environmental changes and adapt to them. Therefore, global health plays a central role in the Earth Institute’s work to understand the adverse effects of development and to find a path that leads to a sustainable future.
Center for Global Health and Economic Development
Based at the Earth Institute, the Center for Global Health and Economic Development (CGHED) addresses issues of global health. Through initiatives like the Access Project and the Millennium Villages Project, CGHED mobilizes global health programs that enable low resource countries to develop quality health systems for the poor, promote sustainable economic development, and achieve the Millennium Development Goals.
Access Project
Established in 2002 to assist countries with financing and implementation of projects supported by the The Global Fund, a group set up to finance a dramatic turnaround in the fight against AIDS, tuberculosis and malaria, the Access Project now focuses more broadly on improving the quality and accessibility of health care systems for the poor.
Millennium Villages
The Millennium Villages are a proof of concept project to substantiate that the Millennium Development Goals (MDGs) can be achieved by 2015 through the implementation of comprehensive, community-based, low-cost, integrated rural development strategies. Millennium Villages currently operate in over 10 countries and 12 geographic sites, with a total coverage of more than 78 villages and approximately 400,000 people.
Although extreme poverty and sustainable development must be addressed through multi-faceted, cross-disciplinary approaches, the most significant and complex piece of the development puzzle is –quite arguably– health. Health is not only a basic human right, but it is also a key precondition to economic development. The burden of disease in some low-income regions, especially sub-Saharan Africa, is a major challenge to economic growth and therefore must be addressed directly in any comprehensive development strategy. This burden includes severe under-nutrition and devastating diseases associated with extreme poverty, such as HIV/AIDS, malaria, neglected tropical diseases, and tuberculosis as well as non-communicable diseases like depression, cardiovascular disease, and diabetes.
To meet these health challenges in the Millennium Villages, the Earth Institute works in New York and on-site in the Millennium Villages to conduct research; to create models and design interventions for addressing and preventing disease; to analyze the impact of these interventions on the on public health and on the achievement of the MDGs; and to strengthen health systems in partnering countries.
The Earth Institute works to advise on the application of proven interventions as well as to use data collection and research to develop new tools for addressing public health in rural, low-income settings. Many keys to reducing the severe disease burden in sub-Saharan Africa are simple and inexpensive, including immunizations, the prevention of malaria, the management of intestinal worms, and the treatment of vitamin deficiencies. For example, malaria is responsible for the death of more than a million children a year in Africa. To combat this disease in the communities where the EI works, every household is provided with long lasting insecticide-treated bed nets to stop the spread of malaria. The results from this simple intervention have been dramatic. In the village of Sauri, Kenya malaria infections were reduced by 75% in 18 months and the number of visits to the health facility by Sauri residents for malaria dropped by about one third.
All interventions, even relatively simple ones like the distribution of bed-nets, are undertaken within the local context. The Millennium Villages work to respect the individual cultural sensitivities and societal structures. No two communities are the same, so these variables are always taken into consideration when developing interventions. Interventions are also applied through local outreach mechanisms and within local and national health systems.
Improvements in the treatment of disease and health services are limited unless they are effectively incorporated into the local and national health systems. Therefore, another key component to the project is its partnership with the local, district, and national governments to integrate the Millennium Villages work on the ground into the existing public health system. By working directly with governments, rather than around them, the Millennium Villages help to increase the capacity of national health systems. This relationship also allows for the “scaling up” of proven best practices –applying interventions that have demonstrated success within a small unit to a larger scale.
Center for National Health Development in Ethiopia
The Center for National Health Development in Ethiopia (CNHDE) is a project of the Earth Institute involved in supporting efforts for Ethiopia’s achievement of the Millennium Development Goals. CNHDE's activities in Ethiopia include assisting the implementation of the Health Extension Package, coordinating the Malaria Quick Impact Initiative for Africa, and coordinating the Millennium Villages Project.
A large part of CNHDE's work is to provide support for the Health Extension Program (HEP), an innovative program of Ethiopia’s Ministry of Health that works to achieve universal coverage of primary health care and control the spread of communicable diseases through community participation.
The International Advisory Panel (IAP) on the National Rural Health Mission (NRHM) of India
The National Rural Health Mission (NRHM) of India is a seven-year initiative, from 2005-2012, mandated to address pressing health challenges facing the rural areas of India by improving the availability of, and access to, quality health care, especially for the poor, women and children. Further, detailed information on the NRHM can be found at the National Rural Health Mission website.
The Center on Globalization and Sustainable Development (CGSD) of the Earth Institute at Columbia University, works closely with the top Indian leadership on the NRHM and issues related to the Mission. The Union Minister of Health & Family Welfare (MOHFW), H.E. Dr Anbumani Ramadoss, requested that the Earth Institute assemble an international group of experts on various aspects of the NRHM to provide broad advice on implementation of the NRHM. Through the support of the Bill and Melinda Gates Foundation, the International Advisory Panel meets with the Ministry in Delhi every six months to assist with the following areas:
- Strategies for improved governance, district-level planning, demand-side financing and public-private partnerships focusing on core reproductive, maternal, newborn and child health issues.
- Strategies for reducing infant mortality to 30/1,000 live births by 2012, and maternal mortality to 100/100,000 live births by 2012, and for strengthening inter-sectoral linkages in the areas of nutrition, sanitation and safe drinking water for substantially improved health outcomes for maternal, and newborn and child health issues.
- Strategies for improved health service delivery through the Accredited Social Health Activist (ASHA) for universal immunization, safe delivery, and newborn care, and the prevention of water-borne and other communicable diseases.
- Implementation of new training in public health with a view to recommend strategies to train and enhance capacity of the Panchayati Raj Institutions (PRIs) to own, control and manage public health services.
- Advising on public health challenges related to non-communicable diseases, such as adult-onset diabetes and obesity as rural health challenges, diagnosis and treatment of cancers in a rural setting, cardiovascular disease, diet and lifestyle as part of the rural epidemiological challenge, and mental health care in a rural setting.
The meetings with the MOHFW help to identify the highest priorities for the NRHM's implementation. The International Advisory Panel provides strategies to obtain the key objectives of the Mission, which is to provide effective healthcare to rural populations in India.
Reducing Arsenic Exposure in Bangladesh
The UN has called it the single worst case of mass poisoning in human history. Others have called it a tragedy of good intentions. Regardless of one's perspective, it is a problem with no easy answers. In Bangladesh, more than 30 million people are at risk of a wide range of health effects associated with arsenicosis, or chronic arsenic poisoning.
A team of researchers from Columbia University composed of public health experts, geologists, sociologists and engineers is working to better understand the human health implications of arsenicosis as well as the geology and geochemical processes behind the arsenic contamination. Their aim is to devise inexpensive ways to give people more reliable access to clean, arsenic-free water.
Read more on reducing arsenic exposure in Bangladesh.
The Global Network for Neglected Tropical Diseases
The Earth Institute is a founding member and key partner of the Global Network for Neglected Tropical Diseases. The Global Network is a partnership formed in 2006 to raise the profile of neglected diseases and to stimulate a paradigm shift in disease control efforts. The major public-private partnerships devoted to the control of individual diseases have agreed to work together in collaboration with the World Health Organization (WHO) to design an integrated drug administration platform that addresses seven of the neglected tropical diseases - trachoma (eye infections), soil-transmitted helminths (hookworm, ascariasis, trichuriasis), onchocerciasis (river blindness), schistosomiasis (snail fever) and lymphatic filariasis (elephantiasis).
To learn more, visit the Global Network website.