NewPublicHealth Q&A: Jennifer Kates, Kaiser Family Foundation
This week the United Nations General Assembly will be holding a high-level summit during its annual meeting on chronic, or non-communicable, diseases. The conference conveners hope to bring attention to the global problem of diseases such as cancer, diabetes and cardiovascular diseases and agree on a plan of action to address them.
While the U.S. already has domestic action plans underway on both the prevention and treatment of these diseases, Jennifer Kates, Vice President and Director for Global Health and AIDS policy at the Kaiser Family Foundation, says U.S. public health officials have a great deal to both share with, and learn from, the global health community. Kates spoke about these learning opportunities with the Robert Wood Johnson Foundation last year in a conversation about the White House Global Health initiative, a commitment of $63 billion, that runs through 2014.
NewPublicHealth: There are some distinct issues globally when it comes to health and then there are some that dovetail issues and problems in the United States. What are some of those that are similar?
Jennifer Kates: That’s a good question. If you think about today’s world – people, animals, insects, birds, ideas, innovations, technologies increasingly recognize no borders. So the idea that there’s a domestic public health problem and a global public health problem increasingly doesn’t make sense.
Now there are some distinct differences. The United States economically is doing much better than developing countries, and we know that the economy is linked to health, clearly, but there are a lot of lessons to be learned. For example, if you think about the developing world, a lot of the models that have had to be developed are in hard-to-reach areas with hard-to-reach populations. That’s actually where we’ve done the worst in our country in public health, reaching hard-to-reach populations, dealing with the issues of poverty, dealing with the complicated but important family and community structures in hard-to-reach places. So we have a lot we can learn and some of the same diseases and challenges exist all over the world.
NPH: Such as which?
Jennifer Kates: Well, there’s increasing attention to a set of diseases called neglected tropical diseases or neglected infections. We think of those in Africa and other parts of the world. They’re infections that affect a large number of people. There are many that can be cured or treated at a relatively low cost, but they just haven’t gotten attention. And some of those same infections and diseases affect people in the United States, on the borders of our country, people that are living in poverty. And in some cases there are low cost solutions, but we just haven’t paid attention to them. We can learn from the increasing attention globally.
Secondly, HIV is still a problem in the United States, and one of the things that we’re starting to do in the United States is paying more attention to what’s happening globally. Every country has been asked by the UN to develop a national plan, a national strategy for combating its HIV epidemic. We don’t have one in the United States, that’s being developed now.
The other way that I think we can learn from the broader approach is if you look at the global health initiative, there are some core principles—a women-and girl-centered approach, strengthening and leveraging partners, improving monitoring and evaluation. These are all the kinds of principles that in the United States public health system we also aspire to.
NPH: The number of students and graduate programs focused on global health has just skyrocketed in the last few years. Why is that?
Jennifer Kates: I think it’s a combination of the idea that they want to make a difference in the world and they see see us as living in a global environment. These days somebody studying any discipline in the United States see the global world as the framework. They want to make a difference. And they want to be able to bring the strengths of what they learn here, but also learn from their counterparts.
NPH: Is there room for both? Are we neglecting the U.S at schools of public health now, or can we bring those two things together?
Jennifer Kates: I hope we can bring them together. I don’t want this one to displace the other, that should not happen, but I do think in general there’s been more recent attention to the public health system and infrastructure in the United States, but there’s a lot we can learn by the focus on the global health initiative. Diseases and germs and people are fluid, our lessons learned and focus should be fluid too.
NPH: What are best ways to bring public health officials from the U.S. and from the global community together?
Jennifer Kates: I think the universities are a good place, as well as forums. And, significantly, a number of the experts in the US government and elsewhere have worked in both settings, have gone to work at global institutions like WHO and the Global Fund and then come back and worked at CDC or in US public health or in a city. So it’s happening, but I’m not sure that information is being shared.