“Lo que elegimos hoy determina nuestro futuro. Está en nuestras manos vivir mejor o vivir en salud” MF Guiñazú
An important paradigm shift is taking place in the world according to the World Economic Forum. The core of the new paradigm is stablishing between tree main issues: (i) the Fourth Industrial (Digital) Revolution, (ii) the Renewable energies, and (iii) the Global Health (1).
The World Health Organization (WHO) defined Global Health as ‘a set of universal values and principles shared by all the cultures. Global health comes from public health and international health. International health is a branch of public health focusing on developing nations and foreign aid by industrialized countries. Global health is the area of study, research, and practice that places a priority on improving and achieving equity in health (including mental health) for all people worldwide (2) y (3).
Recently, a new platform named One Health Initiative broad Global Health definition by considering the reduction of disparities, or a global political and economic impact and protection against global threats, disregarding national borders (4).
1 ONE WORLD ONE MEDICINE ONE HEALTH
The One Health Concept, comes from One Health Initiative, is a worldwide strategy for expanding interdisciplinary collaborations and communications in all aspects of health care for humans, animals, and the environment. The synergism achieved will advance health care for the 21st by accelerating biomedical research discoveries, enhancing public health efficacy, expeditiously expanding the scientific knowledge base, improving medical education, and clinical care. It will help protect and save untold millions of lives under the idea One World One Medicine One Health (5) .
1.1 From One Medicine to One Health
The concept of One Medicine has been introduced to the 19th century by the German physician and pathologist, Rudolf Virchow. His discoveries on Trichinella spiralis in pork led to valuable public health measures. Virchow, coined the term “zoonosis” and proclaimed that there should be no division between human and animal medicine. In 1947, James Steele, founded the Veterinary Public Health division at the Communicable Diseases Center (6). Almost 20 years later, Calvin Schwalbe made major advances in the field of public health conceived the term One Medicine and he strongly advocated for collaboration between professionals in human and veterinary public health to address zoonotic disease concerns.
The One Medicine term has evolved into One Health, placing emphasis on health promotion rather than treating diseases. A further evolution recognizes that environmental factors need to be included in consideration of human and animal health and that the inter-relationships among humans, animals, and the environment are critical to health. In recent years One Health has gathered momentum.
1.2 One Health Initiative
The One Health Initiative, founded in 2006, is doing an outstanding job of promoting One Health through education and advocacy around the world. The goal of this initiative is to promote application of a cross-sectoral, multidisciplinary approach to mitigate existing or potential risks to health that arise from the interactions of humans, animals and the environment (7). Recent outbreaks of zoonotic diseases such as SARS and Ebola virus infection, as well as the threat of pandemic influenza, highlight the significance of One Health (8). We can also do more at a national level to strengthen the capacity of the veterinary profession to provide leadership in public policy (9).
1.3 The One Health Mission
The Mission is “Recognizing that human health, animal health, and ecosystem health are inextricably linked, One Health seeks to promote, improve, and defend the health and well-being of all species by enhancing cooperation and collaboration between physicians, veterinarians, other scientific health and environmental professionals, and by promoting strengths in leadership and management to achieve these goals” (7).
One Health will be achieved through:
- Joint educational efforts between human medical, veterinary medical schools, and schools of public health and the environment.
- Joint communication efforts in journals, at conferences, and via allied health networks.
- Joint efforts in clinical care through the assessment, treatment and prevention of cross-species disease transmission.
- Joint cross-species disease surveillance and control efforts in public health.
- Joint efforts in better understanding of cross-species disease transmission through comparative medicine and environmental research.
- Joint efforts in the development and evaluation of new diagnostic methods, medicines and vaccines for the prevention and control of diseases across species.
- Joint efforts to inform and educate political leaders and the public sector through accurate media publications.
2 GLOBAL HEALTH STRATEGY
Global health strategy seeks to anticipate and combat global health risks and disease threats, as well as financing and mapping a global health architecture. There is a growing need for improved health surveillance and global health systems as current public health infrastructure is inadequate to tackle emerging challenges in the Post-Millennium Development Goals era. We have to consider (10):
- Infectious disease outbreaks: Monitoring and mitigating the impact on travel tourism.
- From security to risk: Reframing Global health Global health security projects also cover antibiotics and anti-microbial resistance, surveillance, biosecurity, and health system reconstruction in post-conflict states (11).
- The role of the private sector in global health security (12)
- Reducing poverty: the case for Universal Health Care (13).
- The political economy of Universal Health Coverage (14).
- The future of global health (15).
- Developing Indicators to Monitor Progress toward Implementation.
2.1 How can the world deliver affordable and quality healthcare for nearly 10 billion people by 2050?
The world will be home to nearly 9.7 billion people by 2050, putting unprecedented stress on healthcare resources. The System Initiative on Shaping the Future of Health and Healthcare aims to ensure that people are healthier and can access the care that they need to fulfil their potential. It is putting individuals at the center of the health and healthcare system
Among the important topics:
- Precision medicine.
- Global health
- Primary care coalition.
- Global healthcare.
- Dialogue series on Non-Communicable Diseases (NCDs).
- Healthy city partnership.
- Technological Innovations for Health and Wealth for an Ageing Global Population. Include “the health span concept”.
3 MEASURES AND BIG DATA
Measures of global health include: disability-adjusted life year (DALY), quality-adjusted life years (QALYs), and mortality rate. Also, morbidity include incidence rate, prevalence, and cumulative incidence. Besides, digital disease detection (DDD), measuring Better Life Index and Well–Being and Progress (OECD 2011) (17).
The ability to share health and care records digitally is essential to offering better, more coordinated care for not only local populations if not for cities or countries. However, delivering key benefits requires the appropriate technology, the right governance structure, and a culture of adoption.
In order to accomplish this, we have to:
- Learn about the direction of national programs on interoperability and data sharing across and between local areas (for Chile, see 18).
- Hear from case studies from around a country where teams have developed ways to share health and care records locally.
- Discuss the challenges involved in implementing data sharing across and between local areas and learn how others have overcome them (19).
4 AGENCYS ASSOCIATED WITH HEALTH
The predominant agency associated with global and international health is the WHO (16). Other important agencies impacting Global health include UNICEF, World Food Program and the World Bank China has also played a part with declaration of the Millennium Development Goals and the more recent Sustainable Development Goals.
- Koplan et al 2009 Towards a common definition of global health, The Lancelet 373(9679): 1993–1995.
- Macfarlane et al 2008 In the name of global health: trends in academic institutions. J Public Health Policy 9(4), 383-401.
- Global health Initiative, 2008.
- Nielsen et al2012 Whither ecosystem health and ecological medicine in veterinary medicine and education, Can Vet J. 53(7): 747–753.
- Nielsen et al2014 Public policy and veterinary medicine, Can Vet J. 55(4): 389–390.
- Centro Nacional de Sistemas de Informacion en Salud CENS, cens.cl
- Puyvelde et al 2017 Beyond the buzzword: big data and national security decision-making, International Affairs, 93(6), 1397-1416.