Care of vulnerable populations constitutes a sizeable proportion of those in need of medical resources, and there exists considerable disparity between those who can, and can’t afford access to medical services. Although these issues have always existed, concerns over global health and health inequities have been emphasized over recent years. For instance, few will forget the devastation caused by Hurricane Sandy in November 2012, where much of the focus was on the U.S., despite the fact that the devastation caused by the hurricane was far more severe in Haiti. As a country that is much more restricted in terms of resources, the impact on livelihood and medical facilities was far greater to the residents of this area.
Many researchers and physicians from a wide variety of disciplines are engaged in bringing awareness to, and improving global health, which is an area of medicine that ‘places a priority on improving health and achieving equity in health of all people worldwide’. This growing interest in also apparent from the Global Burden of Disease study (GBD 2010), which published a series of articles exploring the worldwide distribution of disease using global data from the past decade,with an aim to better understand the health priorities for the global community.
In light of this hugely important area of medicine and research, BMC Medicine has launched the Medicine for Global Health article collection, with guest editors Gretchen Birbeck and Raymond Hutubessy. This collection aims to explore public health initiatives, health care policies, health economics, and research into the control and treatment of communicable and non-communicable diseases that have implications for global health.
Gretchen Birbeck launches our article collection with an editorial, discussing the increasing relevance of medicine in resource-limited settings, highlighting that simple interventions may help to lessen the global burden of disease. Gretchen, who is based in southern Africa for half of the year, has first-hand experience of managing epilepsy in resource-limited settings, and in an interview, she talks about her personal experiences in this area.
You can also listen to Lin Lee’s interview with Gretchen Birbeck in this podcast:
Raymond Hutubessy, based at the World Health Organization (WHO), is a health economist who specializes in economic analyses underlying decisions on whether or not to introduce vaccines against, for example, Human papillomavirus (HPV). In his Q&A for the launch of the article collection, he discusses why this is of particular importance in resource-limited settings.
Ethical issues associated with global health research are discussed by James Giordano in an interview. He highlights that low- and middle- income countries are often the ones in most need of modern medical care, yet there exists an asymmetry in terms of research needs and research funds.
You can also listen to Sabina Alam’s interview with James Giordano in this podcast:
Often, the main concern is whether or not the intervention or research required is sustainable in the host country. This subject is touched upon in a bibliometric analysis by Charles Wiysonge and colleagues. They find that since the onset of the Expanded Program on Immunization, vaccine research productivity in Africa has skewed towards those funded by private means, with researchers from Africa having less research input, suggesting a need for better communication between all stakeholders.
The article collection also includes a research paper by Kathryn Maitland et al., who previously published extremely surprising results from the Fluid Expansion as Supportive Therapy (FEAST) study. Here, African children with severe febrile illnesses given the intervention of rapid fluid bolus exhibited excess mortality compared with controls – the opposite result to what was expected. In a secondary analysis of this data published in BMC Medicine, the authors explored the mechanisms behind the excess mortality, finding that it was due to cardiovascular collapse rather than fluid overload. Clarifying the mechanisms behind death in this population of patients has implications for fluid resuscitation practices in other populations of critically ill patients, an issue that is further emphasized in a linked commentary by John Myburgh and Simon Finfer.
It is hoped that the Medicine for Global Health article collection will highlight and ultimately help to resolve some of the medical concerns affecting global health. Articles offering novel insights into public health initiatives, health care policies, economics, and research into the control and treatment of communicable and non-communicable diseases that have implications for global health are invited to be submitted to BMC Medicine as part of this article collection.