Director of Center for Global Health visits CDC-Zambia

Dr. Kevin De Cock, Director of the Center for Global Health at the U.S. Centers for Disease Control and Prevention (CDC), is visiting CDC’s Zambia office and meeting with CDC’s partners in Zambia from October 31 through November 2, 2011.

As a partner with the Government of the Republic of Zambia in its fight against HIV/AIDS since 2000 and as a key implementing agency of the President’s Emergency Plan for AIDS Relief (PEPFAR) since 2003, CDC maintains a strong presence in Zambia, providing technical leadership to the Ministry of Health to strengthen epidemiology, surveillance, laboratory, and workforce capacity--essential components for strong, sustainable public health systems.  CDC also supports international universities providing technical assistance to the University of Zambia and the University Teaching Hospital to improve and increase academic and clinical training programs.

During his visit, Dr. De Cock presented “Global Health 2012” at the Public Health Grand Rounds at the University Teaching Hospital in Lusaka, Zambia.  Targeted toward physicians, nurses, epidemiologists, health education specialists, laboratorians, and others, the Public Health Grand Rounds are monthly presentations created to foster discussion on major public health issues.  

Dr. De Cock’s presentation covered how the field of global health has evolved from a focus on tropical medicine in the 20th century to addressing a variety of global health challenges facing the world in the 21st century.  Dr. De Cock described multiple variables that are shaping global health now and in the future: fertility rates; migration; urbanization; trade, including commercialization and distribution of food, drugs and commodities; spread of medical technology; diffusion of cultural practices and behaviors; scarcity of natural resources; and environmental and climate change.

According to Dr. De Cock these changes mean that all countries, at all income levels are affected by global health threats. In this context, he recognized the principles of the U.S. Global Health Initiative (GHI)--including country ownership, sustainability, and collaboration--as important components of successful approaches to current and future global health challenges.  Dr. De Cock described equity, social justice and rights as the ethical foundation of effective global health work in the 21st century.

Dr. De Cock highlighted the combined challenges of infectious disease and the emerging global growth of non-communicable diseases as presenting unprecedented need for collaboration and coordination of global health approaches and resources.  With fertility rates disproportionately high in sub-Saharan Africa, certain African countries will continue to demand international attention and resources, especially those plagued by conflict. HIV/AIDS, malaria, and global tuberculosis (TB) continue to cause millions of preventable deaths each year.  Simultaneously, in almost all areas of the world, the numbers of deaths among adults between the ages of 15-64 are outpacing the number of deaths among children.  This change is reflected in recent data showing cardiovascular disease and other non-communicable diseases as the leading causes of death around the world.

As Dr. De Cock directed his remarks specifically to challenges of reducing cases of HIV/AIDS in Africa, he highlighted the significant gains achieved through PEPFAR.  He reviewed recent findings of clinical studies on medical male circumcision and antiretroviral therapy (ART) for prevention that provide a strong evidence base for the potential scale up of both these interventions.  ART for prevention is one component of a multi-pronged approach to reducing HIV infections.  The approach includes a combination of expanded HIV counseling and testing, linkages to care, initiation of ART, prevention with people living with HIV, prevention of mother-to-child transmission (PMTCT), medical male circumcision, services targeting most-at- risk populations, and blood safety.

Dr. De Cock ended his presentation by countering common misconceptions about global health:

• Misconception 1: Global health work you do outside of your own country has little or no benefit to your country.
• Misconception 2: Global health problems spread from Southern hemisphere to Northern hemisphere countries.
• Misconception 3: Global health solutions are transferred from the North to the South.
• Misconception 4: Communicable diseases afflict only the poor, and non-communicable diseases afflict only the rich. 

Correcting these errors, Dr. De Cock emphasized that changes in demographics, trade, and travel mean that all nations must have an investment in and self-interest related to effective global health solutions.

Dr. De Cock’s remarks were drawn from recent articles he has authored or co-authored in the Morbidity and Mortality Weekly Report, October 7, 2011 (see Trends in Global Health) and in Emerging Infectious Diseases, June 2011 (see Reflections on 30 Years of AIDS).

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