Sunday, May 13, 2012

Global Health Diplomacy

The Man
: Scott Ratzan, MD Vice President, Global Health, Government Affairs & Policy for Johnson & Johnson

The Talk: Working Together on Health Literacy, Diplomacy and Innovative Health Communication to Advance Women’s Health

The Question: Health affairs as foreign affairs: how can we create a healthier world for women and girls? 

After hearing Dr. Ratzan at Davos, Harvard Kennedy School Academic Dean, Iris Bohnet, invited him to speak on campus -- I can see why. Ratzan spoke on achieving the MDG goals, using evidence to increase universal access to healthcare, incorporating technology into health education, and using health as a tool for foreign affairs. Not bad for a 60 minute presentation. 

Health as a common currency

Dr. Ratzan specifically focused on women and girls. He believes -- along with many others -- that if women and girls are given access to basic healthcare services, coupled with girls’ education, we can change the fabric of global inequalities. His position? Because health permeates all levels of society, altering this part of the equation affects all other variables. “Health is the common currency if what we’re trying to pursue is happiness,” says Dr. Ratzan. 

Much of what Dr. Ratzan discussed focused on achieving the MDG goals three and five: (3) Reducing child mortality, and (5) Improving maternal health. The highest rates of infant and maternal mortality are regional, but mainly clustered in six countries: India, Nigeria, Pakistan, Ethiopia, the Democratic Republic of Congo, and China. While some progress has been made in decreasing the under five mortality rate, attaining universal access to reproductive health would dramatically impact our ability to achieve these goals. “Short-term campaigns really don’t make the difference; you really need policy change. You need to have the advocacy for women and women in public policy to solve these problems.”

The catch-22, Dr. Ratzan says, is that, “Governments and people don’t want to invest unless they have evidence; but how do you have evidence unless you have investment?” He cited a well-known statistic that between 30 to 50 percent of Asia’s economic growth from 1965 to 1990 can be attributed to maternity and reproductive health programs; yet, we still find reasons to limit investment. 

Global health diplomacy: what is it? 

The WHO defines global health diplomacy as diplomacy that, “…brings together the disciplines of public health, international affairs, management, law and economics and focuses on negotiations that shape and manage the global policy environment for health. The relationship between health, foreign policy and trade is at the cutting edge of global health diplomacy.” 

Ratzan says it’s embedded in everything; from the U.S. Department of State to the Gates Foundation to the ivory towers of academia to the private sector, global health diplomacy engages all areas. While setting a global goal is important, getting there is much different. To bring these goals from ideas to practice, we need innovation. 

Mobile Technology

In April of this year, the New York Times ran a story about a woman in Nigeria who gave birth in an area without running water or electricity. What made this story so unusual? Cell phones lit the birth. In places where clean water is almost inaccessible, cell phone have deeper penetration. Dr. Ratzan called this the potential of mobile health. He then discussed a program called “Text4Baby” in a country with the following statistics:
  • Annually, 500,000 babies are born prematurely
  • Each year 28,000 die before their first birthday
  • 89% of women between the ages of 18 - 49 have a mobile phone
What country is this? The United States of America. 

Text4Baby, founded by Johnson and Johnson, became a direct texting service out of this information. Although many factors influence these numbers -- access to health care, low income, poor health behaviors -- their research found that increasing knowledge around health, coupled with simple text reminders, could help mothers and children stay healthier. The program partnered with state and local government, along with cell phone carriers, to reach the lowest income mothers based on zip code. They plan to bring a service similar to this to Bangladesh and South Africa shortly. 

In closing

Personally, my favorite part of Ratzan’s presentation was the passion and conviction with which he spoke. Often cynicism and failure undermine our energies and ambitions, but Dr. Ratzan had a compassionate charisma that left the room feeling empowered. In essence, he brought it back to simple ways to achieve global health by utilizing existing technologies and innovative approaches. And all of this in the name of happiness.  

Melissa Sandgren is a MPP1 at the Harvard Kennedy School and a participant in WAPPP's From Harvard Square to the Oval Office program.

*Photo courtesy of

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