Delivering global health

In recent years interest in medical practice in poor settings has grown considerably.1 This growth has been fuelled by recognition of health disparities between poor and rich countries and the allocation of new money for global health. Between 1999 and 2005 $40.6bn (£20.7bn; €26.6bn) in new funding was committed to global health.2

Medical schools and junior doctors' programmes have responded by establishing clinical rotations in poor settings.3 Although experience in poor settings is important to educate students about global health, the challenges of providing health care in poor settings require practitioners to learn to think systematically about the delivery of health care. Doctors need to be trained to consider the strategic, organisational, and structural problems involved in delivery of care. The global health practitioner must at once be an astute clinician and an effective manager.

Doctors who work in global health need training in what we have called “global health delivery science,” a new discipline that will combine the study of clinical practice with the managerial skills necessary to effectively deliver care in poor settings. Along with clinical training in situ and laboratory experience, doctors need to learn how to tackle real problems in delivering health care in developing countries. Learning through the study of rich, real life case studies will be central to training in global health delivery science.