A Healthy Dose of Skepticism

Global health is big business in Seattle—which means it may be in danger of forgetting the billions of people it set out to help.

By Tom Paulson

Gloyd arrived in Mozambique in 1979, one year into a civil war fueled, with U.S. support, by two neighboring regimes, white-ruled Rhodesia (today’s Zimbabwe) and apartheid South Africa. He witnessed the war’s toll firsthand—massacres, the bombing of cities, an estimated 900,000 people killed. “It was a life—changing experience for me.”

Upon his return, Gloyd started the -Mozambique Health Committee, now Health Alliance International, a Seattle-based nonprofit with more than 1,000 employees working to improve care systems in -Mozambique, East Timor, Côte d’Ivoire, and Sudan. He and his wife, the Côte d’Ivoire–born public health lawyer Ahoua Koné, have continued working in Mozambique and other poor countries for more than two decades. He recently became associate chair of the University of Washington’s new global health department.

PATH has received about $1 billion from Gates to develop health solutions for the developing world.

Gloyd finds it encouraging that global health attracts so many more resources today, but he worries when he hears it characterized as an emerging industry and a boon to this region. “This isn’t supposed to be about us,” he says. “For me, global health is about making sure everyone everywhere has the same opportunity to be healthy.” And he sees that focus getting lost in the rush to cash in.

Bill Foege, the physician credited with devising the strategy that rid the world of smallpox, shares some of Gloyd’s concern about losing focus. Nevertheless, he says, “I’m not too worried about people referring to global health as an industry.” After decades of wishing the rich world would pay attention, using any lingo at all, to the health needs of the developing world, he’s happy to see the “industry” stimulating so much excitement and interest.

“We do need to get the vision right and not lose sight of the real objective,” says Foege. But as he points out, the fact that some of the world’s richest people have made global health their personal cause (and made Seattle the base for this altruistic enterprise) has already changed the world for the better. Thanks in large part to the Gates Foundation, Foege notes, other long-neglected ills of the developing world—malaria, tuberculosis, vaccine—preventable childhood diseases—have come to the fore.

Diseases such as AIDS, SARS, West Nile virus, and the so-called swine flu remind us that health has indeed become global. “These diseases tie the fears of the rich world to the needs of the poor,” says Foege. When the world comes together to fight them, everyone benefits. “But I agree with Steve that we do need to work to stay on track. Or else we will instead just tie the needs of the rich to the fears of the poor.”

Gloyd, upon reflection, thinks all the “industry” hype may actually help the global health cause stay on track. “Maybe it’s okay to call it an industry,” he muses. “Maybe using the word will shock people into recognizing that when a local biotech firm says it is working on a vaccine to help people in Africa, some will see it is actually just trying to make a few people in Seattle rich.” And, he hopes, we will be able to distinguish between serving the needy and serving ourselves.