Moving from global heath 3.0 to global health 4.0 / Richard Smith

Global health 1.0 was called tropical medicine and was primarily concerned with keeping white men alive in the tropics. Global health 2.0 was called international health and comprised clever people in rich countries doing something to help people in poor countries. It had Cold War overtones. Global health 3.0, which is still the main manifestation of global health, is about researchers from rich countries leading research programmes in poor countries. But global health 4.0, increasingly the present and certainly the future, is research and other activities being led by researchers from low and middle income countries. 

 The 11 UnitedHealth/National Heart, Lung, and Blood Institute (NHLBI) centres are an example of global health 4.0 in that all the centres are led by researchers from low and middle income countries and work on programmes directly relevant to the problems in the countries. Dorairaj Prabhakaran, who is the leader of the New Delhi centre and chair of the committee of the leaders of the centres, told last week’s meeting at the Royal Society about the four phases of global health. 

 As Prabhakaran made clear, the concept came from Peter Piot, who is now the director of the London School of Hygiene and Tropical Medicine. Piot identified other differences between global health 3.0 and 4.0. Global health 3.0 is conducted mostly in sites and is largely biomedical and concerned mostly with infectious disease. In contrast, global health 4.0 is conducted in multidisciplinary centres and covers broader health issues, including NCD and disparities. Global health 3.0 uses predominantly the methods of epidemiology, including clinical trials, while 4.0 employs a much wider spectrum of methods through from discovery to implementation science. (Más)

Richard Smith was the editor of the BMJ until 2004 and is director of the United Health Group’s chronic disease initiative.