Great global health disparities call for worldwide university commitment to build effective partnerships to narrow this gap. The University of British Columbia (UBC) commits to solidify and scale up its existing partnerships with the University of Andina Simon Bolivar (UASB), and the University of Free State (UFS), and to harness the enthusiasm being expressed by students, faculty and alumni to make socially responsible contributions to global health. We will seek to build strong interdisciplinary and respectful community-university partnerships in research, teaching, and service that take into account the full array of social, political, legal, economic, cultural, health system, and environmental contextual factors affecting pressing issues in global health. We will collaborate to develop, implement, and evaluate the impact of attention to 'social offsets*,' which are needed to address global health challenges. The aim is to build mutual capacity to ensure that global health activities are established and maintained in socially responsible ways, and governed by the highest ethical standards.
It is increasingly realized that technological innovation and new biomedical discoveries are falling short of obtaining the impact desired. Universities have an opportunity to support the inspiring expression of commitment to global health from students, faculty, and alumni by using its position to reinforce strong interdisciplinary community-university partnerships to ensure that not only will biomedical discoveries continue, but that their impact will be realized. This commitment must extend from ensuring that new biomedical discoveries target need to ascertaining, evaluating, and promoting measures that solve the 'Know-Do' Gap so that the already well-established evidence-based innovations can be effectively applied to identified health problems.
UBC-Centre for International (UBC-CIH) Health researchers are currently exploring the possibility of promoting the concept of 'social offsets' when new biomedical innovations are introduced: A social offset is an investment that can be made to offset the negative social impact of an innovation in order to facilitate more equitable distribution of benefits and costs associated with change. Just as a carbon offset mitigates impact on climate change of an energy-intensive activity, a social offset will mitigate the negative social/ethical impacts of new technology and new drugs. Our vision is to introduce a process to comprehensively assess the social impact of technological innovation, and promote the development and implementation of an offset system that mitigates impacts of an innovation that may otherwise increase health disparity. New essential medicines, for example, can be of great health benefit and lead to cure of disease. Unfortunately, the benefits of such medications are often distributed very unevenly - and opportunity costs may mean equitable prevention-oriented interventions are foregone. In fact, sometimes health disparities are actually exacerbated by technological innovation, for example, when healthcare staff reductions have to occur to pay for new and expensive technologies and medicines. These healthcare staff reductions may occur in highly vulnerable areas and lead to greater health disparity. When a social offset is purchased, the distributor of the health innovation may, for example, contribute to improving working conditions for healthcare staff, to avoid demoralization and assist in staff retention despite the downsizing. The goal of this approach is to engage citizens to become part of the solution by funding innovative creative solutions to mitigate the negative social impact of innovations. Local expertise is engaged to develop and evaluate social offset proposals, ensuring both community involvement in and community appropriateness of the offsets chosen, and a broad-based alliance for positive change can be built.
UBC has a strong record in fostering community-university partnerships locally and abroad, and addressing the broad cross-disciplinary factors that lead to successful health outcomes. UBC-CIH and UASB have signed a MOU to foster academic and research cooperation based on principles of mutual equality and reciprocity of benefits focusing on health, society, and the environment; and UBC-CIH and Free State have signed agreements to undertake a program of research and capacity building for health workers.
The UBC Chapter of Universities Allied for Essential Medicines (UAEM) has identified two specific goals: first, that universities ensure that drugs and other medical technologies they developed be made accessible in poor countries; second, UAEM seeks to facilitate and promote research and development for diseases affecting the poor.
Given the strength at UBC in respectful north-south university-community partnerships, UBC is prepared to play a leadership role in these areas.
UBC will fortify relationships with the University of Andina Simon Bolivar, and the University of Free State, to harness the enthusiasm being expressed by students, faculty, and alumni to make socially responsible contributions to global health. UBC will support its Centre for International Health (CIH) including service-learning activities by student-led groups such as the UBC Global Health Initiative and the UBC chapter of Universities Allied for Essential Medicines (UAEM) to facilitate the following actions over the next five years:
1) Organize a series of global health symposiums, in collaboration with partner universities, to establish ethical standards and socially responsible means for international engagement in global health. The aim of this cross-disciplinary activity is to promote sustaining innovations to address global health challenges, including the promotion of social offsets.
2) Strengthen our partnership relationships for global health activities ranging from clinical initiatives to international service-learning and community-based action research (led by CIH). This will be established through systematic engagement of university partners in Asia, Africa, and Latin America. We will also develop and promote mechanisms for funding health research, in collaboration with our partners, with proper attention to equity.
The UBC chapter of UAEM is initiating the development of an international network of universities and university-based researchers and students working on medical interventions for neglected diseases. This network would raise funds for research focused on neglected diseases and arrange matched funding from global-health focused institutions, create fundraising sources for neglected disease research, coordinate efforts of university-based researchers, and attract new researchers to the field of neglected disease research. This project would help investigate the feasibility of establishing such a network.
3) Promote partnered undertakings to create new approaches to licensing and developing medical technologies, and working to promote their adoption, so that access to these breakthroughs will be made readily available to those in need, especially by eliminating legal barriers to generic provision in poor countries, and requiring at-cost access in cases where generic provision is infeasible. With the support of the CIH through this project, the UBC chapter of UAEM will lead an effort to establish such approaches in a systematic, transparent, and measurable way, at universities throughout Canada and elsewhere.
UBC has a senate-approved Centre for International Health, which provides modest stipends for a director and associate director, but it lacks infrastructure funding support. This UBC commitment represents a new commitment to enable CIH to establish dedicated infrastructure to accomplish the CGI_U activities committed to in this proposal, and to promote socially responsible approaches to global health activities on campus. The commitment will complement UBC's recent investment in establishing a senior Canada Research Chair in Global Health and Capacity-Building.
- June 2009-~December 2009:
Solidify staff support and plan the Global Health symposium to launch the 'social offsets' discussion;
Begin grant proposals for specific community-university partnership engagement in South Africa, East AFrica and the Andean Region; and
Prepare policy discussion papers re a) new paradigms for licensing and developing health technologies to improve acces by those in need and b) considering, implementing and evaluating 'social offsets'.
- CIH Faculty teach at UASB.
- CIH Faculty continue research, capacity building and service in Free State.
- January 2010- March 2010:
- Hold the Global Health symposium.
- Finalize detailed community-university health studies planned witrh partners and submit grant proposals.
- Revise policy paper based on discussions at the symposium and set out an implementation plan.
- April 2010 -September 2010: Complete Five-year plan in collobaration with partners and funders.
- October 2010-Onward: As per 5-year business plan developed.
- Number of students actively engaged in global health efforts in collaboration with students from partner institutions: 200.
- Number of faculty conducting mutual capacity building activities: 50.
- Number of community-based projects undertaken: 20.
- Number of new agreements signed using new paradigms developed (e.g .re licensing, social offsets, etc.): 5.
- Collaborative presentations/articles/chapters/monographs published: 12.
- Number of communities to show documented benefits: 6.
SEEKING: Financial Contribution - $950,000. UBC has estimated the overall cost of the inititaives they wish to undertake at approximately $2 million over five years, and have rasied approximately half of this. These funds are needed to hire a staff person at CIH to coordinate these activities ($50,000 per year for 5 years), in addition to $100,000 to heelp support travel expenses for the student placements and faculty interactions, and $40,000 annually for the global health symposia, and the partner workshops.
OFFERING: In-Kind Goods - >$5,000,000. UBC is offering a variety of teaching materials (hard copy and on-line resources), research instruments for community-based health projects, and a health information system for the healthcare sector in South Africa - to facilitate research as well as improve the healthcare environment.
-In-Kind Services: >$1,000,000. Faculty and staff time funded from other sources at UBC.