Someone recently asked me the following question: “Ten to 20 years from now, what would you consider absurd?” Examples included smoking on planes, not recycling, and women not being able to vote. My response was immediate, “Inequity.”
It instinctually rolled off my tongue, perhaps because addressing its public health manifestations in the developing world has become my life’s work. Over six million children under the age of five will die this year. The majority of these deaths are due to conditions that could be prevented or treated with access to simple, affordable, existing solutions. Childhood trips to India, where I witnessed the impacts of poverty on children my own age, had a profound effect on the way I saw and thought about the world. As a Canadian (and a human being more generally), it instilled a sense of responsibility in me. It wasn’t until years later that I was introduced to the practice and profession of public health at the University of Waterloo. After entering the health studies program, I quickly became enthralled with social and behavioral sciences, epidemiology, and nutrition. I hate to admit it, but I even found biostatistics interesting.
The idea of being able to improve the health of thousands or millions of people at a time excited me — particularly when it came to issues of equity and human justice. I was exposed to a holistic way of thinking about the human experience, and encouraged to apply this “systems-thinking” to real world problems. I had found my calling.
As a practitioner of global health, I have had the opportunity to work in developing countries around the world. While I’ve witnessed tremendous progress in the health and development sector, the rate of improvement leaves much to be celebrated. The 4th Millennium Development Goal (MDG 4) aims to reduce the 1990 mortality rate among children under five by two thirds. If current trends were to continue, the world would not meet the MDG 4 target until 2028. An additional 35 million children would die.
While progress and advances in other areas of science and technology are developing at a rate the world has never seen before, the rate of progress in evolving people’s health, and improving basic quality of life, simply has not kept pace. Clearly, the status quo isn’t cutting it. There is a clear need for new and innovative approaches involving transdisciplinary and cross-sector partnerships.
I am dumbfounded, for example, by the fact that we can put robots on Mars, yet we can’t get simple medicines to the people that need them the most. ORS and Zinc are two examples of cheap, effective medicines that could have saved the lives of the nearly 600,000 children that died from diarrhea related causes in 2012 (making it the second leading cause of childhood mortality). Yet access to this globally recommended combination therapy is still very low. Global health delivery and implementation sciences are of paramount importance in advancing global health.
My work over the past few years, and the basis of my doctoral research, has focused on improving access to life-saving medicines in the farthest reaches of the developing world through the development of a public- private partnership with Coca-Cola (a product that gets everywhere) and its system partners in Zambia, and evaluating the impact of this model in getting essential medicines to the community level.
By applying the successful principles used by Coke to a public health commodity and the establishment of its value-chain, ColaLife has been able to substantially improve access to ORS and Zinc in rural Zambia.
I leave you with the same question I began with: in 10 or 20 years from now, what would you consider to be absurd?
ROHIT RAMCHANDANI, MPH, DrPH (cand.), BSc ’04 is a doctor of public health candidate at Johns Hopkins Bloomberg School of Public Health. He is founder and CEO of Antara Global Health Advisors, public health advisor and principal investigator at ColaLife, a new father and recently joined the Faculty at the University of Waterloo's School of Public Health and Health Systems. For more information about ColaLife please visit The Cola Life website.
