Kim highlights global health past
By Katie Gonzalez, The Dartmouth Staff
Published on Thursday, April 8, 2010
Drawing from his experiences as a leader in global health administration, College President Jim Yong Kim stressed the need to incorporate “health care delivery science” into undergraduate education during a lecture to community members held in Spaulding Auditorium on Wednesday.
Dartmouth “definitely needs to get moving” on adapting programs where students can “think creatively about the biggest troubles of our times,” Kim said in response to a question asked by an audience member after the lecture.
“If we start teaching this at the medical school stage, it’s too late,” he said. “We need to start training people at the undergraduate level. We have to build into the liberal arts education that taking on some of our complex organizational challenges are the most important of all.”
Low aspirations and poor execution among public health administrators continues to hinder the delivery of aid to poor countries, according to Kim.
“It’s not just about health care,” Kim said. “It’s about getting serious about executing our social goals. In the social sector, we’ve been able to execute poorly and stay in business.”
When Kim was treating patients with multidrug-resistant tuberculosis in a rural area near Lima, Peru, critics in the global health industry told him that treating the area’s sick and impoverished was too complicated and expensive, he said.
“What everyone said was, ‘you can’t do it, it’s impossible,’” Kim said. “The Minister of Health of Peru along with people at the World Health Organization said, ‘If you treat a single patient we will kick you out of the country.’”
Despite being told that the task was too large an undertaking, Kim and his associates at Partners In Health, which he co-founded, defied convention and achieved an 85 percent cure rate in the first group of patients that received the $30,000 treatment, he said.
“If people from the military or the business world said you can’t do it, we would understand,” Kim said. “But it was people from the health world. When President Kennedy said that we were going to fly to the moon, do you think the people at NASA said, ‘Oh, it’s too far, it’s too difficult’?”
PIH conducted extensive research into alternative means of obtaining the drugs needed to treat the tuberculosis strain, and within a year the price of the treatment dropped 84 percent and 90 percent, according to Kim.
His experience with the medical community in Peru demonstrated the importance of innovation as a way to make medical efforts as efficient and effective as possible, Kim said.
Despite the presence of approximately 9,000 charitable organizations in Haiti, making it a country with one of the largest numbers of charitable organizations in the world, the groups’ lack of effective execution has prevented them from providing adequate services to victims of the recent earthquake, Kim said.
Nonprofit groups and nongovernmental organizations allowed their operating expenses to exceed a responsible amount, in some instances reaching overhead costs of 30 to 50 percent, Kim said.
“[PIH] never allowed our overhead to get over 5 percent, and we’ve held ourselves to a standard of execution we would hold in the United States,” he said. “For years we were called crazy, too idealistic.”
Poor implementation of health policies will lead to greater inequality in countries, according to Kim.
“The Gates Foundation says that there are three important things in global health: discovery, development and the third ‘d,’ which is delivery,” he said. “But they’re still trying to find out what that means. We’re always, always shortchanging delivery.”
A lack of coordination and consistency plagues the health care policies of the United States, Kim said, citing the U.S. health care system’s high costs.
“[The health care bill] ensured access to a large group of people, but it’s not attacking cost and quality,” he said. “What we need to do is make the argument that it’s time to really invest in making the delivery of health care into a field, into a career where the best and the brightest can devote their lives.”