Before looking more closely at the Partners in Health (PIH) model, we analyzed the impact of NGOs. While most NGOs are able to provide temporary relief to individuals in a population, they often fail at creating sustainable infrastructure to address broader issues affecting a whole population. One example of an NGO, however, that has been rather successful in creating structural-based changes has been PIH. Although we’ve mostly been following PIH’s work in Haiti, the organization’s involvement in Rwanda has also led to promising changes in healthcare delivery there (4). PIH can’t take all of the credit though. Rather, their partnership with the Rwandan Ministry of Health (5) as well as with their well-endowed affiliated institution, Harvard University, has been crucial to their continued success. Harvard Medical School, along with its affiliated medical centers like Brigham and Women’s Hospital, has especially been able to supply much of the initial resources and expertise necessary for this endeavor (4). Corrado Cancedda uses the work of Harvard as a guide for other U.S. institutions on how to “channel the innovation, creativity, resources, and expertise of academia toward the pursuit of global health inequity” (4). Institutions no doubt can play an important role, yet with the exception of other institutions in the Ivy League and perhaps Stanford, I wonder how reliably PIH’s institutional model applies to less-endowed U.S. institutions.

Many institutions have already been aiding in the Global Health effort. Brown’s Global Health Initiative, for example, provides scholarships to students seeking to conduct relevant projects or research in other countries, just as it encourages collaboration with institutions in other countries. The Alpert Medical School even has some collaboration with St. Damien Hospital in Tabarre, Haiti (2), yet there haven’t been updates regarding this collaboration since 2010 (1). For the most part, Brown’s position in the Global Health effort mainly takes the form of research, as do other institutions. Case in point, the most recent global health related article published by Brown discussed research done on HIV incidence in Nigeria (3). Harvard University certainly pioneered a different approach to institutional involvement, one that partnered with an NGO founded by two of its alumni and the Ministry of Health of Rwanda in attempt to change the way healthcare was delivered there. With one of the highest U.S. institutional endowments, some of the brightest educators and doctors, and some of the top medical and research centers in the world, Harvard is no doubt an institution that can afford to go to these great lengths and do so well. Its financial and research position allows it to wield great power and influence over systemic changes in other countries. In the case of other institutions that have fewer resources, money, and prestige, it seems they would be less likely to get past the “NGO state” when conducting global health projects, i.e. providing temporary fixes as opposed to broad, structural-based changes. This is not to discredit the global health work other institutions do and have been doing, but this is to question how replicable the PIH partnership model is for other institutions.

Discussion Questions:

1. How can the PIH partnership model apply to other less-endowed institutions?

2.  What are some other ways these institutions can create broad, structural-based changes in other countries?

Cited

1. Brown University (2015) Global Health Initiative: Alpert Medical School in Haiti. Retrieved from http://www.brown.edu/initiatives/global-health/haiti/alpert-medical-school-haiti
2. Brown University (2015) Global Health Initiative: Medical Education and Leadership Development. Retrieved from http://www.brown.edu/initiatives/global-health/haiti/medical-education-and-leadership-development-project-meld
3. Brown University (2015) News From Brown: HIV Spreads Faster as Violent Conflict Looms. Retrieved from https://news.brown.edu/articles/2015/11/hivwar
4. Cancedda, C., Farmer, P.E., Kyamanywa, P. (2014). Enhancing Formal Education and In-Service Training Programs in Rural Rwanda: A Partnership Among the Public Sector, a Nongovernmental Organization, and Academia. Academic Medicine, 89 (8), 1117-1123.
5. Farmer, P.E., Kim, J.Y., Kleinman, A. (2013). Reimagining Global Health: An Introduction. (172-182). Berkeley and Los Angeles: University of California Press.