An evolution in global health
Authors: Keith Martin, Zoë Mullan, Richard Horton
Journal: The Lancet Global Health (2014)

Fashions are dangerous things. But it seems that global health is no ephemeral trend. Every year, the field grows stronger. The Consortium of Universities for Global Health (CUGH) is a young organisation—its 2014 conference is only its fifth annual meeting. But in this short time, CUGH has established itself as a major venue for the presentation of the very best new work in global health. This year is no exception. More than 1400 individuals from around the world are attending the event. This year, the meeting sees a number of firsts: the Gairdner Global Health Awardee lecture and CUGH's inaugural Global Health Film Festival. 550 abstracts were submitted and the 48 chosen as oral presentations are published here by The Lancet Global Health. The work is unusually diverse—from interprofessionalism to the wisdom of crowds, from global surgery to medicine practised in slums, from global health ethics to the connection between agency and wellbeing. CUGH was formed in 2008 by 24 leading academic institutions in North America, with funding from the Bill & Melinda Gates Foundation and the Rockefeller Foundation. Its purpose is to harness the power of academia across disciplines and across research, education, and service to address global health challenges. In particular, it strives to improve the wellbeing of the world's poor. Since its founding, CUGH's membership has grown from 24 to more than 120 academic institutions, with increasing representation from low-income and middle-income countries. Collaborations have also developed with professional associations, the private sector, non-governmental organisations (NGOs), and consortia in Africa, Latin America, and Asia. This collaboration between sectors is vital to address global health threats, especially the twin challenges of sustainability of the planet and human health. Climate change, environmental degradation, and biodiversity loss have placed us on a dangerous, unsustainable trajectory. This is in the face of a global population that will reach 9·3 billion by 2050. Most of this growth will occur in the world's poorest regions and will be absorbed by cities that possess infrastructure that is often weak, broken, or non-existent. Despite enormous advances, we still face the scourge of infectious diseases—pneumonia, diarrhoea, HIV, malaria, tuberculosis, and neglected tropical diseases, among others. This burden will be compounded by the rising wave of non-communicable diseases and injury that threaten to break the back of government budgets. The dominant cause of ill health in affluent nations, these chronic diseases are poised to overtake infectious diseases in low-income countries as the leading cause of mortality and morbidity. All of these trends are against the backdrop of relative declines in official development assistance, increasing economic power in the global South, inequality within and between nations, and the persistent drain of endemic corruption that can paralyse a nation's progress. There is, however, much good news. The global health enterprise generates vast quantities of remarkable research every year. Sadly, too little of this knowledge moves from the pages of journals and into the field to produce an impact in people's lives. Publication as an end does a disservice to the knowledge produced. It fails to capture its potential through implementation and does not maximise the return on investment made by the researchers and their funders. The zeal for publishing research must be matched by an equally vigorous desire for implementation. In this, universities have an extraordinary opportunity. They can bridge the knowledge–implementation gap by working cooperatively with institutions in low-income settings to build and retain capacity, and scale up evidence-based solutions that address environmental sustainability and human wellbeing. This is why the subtitle of this year's conference is what you would, at this special moment, expect it to be—"advancing global health in the post-2015 era". And with the theme being Universities 2.0. Bridging the knowledge–implementation gap will necessitate a cultural shift. Incentives within academia need to change. Research and its implementation must be valued in career advancement. Partnerships between institutions in high-income and low-income countries should benefit the low-income partner most of all. Innovation is a two-way street and not one that flows from the rich to the less well off. We have much to learn from each other. Initiatives should include an array of skills including medicine, law, engineering, social sciences, management, veterinary science, and more. It should also involve many sectors: academia, government, the private sector, NGOs, and the public. This shift will create new research, education, monitoring, and evaluation opportunities and potentially new resources from funders that put a premium on durable outcomes and impact. Information must also be shared. Good practices and individuals who can train and build capacity need to be identified. CUGH is creating a new online site to do this. This platform will facilitate knowledge sharing, capacity building, and the mobilisation of academia, the public, NGOs, and other sectors to advocate for evidence-based solutions that can improve people's lives. CUGH will continue to work to strengthen global health programmes and harness the capabilities within academia to drive the change we need to reduce health inequities everywhere in a sustainable manner. With this shared commitment to implementation science and open access, CUGH and The Lancet Global Health are delighted to be collaborating to share the research presented at this year's conference.