The Hope of Prevention Training in South Asia

1. The Hope of Prevention Training in South Asia Dodani Sunita1, Chandrakant Pandav2, Sisira Siribaddana3, Ronald E LaPorte 4 & Paras Pokharel5 (1Pakistan, 2 India, 3 SriLanka, 4 USA, 5 Népal) South Asian Health Preventionists Association (SAHPA) www.pitt.edu/~super1

2. Prevention Training in South Asia Learning Objectives • Current Health Problems in South Asia • Overview of health training in South Asian Countries • Power of prevention and health Prevention training programs • Use of supercourse global health network for building prevention training programs in south Asia

3. Prevention Training in South Asia • The BMJ issue on Health in South Asia addressed the current health problems. • In almost all South Asian countries (India, SriLanka, Bangladesh, Pakistan, Nepal etc) double burden of diseases is increasing • Some of the solutions and hopes for improvement were mentioned • This double burden is difficult for South Asian countries who have little health means • A basic resource for health improvement was not mentioned and that public health and prevention

4. Prevention Training in South Asia • The power of prevention world wide resulted in a 25 year increase in life expectancy. (WHO,2000) • Almost all of this is due to prevention • SriLanka is a best example as a developing country Health system in SriLanka • Sri Lanka achievements in public health with relatively low levels of public expenditure are impressive • The gains in Sri Lanka are apparent with a 99% vaccination • Pakistan, and India has achieved 50% of children vaccination against measles

5. Prevention Training in South Asia Health system in SriLanka • The health improvements are achieved inexpensively with public health, prevention, an emphasis on education in particularly women’s education. • Government commitment played a major role of linking health care and prevention. THIS IS ALL BECAUSE OF PREVENTION

6. Prevention Training in South Asia Health training in South Asian Countries • In South Asia, very few are trained as Preventionists • There are approximately 200 medical schools In South Asia, more than 5,000 students graduate every year • There are only 23 public heath programs providing some training but no Schools of Public Health in whole of South Asia

7. Prevention Training in South Asia • There are 10-20 times more people trained in clinical medicine than those trained in preventive medicine • Training in public health has been neglected • Public health protects the health of populations, with a key emphasis on preventing disease • Medicine focuses on treating patients who are already ill. • Little cross-fertilization • In South Asia and other developing countries, first step should be to train medical students in the area of public health

8. Prevention Training in South Asia • Public health is considered a second-rated profession • Very little emphasis is on research training in prevention • This has resulted sparse baseline data on much of the diseases in South Asia • Public health training in medical students can be improved with better health prevention lectures

9. Prevention Training in South Asia Supercourse (www.pitt.edu/~super1) • Established by Dr Ronald E LaPorte in 1996 and currently funded by National Library of Medicine • The mission is to connect world class scientists by sharing their best lectures and provide better material for teaching • There are 15,000 members worldwide, 40% are from developing countries and more than 800 are from South Asia • This is the library of more than 1,800 lectures from world renown scientists

10. Prevention Training in South Asia Schools of Public Health in South Asia • South Asian preventionists have contributed more than 150 lectures • We can reach a large segment of population to enrich curricula in the medical schools by using Supercourse lectures • The cost to accomplish this would be minimal as the content is readily available on the supercourse for free • No cost to access lectures as majority of medical schools are connected to the internet

11. Prevention Training in South Asia • This will not only provide free teaching material, but also a global expertise of thousands would be willing to help • A model of a school of public health in Pakistan has already been developed which can be used as a template www.pitt.edu/~super1/lecture/lec11921/index.htm • Telepreventive medicine could link medical schools in South Asia, with improved prevention lectures and networking of those engaged prevention.

12. Prevention Training in South Asia Accredited Schools of Public Health • Brick and Mortar schools of public health (like John Hopkins & Harvard) are needed to build the upper level infrastructure for prevention and health. • World-class schools of public health can be built for a fraction of the cost of a hospital, a medical school or a public health school in the US. • Schools should be accredited to world class standards. • These schools will compete with world-class programs because of unique populations and type of diseases. • Schools would be the training grounds for Ministers of Health and leaders of public health nationally and internationally.

13. Prevention Training in South Asia Accredited Schools of Public Health • Proper training in public health can inexpensively reduce the morbidity and mortality of diseases in South Asia. • It will also provide nations the best means for prevention. • This will rapidly improve training of all medical students in public health virtually for free. • The optimal approach to health in South Asia will be to train as many individuals in preventive medicine as those in clinical medicine. • The costs would be small, but the impact on health, immense