The world in the early 21st century is both a very dangerous and a very promising place. Through their hard work and ingenuity, people have used science to develop wondrous new technologies that could feed, clothe, shelter, and keep healthy every person on earth. Unfortunately, however, we have not done nearly enough to move toward equity, in health or elsewhere. Equity means being able to get a decent home, have a good job, take children to school, and have access to adequate healthcare. Equity is essential to human life and well-being, but all too often the wealthy people and nations have been unwilling to help their less fortunate and less healthy neighbors. All nations must wake up and deal with the health disparity gap. Political will needs to be in place in both the donor and recipient countries to invest wholeheartedly in healthcare and healthcare systems, where everyone is treated with dignity and respect and is empowered to manage his or her own life.
In my experience, I have learned that one of the most critical areas for this is in Africa, where many poor people suffer from HIV/AIDS and other diseases, without access to adequate treatment. The problem has been compounded by the emigration of many African healthcare professionals to the less troubled, wealthier, and higher-paying western nations.
Partnerships are a means of creating synergy by combining resources and talents to pursue mutual interests. Successful partnerships are built on trust, shared values, and a clearly articulated vision of outcomes. One of the best examples of utilizing the partnership concept to address the problems of inequities in health is a United Nations Associate Member organization where I serve on the Advisory Board, the Medical Knowledge Institute (MKI) (http://www.infomki.org). Based in the Netherlands and the United States, the MKI is an international nonprofit foundation committed to healthcare education and health information dissemination. The MKI acts from the premise that healthcare is a human right, and works with numerous businesses, foundations, governments, and professional associations. Its programs are designed to improve the quality and values of life, particularly among the poor in developing countries. Successful MKI HIV/AIDS partnership programs include the Mother and Child First and the HIV/AIDS Workforce Policy Development and Education program with goals of reducing the transmission of HIV/AIDS and developing employee, their families, and business management skills to cope with the related economic and social problems. Partners in these health equity programs include The Netherlands Red Cross, International Confederation of Midwives, the VU Medical Center Netherlands, South African local health departments, South African women who are infected with HIV/AIDS, the South African Services Sector Education and Training Authority, and the Southern African Netherlands Chambers of Commerce.
The newest MKI project with the capability of worldwide impact is the establishment of health information centers (HICs). These centers have the potential of being established around the world through corporate and other partnerships and will foster individual and community self-reliance in addressing health problems and promoting healthy lifestyles. The HICs will provide healthcare and public health education and information to the general public, especially the underserved and those living in remote areas. Each of the HICs will have libraries and Internet connections, where otherwise unavailable, and will provide practical publications and links to electronic databases in such areas as child health, primary healthcare, family planning, HIV/AIDS care, nutrition, and common skin diseases. The HICs will also serve as training venues for the MKI Human Resources for Health Division that will assist local and national governments and organizations, as well as other healthcare and public health entities, in efforts at assessment and development of healthcare workforce capacity and healthcare systems. Partnerships are being established with healthcare organizations, medical schools, and other university departments around the world for staff, faculty, and student exchanges, putting in place a system for the transfer of health knowledge to developing nations where it is so desperately needed. Through these exchanges, MKI will strengthen health equity efforts and, specifically, the public health and healthcare community-based programming. Other MKI HIC partners to date include the World Health Organization Health Academy; Erasmus University Medical Center, The Netherlands; Albert Schweitzer Cluster Hospitals, The Netherlands; the Desmond Tutu HIV Foundation; the Africa Centre for HIV/AIDS Management at Stellenbosch University; TNT Express Worldwide, Cape Town; the Southern Africa-Netherlands Chamber of Commerce; and TALC (Teaching Aid at Lower Cost).
Throughout the world, despite continuing advances in healthcare and technology, there are large and growing disparities. The poor continue to suffer from more disease, disability, and early death than their wealthier brothers and sisters. This must not continue!! No country or people, however powerful, can exist in isolation. People and their nations must reset their priorities, redirect their resources, and partner together to help the less fortunate to secure enough clean water to drink, enough food to eat, enough education, and healthcare that is affordable and effective.
The world must take a stand in support of equity that is aligned with truth, respect, dignity, and empowerment. A central component of this stand must be the development and maintenance of effective health systems for the needy. These systems must foster individual and community autonomy, not dependence and subordination. That means supplying the needy with the tools necessary to make their own health decisions. Inevitably, these efforts cannot be developed and imposed by a central authority. They will require the active partnership of the private and public sectors, government, business, healthcare, and-most importantly-the clients themselves. Partnerships have a key role in achieving health equity and must be woven into strategies for the elimination of this inhumane disparity.