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welcome back this is another questions
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and answer sessions about public health
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and Global health and I'm going to start
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off by answering some of the questions
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that have already been asked on my
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YouTube channel in the comments I'm
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going to address those first the first
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question comes from Alexander Smith and
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this question it's quite it's a good
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question what are the key challenges and
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opportunities in public health today the
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answer to this really is focused on two
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types of people the one is you've just
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recently finished studying Public Health
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you did an mph or something like that
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maybe you've done a PhD and you're
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thinking about where do I go from here
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where do I lean into what should I be
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focused on so that my career has got
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legs right so that I'm doing something
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that'll still be relevant 10 15 20 years
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from now and the other kind of person
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that should be interested in this is
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you're starting to study Public Health
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right you've you you're and at this time
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of the year that'll be a lot of you
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you're starting an mph you're going to
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be exposed to all sorts of different
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things what should you focus on where do
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you want to really pay close attention
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where's the future of Public Health
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gonna be and there's a couple of things
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that jump off the page and I'll tell you
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what I think they are this is isn't a
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comprehensive list but this is just
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where I think if if I were studying
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Public Health today if I was doing an
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mph right now this is what I would be
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focused on the one thing that we have to
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acknowledge upfront is that there's been
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a huge shift from communicable to
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non-communicable disease right and with
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that shift there's going to be a shift
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in focus and emphasis right so we're
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going to talk about cardiovascular
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diseases and cancer
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etc etc diabetes metabolic syndromes Etc
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there's going to be a huge emphasis on
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preventing those disease and helping
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people with those diseases live healthy
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lives
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etc etc so certainly anybody that's
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interested in what the future looks like
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that's going to be increasingly the case
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having said that okay built into our
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thinking must be that firstly there's
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this ongoing risk of pandemic you know
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ongoing pandemic risk right so pandemic
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preparedness is going to be extremely
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important in the years to come something
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and and there's a little bit of an
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unknown there right is there going to be
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another pandemic in the near future or
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not are we going to wait another 100
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years nobody knows but certainly things
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like Avian Influenza are on our minds
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we're thinking about it we are seeing
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changes to the biology of the of some of
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the viruses that are floating around and
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it's going pandemic preparedness is
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certainly going to be an important area
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without question in years to come
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something where there's not really a
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question mark it's certainly going to be
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the case that antimicrobial resistance
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is going is going to be one of the
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biggest challenges facing Us in the
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medical and public health space
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antimicrobial resistance or AMR is
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likely to contribute to about 50 million
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deaths a year by the Year 2050. we're
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very unfortunately kind of stumbling
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into this post-antibiotic era and there
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is there are things that we can do but
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we have to be proactive it's going to be
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a huge space for public health to step
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into
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yeah the obvious one of course is
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climate change and health and I've got
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videos out there on climate change and
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the impact on health and what it is we
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need to do to be more resilient in the
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face of climate change I mean obviously
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on the one hand we need to try and
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prevent and mitigate climate change
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itself as much as possible but then if
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we accept that it is a reality climate
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change is happening there will be
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consequences in terms of where people
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live and where diseases spread we need
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to do things to make sure that our
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health systems are resilient okay so
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climate change and health is going to be
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a big area definitely make some time to
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focus on that next digital health and
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Innovation and in particular the
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application of AI in Health Systems
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there is so much happening in the space
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you really have to pay attention to keep
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up there is a need for people that are
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in public health to have a deep
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technical understanding of how AI is
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unfolding and what the implications and
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opportunities there within are if you
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are that way inclined definitely focus
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on it there's going to be so many
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opportunities Ai and health is very
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exciting so you know watch that space
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Urban Health and planning going to be
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big definitely learn about that then
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there's also the usual things and I'm
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going to mention them because they
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haven't gone away things like inequity
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and inequality and Healthcare definitely
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be thinking about hard to reach
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populations that's not going to go away
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that's going to continue to be important
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Health System strengthening that's not
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going to go away it's going to continue
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to be important you cannot go wrong by
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getting a good skill set in that space
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it's useful across the board no matter
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what you land up doing if you've got a
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good understanding of Health System
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strengthening you will add value 100
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percent
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and then lastly of course universal
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health coverage of course this isn't new
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I've got videos on that if you don't
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know what it is look at those videos
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universal health coverage is going to
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continue to be important it isn't just a
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one simple thing that you switch on it
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has to be worked toward it's complicated
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it needs people that understand it if
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you want to really understand something
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that will absolutely have relevance in
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decades to come universal health
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coverage is going to be one of those
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there will be jobs available for people
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that know and understand the application
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of universal health coverage in
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different settings so you know
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absolutely spend time learn about that
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conquer wrong thumbs up the next
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question comes from Emily Thompson
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thanks for this question Emily and the
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question is how is the covid-19 pandemic
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reshaped the global Health landscape
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great question Emily and I think why
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it's important that we take stock of
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this is that it impacts on where it is
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that we as public health professionals
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need to lean in and where it is that we
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can add value what is our sort of value
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proposition in this very quickly
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changing landscape now the one thing I
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will say is that some of the changes
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because of covid-19 are perfectly
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obvious we there is an emphasis now on
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pandemic preparedness that simply didn't
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exist before certainly not at the scale
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we've always known that a pandemic could
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and would happen at some point in time
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and of course now it has has happened
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and and and of course
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it will happen again in the future and
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we're not entirely sure when it'll be
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but it's again an editability an
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inevitability and we need to prepare for
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it now
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what are the things that we're doing a
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little bit differently now uh we we
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probably thinking about a broader
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spectrum of pathogens that we need to
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get ready for there's I think a stronger
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emphasis on Health System strengthening
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and Health Systems resilience
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we're thinking more about what needs to
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be in place in a health system when
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masses of of existing Healthcare
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resources get diverted to responding to
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the needs of a pandemic in other words
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we need to be able to ensure that people
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with other health needs continue to have
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those Health needs met and just so that
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you know this channel is sponsored by
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nested knowledge that's a platform that
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supports systematic literature review
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and meta-analysis they're absolutely
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amazing check out the link in the
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description below and with that on with
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the lesson we certainly found that
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during covid-19 there were people that
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for example didn't get diagnosed as
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early as they might have with other
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diseases and there's a huge knock-on
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effect because of that because Health
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Systems and Health Services and acute
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hospitals were under so much strain
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during the height of the pandemic so
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these are things that we really need to
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think through a little bit more
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carefully and get right going forwards
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um certainly in terms of pandemic
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preparedness another area that we're
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thinking about a lot is how it is that
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we work with other countries and how it
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is that we do surveillance in a way that
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multiple countries are speaking to each
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other that we're seeing the outputs of
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whole genome sequencing from one country
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to the next
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in real time in as much as possible
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that's really important how it is that
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we engage with International Health
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regulations the ihr we've always done
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that but I think we're leaning into that
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a little bit more closely now because of
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the importance of it we're recognizing
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the importance of it
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um so there's quite a few things in
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terms of the international sort of uh
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and and the cross-border uh threats that
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we think about in in a little bit more
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detail now than we may have in the past
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or the emphasis is is certainly has
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certainly changed the other thing that's
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new following covid-19 is now the rapid
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development of RNA vaccines I mean we
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can do this very quickly now and I think
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that's a huge thing that we've got now
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that we didn't have in the past and we
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can start thinking about what needs to
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be in place in order to have a vaccine
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ready to use within 100 days of a
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serious uh pandemic or serious outbreak
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and then there are lots of people
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working like working very hard to ensure
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that that sort of capability is in place
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so that's very exciting the other thing
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that came out of the covid-19 pandemic
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is was really the rise of 10 daily
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health and and video conferencing and I
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think that that had a huge impact on our
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ability to provide services to people
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um under under circumstances under which
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they may have otherwise been very
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difficult so Telehealth has become a big
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thing and I think it'll continue to grow
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I think people are now used to it and
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that means it'll just become part of
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normal business as usual
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and finally I think that as public
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health professionals we've grown to
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understand that the solution to some of
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our problems are extremely practical in
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other words when we talk about
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Diagnostics and we talk about treatments
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a lot of what we need to lean into is
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really understanding the logistics of it
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how do things get into a country where
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do they get stored where how do they get
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distributed how do they get used how do
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we distribute information about how to
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use them how do we get information from
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a testing center into a data Lake that
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can be accessed by a clinician who can
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make a clinical or public health
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decision in real time all of these are
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extremely practical problems that have
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to be solved and we need to realize that
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as public health professionals we we
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need to have a detailed knowledge of
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each of these steps now not every single
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one of us can have a detailed knowledge
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of every single step but we need to
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accept the fact that this is a whole
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area of work that we've got to lean into
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it might be that any one of us may have
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deep skills and understanding of a small
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part of the bigger picture but it's
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something that we cannot ignore and that
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is that there is a a an agile management
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a getting things done uh component to
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Public Health that becomes increasingly
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important in the context of an emergency
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in the context of something that has to
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be done urgently when there's an
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emergency when there's a pandemic the
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time for kind of stepping back and
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writing academic papers and you know
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pontificating about what should or
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shouldn't happen is gone it's about
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rolling up your sleeves and getting
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stuff done getting it done quickly
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working with all sorts of stakeholders
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and working with technology working with
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the private sector where needs be
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working with government working with
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other sectors working with public health
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working with clinicians and doing it all
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very fast in an agile management kind of
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way and finally and I'm going to make
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this the last question for today because
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I want to keep these sessions relatively
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short Brian Johnson asks which countries
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and regions are at the Forefront of
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Public Health Innovation I think it's a
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lovely question because we wanted to be
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looking around
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at what other countries are doing and
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say what can we learn okay where is
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their best practice where is there
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something that's being done that's a
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little bit different that's a bit maybe
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a little bit eccentric but obviously
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good and productive uh and impactful and
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can we adopt those uh those the you know
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those things in our own country so I
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think that it's a lovely question to ask
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one that we should always be asking okay
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a few come to mind and obviously there's
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a long list there's many countries that
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are doing interesting things but I will
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just sort of say let's just put a couple
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of them on the table and maybe we
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revisit this question again and again
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and again but the ones that come to mind
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the Scandinavian countries are doing
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fantastic work in the in in the in the
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area of preventative care uh we all need
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to do better there right because if you
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can prevent illness firstly that's a
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person you know who now isn't sick so
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you know high five thumbs up well done
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but you also taking a lot of pressure
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off the acute Hospital systems and the
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Health Care system which can then
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reoriented itself and focus its energy
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and resources on the people that are
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sick and that do need care so when you
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prevent illness in one person who
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actually increase the level of care
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that's available to another person so
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prevent prevention you know it's always
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prevention's better than cure it's a lot
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better than Cure All right so like let's
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and there's huge money to be saved those
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resources as as you know can be
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redeverted so preventative work and
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incidentally it shouldn't be this
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difficult I mean we should
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I like I don't understand why it's
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taking us so long to catch up with uh
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countries like the Scandinavian
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countries in terms of making this a
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priority
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um anyway but nevertheless Scandinavian
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countries doing phenomenally well in
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that space uh Singapore in terms of the
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application of new technologies doing
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amazingly I think there's a lot to learn
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from them and we we should all be saying
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are there technologies that we can apply
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in the public health space and in the
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Healthcare in healthcare space better
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and do we need to be so slow in adopting
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these things it really is kind of quite
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startling how slow it is that we can be
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to adopt new technology uh when when you
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know the applications in my mind are
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absolutely obvious
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um
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African nations have done remarkably
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well in terms of identifying
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opportunities for cost savings and often
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that's been out of necessity right so
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you you may be a country that has
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doesn't have as many resources as
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another country but you still want to be
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able to provide exceptional care and
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treatment and good Public Health
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Services and you find in many African
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nations there's a lot of very innovative
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ways of really focusing down on how to
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provide cost-effective Health Care um in
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in all sorts of low resource settings
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and maybe I'll make a whole video about
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that at some point in time
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um a a good friend of mine actually I've
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got the book right here I didn't think
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I'd talk about this but here it is uh
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decolonizing Healthcare Innovation this
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is a good friend of mine Matthew Harris
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he writes and talks a lot about this
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idea of reverse reverse Innovation what
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it is that
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High income in industrialized countries
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can learn from poorer countries and
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there's a lot and I I recommend the book
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so you know buy that and read it shout
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out to Matthew and finally I just want
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to talk about countries that did very
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well with respect to pandemic response
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during the pandemic the two countries I
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want to talk about are New Zealand and
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Ireland and I'll talk about Ireland
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because I'm in Ireland and I know and
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understand what happened here and New
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Zealand was faced with very similar
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challenges and they did exceptionally
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well now obviously there's a lot of
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looking back in retrospective in which
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countries did what what was effective
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and what was the best strategy etc etc
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it's very difficult to compare one
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country to the next because each country
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is faced with their own set of internal
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challenges
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let me let me tell you what I mean by
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that both Ireland and New Zealand have
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very few ICU beds per capita relative to
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other similar countries okay so both
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Ireland and New Zealand extremely low
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numbers of ICU bids and so the response
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that that New Zealand and Ireland needed
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to have was
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necessarily different from countries
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like the UK for example uh you know
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because we had that the UK had certainly
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many more ICU beds that's Intensive Care
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Unit beds per capita okay and so they
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could afford to have more covid-19
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floating around and they had more
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capacity to absorb additional sick
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people that wasn't the case in Ireland
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and New Zealand the island and New
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Zealand really stand out as countries
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with very very few ICU
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and because of that there was an
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enormous there was enormous pressure on
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the two countries to control Community
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spread of covid-19 and I think both
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countries did a really good job in
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different ways that adopted different
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strategies but both countries did
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exceptional jobs in terms of uh good
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evidence-based policies firstly and
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secondly uh in both countries there was
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enormous enormous response from the
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population people being compliant with
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with policy advice and guidelines
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um Ireland at one point had the highest
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number of the highest number of
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vaccinated you know the highest
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proportion of the population fully
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vaccinated with the exception of a few
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very very small countries where you know
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there's eight people and all eight of
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them got the vaccine fair enough but if
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you compare Ireland to have a similar
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sort of industrialized countries uh they
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did exceptionally well in that space and
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in other spaces so very proud of what we
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did in Ireland I think that you know and
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I'm not blowing my own uh horn here I'm
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talking about my colleagues and other
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people that did an exceptional job here
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and I know what what happened in New
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Zealand was phenomenal many other
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countries did remarkable work and you
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know this is not to to say that that
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wasn't the case I'm just very conscious
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of how similar Ireland and New Zealand
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were in terms of the challenges in front
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of them and what they needed to do to to
00:16:00
manage down the risks associated with
00:16:02
ICU beds filling up because there's a
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huge knock-on effect people that are ill
00:16:07
for other reasons outside of covid-19 if
00:16:10
you ICU bids Philip will
00:16:13
just not get the can treatment they need
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um so it becomes an important challenge
00:16:17
okay that's all I'm going to say about
00:16:20
uh the pandemic story thank you very
00:16:22
much for watching this q a session uh
00:16:25
send more questions to me just put
00:16:26
questions in the comments below any of
00:16:27
my videos and I'll try and pick them up
00:16:29
and put them into these q a sessions
00:16:31
great to see you take care don't do
00:16:33
drugs don't ever change always do your
00:16:35
best speak to you soon take care bye
