COVID-19 is the quintessential global health problem. One virus, and the disease that relates to it, manifest all of the major issues in global health. I comment further below on how COVID-19 does this and how one might use COVID-19 as an, especially valuable teaching tool.
COVID-19 as an Expression of Critical Global Health Issues
Let’s start by looking at the most important issues raised by COVID-19. Let’s do so in the order in which most of us would teach an introductory course in global health.
Cooperation in Global Health – COVID-19 highlights the extent to which the “health of anyone, anywhere is the health of everyone, everywhere.” It also raises substantial questions about the role of various actors in global health during a pandemic, including WHO, GAVI, and individual countries and their development assistance agencies.
The Health-Economy Link – COVID-19 has illustrated the strong links between health and the economy. We have seen more than ever in modern history that a pandemic has upended the world economy. We have also seen that righting the global economy requires getting the pandemic under control.
Ethics and Global Health – The pandemic has raised many ethical issues from the most macro to the most micro level. At the macro level, for example, we need to examine the fairness of global vaccine distribution and the ethics of travel bans. At the micro-level, we have seen arguments over the ethics of government mandates for mask-wearing, among other things. Developing and implementing crisis standards of care has also raised a range of challenging ethical issues.
Equity – The pandemic has also brought out a range of equity issues. Among the most important have been the disproportionate impact of the disease on minority groups and the inequitable distribution of the vaccine within and across countries.
Health Systems – The pandemic has reminded us of the importance of health systems and their weakness in many countries. Public health work in many countries was weak, poorly implemented, or both. It was also stretched beyond its capacity in many countries by a large number of infections. The pandemic also raised enormous challenges for the financing, management, staffing of health systems, and the quality of clinical care.
The Burden of Disease – COVID-19 has had a major impact on the burden of disease in almost all countries. It has led to many deaths, remarkable amounts of illness, and a substantial amount of disability for many of those infected. Indirectly, it has led to substantial deaths and disability from other causes, which were not attended to appropriately during the outbreak.
Emerging and Re-Emerging Infectious Diseases – The pandemic is “right out of the book” of emerging and re-emerging diseases. Its origins appear to be zoonotic. It spread rapidly around the world. Most countries were ill-prepared to deal with the pandemic. Other countries lacked the political will to address it effectively.
The Role of Vaccines and the Political Economy of Health – There has always been “vaccine hesitancy.” However, we are now witnessing high levels of anti-scientific, misinforming, and populist views about vaccines against this virus in a substantial number of countries. In addition, views about the disease and related vaccines have been politicized in many places.
Working in Global Health – The pandemic has become a political issue in many places, leading to attacks on science, public health, and public health workers. While public health workers might have been seen as “heroes” in the fight against earlier diseases, such as smallpox, they now sometimes face harassment and villainization.
COVID-19 as a Teaching Tool
It is likely that those who teach global health have already made very good use of the pandemic as a teaching tool. This can be done in many ways, and I would like to comment below on three possible approaches.
Starting with COVID and Working Backwards – Some instructors might want to start their course with “COVID-19 as the Ultimate Global Health Issue.” They would set a foundation for the rest of the course by going over the points above and helping students immediately grasp some of the main themes in global health.
Ending the Course with the Pandemic – Another possibility would be to end the course with a discussion of how the pandemic brings together all of the themes of the course. It is also easy to see how one might make a final examination, for example, around the question: In what ways is COVID-19 the quintessential global health problem? In answering, be sure to write at least three lines on how the pandemic relates to the themes noted earlier in the blog.
Using the Pandemic Through the Course – Instructors will almost certainly be using the pandemic as a teaching tool as they go through their courses. The pandemic provides exceptional opportunities to explore key global health themes, and it will be easy to frame thought-provoking questions for your students to help bring them out, such as:
- In what ways has the pandemic shown that thinking only about the direct costs of pandemic-induced health care seriously underestimates the true economic costs of such an outbreak?
- What are the most important ethical issues raised by the pandemic at the global, national, and local levels?
- What has been the direct and indirect impact of the pandemic to date on the burden of disease in selected places? How might this trend in the medium- and longer-term?
- What lessons has the pandemic provided for how to prevent and deal with future outbreaks more effectively, more efficiently, and more fairly than many countries have been able to do so far? In moving in the needed directions, what changes need to be made in the efforts of global actors to work together to prevent and address disease outbreaks?
- In what ways is vaccine hesitancy manifest in your country, and how can it be addressed?
Like you, I hope that the pandemic will soon be brought under control and that we will have learned enough from this experience to do better when we face the next major disease outbreak. For now, however, I can’t think of many teaching tools for an introductory course on global health that would be better than the present pandemic.
About the Author
Richard Skolnik, MPA - Author of Global Health 101, Fourth Edition.
Richard Skolnik has spent more than 40 years working on international development and global health and was formerly a lecturer in the Yale School of Public Health, the Yale School of Management, and the George Washington University School of Public Health.
Note: Dr. Terry Dwelle, Hope Van Bronkhorst, Alison Zerbib, and Rachel Light graciously provided the author with comments on the draft of this piece.