BETHESDA, Md. -- The focus a dozen miles away at the Capitol was domestic health reforms, but here five university presidents took the stage Monday to push for intellectual and financial support to sort out an even bigger mess: global health.
At the end of the first day of the Consortium of Universities for Global Health’s inaugural annual meeting , the presidents – Richard H. Brodhead of Duke University, Robert A. Brown of Boston University, Ronald J. Daniels of Johns Hopkins University, Mark A. Emmert of the University of Washington and James W. Wagner of Emory University – came together to consider the role their universities are beginning to play in the rapidly-emerging arena of global health and how global health fits into the well-established set of departments, centers and schools that each university has. (The consortium, true to its name, includes only universities among its 58 institutional members.)
Global health programs, initiatives and centers have in the last decade emerged from almost nonexistent to quickly spreading as students and faculty demand institutional support for their efforts to leverage academic strengths into real-life solutions.
The five presidents all lead institutions that are among the 55 North American universities with major efforts already in place  and all have allocated millions of dollars to making global health a major educational and research imperative.
Brown, in fact, used the panel discussion to officially announce the reorganization of Boston University’s global health efforts  into the Center for Global Health and Development, for which the university and its School of Public Health will provide $10 million in funding over the next five years.
Rather than needing to hire scores of new faculty and invest millions just to put a program in place, all five of these universities have been able to draw on the strengths of their professional schools and arts and sciences faculties to create interdisciplinary global health teams. “If global health is only an add-on, it’s never going to survive,” Duke’s Brodhead said. “It has to be drawn from the passions that are already there.”
Still, the structure of large research universities is dependent on disciplinary departments and schools, whereas global health reaches across many subject areas. It isn’t simply a health sciences, business or public policy issue; it’s all those things and more, all at once.
Daniels, who was formally inaugurated as president of Hopkins on Sunday but has led the university since March, said his challenge is to “think about how to really draw the rest of the university, aside from the life sciences” into the discussion on global health. He hopes global health can  “knit the university together,” uniting its strong medical, nursing and public health schools with its School of Arts and Sciences and Washington-based School of Advanced International Studies, among other divisions.
The key, Washington’s Emmert said, is “lowering the barriers to doing the things that the faculty and students want to do, because you’re working inside the traditional disciplinary boundaries, because you’ve got all the functions that are locked into place by budgets and standard operating procedures.”
Presidents and administrators, he said, should “start shoving some of those barriers down” by helping faculty and students figure out the logistics of establishing and running research and aid projects around the world.
At Emory, Wagner said, the administration tries to do the same. Its Global Health Institute is “a hub … with intentional structure”  to coordinate all the global health programs happening across its Atlanta campus and beyond. It is led by Jeffrey P. Koplan, vice president for global health, a former director of the Centers for Disease Control and Prevention.
Duke’s Global Health Institute was created in 2006  and ballooned into one of the university’s largest undergraduate draws, Brodhead said. Its undergraduate certificate program is already the university's second largest, drawing in students with interests in the health sciences, liberal arts, business and the law, among other areas. The first entering class into the institute’s Master of Science in Global Health arrived in Durham last month.
Even at colleges and universities without world-renowned graduate programs like Duke’s, he said, there is room for global health. “Every school can do its own version based on where the interests of its students and faculty lie.”
Whether overseeing global health or coordinating it, all these new efforts in research, academics and administration do require cash, a challenge for any nascent university offering, let alone an interdisciplinary one in the midst of a recession.
The University of Washington has more than 40,000 undergraduate students, close to 6,000 faculty members and an endowment of over $1 billion. Though it has faced significant state budget cuts this year, Emmert said, global health has remained a priority , getting some cuts, but still treated more favorably than most other fields. “This is a field that has incited more student interest and engagement in a relatively short period of time than virtually anything I’ve ever seen,” he said. “Similarly, it fits our faculty’s strengths in many fields.”
Even at institutions far wealthier and less drastically hit by the recession, global health -- while a priority -- has faced a slowdown in funding. At Duke, Brodhead said, the Global Health Institute will get the $30 million pledged by the university and its medical school three years ago, but the money will have to last longer than planned pre-recession. He did not go into detail on the cuts. Emory's program got about $20 million when it was created in 2006 but the contingency of $15 million in university funds for the effort has disappeared, Wagner said.
Though the emphasis of the global health programs at these and other North American colleges and universities is on issues facing Africa, Asia, Latin America and the Caribbean, the presidents are cognizant that many of the global health challenges plaguing those regions also exist within the United States.
Daniels, of Hopkins, said global health programs “allow us to hold a mirror up to ourselves,” to see the health problems that exist in the developing world and within the United States. “It seems to me this is a wonderful way to enrich what is at times an impoverished debate about health care in this country.”