How Do We Build Global Health Systems Ethically?

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Abraar Karan
Dr. Abraar Karan is an MPH candidate at the Harvard T.H. Chan School of Public Health. He has worked in several countries in Latin America, Asia, and Africa on global health and human rights projects. His current interests include health systems improvement, medical ethics, political leadership in health, and anti-corruption. Abraar graduated from UCLA David Geffen School of Medicine and Yale College. t: @AbraarKaran

The construction of global health systems is fraught with challenges. The expertise required to inform systems development involves multiple disciplines, many which inherently have conflicting aims and methods of practice. This month, the American Medical Association’s Journal of Ethics released its July issue, “Ethics of International Healthcare Systems Development.” The issue examines the ethical dilemmas that accompany the complex medical, public health, anthropological, and economic aspects of building hospitals, clinics, medical schools and more for countries in low-income regions of the world. Contributions include HIV/AIDS experts from South Africa; the physician who advised the President of Guinea on how to control Ebola; the Minister of Health of Rwanda, one of the world’s leading authorities on health systems; historians who have studied the development of modern healthcare in the context of colonial legacies; medical anthropologists who elucidate how we can respect other cultures in our attempt to collaborate internationally; health economists trying to find the most cost-effective interventions in light of limited global funds; lawyers navigating patent law with regards to essential medicines that are unavailable to the neediest. The issue proves to be comprehensive and nuanced, compelling yet leaving space for more than one right answer or solution.