American psychology/cultural researcher Joey Florez has sparked a critical debate in U.S. foreign policy by proposing a new model for global health aid, in a story published by the state-owned daily newspaper the Ghanaian Times. He argues that instead of just funding, the U.S. should prioritize strategic partnerships between its academic/tech sectors and developing nations (i.e., Africa) to transfer essential knowledge, best practices, and telehealth technology.

 

This approach—focused on systemic reform, education, and knowledge transfer—raises questions about how the U.S. should allocate its global health/monetary resources.

 

As a matter of U.S. foreign policy and ethical spending, where should the emphasis be placed: on providing significant direct aid (cash/USAID) to local organizations, or on strategically leveraging American academic and technological expertise (knowledge) for capacity building and systemic reform in global health sectors abroad? What are the political pros and cons of this strategy for the U.S.?

 

(Ghanaian Times / See article below)

 

https://ghanaiantimes.com.gh/joey-florez-bridging-community-mental-health-initiatives-and-american-expertise-in-ghana/

If you give them cash they're just going to steal it

Healthcare providers in the US like the capacity building; its not alturistic, because it provides a steady stream of healthcare workers.

 

Every Western economy, due to an increasingly aged population and increased demands on healthcare services, is facing shortfalls in production of domestically trained healthcare workers, and that's largely due to a lack of funded programs. By 2036, the US faces a shortfall of 86,000 doctors. Europe is much the same. The UK NHS has set up partnerships with medical schools in India and the Phillippines to train healthcare workers to a British standard. These doctors and nurses has no intention of working in their own countries, and naturally there is intense competition for places.

 

Yes, this does result in some capacity building; some of these doctors and nurses will eventually return home, with experience, but many do. But the West is stripping these countries of doctors. Its a long standing  issue. There is an argument that says Western largesse enables people to receive medical training who wouldn't otherwise. Yes and no; those imported medics represent the brightest and best in their cohorts. They iely would have been trained using the  existing domestic infrastructure.

 

We knew about the demographic timebomb decades ago, and did nothing, except strip the developing world, to prepare for it. There has been a lack of investment  in technologies, such as robotic surgery, non-surgical interventions. The profession in some countries has conspired to artificially drive up demand. Take Spinal Fusion Surgery;  500,000 surgeries a year in the US. Thats more than double the rate seen in Europe. Is the US a nation of spinal cripples, or are patients being conned into unecessary surgery. The insurers think so, and they are increasingly pushing back on claims for back surgery. It was probably this that caused a deranged man kill a healcare executive (pain does odd things to perception). US hospitals have appalling readmission rates; patients are discharged too quickly, with no follow-up because the hospitals can't be bothered to invest in community based nursing. Again, the insurers are hitting back, cutting reimbursement rates on hospitals with readmission rates that are too high.

 

COVID exposed further issues in the under investment in medical training. Most surgeons learn on the job. They usually shadow experienced surgeons, who pass on skills. COVID saw many experienced surgeons delay retirement. The end of lockdowns saw a hard stop. Surgeons left the profession without passing on skills, leaving a cohort of surgeons less trained than their predecessors. So we need more imported surgeons. Because that's cheaper than investing in robotics and remote surgery.

 

COVID saw lots of people have their surgeries delayed. Post COVID, you would have thought there would be an expansion in surgical theatres, more night surgeries, clever software to better manage utilisation rates. Nope, because that would cost money, and they didn't have the surgeons and nurses to staff out the extra operating theatres. Instead the solution is simple and cost free. You wait for the patients to die, or get to an age with surgery is no longer an option. Seeing that everywhere when you dig into the registry data coming out. Surgery rates have mostly assumed pre-COVID by now (Germany is still a bit down). There was never an increase in surgeries to deal with waiting lists etc. Thats apparent in US, UK, German, French, Swedish, Finnish, Spanish data sets. Australia had less of a problem, because they didn't experience the same kinds of lockdowns as the Northern Hemisphere.