Global Health Institute

According to Dybul, today we are at a point in history similar to the Industrial Revolution. Massive change can bring fear, which causes individuals to move “forward or inward,” said Dybul. As the former executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, and as someone critically involved in the President’s Emergency Plan for AIDS Relief during the Bush Administration, Dybul explains that concerns such as the HIV/AIDS epidemic in Sub-Saharan Africa require approaches beyond the health field.

Encapsulated in the Sustainable Development Goals (SDGs), these approaches place greater focus on maternal and child health, education, and gender equality, with local capacity building. Because there are no education systems in place to address linking concerns between health financing, outcomes, and quality, Dybul hopes to provide such instruction with the Center for Global Health and Quality.

“This is why [now] is the most exciting time for development and global health,” said Dybul. “Our generation today has the opportunity to challenge existing structures to improve the lives of others.”

He cites historic advances once thought to be impossible, such as antiretroviral therapy for AIDS and the eradication of smallpox, to be analogous to developments today. For Dybul, global health’s history of colonialism and foreign aid, and progression from “internalism and money” to “partnership, accountability, and results” after the Monterrey Consensus in 2002, contextualizes today’s advances.

In 2012, the U.N. developed the SDGs using lessons learned from the strengths and weaknesses of the Millennium Development Goals. Today’s “SDG era” focuses on care of the person through the emphasis of universal healthcare (UHC), health disparities, social justice, and vulnerable populations. As for today’s preventable diseases, Dybul says that “T.B. is the single best marker of health disparities,” and that “if you can cure something you can eliminate it.”

Dybul articulates the movement toward UHC as a current megatrend. But rather than placing weight on systems-strengthening as is often urged, Dybul believes UHC should adopt an outcomes focus. “A system is a tool, not an outcome," said Dybul. "Healthcare systems should focus on the quality and impacts of their programs.”

Dybul additionally cites focuses on sustainability, transformation, and co-financing as essential in capturing the demographic dividend. Development efforts cannot be rushed and should harness the value in lessons learned.

Finally, for Dybul, mass mobility of ideas and people has led not only to concerns over migration and rights for refugees, but concerns over safe migration for the general population. This trend concerns economic mobility necessary for demographic growth, development, health, and education.

Whether it is substantive historical change such as the industrial revolution, or today’s larger concerns related to the growing needs of both our population and planet, it is our response and action to such changes that can guide the movement towards greater development.

Dybul similarly quotes Theodore Parker: “I do not pretend to understand the moral universe; the arc is a long one, my eye reaches but little ways; I cannot calculate the curve and complete the figure by the experience of sight; I divine it by conscience. And from what I see I am sure it bends towards justice.”

Emily Graul (NHS'20) is a global health major and a student fellow with the Global Health Initiative.