Disease Prevention and Control

The concentration in Disease Prevention and Control will provide in depth training on the epidemiology, impact and control of infectious, as well as non-communicable and chronic diseases. Students who choose this concentration will develop competency on topics as divers as global emerging and re-emerging diseases, the threat of bioterrorism, large-scale international disease control partnerships, global environmental health issues, and the growing double burden of infectious and non-communicable diseases in developing countries. A concentration in Disease Prevention and Control will provide graduates with comprehensive program planning and management skills and will prepare them for a career in local, national and global diseases control programs in low- and middle-income countries.

Health Policy and Financing

The Health Policy and Financing concentration will prepare graduates for quantitative financial and policy work in support of governments in low- and middle-income countries. Students will learn to analyze and assess health insurance and other risk-pooling systems, They will master the techniques of health economics and acquire a framework for analyzing health care systems and designing strategies for system reform. By the end of the course, graduates will have the training and skills necessary to assess the performance of a health system and to formulate a plan to improve health system performance and results.

Health and Development in Africa

The Health and Development in Africa track provides students with training on critical aspects of African development from a demographic, economic, political, social, environmental, cultural, and health perspective. The concentration offers historical analysis as well as a vision for the future of African development. Students will analyze the causes and consequences of poverty, key issues in African population health, the impact of rapid urbanization on health and development, and the state of African health systems. Graduates choosing this concentration will develop the knowledge and skills necessary to appraise health and development issues in Africa and to devise appropriate policy responses and programmatic solutions that will help to address the multiple opportunities and challenges facing African countries today.

Trade and Health

The concentration in Trade and Health introduces students to the relationship between international laws governing patents and trade and efforts to protect and promote human health. Students will examine the economic, social, technological and political dimensions of globalization and how they impact health status, the provision of health care and global public health. They will think critically about how globalization and the international trade regime affect national regulation in the interests of human health. In depth study of international treaties such as the Framework Convention on Tobacco Control and international agreements such as TRIPS will provide students with the conceptual and evidence-based foundation for the analysis of globalization, trade, transnational legal frameworks and health.

GLOH Courses

The following courses are offered by the Department of International Health. MSGH graduate students may enroll in courses offered by other Georgetown schools and institutions, subject to the approval from the program director.   

GLOH 614: Changing Global Demographic and Economic Patterns 
Spring semester, 3 credits

This course is designed to provide students with the key concepts to assess critical changes in patterns and trends of global demographic, health, and socioeconomic prospects.  It will first highlight the diverse and dynamic regional patterns, including the demographic divide, urbanization trends, and migration flows.  It will focus in particular on high fertility and below replacement fertility situations, and include aging.  The course will then review major theories about demographic and health changes, namely the demographic, epidemiological, and migratory transitions. Finally the course will examine current emerging analyses concerning population changes and their relevant impacts on economic growth, with special emphasis on the theory of the demographic dividend.

This course offers historical analysis as well as a vision for the future. Students will examine changing global demographic, epidemiological and migratory regimes.  This course will blend theoretical approaches with current data.  Students will also review classic papers on core topics such as the demographic transition, adjustments in fertility regimes, population policies and other topics relevant to understanding the current dynamics of demographic change.

The course will assess the implications of rapid population growth for economic and social development, and national and international security concerns. Throughout the course, students will be encouraged to consider policy implications and the feasibility of interventions.

GLOH 627: The Politics of Global Health and Development
Spring semester, 3 credits

This course focuses on the political dynamics shaping the health and development agenda. It considers the flow of international and domestic resources for health and the financial instruments used by donors, governments, and individual health care consumers. It analyzes and critically assesses the global governance structure for health and examines the roles played by multilateral, bilateral, private sector, foundation and civil society actors that shape the global health agenda. The course positions this discussion in the context of the current thinking about aid effectiveness with a view to the post 2015 agenda.

GLOH 650: Combating Non-Communicable Diseases in Developing Countries: Challenges and Strategies
Spring semester, 3 credits

This course focuses on the rising burden and increasing challenges associated with the shift from infectious and communicable diseases (ICDs) to non-communicable diseases (NCDs) as the major causes of mortality, morbidity, and lost years of healthy life.

In September 2011, the United Nations held a high-level meeting on non-communicable disease (NCD) prevention and control that culminated in a political declaration to address the prevention and control of non-communicable diseases worldwide. The last time any disease received such high-level political attention was in 2001 at the high-level UN General Assembly Special Session on HIV/AIDS.  The Global Fund was created after a G8 meeting that supported efforts to reduce HIV/AIDS, tuberculosis, and malaria. In comparison, subsequent attention and action after the NCD Summit last year has been paltry.

For high-income countries NCDs and injuries account for 95 percent of the burden of disease; that share is 65 percent for low- and middle-income countries as the more successful middle-income countries move ever closer to the high-income norm. NCDs are ‘the’ major health burden worldwide. They include cardiovascular disease, most cancers, diabetes and chronic respiratory disease. NCDs kill about 57 million people globally each year, 80 percent of whom live in low and middle-income countries.

This course will provide the students with an in-depth understanding of the challenges of NCDs and the policies and strategies to curb them in low- and middle-income countries.   The first half of the course will cover the rising global burden of NCDs in terms of total and premature deaths and the leading causes of morbidity.  The students will also learn about the environmental, metabolic and behavioral NCD risk factors such as air pollution, high blood pressure, high glucose level, alcohol, smoking, and obesity.  In addition, there will be an overview of the rising costs and the macro- and micro-economic impact of NCDs at the state and household levels as well as the principles of behavioral economics and its relationship to NCDs.  The second half of the course will present a comprehensive framework for the prevention and treatment of NCDs.  This framework will cover the interventions for behavior change and prevention of NCDs, the integrated service delivery model for the effective management of NCD.  At the end of the course, there will be a discussion on the role of the government and different sectors in adopting policies to respond to NCDs as well the different financing models to cover them.

GLOH 706: International Health Partnerships and Disease Control

Spring semester, 3 credits

The course will review large scale international disease control partnerships such as Malaria, TB, Onchocerciasis (River-Blindness). On the research side health partnerships such as the program on Research and Training in Tropical Diseases (TDR) will be compared with similar programs in the agricultural research arena. The course will analyze the programs from several perspectives and attempt to draw some general conclusions as to modalities for effective large scale disease control programs. These perspectives are: intervention strategies, organizational framework, financing mechanisms, and typology of partnerships. The course will also convey a thorough understanding of the history and current international disease control efforts, and associated political implications from an international perspective.

GLOH 708: Poverty and Health: Ensuring Access to Pharmaceuticals in Developing Countries
Spring semester, 3 credits

Relatively little medical research is devoted to alleviating the burden of disease affecting the overwhelming majority of the world's population. At the same time, new pharmaceutical inventions are commercialized at prices that are beyond the reach of most people in developing countries and beyond the public health budgets of the governments of these countries. This course addresses the resulting global inequity with respect to access to medicines. We will review the institutions (such as international organizations, governments, pharmaceutical companies) and market processes that determine the current state of affairs and examine all major transnational initiatives aimed at improving the situation. The tension between the high prices of patented medicines and affordability of life-saving treatment will be examined particularly, though not exclusively, in the context of antiretroviral drugs for HIV/AIDS.

GLOH 725: Health Insurance and Risk Management
Spring semester, 3 credits

The health financing scheme adopted by a country to fund its health system is key to its performance. It will not only impact its accessibility, affordability and equity, it will also impact its quality, cost-effectiveness and sustainability. For example, it is now widely acknowledged that there is no other way to reach universal health coverage (defined as ensuring that all people can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship) than to establish a risk pooling scheme that includes all the members of a society.

It is clear that some schemes are more successful than others. And if there are still many debates about which risk pooling scheme is the most effective, cost-effectiveness or cost-benefit analyses clearly demonstrate that some schemes cost more (in GDP percent term) than others, for lesser results (health indicators of life expectancy, mortality and morbidity). However, in this course, we will not limit our measure of a health financing scheme success to its degree of cost effectiveness/cost benefit. We will essentially measure its success by its degree of achievement of universal health coverage.

There are three main risk pooling schemes that are implemented in the world:
•The first model is general tax-based, managed by a National Health Service (NHS) or a Ministry of Health (about 100 countries in the world);
•The second is payroll tax-based, managed by a quasi-public entity (about 60 countries in the world);
•The third is private sector-based health insurance financed by voluntary contributions, managed by private insurers (less than 10 countries in the world).

In this course we will present a detailed analysis of these three models, from their generic principles to the versions that are currently implemented in countries, both developed and developing. We will look at their history and especially at the enabling conditions that made possible the launching of the scheme. We will study the numerous changes that were made for the schemes to survive and/or become more efficient. We will underline the difficulties faced as well as the successes. We will study the controls and regulations, so essential for the scheme’s sustainability, which were developed and implemented to compensate the scheme’s flaws and ultimately contain costs. We will also study the logistics (such as patients’ reimbursement modalities, health providers’ payment modalities or information system) because they are key in the level of administrative costs spent for the scheme’s functioning. We will eventually assess the scheme’s performance through different sets of indicators (such as: accessibility, coverage, quality, affordability, equity, cost-effectiveness, sustainability and population health status) and through its universal coverage achievement.

GLOH 730: Planning, Costing, & Budgeting Health
Spring semester, 3 credits

Can increased health expenditures improve health results for the poor in developing countries? What are the tools and processes used by government authorities to identify priorities and allocate resources, estimate and mobilize adequate funds, and disburse resources effectively and efficiently? The course will address these questions by: (i) focusing on how decision-makers plan, budget, and spend money for health services; and (ii) examining the impact of their choices on various dimensions of health sector performance: accessibility, affordability (and equity), quality, effectiveness, and sustainability.

The course will look at both the broad context and the practical issues of health systems financing and examine how governments:

  • identify, prioritize, and plan health sector requirements within the broader context of the formulation of the national budget;
  • mobilize sufficient financial resources by: (i) estimating program and project costs for given outputs of services; and (ii) identifying the sources and characteristics of funding to provide these services;
  • allocate these resources in accordance with: (i) priorities established in health sector policies, plans, and operational directives; and (ii) management of the budgetary process in a strategic and skillful manner; and
  • disburse the authorized amounts effectively and efficiently, that is: (i) on the budgeted activities/items; (ii) in accordance with the approved plan to achieve the planned objectives; and (iii) within the proposed time period.

GLOH 740: Urbanization, Health and the Environment
Spring semester, 3 credits

According to the projections of the United Nations Population Division, by 2030, more people in the developing world will live in urban than rural areas and by 2050, two-thirds of the population in developing countries is likely to live in cities. This course focuses on the aspects of urban development and life that impact on the health and well-being of city residents in developing countries and particularly the urban poor.

It explores the social and economic diversity of urban populations and the complex public health issues and health disparities associated with this rapidly growing urbanization. The course addresses urban demography, epidemiology, changes in the physical and social environment and their consequences for health, nutritional and lifestyle issues, the state of urban health services, as well as public policy approaches for addressing the unique health issues of urban areas in developing countries.

The goal of this course is to prepare students to analyze the urban health problems in developing countries and to identify viable solutions to address them.