How can history help the global health community today?

False coloured light micrograph of MRSA colonies. Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium which is difficult to treat due to its resistance to common forms of antibiotics.

The latest WHO Global Health Histories seminar tackled the difficult subject of antimicrobial resistance. And the actions we take today can benefit from an appreciation of those in history, writes Alexander Medcalf.

The World Health Organization (WHO) has identified antimicrobial resistance as a major global problem. Organisms that are able to adapt to resist attack by antibiotics, antivirals, and antimalarials mean that standard treatments are becoming ineffective. For some, the pressing concern is that without urgent efforts, large parts of the world will be plunged into a ‘pre-antibiotic’ era. World Health Day 2011 underlined this hard reality of antimicrobial resistance; “no action today, no cure tomorrow.”

Since their discovery over seventy years ago, antibiotics have helped to revolutionise healthcare. But several factors now drive resistance, including the use of poor quality antimicrobials or when patients do not complete a full course of antibiotics as prescribed. The results are alarming. The WHO has reported that every year close to 440 000 new cases of drug-resistant tuberculosis emerge, resulting in approximately 150 000 deaths. In other instances the malaria parasite is developing resistance, and resistant strains causing gonorrhoea are restricting treatment choices. The WHO Director-General has warned that the world is on the brink of losing its miracle cures.

It was therefore fitting that on 11 January 2013 the first Global Health Histories seminar to be hosted outside of the WHO’s Geneva headquarters should deal with this significant and urgent subject. Held at the WHO Regional Office for Europe in Copenhagen, the speakers were both high-profile experts in their field – Professor Christoph Gradmann of the University of Oslo and Dr Danilo Lo Fo Wong, Senior Adviser on Antimicrobial Resistance at the WHO Regional Office for Europe.

Professor Gradmann’s presentation outlined the story of antibiotic resistance in medicine and public health after World War Two. It followed WHO-sponsored initiatives to support the establishment of international standards for antibiotic sensitivity testing. Dr Lo Fo Wong spoke of the WHO’s renewed efforts in the field of antimicrobial resistance, detailing its more comprehensive approach and broader partnerships than ever before. The WHO has provided renewed advice and leadership on this issue.

Linking the two presentations in this way is a central feature of the Global Health Histories initiative, which has operated since 2005. It seeks to bring together academic speakers and WHO officials, and is based on the principle that an understanding of the past helps frame current discussions, and assists responses to present-day issues in global health. To date, more than sixty Global Health Histories seminars have been delivered in Geneva, examining subjects including Malaria; SARS; tobacco control; obesity; and Chlamydia.

The series has met with mounting support. Copenhagen’s seminar, for instance, attracted a capacity audience at the venue and large numbers over the Internet . The popular webinars have allowed people from across the world to benefit from the important discussions, with the broadcasts being subsequently archived and made available to all. In Copenhagen, speakers and organisers were delighted by the energetic response of both audiences who were eager to discuss the topic during the event and also at length afterwards.

This latest seminar represented the first step in a major expansion of the Global Health Histories initiative, marking an important new collaboration between the organisers, the Centre for Global Health Histories at the University of York, UK and the WHO Regional Office for Europe. This will see important global health issues tackled at seminars in Copenhagen on a regular basis. This expansion has been possible thanks to the tireless energy of many individuals, not least of which is the Wellcome Trust, who have provided generous support to this and other events in the series. This year’s Global Health Histories seminars will continue at the WHO’s Geneva Headquarters from February. Now in its seventh year, the initiative continues to show that understanding the history of health can play a key role in helping the global public health community to better respond to the urgent challenges faced today.

Alexander Medcalf

Alexander Medcalf is Outreach Historian at the Centre for Global Health Histories, University of York.

Catch up on the Global Health Histories seminars on the WHO website.