“It’s a call to future-proof public health. To ask what we as a public-health community are doing about the fourth industrial revolution,” says Prof René English, Head of the Division of Health Systems and Public Health of the Faculty of Medicine and Health Sciences at Stellenbosch University (SU).
“I’m not the expert. I’m asking the questions. We must start the conversation,” she continues.
“What will South Africa and the world look like in 20 years? How will this shape our response to health systems and public, global and planetary health issues? We have to consider the changing times as we conduct research, plan systems and teach public health. Novel, yet feasible solutions that take into account the social, environmental, digital, biological, economic and other structural changes, are required.
“If we in the public-health community don’t seriously take stock of where the world is going and what we can learn from other disciplines, we may become less relevant, maybe even obsolete.”
A futuristic lens
English was outlining the thinking behind her latest endeavour: To start a community of practice that looks at how public health and other disciplines can prepare for non-communicable diseases (NCDs) and cancers. Social-impact funding has been secured from SU for this project.
“It’s building a community of practice that focuses on strengthening public health,” she explains. “Using a futuristic lens – while considering local realities.
“The rise of NCDs is a ‘wicked problem’ that will burden already-complex health systems especially in resource-poor settings,” she continues. “NCDs will be the leading cause of death in our country. Co-morbidity with HIV and other infectious diseases will be a big factor. It cannot be business as usual. Wicked problems require multifaceted solutions.
“Public health is by nature interdisciplinary. The challenge is complexity - combining everything to solve problems.”
Embracing technological age
English’s passion for public health started in the early 2000s when she worked in a primary healthcare facility as part of her PhD. She then specialised in public health medicine at the University of Cape Town, followed by eight years at the Health Systems Trust.
“What I realised is that the health landscape and burden of disease had changed, but also that we had moved into the technological age. When I started, certain funders were funding public-health ideas where people were central to the intervention. But fast forward six years and few were funding an idea that didn’t have some embedded technology.
“Conversations in public health now still focus on health systems – which is needed – but must better consider broader global issues,” she continues.
These issues include new ways of measuring disease – epigenetics, artificial intelligence, robotics, geographical information systems (GIS) and big data.
The issues that English hopes the initiative can start to tackle the trends and impact of NCDs; what public health can learn from other disciplines; the emerging trends in how communities learn and organise; and how technology, social innovation, entrepreneurship and design thinking can aid planners and teachers of public health.
To achieve this, she will bring together sectors, including government, industry, civil society and academics, to exchange and create knowledge, and to support the strengthening of teaching, learning and research in the public-health curriculum for NCDs. The initial plan comprises a series of seminars.
“I hope to facilitate, to bring the disciplines and sectors together to learn from each other,” she explains. “It will be an iterative process with reflection between sessions on what has been learnt and how to take that learning into the next session – using innovative media where possible.
“It’s about bringing the managers, policy makers, researchers, the people who deliver the care, even the patients, into a room to provide perspectives on what we are facing, how the system has responded and, importantly, understand the determinants outside health.”
It’s also about harnessing technologies, methods and tools from other sectors that can be used for effective, quick solutions.
A humble request to learn
“I’m a stickler for robust research,” says English, “but we need other ways to fix the system.”
She is also keen to involve students.
“Teaching public health has become a passion over the years,” she said. “But I pictured myself in 10 years and wondered what I would be saying. We have to reflect on how we deliver content to a generation that’s all about technology.
“The long-term view is to rethink the curriculum so that we can ensure that people think and understand the world through a particular lens. Reframing how we think as public-health practitioners in the era of the fourth industrial revolution.
“The initiative is a humble request to learn from everyone,” she concludes. “We need to start a conversation. We don’t know where it will end.”
‘If we in the public-health community don’t seriously take stock of where the world is going and what we can learn from other disciplines, we may become less relevant, maybe even obsolete.’ – Prof René English
Photo credit: Wilma Stassen