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Alum Farmer among speakers at launch

Three keynote speakers-a Nobel Prize winner, the former president of the International AIDS society and the subject of the class of 2008 summer reading, spoke Tuesday to an overflowing crowd in Schiciano Auditorium. The discussion celebrated the launch of Duke's Global Health Institute.

The speakers tackled topics such as health care disparities in countries like Africa, India and China, health insurance, student advocacy, medical ethics and the role of research universities with regards to community service.

Dr. Victor Dzau, chancellor for health affairs and president and CEO of Duke University Health System, opened the symposium. Dzau called the new institute one of the most important initiatives at Duke, saying it had the potential to shape many future institutions. He also cautioned the audience that Duke's global health efforts may not always be well received in other countries or even within the United States.

"There is a risk [these initiatives] will be perceived as American arrogance," Dzau said. "We cannot assume that we always have the best answer-the best solution-so we have to learn from each other."

The institute will work with the Durham community to combat local problems, Dzau said.

"Eighteen percent of Durham residents do not have health insurance, and 79 percent of Durham Hispanic residents do not have health insurance," he said.

Dr. Paul Farmer, a Duke alumnus and founder of an international charity organization that made him the subject of the book Mountains Beyond Mountains, echoed Dzau's theme.

"We have some work to do to gain trust-I'm not talking about Haiti.... I'm talking about the trust that can be made by going around the corner," he said, alluding to the recent tensions in Duke-Durham relations incited by the allegations of a rape by members of the Duke lacrosse team.

Farmer, who is also The Maude and Lillian Presley Professor of Social Medicine at Harvard Medical School, urged Duke's administration to motivate young faculty members, who are often concerned with rising in the ranks of an institution quickly, to be rewarded for volunteering abroad rather than penalized. He also encouraged faculty to stress the importance of student advocacy, citing his time at Duke as the impetus for his interest and involvement in global health efforts.

"Student activism has been very important in galvanizing American universities to get engaged in these problems of global health," he said. "It's not a good way to proceed to have students merely be spectators to poverty-if we don't act, our welcome will be revoked."

Farmer also praised the multi-disciplinary approach of the new institute because it involves more than just the medical community. "Saving someone's life is only the beginning of the conversation," he said, noting that AIDS medication is useless to someone dying of starvation or another disease like tuberculosis.

Although Farmer spoke primarily about issues related to Duke, the other two speakers-Amartya Sen and Joep Lange-tackled broader issues.

Sen, a Nobel prize winner in economics, dismissed the common perception that global health care efforts in impoverished countries would not be cost-effective.

"Health is an integral part of being a human being. It's not just about being productive-there's a deeper ethical responsibility," he said. "There's got to be some way to differentiate a good human being from a good chest of drawers," he added, eliciting laughter from the audience.

Sen also cited widespread illiteracy, a lack of resources and insufficient personnel as major but solvable problems in the fight for health care equity.

Lange's speech focused on sustainable health care in Africa. He explained that the migration of African doctors to Europe and United States is a major problem that results in a lack of resources and medicine throughout the continent.

He suggested increasing local training opportunities for young doctors, and in a moment of levity, expressed his bewilderment that modern medicine has yet to spread to many parts of Africa. "I know there's not a place in Africa where you can't get a Coca-Cola or a cold beer," he said. "I don't know why it works for these types of products, but does not work for medicine."

Lange criticized U.S. President George W. Bush's administration for taking an apathetic, insular approach to health care disparities. "We do not live in isolation," he said. "This is not the leadership we need in light of this emergency," he added, finishing his PowerPoint presentation with a cartoon of Bush making paper dolls and shapes out of various international treaties.

Lange ended on a theme that ran throughout all three speeches-the growing need for superior health care across the globe and the need for action by the government, universities and individuals.

"We are reaching a point where 'emergency response' will no longer do," Lange said. "But we should see this as an opportunity-and not as a threat."

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