The independent news organization of Duke University

Global health injects new life into North Carolina

If Washington Duke—one of the famous tobacco giants during the late 1800s and a large benefactor of then-named Trinity College—were alive today, something about Duke’s progress might make him take a smoke break.

According to a recent University study, the once-heralded North Carolina tobacco industry may be replaced by a field that could not be any more different from the industry that produces cigarettes.

The study, which is authored by members of the Duke Global Health Institute and the economics department, found that global health accounted for more than 7,000 jobs and $508 million in salaries in 2007, making the total impact of global health on the state’s economy somewhere between $1.7 and 2 billion.

The figures from the study are representative of what Dr. Michael Merson, director of the Duke Global Health Institute, calls a “new North Carolina.” He added that much of the $2 billion contribution came from organizations or companies based in the Research Triangle Park area.

“We want North Carolina to be the place where people come for global health in this country,” Merson said.

And it may be just that, especially in the case of non-profit organizations.

According to the study, non-profits contributed the most to the global health sector of the N.C. economy, consisting of more than 3,400 jobs and $1 billion in total business activity in 2007.

DGHI Assistant Director Kim Chapman-Page, who was one of four authors of the study, said the researchers were surprised by the large impact of non-profits. She said she hopes the study will direct the government to increase funding of global health initiatives.

“One of the things that I hope is a main outcome of this study is that it helps make not only our students and our global health experts aware of the importance of the global health sector and the role that North Carolina is playing in the global community, but it will also help some of our legislators and our policymakers be more aware of how important this sector is for the state’s economy,” Chapman-Page said. “It’s sort of a win-win for North Carolina because it’s a sector that is benefiting us at home through the economic impact that it has, but it is also literally helping save lives around the world.”

Chapman-Page said the N.C. textile industry—which has historically been one of North Carolina’s signature fields—was worth $2.6 billion in 2007, only about half a billion dollars more than global health.

Although this study measures the impact of global health on the N.C. economy, that figure is hard to compare to other states, Chapman-Page said. Only the University of Washington has conducted a similar study.

The Washington study, however, differs from Duke’s because it accounted for organizations that aim to improve the health of residents in the state, making its total impact much larger, the report noted.

Survey may underestimate impact

The study also researched academic institutions’ contributions to the global health industry, finding that Duke and the University of North Carolina at Chapel Hill accounted for approximately 90 percent of the almost $51 million in total business activity coming from the academic community.

But, if anything, the study’s findings underestimate global health’s actual impact, said DGHI Assistant Director for Communications Geelea Seaford. The institute had only been in existence for one year when the study’s data was compiled.

“When we talk about the study, we talk a lot about it being a baseline because we know there has been a lot of investment, particularly here at Duke,” Seaford said.

In addition to the increase of funds for the DGHI, RTI International, a N.C. non-profit organization listed in the study for contributing heavily to the global health sector of the economy in 2007, received almost 16 percent more revenue from contracts and grants in the 2008 fiscal year, receiving $709.7 million last year, according to RTI’s 2008 Annual Report.

Chapman-Page said the authors had to sort through the tax returns of all N.C. non-profit agencies to determine which organizations seek to eliminate health disparities in low- and lower-middle-income countries. But dealing with a lack of data made the study an underestimate, she said.

“A lot of organizations, including religious organizations and those that make under $25,000 in growth receipts every year, don’t actually have to file with the government,” Chapman-Page said. “The data simply isn’t available for a lot of these organizations.”

A recession-proof industry?

Although it is hard to quantify the recession’s impact on the global health industry, Adrian Garcia-Mosqueira, who received a master’s degree in economics this Spring and is one of two student authors of the study, said research shows that the global health field does not show signs of slowing down.

“It will continue to increase in importance because this is something that people are just now starting to take a look at and realize that it’s pretty important,” said Garcia-Mosqueira, who compared the global health industry to the growing amount of spending on the environment. “As a culture, we have eliminated a lot other problems of the past, and now we need to focus on a more global perspective.”

Merson said many industries—and the U.S. government—are beginning to recognize the importance of the global health field. President Barack Obama announced in early May that he plans to spend $63 billion on global health programs that benefit poor countries.

Merson said the field is emerging at this time partially because college students are interested in the topic. He added that the global health commodities market is worth $3.5 trillion, which has attracted the attention of the business world.

“We recently had a meeting in [Washington, D.C.] of 60 universities who are working in global health,” Merson said. “And I was very impressed at how much global health has grown as a field in academia and how many nongovernmental organizations there are now working in the United States. That energy of today’s youth is very much driving much of what we’re seeing on college campuses.”

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