Dean Bloom had a suggestion. "If you really want to have an impact in India," he told Gupta, "start a school of public health."
Gupta didn't forget.
Describing his next steps to HSPH supporters at a meeting in New York City in May, Gupta explained that, as a member of the HSPH Dean's Council, he decided to take advantage of his access to Bloom and faculty by jumpstarting research projects involving the School's experts in India, "but that didn't get us where we wanted to go."
A turning point came in 2004 when Gupta, whose management consulting firm advises leading companies worldwide, took part in meetings with several deans of the American Association of Schools of Public Health that involved government representatives from India and business leaders like himself. The result: an idea to forge a public-private partnership to develop a better public health infrastructure--including a network of preventive health services and professionals--that might help solve India's massive health challenges, which range from a lack of clean water and malnutrition to epidemics of tuberculosis, HIV/AIDS, and chronic diseases, including obesity and heart disease.
"You can't expect to solve India's health problems by focusing on curative health interventions," Gupta observed at a recent HSPH Dean's Council gathering in New York. "The U.S. hasn't been successful in doing that, and it spends 16 percent of its gross domestic product on health care." By contrast, India spends less than 1 percent--although the government aims to triple that figure in the coming decade.
Last spring, their work culminated in the launch in New Delhi of the Public Health Foundation of India (PHFI), a public-private partnership that will create five to ten new schools of public health, two by 2008. PHFI's primary objectives are to develop qualified public health professionals, undertake research, and set schools' educational policy. The foundation is modeled after the American Academy of Sciences in the United States, with a board made up of representatives from national and state governments in India, and non-governmental organizations, corporations, and universities from around the world. While it has the enthusiastic support of Indian Prime Minister Manmohan Singh, PHFI will operate autonomously, unfettered by governmental controls.
"Just 18 months ago there were about 300 people graduating with masters' in public health in the entire country each year. We need so many more," Gupta said. "If India is to put even a single public health worker in each village, as the government plans to do, ultimately we will need 500,000 trained people just to deliver public health programs and messages. We'll need experts to train workers, address myriad health policy issues, and conduct research." The vision for PHFI is to train people at multiple levels: public health professionals, district health workers, field epidemiologists, and high-level researchers. HSPH's role is to help train leaders and trainers at each level.
In addition, HSPH, Harvard University, and PHFI will foster a "think-tank environment," Gupta said, in which to conduct research that will lead to new policy and action. Citing a 2005 McKinsey report, he stressed that creating a demand for research in India will be challenging, given the lack of public-health-oriented academics and policy makers.
A priority for PHFI is to set educational standards. The foundation will establish an accrediting mechanism for new and existing schools, and recruit permanent faculties. More than 150 academics around the world have already signaled interest in helping.
Preparing for take-off
India's 28 states are in competition for the first two schools; those demonstrating the greatest commitment to building a better public health infrastructure will win out. With 80 percent of health care run by the private sector, Gupta said, it's unclear what role India's national government, states, 540 districts, and half a million villages will play in developing a web of professionals capable of delivering preventive services population-wide.
Some infrastructure does exist, noted Dean Bloom, pointing to India's immunization of 100-million-plus children against polio within six days in 2004. "It will be interesting to see a high-functioning public health system created from the ground up," Bloom said. "It's estimated that huge numbers of India's citizens will soon have cell phones. How might technologies like this be used to track delivery of services that will be innovative and low-cost?"
"We've accomplished a lot in the last 18 months," Gupta said, "but the work has just begun. I've never been as excited about a project in my life as I am about this one."
Julie Rafferty is the senior director of development marketing and planning in the Office for Resource Development at HSPH.
Photo: Reuters-Amit Dave
This page is maintained by Development Communications in the Office of Resource Development.
To contact us with suggestions, comments, and questions, please e-mail: firstname.lastname@example.org
Copyright, 2006, President and Fellows of Harvard College