History of Mount Sinai Global Health

Mount Sinai Global Health was developed to meet the many challenges of global health. Because it builds synergies among the many global health initiatives already in place across many departments at Icahn School of Medicine, it has the potential to rapidly become one of the leading medical school global health programs in the United States.

The initiative gathers its strengths from the fact that it:

  • Has strong faculty leadership
  • Has a base in a highly ranked medical school
  • Has a foundation in Mount Sinai’s tradition of service to the community
  • Is located in New York, the nation’s largest, most diverse and most global-oriented city

By supporting innovative research and training the next generation of leads in global health, the initiative will be able to keep up with our changing world and the attack global health issues such as infectious diseases, chronic diseases, and diseases caused by toxic chemicals.

Our Changing World

Year by year our world is becoming smaller and more highly interconnected. The idea of a “global village” is coming closer and closer to reality. A person can fly today from West Africa to New York in 8 hours - and in 12 to 14 hours more move on to Buenos Aires or to Tokyo. With television, cell phones, and the internet, images and ideas can move at the speed of light from anywhere on earth to virtually everywhere else.

The world’s population is rapidly growing. Today there are 6.9 billion people on Earth, of whom 2.2 billion are children1. By 2050, there will be 9 billion people2.

The world is rapidly becoming urbanized. According to the United Nations Population Fund, in 2009 – for the first time in all of human history – more than half the world’s population lived in cities. Extreme crowding in the slums of third world megacities creates great risks for human health.

The world is becoming warmer. Diseases such as malaria and dengue that once were seen only in the tropics are now spreading far beyond their traditional boundaries. Sea levels are rising. Extreme weather events are becoming more and more frequent. The United Nations Institute for Environment and Human Security (UNU-EHS) has estimated that 500 million to 600 million people, or close to 10% of the world's population, are at risk from displacement by climate change. Already 26 million people have been forced to leave their homes, a number which could grow to 150 million by 2050. In many cases, these new ‘climate refugees’ will put undue stress on the medical infrastructures of the communities into which they migrate. Global warming will also influence health by provoking shortages of safe drinking water, resulting in waterborne epidemics such as cholera.

The world is becoming more polluted. Toxic synthetic chemicals that once were found only in developed countries have now spread worldwide. Toxic synthetic chemicals and pesticides banned in North America and Western Europe are exported to less developed nations where they cause cancer, birth defects, and sterility. Hazardous waste, including millions of tons of highly toxic e-waste is shipped from the most developed to the least developed countries where it accumulates in vast landfills and is scavenged by child workers.

The world is beset by extremes of wealth and poverty. According to the World Bank Development Indicators, almost half the world’s population – over three billion people – lives in poverty with a daily income of less than $2.50 US dollars.

The Rise of Global Health

All of these changes have already had profound impacts on human health. They will continue to strongly influence health and disease in the years ahead. Global health is now recognized to be one of the truly critical issues of the 21st century.

Infectious Diseases
Infectious diseases remain a major problem for world health as they have for millennia. In the developing world, infectious diseases remain the major causes of sickness and death. Pneumonia, dysentery, malaria, AIDS, and other infectious diseases are still today the leading killers in the poor, relatively undeveloped counties of sub-Saharan Africa, Latin America, and Asia. They account for tens of millions of deaths each year – most of them in children3. They sap the future of entire nations and condemn countries to an unending cycle of poverty.

New infectious diseases such as SARS, influenza, Ebola fever, and West Nile Virus will continue to emerge from the far corners of the planet. They can spread worldwide with astonishing rapidity. They have potential to spread to the United States, in the worst case within days or even hours.

Chronic Diseases
Chronic diseases – heart disease, cancer, stroke, and diabetes – are also spreading worldwide as the Western lifestyle becomes the world’s lifestyle. Western-based multinationals target urban areas in the developing world with advertising campaigns, persuading people that they must have a hamburger, a beer, or a cigarette. Centuries-old diets and traditional norms of behavior erode. As a result, heart disease is now the leading cause of death in India. In China, 25% of schoolchildren are overweight or obese3.

Diseases Caused by Toxic Chemicals
The US Environmental Protection Agency estimates that more than 80,000 new synthetic chemicals have been invented in the past 50 years. More than 10,000 of these materials are commercially significant. They are distributed widely in countries around the world – in developed as well as developing countries. Many of these chemicals, such as pesticides, solvents, and industrial chemicals are known to be toxic to human health. Many thousands more have never been tested for toxicity. Exposures to toxic chemicals have been shown to cause cancers, birth defects, lung disease, and injury to the brain and nervous system. Far too commonly in third world countries, exposures to toxic industrial chemicals are uncontrolled. Young children are the segment of the population at greatest risk of disease caused by toxic chemicals.

Diseases of Mothers and Infants
Infant mortality in the world’s poorest countries exceeds 150 per 1,000 births in contrast to 6 per 1,000 in the United States. Maternal mortality continues very high in developing countries with 1 in 75 women in poor countries dying during pregnancy and childbirth in contrast to 1 in 6,000 in the United States. In the world's poorest countries, 18 percent of the population is undernourished. Most of the undernourished are children3.

The Global Health Care Crisis
Governments of poorer countries lack the money for effective public health programs. Hospitals and clinics in these countries are often underfunded and understaffed.

References
1 Kunzig R. Population 7 billion. National Geographic 2011; 219: 32-69
2 World population 1950-2000: perception and response,' in P. Demeny and G. McNicoll (eds.) The Political Economy of Global Population
Change, 1950-2050 (New York: Population Council, 2006), pp. 1-51. (Supplement to Population and Development Review, vol. 32)
3 Per the World Health Organization