Finding a job in Global Health

Hi, my name is Greg Martin. This is a short video blog on career opportunities within the global health space. I was actually meant to come into the London School of Hygiene and Tropical Medicine and give this talk to the students. I couldn't make the dates we talked about, so we decided to make a video instead. Okay, so what we're going to cover is this. Firstly, what organizations might you want to work for if you're going to work in the global health space? Number two, what skill sets do you need if you're going to work in the global health space? And number three, what are the different areas, what is the subject matter that you might work within? How does that relate to the skill set and how does that relate to the various organizations that you might want to work within? Okay, but firstly and very briefly, who am I? My name is Greg Martin. I'm the Editor-in-Chief of the journal Globalization and Health. I'm also the Director of Elimination of Mother-Child Transmission at the Clinton Health Access Initiative. My background briefly is I'm a medical doctor from South Africa. I've done a Master's in Public Health as well and I've also done a Master's in Business Administration. When thinking about global health organizations, there's more than one way to divide things up. The one way to do it is to think about it in terms of is this organization global, national, subnational or local? I think for practical purposes it's actually easier to think of the organizations in terms of their function. So, are they providing funding? Do they do implementation work? Do they do research work? Do they do advocacy work? Do they do governance work? Do they do product development work? Do they do clinical and community work? And most organizations actually don't fit completely neatly into one of these categories, but it's a good place to start. In terms of funding organizations, there's the Global Fund, there's the Gates Foundation, there's DFID, there's USAID, there's PEPFAR, there's UNITAID, certainly lots of smaller charities that provide very specific funding in either a very specific geographic area or a very specific subject area. These donor agencies, either bilateral or multilateral donor agencies, either provide funding directly to national programs, for example the Global Fund give money to countries to procure products for HIV, TB and Malaria, or they provide money to implementing partners who actually go out and do work, or provide technical assistance to those governments. So these implementing partners might be the Clinton Health Access Initiative, or EsterAid, or MSF, or the ICRC. Some donor agencies very specifically fund research, like the Wellcome Trust funds a lot of global health research and health research. That research is being done by primarily universities, but also think tanks. So you've got, for example, the London School of Hygiene and Tropical Medicine, Johns Hopkins Universities. Actually, you'll find most universities in some shape or form have research programs that contribute into the body of knowledge that we use in the global health space. In terms of advocacy, if that's what you're interested in, you'll actually find most organizations in some shape or form are involved with advocacy, even if that's not their primary mandate. So MSF, for example, do a whole lot of work in countries with disaster relief, et cetera, et cetera, but they do a lot of good work in the field of advocacy. In terms of governance, the most important actor, of course, is going to be the national programs themselves, the Ministry of Health within the countries that you're dealing with. But providing support to those ministries in the form of normative guidelines are the various UN agencies. So that would include the World Health Organization, UNAIDS, UNFPA, UNHCR, the World Bank, which is not a UN agency, the ILO, the IMF, which is also not a UN agency, but these are what we call supranational structures. They don't fall specifically within the jurisdiction of a particular nation state. In terms of product development, so we're talking about drugs that are important in developing countries and diagnostics. You've got, on the one hand, your big pharma and your private sector. You've also got public-private partnerships, and you've got non-governmental organizations that have got projects on the go that are dealing with these things. So, for example, you've got FIND, you've got MMV, you've got PATH, you've got DNDI, and multiple others, and that's a particularly interesting area of work at the moment. And then you've got your clinical and community work, and this is technical support and work that's being done right at the coalface in the communities, you know, with people that are ill. And you've got Baylor that provide clinical support. You've got EGGPATH, you've got Mothers to Mothers that provide work in the communities, and these are extremely important. And finally, I just want to mention that, of course, there's a lot of people that work in the global health space, but don't necessarily work for a specific organization. So they sell their time as independent consultants, and they work on projects as and when across multiple organizations. Okay, let's talk a little bit about the different subject matter or the different areas that you may get involved with. And the list, in this sense, is literally almost endless. I mean, there's so many things that people get involved with. But we're going to just, again, we're going to touch the surface, but you'll see there's a lot out there. Okay, and then the reason I want to get into this is that people often have the impression that global health is really dealing with HIV in Africa, and that's global health, and that's simply not true. Right, what's out there? Let's start. Communicable disease. We've got HIV, TB, and malaria. Those are the big guys. But equally important, pneumonia, meningitis, diarrhea. You've got neglected tropical diseases, bird flu, polio eradication, measles vaccination, hemorrhagic fever. Next, we've got our non-communicable diseases, cardiovascular disease, strokes, tobacco and alcohol-related diseases, cancer, diabetes, obesity, malnutrition, mental illness, accidents, and trauma. And then, of course, we've got a whole lot of special issues and special population groups like reproductive, maternal, and newborn, and child health. We've got human rights, gender issues, refugees, and displaced populations. We've got disaster relief and emergency aid. We've got conflict in health. We've got climate change in health. We've got bioterrorism. We've got e-health, m-health, food security. We've got fresh water and sanitation issues. We've got health services. We've got essential medicines and diagnostics. And, of course, we've got the social determinants of health. So there's a lot out there, and this is just scratching the surface, trust me. Okay, next we're going to talk about the various skills and disciplines within public health. Now, don't feel as if you need to be an expert in everything, but it is going to be useful for you to know a little bit about each of these areas. Okay, let's just go through the list. Of course, you need to know about public health in general. The underlying science that defines public health is epidemiology, and you can't get away with not knowing a bit about epidemiology. And with epidemiology, you need to know some stats. You don't need to know a lot. You don't need to be able to be a statistician, but you need to have at least an understanding of what's going on in that world. Added to that, health policy, how health policy gets made, health systems, what are health systems. There's, you know, the WHO defined five sort of building blocks of health systems. Health economics, and with that, of course, development economics, social sciences, medical anthropology, these are important. Demography, especially if you're involved with maternal health and child health issues. Whatever you're doing, you need to have a good grounding in ethics and understand various, you know, medical ethics and how that came about and why that's important. Depending on what you're getting involved with, it's always a good idea to have a good sense of clinical and biological sciences that underpin what it is that you're trying to get done. Of course, you need to understand research. Even if you're not going to be an academic, you need to know where the evidence is coming from. And the last thing I want to bring up, which actually isn't talked about very often in public health circles, but that's management science. And the reason I'm saying this is because wherever you work, whatever you do, ultimately, you're going to be trying to get stuff done. And that's where management science comes in. And then down the line, if you land up leading an organization, then it becomes particularly important. Or in the middle of your career, you may have a sort of a middle management job. So these are important things. So strategy development, finance and budgetary management, organizational structure, operational excellence, human resource management, project management, portfolio management, potentially procurement and supply chain management, if you're getting involved with products and access to medicine, information management, and of course, leadership. And leadership is something that, you know, people often confuse leadership and Okay, let's try and make some sense of the different options that you have. Let's assume for a moment that you're an MPH student, you've just about to finish your master's in public health, you're thinking about working in the global health space, you're not quite sure where to go, what the what the work opportunities are, how do you make sense of what I've been saying is there's there's multiple organizations, there's a lot of different skills that you need, there's lots of different subjects that you could get involved with, what should you do? Okay, so what are the options? Option one is you become a super duper expert in a specific disease area. So you take one or two disease areas or issues and you become an expert in those things and organizations that work in that in those areas, you know, will represent possible job opportunities for you. Option two is that you develop a skill set that can be applied across a number of disease areas and you make that your marketing point, right? So you become very strong in health economics or statistics or epidemiology. And that allows you to apply, you know, the range of organizations that you can apply to is increased dramatically by making that your skill set. Having said that, organizations, if they work in a particular disease area, they tend to want you to have a good detailed working knowledge of that disease area too. So while you don't have to be the super duper expert, you're going to need to know a little bit. And so that really brings me to option three. Option three is that you get a combination of option one and two, right? So you don't try and learn everything about every disease, you take a handful of diseases that you're interested in and understand them. Add to that a skill set that you, you know, an area, a way that you know you're going to be able to add value and use that as a combination as a sales pitch. So for example, you might know a lot about HIV and a lot about health economics and you want you, your value add is going to be in the area of health economics as it is applied to the HIV epidemic, for example. Academia is a little bit of a special case, right? So if you want to go if you want to be an academic, you're really going to need to hunker down and have detailed specific knowledge in a particular area. If you're going to be an academic, you're going to need to do a PhD, right? You can sometimes get away without a PhD in academia, maybe if you're a medical doctor that, you know, they have a little bit of leeway. But by and large, you need to do a PhD and it's a big commitment. So, you know, think about it carefully. I think the question I probably get asked most common, most often by students doing MPHs is should they do a PhD after their MPH? And the answer is, well look, the reason that that question comes up is people sometimes don't have a job on the table. They're not quite sure what to do and so doing a PhD sort of seems like the sort of default thing, right? In lieu of actually having a job, I'll just throw myself into four or five more years of studying. And the other reason that they, you know, they often think it's a good idea is because the people they're asking for advice are often their lecturers and their lecturers are people that did PhDs and nine times out of ten, if you ask a person for advice as to what you should do, they're going to tell you to do the thing that they did, right? So take advice with respect to doing a PhD from lecturers and professors with a pinch of salt unless it's the case that you are interested in becoming an academic, in which case you've got to do a PhD, right? And then it's about choosing the right supervisor in the right subject matter. If you're not going to go into academia, a PhD is a big time sink and there's an opportunity cost, so think about it very carefully. Another question I get asked quite a lot is do I need to have work experience in developing, in a developing country context? And the answer to that really is yes, with exceptions, but by and large, you know, you're never really going to get taken seriously by global health organisations unless you've already got some experience and some time on the ground in a developing country context. Now I can see that this is a little bit of a chicken and an egg, right? So how do I get the experience that's needed in order to get the job that I need to get the experience? So, you know, I think a lot of people nowadays go and do some work experience, they work as a volunteer or as an intern, that's a great way to do it. There are career paths in the global health space that are a little bit more forgiving, so for example, if you're a lawyer and you're interested in getting involved with intellectual property issues that relate to access to medicines in poor countries, you can get involved with those sorts of issues and probably find work without necessarily, you know, having spent a lot of time in a developing country context. And what about jobs in the private sector? You know, if you're struggling to find a job at an NGO and, you know, are you selling out by going to work for a big pharma or something like that? And the answer to that is not necessarily. I mean, a lot of these big companies like GSK, they've got drug access programs that are very focused on increasing the access to medicines in developing countries or they've got corporate social responsibility programs or philanthropic branches that you can get involved with. So getting a job in the private sector isn't necessarily selling out to the big bad, you know, evil private sector. I mean, I think, you know, there's a lot of good that can be done and it's certainly a career option that you should keep in mind and keep on the table. Okay, and then finally, of course, there's the, what if I just can't find a job? I've been applying and there's nothing out there and I'm just getting no's or I've been to interviews but nothing. Keep working as an independent consultant as an option on the table during a period of time during which you haven't managed to find a job for a couple of reasons. Firstly, you know, you're not going to have dead space on your CV, so you're going to have been doing something. Even if it's not going to be necessarily your dream job and you don't love it and, you know, typically, you know, if you work as a consultant and you're young and you don't have a large network, you might just have to take what you can get. So it might not be the most glamorous work but it's work and it's an opportunity to network and it's an opportunity to prove yourself. So, you know, it's often like an important stepping stone to getting a job. I know a lot of, you know, a lot of people working at the WHO and UN agencies got in there by doing some consulting work, people got to know them, they got a good reputation, you know, and the next thing, you know, a job opportunity arose and they were the preferred candidate. So consulting work is a good option. Again, the consulting work problem is often one of a chicken and egg. To get consulting work, you usually have to have a bit of a network but you're wanting to do the consulting work in order to get the network. So it's not necessarily that easy to get the consulting work but it is out there and, you know, you do need to just contact the people that you do know, ask for it and you'll probably find there's something out there that you can do. Right, I hope that was useful. I'm conscious of the fact that I'm literally just, you know, scratching the surface on any one of these issues. We could talk for hours and hours, you know, in terms of the number of organizations you might want to get involved with, you know, there's literally hundreds. In terms of the subject matter, there's hundreds. I mean, it just, it never ends. I hope this was useful. I'm happy to field questions. So if you've got questions or you want to get in touch, please do and, you know, if I can give advice, I will, you know, if you've got something to add or a comment to make, that's fantastic. Okay, I hope you enjoyed this and I'm looking forward to hearing back from you. I'm happy to have it and for providing the graphics. Thanks very much.