Western Doctors Must Refocus Training, Clinical Practice, To Successfully Combat AIDS, Opinion Piece Says

In order to successfully implement President Bush's five-year, $15 billion AIDS initiative, "we must now begin to change" the fact that "with few exceptions, diseases of the developing world are only at the periphery of [Western doctors'] collective consciousness," Dr. Dennis Ausiello, physician-in-chief of Massachusetts General Hospital and the Jackson Professor of Clinical Medicine at Harvard University, and Dr. David Shaywitz, endocrinology fellow at the Massachusetts General Hospital and Harvard Medical School, write in a Boston Globe opinion piece. In order to make this change, it is "critical" that Western physicians and public health workers establish relationships with health care providers in the developing world to understand the "unique limitations" and "undervalued strengths" of these regions, Ausiello and Shaywitz say. In addition, Western medical journals should dedicate 15% of each issue to addressing health concerns specifically relating to developing nations to "familiarize Western physicians and scientists with the unique medical needs and problems of people living in low-income countries and ... generate fresh insights and novel approaches" to fighting diseases in developing nations, Ausiello and Shaywitz say. Western scientists also need to reexamine the focus of research projects because less than 10% of the world's current health care spending is devoted to illnesses that account for 90% of the global burden of disease. Finally, medical school programs should incorporate a more global perspective, as they are currently "biased to the problem of diseases in the Western world -- diseases that medical students will most frequently encounter once they become physicians," Ausiello and Shaywitz say. They conclude that while the health problems facing the international community represent "a challenge in monumental proportions ... it is difficult to imagine a pursuit more closely aligned with the professional values and visceral instincts of most doctors" (Ausiello/Shaywitz, Boston Globe, 5/21).