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A Call For Western Doctors To Refocus On HIV/AIDS - 2003-05-23


There’s a call for western doctors to “refocus their training and clinical practice” to help combat HIV/AIDS in the developing world. Medical students in particular are being asked to broaden their knowledge and experience.

Writing in the Boston Globe newspaper, two prominent American doctors say most “diseases of the developing world are only at the periphery of western doctors’ collective consciousness.”

Dr. Dennis Ausiello is physician-in-chief at Massachusetts General Hospital and professor of clinical medicine at Harvard University. Dr. David Shaywitz is an endocrinology fellow at Massachusetts General and Harvard Medical School.

Dr. Ausiello says it’s important for medical students in particular to understand the “limitations” and “strengths” of medical systems in developing countries.

He says, "We started a program here at Harvard called the Pasteur program to entice medical students to see both the joys and the rewards of clinical research in general. And I think as part of that an international approach to this both kinds of education and opportunity are on our agenda."

However, the rigors of medical school can narrow the focus of students, despite their best intentions.

He says, "We find that medical students coming into our medical schools each year are very much aware of the problems, are very excited about the opportunities to learn about it and participate. And yet quite frankly as they migrate through medical school and into residency programs, the focus is so extremely dedicated to the important needs of the community being served at the moment that this is sometimes a loss of touch with the outside world."

Drs. Ausiello and Shaywitz also write that western scientists need to reexamine the focus of their research projects. They say, “Less than ten percent of the world’s current health care spending is devoted to illnesses that account for ninety percent of the global burden of disease.”

Western medical journals are also being called on to dedicate fifteen percent of each issue to addressing health concerns in developing countries.

Dr. Ausiello says another to raise awareness is to develop international partnerships.

He says, "Well at the end of the day, we have to have a mutual program between developing countries and the United States and other countries that have already established health care delivery systems for other diseases to put that power to the diseases that most prominently affect the non-western world. And that certainly includes tropical illnesses; it certainly includes HIV; includes tuberculosis. It includes a whole host of illnesses."

He believes doctors and researchers are up to the challenge he and Dr. Shaywitz have put forth.

He says, "There are great aspirations and higher aspirations among the medical profession and the young students often carry that with them. And we should both celebrate that and reward it with the opportunities that will fulfill it."

In writing about the health problems in developing countries, Doctors Ausiello and Shaywitz write, “It is difficult to imagine a pursuit more closely aligned with the professional values and visceral instincts of most doctors.”

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