Trade, foreign policy, diplomacy and health

6. Public Health Infrastructure and Knowledge

John Powles, Flavio Comim

2. Education, training and wider knowledge

  • Capacity of a country to absorb and use knowledge is a powerful predictor of mortality decline
  • But competent staff do not just emerge and nor can they function effectively in professional isolation
  • Quality of vocational and research training institutions therefore vital
  • Changes in public consciousness and behaviour are also key determinants of health

Staff with appropriate competences do not emerge from nowhere, and nor can they function effectively in professional isolation. The quality of institutions for vocational and research training in public health disciplines is an important determinant of staff effectiveness. Their capacity to absorb the evolving international professional culture of public health and to acquire and assimilate the latest knowledge - increasingly with the aid of digital technologies - will also determine their effectiveness.

The capacities of countries to absorb and make good use of the global stock of knowledge has been shown in the work of Jamison and colleagues to be a very powerful predictor of mortality decline: "some countries are better than others at absorbing ideas and technology from the world, harnessing technological and intellectual developments outside their country to boost those within it, and implementing new solutions as they become available".

Increases in knowledge bring health benefits not only by enhancing the effectiveness of professional medicine and public health, but also by contributing to changes in public consciousness and behaviour. If the assimilation of knowledge by the whole population is important, and if, in many important instances, such assimilation depends on informal channels rather than formal public health programmes, then it makes little sense to talk about health as some commodity-like entity that can typically be 'delivered' by 'interventions'.