- You can't be involved, I don't think, in medicine
and be a luddite.
You can't be against tech--
You can't have this balkanized view
that Jeff said was bad.
It's bad for social change,
it's bad in the social sector,
it's bad in medicine and public health.
To believe that everything is a competition between
scarce resources is going to doom a lot of the work
that Jim has worked on or I would work on
or many of us work on.
It will doom it to failure to have that kind of--
We need just as much
in global health, for example,
that commitment to the bigger vision.
And you asked me what that was
but I just want to say, I feel that
what I'm saying is really echoing what Jeff said.
He said, "Green is green". I understood the metaphor.
Actually, Harvard's pretty savvy.
They have quite a, (laughter)
Harvard, they have a slogan there
that I see at the medical school all the time.
"Green is the new crimson."
(laughter and clapping)
Here, it's just "Green is the new green." At Dartmouth.
But, I think where we're going is, again, systems thinking.
In medicine, the interaction with an individual patient,
whether that be in Haiti or at Harvard,
You need to be attentive.
You need to be listening to what patients have to say.
But if you can't take that individual experience
and put it into an interpretive grid
that is really systems thinking and drawing on the evidence,
then you're not doing your patient a service.
You could be the most compassionate person in the world,
but if you don't know the literature,
if you don't know the data,
if you don't know what's gonna help that person
in terms of prevention, diagnosis, or care,
you're going to do a disservice to the patient.
I see global health the same way.
If we cannot apply systems thinking to--
this is why, as Jim said, we asked Mike
to spend time with us in rural Haiti.
We said, "Go to the clinics. See how this is done.
"Help us find ways of doing it better."
And that's really the future of a lot of these initiatives.
And I'll give one specific example:
If we fight for an idea
and that idea, the grand idea is, let's say, social justice.
Equity, fairness, whatever you call it.
Some of these words are sort of tarred,
inappropriately I might add.
But, it's fine to say social justice.
The idea that people deserve a fair shot
just because they're humans and they're on the Earth.
You take an idea like that
and let it drive forward a program.
And Jim has been a master at this
in my experience working with him.
The implications of saying well, you know,
it's not a good idea to say
you can't treat cancer in rural Rwanda.
What if cancer's a big problem in rural Rwanda?
It is, by the way. So that's not the good idea.
No, we need an idea that everyone deserves a fair shot.
Then you apply systems thinking.
How can we bring down prices
because of pooled procurement?
Jim taught me a lot of these things back in the early '90s.
And that's a specific example,
talking about cancer prevention,
diagnosis, and care in rural Africa.
A lot of people who are constrained
by this idea that we have very limited resources.
How many times do you think I hear, in the course
of a single week, "But we're living in a time
"of really constrained resources."
And what I've tried to do
is learn how to say rather cheerfully,
cheerfully mind you, that's another trick.
Ruth, how did I do?
- Good. (laughter)
- Cheerfully, "Yes that's true,
"but they're less constrained now
"than they ever have been before in human history."
So, what is the new strategy to drive forward
the big idea, which is equity and social justice?
What are our strategies
to make this a systematic approach to these problems?
That's the big future for global health.
And I'll just say,
to link global health to social justice movement
we're gonna have to also get together
with those environmentalists Jeff didn't like.
I'm kidding. I bet you like them now, don't you?
Green is green?
(laughter)
So, that's-- - There are many things
I've learned as I've aged, Paul.
I've mellowed a little.
- Bringing together these two big movements
in my line of work.
This happens a lot in universities and colleges.
You bring together the social justice movements.
People talking about fair trade and,
you know these are young Americans,
they care about this stuff.
And then, bring that together with the movement
for environmental justice and, you know, saving the planet.
That's gonna be where things are gonna go forward.
And just avoiding this balkanization and saying,
"If I profit, he or she will not profit." That's not true.
Any doctor working like we do, in places where we do,
know that people will be sick if they don't have jobs.
And they can't have jobs if we don't have a vibrant industry
and growth beyond the sectors that we might work in.
So, I think that that's where this is moving forward
is a less balkanized view of the world.