Developing global health education in Chinese universities: challenges and opportunities

Global health has increasingly become a critical academic field of study and practice in today's interconnected world.1Merson M.H. University engagement in global health.N Engl J Med. 2014; 370: 1676-1678Crossref PubMed Google Scholar With Emerging health crises like the COVID-19 pandemic, it is imperative for future healthcare professionals, researchers, and policymakers to understand global health issues and challenges. Chinese universities have recognized the importance of global health education and have made significant strides in incorporating it into their academic programs. The Chinese Consortium of Universities for Global Health (CCUGH) established a decade ago is one of the examples showing their seriousness in advancing the discourse of global health education and research. This new development aligns perfectly with the "Belt and Road initiative"—an initiative that has promoted economic cooperation, trade, and investment between China and participating countries. It is designed to boost economic development in less developed regions, encourage cultural exchanges, and increase China's global influence. This commentary assesses the current state of global health education, explores innovative practices in developing global health education programs, and highlights both the challenges they face and the opportunities they can seize to further enhance this vital field. The past three decades see China's rapid global engagement in almost every aspect of socio-economic development cooperation with other countries. In the areas of global health, China has deployed medical teams, constructed hospitals, donated drugs and equipment, trained health professionals in Africa and Asia.2Liu P. Guo Y. Qian X. Tang S. Li Z. Chen L. China's distinctive engagement in global health.Lancet. 2014; 384: 793-804Summary Full Text Full Text PDF PubMed Scopus (0) Google Scholar Under such a context, an increased number of Chinese universities have developed global health research and education programs. Members of CCUGH led by Peking University, Fudan University, Wuhan University, Duke Kunshan University and other six leading Chinese universities, following the model of the Consortium of University for Global Health in North America, have introduced global health courses and programs, and established global health schools, departments, research centers and institutes. These initiatives have been met with enthusiasm from students and faculty alike, indicating a strong demand for global health education. By today, the CCUGH now has 31 member universities in China, most offering global health education programs for their under- or/and post-graduate students. Wuhan University has enrolled undergraduates in global health since 2012 and established student exchange programs with universities in Asia and North America.3Guo Y. Development of global health research in China.J Glob Health. 2017; 7020102Crossref Scopus (8) Google Scholar,4Sun L. Zhao D. Xiong S. et al.Disciplinary development of global health academic degree programs in China.Glob Health J. 2021; 5: 102-111Crossref Scopus (2) Google Scholar Peking University, Fudan University, Tsinghua University, and Shanghai Jiaotong University have long recruited postgraduate students for global health training. Some programs were funded by the Ministry of Education, China, as special training programs attracting overseas students studying in China. Duke Kunshan University—a China-US joint venture university, launched its Master of Science in Global Health in 2014, and has recruited undergraduates in global health since 2018. Its master students have been encouraged to spend ten weeks in one country to complete the fieldwork upon which their theses are written up (Fig. 1). In addition, students from Duke Kunshan University are given opportunities to intern with UN and other international organizations with scholarship supported by philanthropic organizations. Unlike the universities in Western countries, the history of the global health education program in China is about one decade. There are many barriers and challenges that Chinese universities are facing. The first major challenge is the limited pool of faculty members with expertise and hands-on experiences in global health research and practices. Building a strong cadre of instructors who can effectively teach global health concepts and skills is essential. This requires investing in faculty development and recruitment to ensure a diverse range of perspectives and expertise. Secondly, integrating global health courses into existing medical and public health curricula can also be challenging, as more and more new medical/health science and knowledge need to be included in the curricula, let alone the inclusion of humanity and social sciences being seen as an important element of medical and public health education. In addition, essential courses related to global health competence,5Schleiff M. Hansoti B. Akridge A. et al.Implementation of global health competencies: a scoping review on target audiences, levels, and pedagogy and assessment strategies.PLoS One. 2020; 15e0239917Crossref Scopus (11) Google Scholar introduction to practical skills, such as consulting services, have not been brought into the curricula in these programs in China and even some Western countries. Climate change and its impact on health, anti-microbial resistance, among others, are rising global health challenges that should be included in these education programs. There is clearly a need for the guidelines and standardized frameworks to help universities effectively integrate global health content. Thirdly, adequate funding and resources are crucial for the growth of global health education. Developing and sustaining global health programs, establishing partnerships, and supporting research initiatives require financial investment. Over the past decade, the Department of International Development of the British Government, the Bill and Melinda Gates Foundation, and the China Medical Board have provided research and training grants to support a number of Chinese universities to engage in global health activities. However, funding from Chinese government agencies, such as the National Science Foundation or the Ministry of Education, has been very modest so far. While the Chinese universities have faced many challenges, they also have abundant opportunities. They can leverage their growing academic influence to foster international collaborations in global health. Partnering with universities and organizations from other countries, especially the global south, can provide valuable resources, knowledge exchange, and research opportunities. Embracing an interdisciplinary approach is a key to advancing global health education and research, as global health is inherently interdisciplinary, spanning medicine, public health, social sciences, and economics. Research and Innovation is another area of opportunity: China has made significant strides in research and innovation in various fields. They can channel this energy into global health education and research, addressing pressing issues such as infectious diseases, climate and environmental health, and healthcare access. By investing in research infrastructure and promoting innovation and potential collaboration with private sectors, Chinese universities can contribute to global health solutions. Engaging students in global health activities, such as internships, fieldwork, and international exchanges, can enhance their understanding and commitment to global health. Chinese universities should do more to create opportunities for students to gain practical experience and become global health advocates. Global health education in Chinese universities is at a crucial juncture, with challenges and opportunities. Universities must prioritize global health as an essential component of their mission and allocate resources accordingly. With strategic investments in faculty expertise, curriculum development, and international collaboration and partnership, Chinese universities can play a significant role in addressing global health challenges and producing the next generation of global health leaders. As the world continues to face emerging health crises and challenges, the importance of global health education cannot be overstated, and Chinese universities have a vital role to play in shaping its future. Shenglan Tang conceptualized and drafted the commentary. Chenkai Wu and Yunguo Liu reviewed and edited it. The Lancet Group takes a neutral position with respect to territorial claims in published maps and institutional affiliations. No conflicts of interest declared. Funding: no funding received for working on this commentary.