President Jim Yong Kim of Dartmouth College presented his proposition for improving health care to members of the Institute of Lifelong Education last Wednesday at Dartmouth. Kim emphasized execution as the most deficient component in health care provision.
Kim, who served as the Director of the World Health Organization’s (WHO) HIV department and founded the Partners in Health organization, used personal anecdotes from his own experiences to highlight the difference that details could make in determining success or failure.
During his work with Partners in Health, Kim developed a treatment program for drug resistant tuberculosis in developing countries. At the start, costs of medication and lack of practicality barred Kim from receiving any institutional support, but through his commitment to finding a solution, he was able to lower drug prices by up to 98% within two years. The solution was to simply check whether or not the drugs were on or off patent. A fully preventable epidemic could have swept the developing nations through the quick dismissal of achievability. The drugs were available, but there was a block in execution.
Kim also pioneered the “3 by 5” initiative for treating 3 million HIV patients by 2005. While designing the initiative, Kim emphasized defining a clear target and deadline. Although the WHO missed the target in 2005, 3 million were treated by 2007, which was ultimately the most effective initiative implemented by the WHO.
President Kim predicted the growing implementation bottleneck that will exacerbate inequality with the rise of new and more expensive technology, and he urged for the study of health care delivery. Some organizations are able to effectively deliver the care to those in need. One example is Partners In Health, which is treating half of the victims of the 2010 Haitian earthquake. Prior to the earthquake, Haiti was the most highly served nation of non-profit organizations, and yet most have failed to bring care to affected citizens.
Kim has led a group of researchers in collecting health care delivery case studies in order to analyze the successes and failures of projects and initiatives. He points out that discovery and development of health care techniques are useless without effective delivery of care to patients.
Kim believes that healthcare delivery is a highly interdisciplinary field and “it is so important to make the science of health care delivery a true field of study.” As president of a greatly undergraduate focused college, Kim believes the development and success of this science can only result from a liberal arts education starting at the undergraduate level.