Emergency medicine and global health policy: history and next steps.

Abstract

The transformation of global health and the specialty of emergency medicine are both relatively new phenomena. Over the last three decades, they have developed rapidly and in parallel. Utilizing a review of the recent changes of global health policy and practice, and a review of the changing nature and understanding of the global burden of disease and its intersection with emergency medical care, this paper attempts to demonstrate missed opportunities to support the development of emergency medicine on a global scale. This paper also seeks to highlight the need for improved alignment between the global burden of disease, global health policy–setting, and emergency medicine development. Emergency medicine is a relatively new medical specialty that, when implemented, provides rapid management of acute critical illness and injury. The specialty of emergency medicine allows health care providers to adjust their scope of practice to respond to both the immediate situation and the long–term needs of their community. It supports other branches of medicine by freeing them to practice their own specialized skill set, by providing emergent supportive care, and by serving as a directed gateway to the most appropriate levels of health care delivery. Regions that have weak or dysfunctional emergency medical services, or have not yet established emergency medicine as a specialty, are at risk for avoidable morbidity and mortality. The resulting impact on individual and population health creates an avoidable social and economic burden. Global burden of disease projections indicate that the developing world should expect more trauma and injury, higher rates of chronic illness, and changes related to urbanization [1]. Yet global health priority setting and funding allocations have failed to address the predicted increased need for emergency medical services. The global community has an opportunity and a responsibility to prioritize emergency medical care through policy changes and investment in education, awareness, and infrastructure to meet the needs of our evolving health care environment.