Global Medicine, Parasites, and Tasmania.

Goldsmid Jm ,Ss Bettiol

doi:10.3390/tropicalmed5010007

Abstract

Until the 1970s, infectious disease training in most medical schools was limited to those diseases common in the area of instruction. Those wishing to explore a more globalised curriculum were encouraged to undertake specialist postgraduate training at schools or institutes of tropical medicine. However, the increase in global trade and travel from the 1970s onward led to dramatic changes in the likelihood of returning travellers and new immigrants presenting with tropical infections in temperate regions. Furthermore, population growth and the changing relationships between animals, the environment, and man in agriculture accentuated the importance of a wider understanding of emerging infectious diseases, zoonotic diseases and parasitic infections. These epidemiological facts were not adequately reflected in the medical literature or medical curriculum at the time. The orientation on tropical infections needed specialised attention, including instruction on diagnosis and treatment of such infections. We describe key global health events and how the changing field of global medicine, from the 1970s to early 2000, impacted on medical education and research. We describe the impact of global health changes in the Tasmanian context, a temperate island state of Australia. We retrospectively analysed data of patients diagnosed with parasites and present a list of endemic and non-endemic parasites reported during this period. Finally, we reflect on the new approaches to the changing needs of global health and challenges that medical programmes, learners and educators face today.

Highlights

In 1964 and based on concerns regarding tropical disease in temperate climates, Dr Kevin Cahill published a series of articles in The New York State Journal of Medicine
By 1974, Woodruff in the preface to his book stated that “Medicine in the tropics is of great importance to all practitioners be they working in temperate or tropical regions” [2]. He had already noted that through travel “even in temperate regions, a significant proportion of the community has been exposed to disease in tropical and subtropical regions” [2]
In 1986, the Global Programme on AIDS (GPA) was launched by the World Health Organization [22] followed by the Global Polio Eradication Initiative (GPEI) in 1988, which was led jointly by national governments, the WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC), and UNICEF [22,23]

Summary

Introduction

In 1964 and based on concerns regarding tropical disease in temperate climates, Dr Kevin Cahill published a series of articles in The New York State Journal of Medicine. He had already noted that through travel “even in temperate regions, a significant proportion of the community has been exposed to disease in tropical and subtropical regions” [2] What he said is even more important with more global connections involving travel and trade, changes in climate, and the environment and human spread into previously uninhabited regions. This, has led to growing clinical needs and development of medical practitioners, public health and health professionals with an understanding of these diseases, working at the local, regional, national, and global level For those teaching and developing medical curricula these diseases present many challenges and have become more complex due to the changing focus of healthcare systems, globalisation, cultural and societal factors, and technology.

Time Line of Selected Global Health Events

Historical Overview of Tasmania and Parasites of Medical Importance

Findings

Conclusions