The Dragon and the Elephant

It is always an honor to host the Dean’s Lecture Series with my colleague Arthur Rubenstein from the School of Medicine. Because we thrive on rich, invigorating discourse about global health, we felt it necessary to invite Dr. Lincoln Chen, president of the Chine Medical Board of New York, to campus to discuss what he refers to as “the dragon and elephant in global health,” a metaphor he borrows from a popular book.

In his acclaimed bestseller, New York Times columnist Thomas Friedman said that the world was flat, that advancements in technology have created a level playing field in which India and China are the major players in the commerce game long dominated by Americans. In the area of global health, Dr. Chen has taken this idea one step further, by using the metaphor of the “the dragon and the elephant” to describe the colossal roles of the two countries in shaping a global future. We are looking at the center of the world in the 21st Century when we look at these two nations, he says. And Dr. Chen makes a very compelling case.

With 30 percent of all births and deaths in the world occurring in China and India, we must take into account the “sheer weight” of these countries. But their outreach is exploding in other ways, as well. From the low-cost antiviral medicines produced in India and used throughout Africa to the first Chinese president of a UN agency (Dr. Margaret Chan of the World Health Organization), these societies are intimately engaged in global health. Still, problems exist within these countries, and the consequences could be universal. One in four doctors worldwide are Chinese, and in nurses, the ratio changes to one in 10. India exports more doctors to the US than any other country, and in China, millions of nurses and doctors have limited education, practicing with just high school degrees and some vocational training. Thus, their health workforce might change the landscape of global health, according to Dr. Chen, because if these countries produce large numbers of doctors and nurses, the impact will no doubt be global.

I have had the pleasure of working with Dr. Chen when he served as chair of the board of directors of CARE, the international relief organization of which I am also a board member. At the School of Nursing, our commitment to global health is evidenced in our programs, which range from the University-wide Penn in Botswana program to Dr. Linda Aiken’s research on nurse migration from developing countries. When discussing global health, there is much to take into account, and I want to thank Dr. Chen for opening up further channels of communication and areas of discourse.