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Q and A with Dr Peter Singer of Grand Challenges Canada
July / August 2017 | Volume 16, Issue 4
Peter Singer, O.C., M.D., M.P.H., F.R.S.C.
Dr. Peter Singer is a professor of medicine at the University of Toronto, director at the Sandra Rotman Centre for Global Health, Foreign Secretary of the Canadian Academy of Health Sciences, and, since 2010, CEO of Grand Challenges Canada - a government-supported organization that funds innovators to find health solutions that save and improve lives in low- and middle-income countries (LMICs).
In 2011, Dr. Singer was appointed an Officer of the Order of Canada for his contributions to health research and bioethics, and for his dedication to improving health in developing countries. In 2001, he received a multi-year Fogarty grant that supported international bioethics training for scores of candidates from LMICs.
What are the parallels between work with Grand Challenges Canada and Fogarty?
Grand Challenges Canada supports bold ideas with a big impact on global health. Over the last seven years or so, we've supported 700 innovations in 80 countries, in areas like women's and children's health or mental health. Those innovations are expected to save about a million lives and improve millions more lives by 2030.
Grand Challenges is like Fogarty in that it promotes innovation in LMICs. Where they differ is in their primary focus. Fogarty focuses first on people and secondarily on ideas, while Grand Challenges Canada's main focus is on the ideas first and secondarily on the people. At the end of the day, however, those are the same thing, because the best way to develop people is to let them explore their ideas, and the best way to get the best ideas is to support the best people. So it really is just picking up the problem from two different ends.
What changes have you seen in the field of bioethics?
We used to have global bioethics by policy document or treaty, such as the 1964 Helsinki Agreement, which spelled out the ethical principles for medical research involving human subjects. But bioethics by treaty is much less potent than bioethics by in-country leaders. Fogarty has been instrumental in globalizing and shifting the focus of international bioethics from treaties to people. This resulted in growth and change in the field. When we started our master's program in international bioethics at the University of Toronto with support from Fogarty in 2001, there was no systematic bioethics network, little awareness of the field, and, most importantly, no cadre of in-country leaders who wanted to move bioethics forward. Since Fogarty launched its international bioethics program in 2000, the field has grown to where we now have a vibrant cadre of in-country leaders around the world, trained in, and focused on, bioethics.
What brought about this shift in focus?
Credit has to go to Fogarty and its leadership for choosing to go down the route of people-focused bioethics, and particularly on people inside a country. When the University of Toronto teamed up with Fogarty, we started looking at bioethics through Fogarty's lens, and we ended up training dozens of leaders from LMICs in bioethics at the university. These leaders and social entrepreneurs who were trained by Fogarty-supported programs like ours, went back to their countries and made broad-based changes. What our trainees have done and continue to do shows bioethics in its true colors - as a form of social innovation and a tool for social change.
How is bioethics a force for social change?
Bioethics is a way of innovating and improving practices, and bioethics leaders are, in effect, social entrepreneurs. Our bioethics training program focused on research ethics - which is important for ensuring ethical practices for research around the world. The leaders who came from India, Pakistan, South Africa, to name a few countries, to do the program had broad interests, from organ transplantation to issues of consent and end-of-life care in a particular cultural setting. They had seen bioethics issues in their fields of interest, and with Fogarty support underwent training in Toronto that increased their understanding of bioethics and gave them the communication, advocacy and policymaking tools needed to improve the situation. Pretty universally, they went back to their own countries after the training and set out to ameliorate the social and ethical aspects of care through their institutions.
Fogarty understands that global change starts within individual countries, and during its 50 years of existence, its unique, sustained focus on supporting people in their own countries to solve their own problems has been a critical piece of the architecture and development of global health.
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