Thread on 'global health degrees:

Ever wondered what a "Master's degree in Global Health" might cost you?

In our @GlobalHealthBMJ paper, by @svadzianita @av_Nathaly & @seyeabimbola, we identified 41 degree programs & estimated total tuition costs.

https://gh.bmj.com/content/bmjgh/5/8/e003310.full.pdf

Vast majority of such degree programs are in Europe & North America.

Across all 41 degree programs, the mean tuition fee was US $41,790 for international students and US $33,603 for domestic students.

This does NOT include living expenses, travel, healthcare or other costs.

Tuition was higher for international students, on-campus degrees, and in private schools. Even online degrees cost US $19353.

For US schools, the average tuition fee for all students was US $68,093. There was little difference between domestic and international student fees.

The least expensive programme is at the University of Bergen where tuition fee is US$0.

The most expensive programme identified is based at Duke University (US$126 334).

Key inferences:

- there is a disconnect between where global health training is needed most versus where the degree programs are currently offered
- fees are high for most programs; without substantial external support, these degrees would be unaffordable to LMIC trainees

- We need data on diversity among global health students.

- We also need data on what proportion of the LMIC students in these degrees get full tuition fee waivers. Such data are not easy to obtain.

-Most degrees may be catering to HIC students and students from elite & privileged backgrounds in LMICs, thus privileging a student group that is already privileged.

-This pattern of global health training serves to perpetuate lack of diversity, a huge problem in global health.

- Contrary to using global health degrees to enhance equity and reciprocity, many HIC universities, especially med schools, (including private universities with big endowments) apparently see global health training as a mechanism to generate revenue

-Although few schools in LMIC offer 'global health' degrees, those that exist do charge high fees. So, even within LMICs, these degree programmes may be serving the privileged and elite.

- Contrary to using global health degrees to enhance equity and reciprocity, many HIC universities, especially med schools, (including private universities with big endowments) apparently see global health training as a mechanism to generate revenue

-Because of the pandemic, more global health degrees might move to distance education. But online global health degrees still cost about US$20 000 for international students. If tuition fees were more affordable for LMIC trainees, then thousands of students can be trained.

To democratise global health education and improve equity, & reciprocity, HIC schools must allocate a certain % of their slots for LMIC students, offer full funding support (including accommodation), and support with travel and visas. @Fogarty_NIH is a good model to consider.

By working with LMIC experts to create affordable, quality, online training programmes for LMIC students, HIC universities can demonstrate that they can deliver on reciprocity and equity.

But, even if HIC universities made their degrees more accessible, we should still ask why an African trainee must go to London or Boston to learn about control of sleeping sickness or malaria (and pay top $$$ for such training)?

Building top-notch institutions in LMICs is critical, to reduce dependence on HICs, and to improve the overall quality, depth and relevance of global health training and research.

Someday, we hope HIC trainees will earn global health degrees from such LMIC universities, and learn directly from experts who are closest to the problems and closest to the solution.

Senior authors of this paper ( @seyeabimbola & me) acknowledge that we had the privilege of training in HIC universities. We are currently professors at HIC universities, and are aware of our obligation to address the inequities discussed in this paper.

END