Global Health

This module prepares students to read and critically appraise literature that reports on studies conducted using various research methodologies.

Today all countries, and most especially low-income countries, are threatened by several significant global health challenges. The effects of globalization and global decision-making on issues that affect health may inform, or sometimes compromise, national health policies, strategies, and plans. Government leaders must not only address health problems within their borders, but those that come across their borders, for example specific diseases like HIV/AIDS, avian influenza, and Covid-19.

As our understanding of the multiple and wider determinants of health has dramatically expanded, exercising governmental responsibility for the human right to health on behalf of their populations calls for political commitment to the development of a national health policies that go beyond planning for the personal health care system. It is necessary to consider of political, economic, social, institutional, educational issues, and environment circumstances, among others, from a broader perspective. In addition, health inequities, and issues concerning access to, and the quality of health and health systems have moved centre stage in policy thinking. Now globally, nationally, and locally these “goods” are very unequally distributed.

The module will consider the origins and determinants of health in relation to development, and the international architecture, institutions, and mechanisms which for part of global health governance. It will consider key current issues such as health and foreign policy; health and diplomacy; governance for health and country level including international development assistance for health; and current global mechanism for the control of biological threats to health. The impacts of locally distributed products which are distributed globally, such as tobacco, alcohol and foodstuffs, and the activities of global businesses such as the global tobacco and pharmaceutical industries, will also be considered.

Issues relating global health governance to ethics and law are increasingly important and discussed. The module will introduce students to several relevant ethical and politico-philosophical approaches to the topic of global health, as well as the range of international instruments relevant to global health law. Using concepts and arguments drawn from the fields of political philosophy, moral philosophy, and international law and governance, the module also seeks to develop students’ ability to critically assess ethical and legal issues in global health.

The module will explore the role, functions and effectiveness of global organizations affecting health, such as the United Nations, intergovernmental organizations, NGOs, and the private business sectors, as well as multilateral and bilateral donors, and their interactions with national leadership. The role of regional and local governments, professionals, civil society, communities, and individuals will also be explored, as well as the impact of the global labour market that lead to movement of health professionals seeking better pay and working conditions from low to higher income countries.

In today’s globalised world there is an urgent need to prioritize global disease management and control according to individual disease burden. High income countries are predominantly affected by non-communicable diseases (NCD) whereas Low- and Middle-Income Countries suffer from the dual burden of communicable diseases (CD) and NCDs, the latter being on the rise due to rising incomes in some countries and changing lifestyles. This module will enable students to understand key diseases that contribute significantly to overall mortality and morbidity across the globe.

The core of the module deals with aetiology, pathology, clinical manifestations, prevention and treatment. Each disease is discussed from a global perspective and addresses different geographical contexts when considering the disease. Other important aspects such as overviews of epidemiology, surveillance, data gathering and organization, global and national public health initiatives and the major organizations involved in disease control will also be presented.

This module covers research methods appropriate to researchers undertaking projects in areas from biomedical science to health services research. It is suitable for students registered on postgraduate diploma, MSc, MRes or MPhil/PhD courses which require them to conduct their own research.

This module is compulsory for the MRes and optional for the MSc.

You will conduct an independent research project in an area of interest to you. Dissertation projects will involve the assembly, analysis and interpretation of data. The project covers preparation and planning for the research as well as the analysis, discussion and presentation of the outcomes. You will be supervised by an experienced academic based at the university and, if you complete your research project abroad, will also receive local support. Previous projects have included a critical literature review of therapeutic mental health interventions in rural South Africa, for example, and a scoping review of how effective water, sanitation and hygiene (WASH) interventions are in reducing stunted growth in lower middle income countries of Southeast Asia.

The World Health Organization (WHO) defines a health care system as consisting of: ‘All organizations, people and actions whose primary intent is to promote, restore or maintain health. This includes efforts to influence determinants of health as well as more direct health-improving activities’ (WHO:2007). This is a necessarily simplified definition, but it does point to the complexity of Health System objectives, functions, and infrastructure. This module will focus on addressing the following series of questions and challenges that directly relate to the comparative analysis of health policy and health systems.

Humanitarian responses in conflict settings play a pivotal role in addressing health needs that arise directly and indirectly due to the impact of war on health systems and infrastructure. The nature of a conflict also influences the physical and mental health of the population. Even though civilians should be protected during conflict, not all conflict settings are examples of armed conflict, and conflict is embedded within a socio-cultural and political context and affects all aspects of everyday life. We propose this module to address different forms of conflict and to critically examine ethical challenges during times of conflict and humanitarian action.

Humanitarian action must now respond to increasingly complex crises. Challenges faced by humanitarian workers, when working both nationally and internationally, are impacted by the changing nature of conflict, climate change, and disasters in a globalised world. In addition, humanitarian organisations are under pressure in terms of their values and roles in volatile political situations especially when they are structured by extreme religious ideology. The effects of humanitarian crisis are increasingly globalized, as seen in current trends of migration and forced displacement. Humanitarian health efforts involve cross-cultural endeavours and due to advancements in medical technologies, medical dilemmas are further fraught with ethical challenges. Human rights frameworks are applied against the backdrop of health injustice and vulnerable populations in conflicts and demand that humanitarian actors undertake roles in truth, peace, reconciliation, and justice efforts. This module exposes some of the most pressing questions about the fragility of the human condition; responding to human distress in extreme situations means that decisions are not always ideal. Ethical dilemmas faced by humanitarian health actors will be critically analysed drawing on case scenarios and on examples of their moral experience of the field.

Social scientists, including anthropologists, understand gender as the meanings that society ascribes to particular biological or physical traits associated with being male or female. This module will explore how gender and sexuality are socially and culturally constructed, and how the ways that gender and sexuality are defined, understood and constrained has significant impact on how people experience their own bodies, identity and health, within their socio-cultural contexts. It will explore the ways that inequalities are produced and perpetuated by structures of power and explore what this means in relation to the provision of care. The anthropological lens on gender and sexuality, as well as health, provides a unique perspective on significant imperatives and interventions in the field of global health- to control women’s fertility and sexuality, to prevent and contain the spread of disease epidemics including HIV, and to categorise maleness and femaleness. Using some key concepts including embodiment, medicalisation, medical pluralism and structural violence, this module will explore some key controversies and challenges related to gender and sexuality in the field of global health. In each module session, concepts and the process of making meaning will be explored on multiple levels- from the most local and individual, the body, to national and global discourses that shape peoples’ identity, sexuality and wellbeing.

This module is intended to provide students with an understanding of the growing field of migration and health in a contemporary global context. This module is designed for students wishing to understand the health needs of diverse migrant communities, the impact that the migration process has on health outcomes, and to explore the health inequalities experienced by some migrant groups, with a specific focus on infection.

The module will explore historical and contemporary global migration trends, theories and models of migration, and specific healthcare needs and priorities. Students will learn about global health and disease patterns in diverse migrant groups, their risk factors and vulnerabilities, and explore key policies and practices and international protection structures of relevance to migrant health in low- middle- and high-income countries. The module will explore migrants’ barriers and facilitators to health and vaccination systems, and make students aware of new research to design and deliver innovations to improve the health of these populations in the area of screening, vaccination, mental health, public health communications and data strengthening, and the role of participatory research.

In addition, the course will expose students to a range of key organisations and leaders in the field tasked with improving the health of mobile populations, including speakers from the UK Health Security Agency, the European Centre for Disease Prevention and Control (ECDC), and Doctors of the World. The module will provide students with the knowledge and skills to critically analyse and discuss migration as a social determinant of health, providing them with an understanding of the current evidence-base and emerging hot topics in this evolving field.

The module offers a unique opportunity to address global mental health through viewing transcultural psychiatry from a humanities perspective and to challenge the dominance of a western medicalised way of categorising mental disorders. To achieve this, students will be exposed to different ways of exploring mental health from humanities-based approaches. Through diverse readings, presentations, film/ documentaries, case scenarios, and seminar discussions, students will be encouraged to consider the relationship between mental health and humanities in global contexts. To this end, the module offers a conscientious approach to the material such as texts and resources that students will engage with and will have a special focus on storytelling and trauma. For example, publications or representations of speech/art from exiled writers and narratives from health activists will be studied and critically analysed to critically consider both positive and negative aspects of mental health during adversity and trauma. The students will reflect and consider areas of mental health that they see as needing (further)recognition in global health discourses, with a heavy focus on nuanced and marginalized voices, and the role of narrative for bringing mental health injustice and human rights abuses to light for various organizations. The role of narrative in promoting mental health particularly in societies facing conflict, oppression, and lack of mental health care resources will also be analysed.

Students will be asked to become ‘advocates’ for a particular cause that they will argue is of vital importance for those engaging in global mental health. They will be asked to develop a way of addressing this issue from a humanities perspective, thus enhancing co-created methodologies, and lived experiences into narrative-based theoretical frameworks.

When completing your application, you will be asked to provide contact details of two referees. Please ensure these details are accurate. As soon as you have submitted your application, your referees will be contacted by the university asking them to upload a reference to your online application.

One must be a recent academic reference. The other should be either a second academic reference or a professional/employer reference. They should cover your suitability for the course and your academic ability.

Your referees should know you well enough, in an official capacity, to write about you and your suitability for higher education. We do not accept references from family, friends, partners, ex-partners or yourself.

We will send reminder emails to your referees but it is your responsibility to ensure that contact details are correct and referees are available to submit a reference. References should be uploaded within two weeks of making your application.

Lecturer in Epidemiology

Angela Donin is a Lecturer in Epidemiology at St George’s, based in the Population Health Research Institute. She joined St George’s in 2006 as a researcher to collect dietary assessments in over 2000 primary school children, joining the Child Heart and Health Study England (CHASE) Research Group. She then applied successfully for a British Heart Foundation PhD studentship and later for a Diabetes UK project grant to investigate dietary associations with early risk markers of chronic disease in children.

Since completing her PhD, she has published over 20 research articles related to ethnicity and health and the dietary determinants of early risk markers in children. She has been the Principal Investigator for a feasibility randomised controlled trial, funded by the Wellcome Trust, investigating the effectiveness of an intervention to increase cereal fibre in school children.

Alongside her research, she is involved in teaching evidence-based medicine, epidemiology, behavioural medicine and research methods in various courses across the Institution. She is also Associate Dean for Equality and Diversity Enhancement, involved in many areas of work to ensure EDI practises in research and promote an inclusive and supportive environment at St George’s.

Professor of Epidemiology

Julia Critchley is a Professor of Epidemiology with 25 years of experience working in cardiovascular disease (CVD) and diabetes (DM) epidemiology and public health. She has expertise in both explaining disease and risk factor trends and evaluating preventive interventions.

Her current research programme focuses mainly on the association between common chronic and infectious diseases such as DM, CVD and Tuberculosis (TB). She has evaluated screening for DM in TB patients (FP7 funded TANDEM project), including developing new risk scores, and mathematical modelling of the potential population impact of DM on TB disease. Her NIH-funded research recently found that CVD incidence is roughly doubled among people being diagnosed with TB disease, even after adjusting for pre-TB CVD risk. She has recently worked with the World Health Organization to draft update operational guidance for the joint management of TB and DM (in press). In the UK, her work has identified that 1 in 6 UK infection-related deaths or hospitalisations can be attributed to poor DM control, and that infection is the 3^rd largest cause of death in people living with DM.

Julia has over 200 peer-reviewed publications, many as first or last author in high impact journals.

Senior Clinical Teaching Fellow in Public Health

Richard Alderslade holds the degrees of MA. BM. BCh. (Oxon) and is a Fellow of the Royal College of Physicians of London (FRCP) and the Faculty of Public Health (FFPH), both in the United Kingdom.

His United Kingdom work included five years working with the UK Medical Civil Service, and ten years working in public health within the National Health Service as a Consultant in Public Health Medicine and Regional Director of Public Health, three years as a manager of community health services, and one year as a Professor of Community Care.

Internationally he worked for eight years in humanitarian public health work with the World Health Organisation’s Regional Office for Europe, four years with the WHO Office at the United Nations in New York, and two years again at the WHO Euroean Regional Office working on a new health policy framework for the Region.

Since 2013 he has been a Senior Teaching Fellow in Public Health at City St George’s University of London.

Professor of Clinical Public Health

Sally Hargreaves is a Professor of Clinical Public Health and Section Head for Global Health at the Institute for Infection and Immunity at St George’s. She leads the Migrant Health Research Group, a multi-disciplinary team with a particular focus on vaccination, infection, and strengthening health promotion and screening in migrant populations. She has 20 years’ experience working in a variety of research, consultancy, and lecturing posts relevant to designing and evaluating complex interventions in healthcare, with a strong focus on participatory research and co-design. She is a Senior Technical Advisor at the World Health Organization and an Advisor for the UCL-Lancet Commission on Migration and Health European Hub, involved in global and regional dialogue and policymaking around the promotion of Universal Health Coverage and tackling health inequalities in migrant populations.

Senior Lecturer in Epidemiology

Síle Molloy is a Senior Lecturer in Epidemiology at St George’s, with over 20 years experience in Global Health research. She holds an MSc in Medical Statistics (London School of Hygiene and Tropical Medicine) and a PhD in Parasitology (Trinity College Dublin) and holds a Springboard Fellowship with the Academy of Medical Sciences (AMS). Her work focusses on Cryptococcal meningitis (CM) treatment trials and implementation projects which have been conducted across a number of countries in Africa (ACTA trial, Ambition trial, DREAMM and TRIP projects). She is currently co-Chief Investigator (CI) of the EFFECT Trial which aims to improve treatment regimens to prevent the development of cryptococcal meningitis in adults with Advanced HIV in South Africa and Tanzania. She is also involved in a package of work led by DNDi aiming to develop a sustained-release formulation of flucytosine to simplify inpatient and outpatient treatment of cryptococcal infections (Phase II trials: co-CI for 5FC-PROTECT and co-I for 5FC HIV Crypto).

Alongside her research, Dr Molloy is involved in co-ordinating and delivering both undergraduate and post graduate modules at CSG and in 2021 she won the Education Excellence Award for curriculum design. She is an active mentor on the both the AMS and CSGUL mentorship programs and is an Associate Fellow at the Higher Education Academy, UK.

Clinical Senior Lecturer in Conflict and Catastrophe Medicine

Orthopaedic surgeon Steve Mannion, MA MChir DTM&H DMCC FRCS (Tr & Orth) RD studied medicine at Downing College, Cambridge. After graduation Steve combined his specialist surgical training at Guys and St Thomas' Hospitals in London with overseas humanitarian surgical missions with Medecins Sans Frontieres and other agencies to conflicts in Afghanistan, Angola, Cambodia, Ethiopia, Malawi, Rwanda, Sri Lanka, Syria, Ukraine and Turkey. Since 2003 Steve has been based in the UK as an orthopaedic and trauma consultant in Blackpool and Preston but spends up to 6 months per year overseas, running orthopaedic training and education projects. He founded the charity "Feet First" to support this work and in 2004 was appointed a Winston Churchill Memorial Fellow in recognition of his projects focussed on the treatment of clubfoot deformity in the developing world.

Steve is a consultant advisor to the overseas disability charity CBM, a lead clinician in the UK response to International Disasters and a former Chairman of World Orthopaedic Concern (UK). He was a Founding Fellow and Council member of the College of Surgeons of East, Central and Southern Africa (COSECSA), has been awarded Honorary Fellowship of the College and is still a Council Member and Examiner. In recognition of his work overseas he was appointed Companion of the most distinguished order of St Michael and St George (CMG) in the New Year’s Honours List 2025.