Available knowledge can save two out of three children

Stefan Swartling Peterson, new professor of global health, wants increased cooperation with universities outside Europe.

In Sweden as well as in Uganda, young children often have fevers. If the cause is a virus, a fever-reducing medicine is sufficient. But in Africa, where child mortality is high, malaria, pneumonia and diarrhea are common. For these illnesses it is important to quickly make a correct diagnosis and to give the right treatment.

‘Every year, seven million children die and an estimated two out of three die unnecessarily since we have knowledge that doesn’t reach them’, says Stefan Swartling Peterson.

Recently back from Uganda, he greets us in his office at the Department of Women’s and Children’s Health, right at the centre of Uppsala. As a professor of global health he has the whole world as his field of work, with particular focus on the low income countries in Africa.

In Uganda he has conducted research for ten years in collaboration with Makerere University. The research deals with how medical knowledge is implemented in the Ugandan healthcare system and how new medicines can be distributed to those who really need them.

‘Out in the villages the closest health centre can be five kilometres away by foot. Because of this, many parents choose to go to the corner shop that sells soap, salt, pain killers, malaria medicine and antibiotics. It often works, but without the right tools to diagnose the symptoms there is a large risk of them getting the wrong treatment’, says Stefan Swartling Peterson.

Educating bare-foot doctors

As part of a research project, volunteers were given quick training as ‘bare-foot doctors’, to transfer some tasks from the traditional healthcare system to people in the village. The results were so positive that the WHO and Unicef changed their policy on fevers in 2004.

‘In 2010 the Ugandan government changed their national policy and soon Unicef will present a new policy document where the concept is widened to become a global strategy’, says Stefan Swartling Peterson.

He and his research group have continued to explore how cooperation with private companies can be developed. In a study, ‘diagnosis packages’ were handed out to private pharmacies.

The packages contained quick-tests for malaria and a timer for measuring if the child was taking more than 40 breaths per minute, an indication of pneumonia. Blister packs with malaria tablets and antibiotics were also included, as well as sugar and salt solutions for children with diarrhea.

‘Since public healthcare is not working as well as it should, due to a lack of resources and problems with distribution, all while there are medicines in the private sector, we have to accept the facts and face the challenge: How can we get the pharmacies to sell the right medicines, and even harder, to refrain from selling medicines such as antibiotics when they are not needed?’

Cross-disciplinary work

Over the last few years, Stefan Swartling has divided his time between Makerere University in Uganda and Karolinska Institutet, where he has been professor of global health. Now he is back at Uppsala University where he got his medical education and his PhD in 2000.

He sees many advantages of the university’s great breadth, which is necessary when you are trying to solve complex medical questions.

‘Antibiotics resistance is an example of a question which can’t be solved simply through research in Sweden. Researching bacteria is not enough either. It is a multidisciplinary issue that requires social anthropologists, economists and political scientists. My goal is to create multidisciplinary groups around different questions.’

He also wants to create ties to universities in other parts of the world.

‘If we are to become globally relevant we must see Sweden for the small country that it is and be open for collaborations. We need major partnerships beyond Western Europe and the US, and university partners in the south.’