One of the founding editors of the IHP newsletter, David Hercot, is leaving ITM soon. There is no better place than this blog to host his personal reflections on the future of a European Global Health researcher.


Dear Colleagues, Dear Friends,

Some of you know it already by now, but if you don’t, this blog post is to announce that I’m leaving the Institute of Tropical Medicine at the end of the month. I’ll be joining the Brussels Health and Social Observatory as a medical researcher. Despite this title, I will work more as a broker than a researcher from now on. My work will consist of commissioning, collecting, analysing, disseminating research to inform policy makers and policy implementers on ways to make health policies effective for those who need them most. The centre has a strong focus on tackling poverty and addressing social determinants of health. It is a public service attached to a commission that emerged from the – as you know – incredibly complicated institutional arrangements of the Belgian state.

Short term thinking has not inspired my decision. Instead, it is a decision based on my mid- and long term career plan. Many elements played a role. The workshop organized by the Interdepartmental Center on International Health Policies (ICHIP) on the future of development cooperation has been one. The scenarios developed by HIVA might be extreme caricatures of what the future might be. Still, they point to the emergence of a rapidly changing world where the place of North-South technical assistance in the way we have known it in the past half century will be more and more put into questions. In the long run, the number of emerging voices in global health from BRICS, middle and low income countries will continue to increase. This is a trend I obviously applaud. Yet, it implies that the role of a Belgian “Global Health” policy adviser will probably more and more focus on global affairs and fragile states in the future. To do this job effectively, extensive travel will be needed to remain aware of the reality on the ground. A reality you can’t grasp just online. By contrast, joining the Brussels observatory allows me to work close to (or even “embedded in”) the field, twelve months a year. On another level, the “future we seem to be getting” will raise massive challenges to humankind that go beyond health systems organization. It’s a future I do not accept, so instead I hope to participate in the emergence of another future, the future we really want for our societies that will supersede the good(s) the industrial revolution and capitalism brought us.

A shorter term reality is that funding for northern institutes to do health systems research about the Global South context will probably continue to decrease. On the one hand, the economic crisis will reinforce the concentration of research money form OECD countries on OECD problems and OECD economic development. We can already see this in the shift in priorities in FP8 funding opportunities and rules of EDCTP funding. On the other hand, the Paris declaration principles that the aid community has been advocating for many years, are cutting the very funding basis that this same community relies on. The philosophy that lies behind the third framework agreement between ITM and DGD (which very likely will continue in the fourth agreement) suggests that “more aid money should go directly to those who need it”  and is thus perfectly in line with this. However I am of those who believe that those who need aid are not the governments but the people and that mechanisms have to be put in place that allow aid to reach them. Further, this vision of aid should not deter donors from funding research on aid and aid effectiveness itself. The Holy Grail of aid effectiveness probably does not exist and we should keep questioning our habits and adapt them to a moving context.

I don’t say that there is no space anymore for a committed European researcher to work in Global Health. There is and there will be a long term need for dedicated people to support global health governance arrangements and help failed states’ populations to get out of their predicament. My point is: if you want to do it well, it imposes choices in terms of balance between professional development and family life that I don’t want to make at this stage in my life.

J’ai énormément appris au cours de ces années à l’institut et j’ai la chance de pouvoir utiliser ces connaissances dans mon prochain travail. Les efforts de partage de connaissances et de travail en réseau sont des approches enthousiasmantes et prometteuses à la fois pour la production de savoir et l’atteinte d’objectifs de santé pour les populations que nous servons. J’ai aussi réalisé à quel point la politique de santé est à la fois un élément central et marginal dans l’amélioration de la santé pour tous. Une politique bien menée peut entrainer de grands changements en très peu de temps quand la fenêtre d’opportunité s’y prête. Les enjeux de pouvoir à tous les niveaux depuis le global jusqu’à la relation interpersonnelle sont tellement importants que celui qui arrive à les appréhender pourra mieux faire progresser son agenda. Dans le même temps, les facteurs prédéterminés ou extérieurs sont parfois tels que le changement espéré ne pourra pas se faire.

Tijdens de vier jaren die ik op het instituut heb doorgebracht, heb ik erg veel genoten van een fijne werkomgeving. Omringd door toffe en geëngageerde collega’s met een visie heb ik energie gekregen om veel van mezelf te investeren in het project. Ik heb van elk van jullie heel veel geleerd over internationale gezondheidszorg maar ook over menselijke relaties en over onze samenleving in de eenentwintigste eeuw. Ik heb altijd veel steun gevoeld en vrijheid om te innoveren, zowel in onze departements-eenheden beleid en financiering als meer in het algemeen in het departement. Ik wou dat ik meer had kunnen meedoen aan sociale events op het instituut, maar mijn privé leven vereiste ook dat ik voldoende aanwezig zou zijn thuis bij mijn familie. Door mijn nieuwe baan, dicht bij huis, zal dit zeker makkelijker worden.


I wish each of you a successful career, a healthy life and infinite happiness.


Jullie worden uitgenodigd voor een kerstdrankje en bijhorende hapjes op de health systems “open space”  op 21 december vanaf 4 uur s’ middags.

You are all most welcome to join the Christmas drink of our department on Dec 21 at 4PM in the open office at the first floor Rochus Straat.

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