A prize for global health in the name of Rudolf Virchow

It was recently announced that the 2023 Virchow Prize for Global Health will be bestowed upon Professor Rose Gana Fomban Leke, from Cameroon, in recognition of her distinctive and exceptional lifetime achievements in strengthening global health, pioneering infectious disease research that recognises the need to re-think malaria as a societal and development problem beyond the purely biomedical lens to achieve a malaria-free world and her relentless dedication in advancing gender equality (1). The award ceremony will take place under the High Patronage of the President of the German Parliament, Bärbel Bas, at Berlin City Hall on October 14 this year, the eve of the World Health Summit opening.

This is the second time the Virchow Prize has been conferred to honour contributions to global health. The inaugural award was given to Dr John Nkengasong in October 2022 (2).

Thus, the Virchow Prize for Global Health is still in its beginning, and it would seem opportune to reflect on the motivation for this prize and its coupling to the eminent scientist and physician Rudolf Virchow.

Rudolf Virchow-a trailblazer for global health

Rudolf Virchow (1821-1902) was ahead of his time. He was highly interested in the most advanced scientific methods in optics, biology, physics, and chemistry but also in anthropology, archaeology, ethnology, and other emerging sciences. Virchow used many of these methods to develop a new concept of health and disease. In addition, he strongly emphasized the importance of social, cultural, political, and economic factors in determining health outcomes, famously stating that ‘Medicine is a social science, and politics is nothing else but medicine on a large scale.’ He became an influential member of the German Parliament and opposed military actions. Virchow's work emphasized that health disparities are often rooted in broader societal inequities, including poverty, lack of education, social injustices, regional as well as national prejudice.

Now, more than a centennial later, we see how Rudolf Virchow's thoughts have been brought forward and inspired the discourse on the social and political determinants of health. The United Nations 2030 Agenda with its 17 Sustainable Development Goals (SDGs), unanimously adopted by all member states in September 2015, represents in many ways a belated recognition of the radical and far-reaching thoughts that Virchow espoused in the 19th century. And if ever in doubt: the COVID-19 pandemic laid bare the gross inequities that continue to haunt global health. These disparities-deepened under the pandemic-tell us in no uncertain terms that we must go beyond the realm of biomedicine to secure better health for all.

The Virchow Prize for Global Health was established to honour ‘significant contributions towards strengthening global health through lifetime achievements and long-standing engagement’. In the spirit of Rudolf Virchow, the prize is designed to recognize initiatives that not only address medical and direct health interventions but also tackle the underlying cultural, social, economic, commercial, and political determinants of health inequities. This approach aligns with Virchow's perspective and is meant to reward as well as encourage a comprehensive strategy to improve and promote health while reducing disparities, requiring a close multisectoral cooperation and joint engagement across silos and disciplines.

The establishment of the prize and its governance structure

It is logical that the initiative for a prize in the name of Rudolf Virchow was taken in Germany. The Virchow Prize is initiated and carried by the Virchow Foundation for Global Health, an independent non-profit foundation under civic law. It was established out of civil society engagement on October 13, 2021, which marks the 200th birthday of the foundation's and award's namesake. The Presidents of the National Academy of Sciences Leopoldina and the Berlin-Brandenburg Academy of Sciences and Humanities were among the founders, and the prize was established under the High Patronage of the President of the Federal Republic of Germany (2022) and of the President of the German Parliament (2023).

The Virchow Foundation and its independence, its governance and its compliance with the respective laws and the fulfilment of the foundation's purpose laid down in the statutes (3) are overseen by the responsible German governmental authority.

The Virchow Foundation's council is composed of members from around the globe with expertise across disciplines and sectors (academia, civil society, politics, private sector). The council provides impetus and consultancy for the foundation's work to achieve its goals. The council of the Virchow Foundation nominates and appoints the independent Virchow Prize Committee which selects the Virchow Prize for Global Health laureates. None of the founders are represented in the council. Thus, the Virchow Prize Committee is effectively isolated from the founders of the Virchow Foundation and independent from the board of trustees.

The composition of the prize committee duly reflects the global perspective of the prize, with its social, professional, and geographical diversity. As is customary for other major international prizes, the prize committee is autonomous and loyal only to the eligibility criteria which are to be found in the public domain.

The eligibility criteria

Virchow Prize laureates are recognized and distinguished for their lifetime achievements in the broad area of global health and the related SDGs. The specific eligibility criteria-one or several of which must be met by the successful candidate-therefore emphasize the cross-sectoral and interdisciplinary approach to health. The prize can be awarded to individuals, institutions, or organisations that

• have made outstanding contributions to improve global health, be it through scientific, societal, technological, political, or economic innovations, and by applying concepts of social, educational, behavioural, environmental, economic, commercial and/or policymaking-related determinants of health, have significantly contributed to the attainment of the United Nations 2030 Agenda Sustainable Development Goals, with special attention made to SDG 3 ‘Good Health and Well-Being for All’ and its intersectionality with others of the 17 SDGs,

• have developed and/or implemented health-improving innovations or interventions, governance, and policies with the potential for broad impact on equity,

• have identified and addressed systemic factors leading to increased prevention measures and improved access to medicines, vaccines, therapeutics, or treatments,

• have contributed to the advancement of research or led to the discovery of disease origins, treatment or prevention which impact global health,

• have significantly contributed to increasing global cooperation and inclusivity in addressing holistic approaches to global and planetary health challenges.

The work recognized by the Virchow Prize must rest on a fundament of human rights, solidarity, and equity and be rooted in research and academic values.

The first two awardees were selected based on these eligibility criteria. Both Virchow Prize Laureates have made seminal contributions to global health by addressing health inequities across several dimensions, with a firm basis in research and education.

There is a challenge to identify the worthiest candidates in such a complex and wide landscape as global health, including nexuses such as ‘One Health’, ‘climate & health’, ‘agrisciences, nutrition & health’, ‘education & health’, ‘water, sanitation & health’. To secure the broad coverage of the Virchow Prize, nominations are invited across every area of global health.

The long-term impact of the Virchow Prize

The Virchow Prize for Global Health has the potential to address and reduce health inequities on a global scale in several ways. The prize invites the international community to recognize and celebrate individuals, organisations, or initiatives that improve global health, address health inequities, and reach underserved populations and minorities.

This recognition can motivate others to join the cause and invest in similar initiatives. Identifying and honouring personalities or institutions that have such a holistic view on health and within one person or one organisation unify such a broad spectrum of sectors, disciplines and science may help to better understand the complex problems and encourage optimism and productive actions.

An international prize at this level will promote the sharing of knowledge and best practices among different global health initiatives, and winners of the prize are expected to serve as global health ambassadors, sharing their experiences and strategies with other organisations, governments, and communities.

The prize is young. Several years will elapse and many more awardees will have to be identified before the profile of the prize can be fully appreciated. Obviously, the prize is meant to honour achievements in global health across all disciplines, targeting both infectious and non-communicable diseases, and the prize committee is attentive to the fact that we find ourselves in an era of parallel health crises, and more than this, of a polycrisis where health is challenged by such diverse factors as climate and conflicts, resource- and food shortages, pollution and poverty, and antimicrobial resistance.

It is hoped that the Virchow Prize for Global Health will draw attention to the issue of health inequities, raising public awareness and encouraging governments, policymakers, and organisations to take action. The prize should inspire and serve as a catalyst for progress. The coupling to the name and work of Rudolf Virchow should help us realize this ambitious goal.