For decades, learning in global health has depended on a conventional model premised on the scarcity of available knowledge and an emphasis on establishing mechanisms to transmit that knowledge from the center (capital city, headquarters) to the periphery (field, village, training room). With the Internet, scarcity disappeared. But the economy of high-cost, low-volume training has persisted, with little or no accountability.

Through research and broad sector collaboration, a consensus has emerged on the recognition that uneven quality of personnel is a major limiting factor in humanitarian response, and that serious effort is needed to address the global gap in skills and build capacity of countries and local communities.