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ARRA Investments in Strengthening Global Health in U.S. Institutions

Public Health Burden
U.S. university students and faculty have a keen interest in global health. For complex global health issues with biomedical, social, political, and economic dimensions, systems approaches in health research, education, and training are required. Strengthening global health at U.S. institutions by engaging students and faculty from a wide range of disciplines is important in addressing international health issues. Innovative information and communication tools must be incorporated within this educational environment to enable better interaction between U.S. trainees and mentors and to expose biomedical research theories and methodologies to a wider international audience.

Framework Programs for Global Health
The Framework Program supports the development of new curricula, unique educational opportunities for students, and global health degree programs. Establishment of a core administrative network that ties together faculty from different schools within the same institutions or across different institutions to create new multidisciplinary courses is required. This goal has been achieved through ARRA-funded awards to 16 US institutions, including new awards and supplements to existing programs. Examples of projects are noted below.
  • Faculty and students at the University of California at San Diego and San Diego State University will establish a Center of Expertise on Migration and Health, design a core curriculum related to migration and health, and conduct policy research and analysis on refugees, immigrants, and internally displaced persons.1
  • Curriculum related to global health implementation research (research on the implementation and scale up of public health interventions) will be developed and opportunities will be provided for students to participate in a global health implementation practicum course, including an appraisal of the governmental roll-out of anti-retroviral therapy for HIV/AIDS in Kenya.2
Enhanced Post-Doctoral Opportunities:
The United Nations Educational and Scientific and Cultural Organization (UNESCO) approximates that three out of 10,000 persons are research professionals in lower- or middle-income countries compared to three out of 1,000 research professionals in higher-income countries.3 Creating job opportunities for U.S. scientists to work internationally enhances global health science and service abroad. ARRA funding is preserving 13 jobs through 13 administrative supplements toward existing awards. Examples of US post doctoral research training projects in the domains of injury control and vaccine development are described below:
  • A Hopkins post doctoral student will design a surveillance system to record unintentional injuries in a pediatric population and will develop an acute pediatric injury care course. The target audience will be medical personnel with sparse training in the management of pediatric emergencies and the objective will be to enhance the quality of care provided to children.4
  • The host-pathogen relationship between V.cholera and humans will be assessed using high throughput technologies and other tools of genetic analysis. Once the immunological response is delineated, a potential vaccine may be developed.5
International Clinical Research Fellows:
In addition to the post-doctoral opportunities provided by the administrative supplements, one-year mentored research fellowships at foreign sites are offered to a total of 21 clinical investigators to perform research in low- and middle-income countries. A few examples in the areas of HIV/AIDS and acute respiratory illness (ARI) are presented below.
  • One fellow will compare a new CD-4 counting microfluid device to the standard flow cytometry methodology to measure a specific type of B-cells in a cohort of HIV-infected patients in Tanzania. Validation of the device will facilitate testing a patient’s HIV status and tracking the progression of the disease through a low-cost diagnostic.6
  • Another scientist will analyzing the demographic factors, clinical data, and biological samples collected from rural Honduran children with ARI versus controls matched in gender and age. Evaluation of the results from nucleic-acid based rapid influenza tests administered to the children will improve diagnostic capabilities and enable practitioners to provide personalized treatment.7
Information and Communication Technologies (ICT)
Training personnel to utilize information technology tools to access, manage, analyze, and display biomedical information electronically is increasingly necessary in every area of public health research and practice. Additionally, the introduction of ICT tools to the classroom to facilitate instruction for students who are unable to meet face to face with their classmates or their instructors has been very successful. Development and enhancement of these technologies makes global health research and training more cost-effective. ARRA funds have supported the incorporation of ICT into 36 research and training programs. Examples are described below.
  • Students will receive didactic and practical training on Geographic Information Systems (GIS). After the course, GIS will be incorporated in fieldwork at international sites. Examples of how this integration may occur include utilizing GIS technologies to examine childhood malnutrition in remote villages or evaluating the effectiveness of follow-up visits in providing anti-retroviral therapy to HIV patients.8
  • A virtual global health classroom will be created to link students from multiple countries in a Pacific Rim research network around the issues of “diseases of lifestyle”, including tobacco use, obesity, diabetes, and alcoholism. The virtual classroom will incorporate live web conferencing, online courseware, and distance-learning opportunities. Cell phones and PDAs will also be used to deliver health information related to smoking cessation directed to youth in China.9

  1. 3R25TW007500-03S1 -- Global Health Partnership at UCSD and SDSU-- Stathdee, S, CA.
  2. 3R25TW008129-02S1 -- Galveston Global Health Consortium—White, C., TX.
  3. Lansang, MA.and Rodolfo, D. (2004) Building capacity in health research in the developing world. Bulletin of the World Health Organization. 82 (10). 764-770.
  4. 3D43TW007292-05S1 -- International Collaborative Trauma and Injury Research Training--MacKenzie, E., MD.
  5. 3D43TW005572-09S1 -- Training Program in Vaccine Development—Ryan, E. MA.
  6. 3R24TW007988-02S1 -- Assessing HIV/AIDS Diagnostic Tools and Treatment Adherence Programs in Tanzania--Blander, Jeffery. TN
  7. 3R24TW007988-02S1 -- Determining the Viral Etiologies of acute respiratory infections in a rural Honduran population of children-- Shlaudecker, Elizabeth. TN.
  8. 3R25TW007512-02S2 -- A Multidisciplinary Area of Concentration Program in Global Health—Steward, C. CA.
  9. 3R25TW007751-04S1 -- Pacific Rim Global Health Framework—Palmer, P. CA.

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