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Bringing the Lab to the Village: An Update from Northwestern’s Global Health Initiative (GHI)

As part of NU@AHEAD’s Professional Development Brown Bag series on Thursday, July 1st, Kara Palamountain, Executive Director of the Global Health Initiative (GHI) at the Kellogg School of Management, gave an update on the progress the GHI group has made since it received a $4.9 million grant from the Bill & Melinda Gates foundation in 2006. GHI’s uses an interdisciplinary approach (GHI’s work spreads across various NU schools, including Kellogg, McCormick and Feinberg) to develop and distribute affordable diagnostic devices for infectious diseases to be used in low-resource countries all over the world. GHI initially receives proprietary intellectual properties donated from partner companies, such as Abbott or Invernes, while NU students and faculty then develop that IP into a usable product, test it, and in the end hope to return it to these companies for them to bring the product back to the market.

One of GHI’s products, a handheld portable Early Infant HIV Diagnosis Test (EID), has been developed by NU students and faculty and is currently ready for clinical testing. As is the case with many low-income countries, most births do not take place at healthcare facilities and thus HIV testing of infants is rare, if not non-existent. In Uganda for example, out of the 1.2 million births each year, 100,000 infants are exposed to HIV. Out of these 100,000 infants, an estimated 20,000 babies in fact end-up with an HIV-infection, with only approximately 0.007% of all infants actually getting tested for HIV.  GHI has taken students to various low-resource countries, such as Botswana, Mozambique, Namibia, South Africa, Tanzania and Uganda for market research and market entry analysis.

During their market analysis, GHI researchers and developers have identified several problems, which are an intrinsic part of the lack of market structure. One of the problems is the inherent shortage of healthcare workers, especially technicians. Imagine a piece of equipment breaking in a lab in Durban, South Africa. The closest technician who would be able to fix this piece of equipment lives in Nairobi, while the next closest technician lives in Germany. GHI researchers, therefore, identified the need for portable, easy-to-use, rugged and accurate devices. Another problem researchers identified lies within the distribution of lab results.  Researchers analyzed how long it takes for test results to be delivered to the patient.  In Botswana for example, this could take between 2-16 weeks, in Mozambique at least 3 months, and in Namibia 1-4 weeks. The unpredictable timeframe of delivering tests to the patients results in a backlog of unclaimed results. Most patients can’t afford to return to clinics every week to check in on their test results.  This is a major problem that needs to be solved to assure the delivery of lab results to the patient.

While there are many obstacles in bringing a product to an underdeveloped country, there are routes for the development and distribution of diagnostics products that will benefit global health.  GHI researchers and developers are optimistic and are looking forward to see the first product clinically tested soon.  More updates to follow!

Download a PDF to Kara Palamountain’s NU@AHEAD presentation here.

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The Importance of Approaching Global Health Issues from Multiple Perspectives

During her studies at Northwestern University, Christine Klotz (’06) was involved with NU’s GlobeMed chapter. Her involvement in Global Health didn’t stop there.  Read an interview with Christine who now works at World Food Programme (WFP) in Kenya, where she is a nutrition consultant at the 70,000-person Kakuma Refugee Camp.

Christine Klotz and a UNHCR staff member survey the construction site for a new school in a Somali area of Kakuma

Name: Christine Klotz
Major/Minor: European Studies / Italian
Year of Graduation: 2006
Student or Local Group Involvement: GlobeMed, Women’s Varsity Soccer, Campus Kitchens Project
Email: Christine.L.Klotz@gmail.com

What did you do after graduation and where are you now?
After graduation in the summer of 2006, I moved to Quezaltenango, Guatemala, to continue developing a partnership that began during my undergraduate career between a community health-oriented language school (http://www.pop-wuj.org/), the Northwestern University GlobeMed chapter, and a non-profit organization based out of my hometown of Indianapolis (Timmy Foundation).  Long-term objectives of the partnership included personal hygiene education and a patient referral system to link residents of a rural indigenous village with the public city hospital.

In the fall of 2006, I began a Master of Public Health program at George Washington University.  To fulfill my Master’s thesis, I interned at World Food Programme (WFP) headquarters in Rome in 2007, using Bangladesh health survey data to validate various child anthropometric measurements as indicators of food security. The internship led to my current position as a WFP nutrition consultant in Kakuma Refugee Camp, Kenya, where I have coordinated a micronutrient supplementation program for the 70,000-person population for the past 2 years.  In July 2010, I will transfer to the WFP operation in Juba to collaborate with the Government of Southern Sudan Ministry of Health and NGO partners in establishing and reviewing policies and programs that incorporate the recent developments in public health nutrition treatment, detection, prevention, and advocacy.

Each refugee receives cooking implements, blankets & sleeping mats, jerry cans, tent roofing materials to construct a more permanent house, and a card which recognizes refugee status and provides access to medical services and to collect a food ration

How did your global health involvement at NU influence your career choice and life in general?
I did not discover the global health department until my last year at Northwestern, which precluded the possibility of a major or minor, although I was able to enroll in two departmental courses as a senior which certainly influenced my life direction – Annamaria Pastore’s “Introduction to Health and Human Rights” and Michael Diamond’s “Managing Global Health Challenges.”  I still remember reading Prof. Diamond’s course description that “the responsibility for ensuring the public health rests with governments at local, national and international levels…interventions require cooperation and partnerships between civil society organizations, corporations, businesses and individuals.” In a departure from what had been a largely theoretical liberal arts education to that point, I appreciated the solution-oriented approach and personal call to action. Other students must have felt the same because the class filled up so fast that I had to audit it!

While the NU courses delved into many complex aspects of emergency humanitarian law and policy, I personally found the cost effective and well-understood mechanism of several interventions to strongly resonate–like, for example, blanket provision of vitamin A capsules for a few cents per infant.  Another amazing aspect of the introductory courses was the variety of NU students they attracted, which underscored the importance of approaching global health issues from multiple perspectives.  The combined factors of the introductory global health courses inspired me to consider post-graduate studies in public health, which has since evolved into a career commitment in emergency humanitarian work.

Do you have any advice or suggestions for current global health students on how to get involved or how to choose their career path in global health?
Try to navigate the delicate tightrope walk between policy and program design and high quality research since reliable data powerfully influence policy and program recommendations but ethical dilemmas may regularly surface.  Regular presentation of your research and/or volunteer experiences at conferences and international forums can also provide invaluable opportunities to interact and collaborate with fellow students and leaders who have engaged in complementary initiatives elsewhere.

What’s one life lesson that you have learned since you started working?
As emphasized in my first global health course at NU, successful public health initiatives require concurrent input from various stakeholders, but I have already experienced in my brief career that coordination remains a major stumbling block in the field.  A key way to mitigate the fragmentation of service delivery in times of competing priorities is emphasis on the beneficiary perspective because a technologically advanced solution can never supersede the cultural relevance of the intervention.  On a personal level, this has translated to regular efforts to engage refugee community groups in the planning and decision making process about the micronutrient supplementation intervention in addition to the usual high level policy makers.

– Christine Klotz is a nutrition consultant for the World Food Programme. The views expressed are hers alone.

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Interview with Dr. David Serwadda, HIV/Aids Researcher and Former Dean, School of Public Health, Makerere University, Uganda

Watch an Interview with Dr. David Serwadda, former Dean of the School of Public Health at Makerere University in Kampala, Uganda speaking about Makerere University, its relationship to Northwestern as an international partner institution, as well as his research on HIV/Aids and the current state of the disease in Uganda. Dr. Serwadda was one of the first to research HIV/Aids in Uganda in the early 1980s.

Northwestern has been sending students to study at Makerere University for several years now. Applications are now being accepted by the Office of International Programs for the Spring 2011 Program: “Public Health in Uganda”. You’ll find more information here.

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Social Entrepreneurship in Global Health: When Business and Humanitarianism Mix

Authored by: Student Guest Bloggers Jennifer Long and Rachel Park

We were generously funded by the Office of International Program Development at Northwestern to attend Unite for Sight’s annual Global Health conference on April 17-18, 2010 at Yale University, where we were exposed to a variety of viewpoints and business propositions in the realm of global health. The conference brings together students, entrepreneurs, businesspeople, academics, and field workers from all over the world to network and discuss global health issues. The conference material ranged from keynote speeches by Jeffrey Sachs, an economist and current Director of The Earth Institute, Quetelet Professor of Sustainable Development, and Professor of Health Policy and Management at Columbia University, who bashed rich countries’ propensity toward military spending and away from global funding, to leaders of international health IT firms to 5-minute entrepreneurial pitches.  Seth Godin, prolific business book author and entrepreneur, had an especially amusing speech culminating with, “Just because you’re a non-profit doesn’t mean you’re good,” pointing out the negative externalities and opportunity costs associated with funding projects in the developing world.

While I enjoyed the keynote speakers, my favorite part of the conference was attending the entrepreneurial pitches.  Each presenter had 5 minutes to pitch their idea, followed by 5 minutes of intense interrogation from the audience.  Ideas ranged from low-cost in-vitro fertilization clinics in Africa to packaging U.S. citizens into groups and completely privatizing health insurance.  Many of the audiences forced the social entrepreneurs to be realistic.  A portion of the entrepreneurs pitching business ideas for developing countries had never spent more than a week or two in such an area and their business plans showed it!  The stark cultural gap and unrealistic expectations of U.S. and European citizens working in developing countries causes many good ideas to come to an end—business simply does not function the same way when people operate on “African time!” (“African time” refers to the loose schedule and frequent tardiness of Africans).

A major theme of the conference was building public-private partnerships as a part of enterprises in developing countries.  A movement for medical innovation through private funding may require government participation; a non-profit may generate more social welfare as a for-profit arm of a public company.  In general, for a U.S. nonprofit working abroad, partnering with a private organization and hiring locals delivers public goods at scale while creating jobs.  Not only does it reap the benefits of the non-profit and for-profit sectors, it is more sustainable to teach developing countries how to help themselves.

Jenn: As an MMSS/Econ major who spent the majority of fall quarter practicing case interviews and attending networking sessions with consulting firms, it was both a blessing and a shock to leave Evanston for the winter to collect data in Uganda for my senior thesis.  The years of studying economics at Northwestern have certainly made their impact–I organize my “Favorites” list in my phone by descending frequency of outgoing calls to maximize efficiency!—and  I hope to someday make an impact of my own on the world by applying the mathematical models and business tools I have learned to the realm of international health.

Rachel: When I took my first global health course at Northwestern, I fell in love with the field immediately because it incorporated my existing ideas and opinions about interdisciplinary study, social justice, and cross-sector partnerships. I studied abroad on the Public Health in Europe program at Sciences Po Paris, where the fantastic curriculum on comparative health policy helped me get my post-graduation job at Oliver Wyman, a management consulting firm, in their Health & Life Sciences practice.

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Reporting from the 3rd Annual Clinton Global Initiative University 2010

Authored by: Student Guest Blogger Lalith Polepeddi

At NU I am involved with GlobeMed, which supports a health clinic in rural Ghana. In summer 2009 through the generous support of the IPD, I had the opportunity to travel to Ghana and work at the clinic for a month. The inherent nature of these global partnerships is limited accessibility, so in going there I wanted to be able to bring back my visual experience to my group. To this end I created a to-scale 3D model of the clinic to enhance global engagement through direct visualization (www.virtualclinicsite.org). Upon completion of this project, it became clear there were many applications in addition to global engagement that could positively impact the efforts of global health practitioners.

My explorations of these applications took me to Miami for a weekend in April for the third annual Clinton Global Initiative University (CGIU) 2010 where I had the opportunity to present my project as well as interact with nearly 1,500 students conducting ambitious and inspiring work around the world. From hearing President Clinton speak about the response to the earthquake in Haiti to discussing the role of technology in global health in small group working sessions to contemplating the future of water over Cuban food, my notebook quickly became filled with more notes and ideas than my notebook for class.

One of the most innovative ideas I heard over the course of the weekend was from NYC doctor Jay Parkinson. He created a new doctor-patient model that leverages social networking to build and enhance doctor-patient relationships. His company Hello Health is like Facebook geared for doctors and patients to communicate with each other. What I was most impressed by was the way in which he got it started. He wanted to develop a way for the uninsured population in his neighborhood to get access to health services, so he created a website. Patients could log into his website, view his Google calendar, make an appointment, and enter their symptoms. Jay would get an update on his iPhone and make the house call, and the patient would pay him through PayPal. Jay would then follow up with his patients via Gchat or Skype.

How cool is that? These are tools that we use every day, and Jay simply repurposed these tools to make a tremendous impact in the way doctors and patients interact. Its simplicity is what struck me, because it emphasized to me that we as students have the potential right now to make a significant impact on many of the challenges in the world. It’s just a matter of extending our creativity with the tools we already possess to realize that potential.

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