Many of the public health challenges Boston University researchers engage on a daily basis occur thousands of miles from campus. The University’s global initiative to improve health in low-income countries around the world includes projects such as an evidence-based study of childhood pneumonia that changed the World Health Organization’s guidelines for treatment. A Spanish immersion program for School of Medicine students that benefits local citizens and community health care projects in Ecuador. In Nicaragua, researchers are seeking answers to a kidney disease epidemic affecting young workers, and in Peru, a theater arts pilot program has shown promise in improving public health.
At the heart of these efforts is the Center for Global Health & Development, where numerous research projects in Africa and Asia contribute to the body of knowledge about HIV/AIDS, malaria, and infant mortality. A new focus is rapid urbanization in India and its impact on public health. To support the complex strategic and operational issues involved with international research, education, and community service, the University established the Global Programs Office and is encouraging cross-disciplinary collaborations to address major global challenges.
Which global health programs produce the most bang for the U.S. development assistance buck?
Evaluating global health programs is an ongoing initiative at the Center for Global Health & Development (CGHD), a multidisciplinary research center that focuses on helping to solve critical health and social development issues in poverty-stricken countries. The center has more than 90 employees engaged in research activities in 14 countries in Asia and Africa. Annual research expenditures are about $10 million, and the center has a committed pipeline of $25 million in grants from organizations like USAID, the Centers for Disease Control and Prevention, and the Bill & Melinda Gates Foundation.
Jonathon L. Simon, Robert A. Knox Professor, founding director of the center, and chair of the School of Public Health’s Department of International Health, oversees numerous research projects, including the 25 BU activities under way for Project SEARCH (Supporting Evaluation and Research to Combat HIV/AIDS), funded through the U.S. President’s Emergency Plan for AIDS Relief. Project SEARCH evaluates the quality and effectiveness of AIDS prevention, care, and treatment.
“We found that direct community support in education and nutrition was making a difference,” says Simon, but “we’re having a hard time showing results for psycho-social intervention.”
Also under way is a new body of work focusing on rapid urbanization, following the Global Urban Health Summit the center hosted in 2011. The summit brought together brilliant minds to brainstorm ways to collaborate on disease prevention and treatment and to expand health care for poor people in city slums; urban populations are widely expected to grow to 70 percent of the world population by 2050. Collaborating with the International Clinical Epidemiology Network, Simon is focusing on India’s Palwal district, located south of Delhi.
The questions are many, the science-based answers, few. What happens to the rice and wheat farmers as urban areas spread into the countryside? Do they become the urban underclass or move farther into rural regions? How do they make those decisions? What are the health concerns and psycho-social repercussions of a shift away from agriculture? How do you measure them?
“The social change will be more rapid in the next 50 years than in the last 500 years,” says Simon. “These are profound and important questions in rapidly developing countries. You need a creative, flexible research design to capture this dynamic, and that’s what we’re hoping to develop.”
Donald Thea is out to reform the treatment of childhood diseases.
A six-week immersion program for School of Medicine students teaches resourcefulness and language skills.
A primer for faculty and staff currently operating or planning international programs.