A Global Health-Care Mission Expands

For two accounts of health care and research the Center for Global Health and Development is undertaking in Africa, see the following videos: one about outreach in Zambia, the other from Lesotho.

With a fresh $10 million funding commitment from President Robert A. Brown, a new name, and proven staying power in the battle to improve health in the world’s poorest communities, the Center for Global Health and Development at Boston University’s School of Public Health is poised to expand its mission, and impact.

“Community service is a phrase used in the mission statement of almost every university. Today community means the world,” Brown said yesterday, joining university presidents from around the country (and Canada) at the first presidents meeting of the Consortium of Universities for Global Health. “Research universities are ideally positioned to engage not just in teaching and research in the field of global health, but also service through efforts to affect policies, improve practices, and to help build and support infrastructure around the world.”

This week’s conference, hosted by the National Institutes of Health, in Bethesda, Md., highlights the deepening University commitment to the global fight against disease, with a reconfigured center at the vanguard. Jonathon Simon is the new entity’s founding director, and he is well-established in the field and the University. He and a core of doctors and researchers migrated from Harvard to BU in 2001, forming the Center for International Health and Development (CIHD). Simon has been a dynamic presence since, and is now chair of the SPH department of international health, the school’s largest department. The new center is the product of a merger of the CIHD and the Global Health Initiative, which has been headed by Gerald Keusch, an SPH professor of international health and Medical Campus associate dean for global health. Keusch will become a special assistant to the president and senior advisor to Simon.

“This is an unprecedented foray into global health initiatives,” says Simon. The support will buttress research and health-care delivery that is far from theoretical; the center has 54 active projects spread across multiple continents and 24 countries, with the strongest presence in Africa and Asia. Sixty people work for the center in various capacities, 49 overseas, 35 in Zambia alone. More than 90 faculty and staff members are engaged in center-based research activities.

If fundraising is one sign of success, Simon’s group measures up, with $8.5 million in grants in hand and $26 million committed through 2014. Within three months Simon expects to hear the results from a series of major proposals; if successful, the group could see as much as $56 million in awards.

The center’s work is an unusual combination of research and pragmatism. Initiatives build partnerships on the ground, often focusing on unglamorous but effective ways to attack disease and death, using peer-reviewed research to prove common sense intuitions: distributing mosquito nets stops malaria without huge drug expenses; training indigenous “birth attendants” dramatically reduces neonatal mortality; teaching rural clinics to more effectively deliver antibiotics saves children from pneumonia and death.

Producing bulletproof data drives funding. “There is a strong global movement for more evidence-based medicine,” says Simon.

Organizations like USAID and the Centers for Disease Control “want evidence, real solid evidence, as a basis for making policy, much more than they used to,” agrees Donald Thea, an SPH professor of international health and a principal researcher in Africa. Yet Thea’s work in Zambia proves that the barrier between research and service is permeable; 200 health clinics in that country provide both vital health care and a population for study. Some of Thea’s research, applied and measured, has helped to reduce infant mortality by more than 30 percent in some areas.

Such results mean that a policy maker in Pakistan, for example, can be convinced to adopt guidelines based on the success in Zambia — and that those new guidelines have political as well as medical credibility.

The University’s $10 million commitment is a five-year package, Simon reports, rolling out at $2 million a year. Half of that will come in the form of gifts raised jointly by the University and SPH, another $2.5 million will be unrestricted University support, and the remaining $2.5 million will come from the SPH operating budget.

The University’s growing commitment to global health reflects a dramatic social trend. According to a 2009 survey by the Consortium of Universities for Global Health, the number of undergraduate and graduate students in global health programs has more than doubled during the last three years.

“We are becoming global,” Brown told fellow university leaders from Duke University, Emory University, Johns Hopkins University, Stanford University, the University of California, the University of Washington, and McGill University at the consortium meeting yesterday. “We are changing from places where people come from all over the world to study and work to institutions that are truly engaged in the world — universities with programs, students, and staff actively participating in the world. Why? What is driving this revolution? Like most positive and sustainable movements in universities, this revolution is being driven by the interests of our students and faculty. Their perspectives are increasingly global, whether it is a faculty member thinking about research collaborators or a student thinking about their future or how they might have an impact. The pressure on research universities to engage globally has never been greater.”

The full text of Brown’s address yesterday is available here.

Seth Rolbein can be reached at srolbein@bu.edu.