The Future of Global Health Capacity Building at Yale

April 14, 2021

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00:00I'd like to welcome everyone who is
00:02joining us today for our panel session.
00:05So this is part of our 10th
00:07Annual Global Health Day in the
00:09Department of Internal Medicine
00:11and our theme this year is global
00:14health capacity building at Yale,
00:15past, present and future.
00:17So this morning during our
00:19medicine grand rounds,
00:20we heard from Doctor Oscar Rastagar
00:22who gave us an overview of where
00:24capacity building in the L Department
00:26of Medicine has come over the
00:29past several decades and today.
00:31We're very excited to have our panel
00:33discussion with your colleagues who
00:34are truly at the forefront of different
00:37aspects of global health capacity.
00:38Building here at Yale.
00:40So our moderator for today is
00:42going to be on Doctor Soto Meyer,
00:44who is the director of the
00:46Institute for Global Health.
00:47He's the associate Dean for Global
00:49Health Research and Professor of
00:51Medicine in the School of Medicine.
00:53He's also the Susan Dwight Bliss professor
00:55of Epidemiology of Microbial Diseases
00:56at the Yale School of Public Health.
01:01We will have four panelists as I
01:03mentioned today and they will be
01:05going hopefully in this order,
01:07so Christina Talbert Slagle,
01:08assistant professor of Medicine in general,
01:10internal medicine and core faculty of
01:12the equity Research and Innovation
01:14Center at the Yale School of Medicine,
01:16as well as the associate director of
01:18the Yale Institute for Global Health,
01:20Luke Davis, who is associate professor
01:22of Epidemiology of microbial
01:24diseases at Field School,
01:25public Health and also associate
01:26professor of medicine and pulmonary
01:28critical care and Sleep Medicine
01:30at the Yale School of Medicine.
01:333rd we will have Evelyn Shape,
01:35Assistant professor of medicine and
01:36Rheumatology and Chief of Rheumatology
01:38at the VA Connecticut Healthcare System
01:40and Associate Assistant professor
01:42of Epidemiology of chronic diseases
01:43at the Yale School of Public Health
01:45and last but definitely not least,
01:47will have Christine and Gloria,
01:49who's assistant professor of emergency
01:50medicine at the Yale School of Medicine.
01:53So with that,
01:54I'm going to turn it over to side
01:56to give a little bit more of an
01:59introduction for our first panelist today.
02:01So for Christina.
02:05Hi, it's my pleasure to moderate
02:08this session and sort of
02:10the Department has been at the forefront
02:13of capacity building an and coming up
02:16with new equitable models. City building.
02:20In in global health so so my it's my
02:23pleasure to introduce the first panel
02:26panelist Doctor Christina Talbert
02:28Slagle she's the associate director of
02:31Yale Institute for Global Health and
02:34an assistant Professor of Medicine at
02:36the Yale School of Medicine in general
02:40internal she's a global health scholar
02:42and educator and she is focused for
02:45several years on addressing health and
02:48educational disparities around the world.
02:50Through her focus on really high quality.
02:53Interactive teaching and locally
02:55appropriate and responsive scholarships
02:57and field programs, which is a
03:00particular strength of her with her.
03:03Her PhD was in genetics and biology and
03:07postdoctoral training was in complex
03:09systems and global health Management.
03:12She approaches her work,
03:14teaching and mentorship through
03:16and a very really,
03:18truly interdisciplinary perspective.
03:20In addition to her role at VGH.
03:23They said she had several
03:27other appointments and.
03:30And she's the she's the faculty director for,
03:33among other things of for health
03:36management and preclinical education,
03:38workforce capacity building
03:39programs in Liberia,
03:40and she's been working closely
03:43with colleagues at TL and in
03:46Liberia on that kind of work.
03:48And a little bird tells me that that
03:52that relationship is likely to expand
03:55exponentially in the next few weeks.
03:58And I'm hoping Christina you're
04:01comfortable with me saying that,
04:04and officially this forum,
04:06but it's my pleasure to welcome doctors,
04:09Talbert Slagle.
04:14Thank you so much.
04:15Sad, that was a wonderful introduction.
04:17I appreciate it and thank you
04:19Tracy and the Office of Global
04:21Health for having me today.
04:23As part of this esteemed panel.
04:25I'm grateful to be here,
04:27so I'll just share my screen.
04:29I have just a few slides to to
04:31give some information about the
04:33work that I do and kind of touch
04:36on the future of global health
04:38capacity building at Yale, so.
04:41Can you see this?
04:43Great, OK, so just quickly as Asad mentioned,
04:46I work with colleagues in the West
04:49African country of Liberia so just
04:51to Orient everyone that Liberia is
04:53in the West African sub region and
04:56it's shown here in dark red and
04:58then this is a close up so it's
05:01a small country geographically.
05:03It's about the size of this state of
05:05Tennessee and there about four 4.5
05:08million people who live in Liberia.
05:11I I wanted to,
05:12even though we're talking about the future,
05:15I think it's important to root
05:17our work in the past,
05:19at least in understanding some historical
05:21context of partnerships and and why
05:24things are the way that they are.
05:26So I wanted to show this.
05:28This is a mural on the base of
05:30the statue in the capital city of
05:33Monrovia showing an interesting
05:34interaction whenever people from
05:36the United States were brought to
05:38the country of Liberia as part of
05:41the American Colonization Societies.
05:42Efforts in the mid 1800s an on
05:44the left you have people arriving
05:46and on the right you have people
05:48who are already there and this is
05:50actually why Liberia is called
05:52this because there was this push
05:54from the United States to.
05:56Repatriate people from the United
05:58States back to Africa, supposedly.
05:59But in fact,
06:00many of the people who came to what is
06:03now known as Liberia were from all over.
06:06Including born in the United States.
06:09This is the flag of Liberia,
06:11and it just obviously reflects the flag
06:13of the United States and shows this close,
06:16but kind of interesting and complex
06:18relationship between the United
06:20States and the country of Liberia.
06:22And then here I just am showing
06:25a little close up.
06:26Liberia has 15 counties and the
06:28country the capital city of Monrovia
06:30is actually named after James Monroe.
06:32Marilyn County obviously is a
06:34familiar name in the United States,
06:36so there's this long interesting
06:38tie between the two countries.
06:40And then I'm fast forwarding now to
06:431989 whenever Civil war erupted in Liberia.
06:46This war erupted,
06:47basically as a result of an ongoing
06:50tension between the people who
06:52settled in Liberia in the mid 1800s
06:55as part of the American Colonization
06:58Society efforts and the people who
07:00were already there so that work a
07:03century and a half earlier gave rise
07:06to a civil war that was devastating,
07:09which is pretty well encapsulated,
07:11I think by this picture.
07:13There were lots of child soldiers.
07:15It was actually a period of
07:17civil wars over 14
07:19years. This is a famous picture
07:21because this is clearly a child with
07:23an automatic weapon and a little soft
07:25teddy bear backpack and it really was
07:28devastating to the country of Liberia.
07:30It destroyed so many systems and 2/3
07:32of health facilities in the country
07:34closed and many health providers
07:36left the country and went all over.
07:41But our partners there, Yale, actually.
07:43This is before my time,
07:45but GAIL was working with partners
07:47in Liberia after the Civil War,
07:49but our our colleagues there,
07:50many of whom I now have the opportunity
07:53to know we're working on rebuilding
07:55after the period of the Civil War.
07:58So what we're looking at here is
08:00just a graphic that shows under
08:025 mortality per 1000 live births,
08:04which is one of the ways that
08:06we can measure how a country is
08:09doing and its health condition
08:10in the population of its health.
08:13So you see Liberia here in blue,
08:15and then the bordering country of Guinea
08:18and the bordering country of Sierra
08:20Leone and red and green respectively.
08:22And this line is an average of the 15
08:25countries of the West African sub region.
08:27So we want these lines to be going
08:30down because this is showing a
08:32reduction in under 5 mortality.
08:34So you can see this starts in 1980.
08:37The lines go down.
08:38But then there's this increase in
08:40Liberia during the Civil War period,
08:42but the post Civil War post
08:44conflict rebuilding efforts.
08:45Were very successful an Liberia actually
08:48saw steep declines in this number,
08:50and it was a leader not only in
08:53its the neighboring countries,
08:55but actually in the region in
08:58reducing child mortality post war.
09:00And this is something that we kind
09:02of I I hadn't heard about as much
09:05because what we hear about more with
09:08Liberia is what happened in 2014,
09:11which was an outbreak of Ebola.
09:13And I'll talk about that momentarily.
09:15But I just wanted to take a minute
09:18to anchor us in this history of local
09:21leadership in the country of Liberia
09:23on building their health system,
09:25rebuilding post conflict,
09:27and all the deep experience that
09:29that the people in country have.
09:31On the capacity building work that
09:34I'm now privileged to be apart
09:36of so well before my time,
09:38people were doing great work in
09:40Liberia on rebuilding post conflict,
09:42but it was still a fragile country.
09:45The health system was very fragile
09:47and as many of us know in the
09:51year 2014 and into 2015,
09:52the Ebola virus emerged in this region
09:55of the world and it was devastating.
09:58So this is a picture maybe.
10:00Maybe people have seen pictures
10:02like this from this time period.
10:05West Africa and Liberia and Guinea and
10:07Sierra Leone in particular kind of hit
10:10the world map because everybody was
10:12paying attention to the Ebola crisis.
10:14But this really is a cross sectional
10:16indicator of a still fragile health system.
10:19In a post conflict nation that
10:22was working hard to rebuild.
10:24So the comp consequences of their
10:26Bola virus outbreak were devastating.
10:28What we're seeing here is a map.
10:31Again, here's Liberia,
10:33Sierra Leone is a bordering country Guinea.
10:35The Ebola virus actually emerged right
10:38at the Nexus of these three countries,
10:41and these colors show death the death toll.
10:44So as the the color gets darker,
10:47there are more and more deaths.
10:50So I'll just start in March of 2014
10:53and then the next graphic skips ahead.
10:56A year to March of 2015 and you can see
10:59that the virus had spread around this
11:03entire region and exacted a tremendous toll.
11:07Liberia lost more than 4000 people.
11:09I think it's 4800 and it was particularly
11:13devastating for the health workforce
11:15who did not have the resources that they
11:19needed to be able to protect themselves and
11:22their patients from this devastating virus.
11:25And so Liberia lost about.
11:278% of its health workforce from
11:31the Ebola crisis.
11:34So the Minister of Health at the time,
11:36Doctor Bernice Dahn, during the day,
11:38was working to combat the Ebola crisis
11:40and in the evenings was working with a
11:43large team to develop an investment plan
11:45for building a resilient health system
11:48in Liberia which they released you.
11:50It's a little blurry here,
11:51but they released it in April of 2015 and
11:54this is an amazing comprehensive plan
11:56that includes lots of different elements,
11:58one of which is health workforce capacity
12:01building so that I joined on to this.
12:04Standing on the shoulders of Giants,
12:06many people at Yale had, as I said,
12:08worked in Liberia for a long time.
12:10And, as Saad mentioned,
12:11I worked on health management
12:13and also physician training.
12:14And there's a whole team of us so
12:16I can talk more about this later.
12:19But the work that we're really doing now is.
12:22We're focusing on health management,
12:24capacity building, and education.
12:26There's a certificate program that
12:27our team is developed and handed
12:29over to the University of Liberia,
12:31and we're now working on really
12:34reforming undergraduate medical
12:35education at the only medical school
12:37in the country to strengthen the
12:38pipeline of physician training for that
12:40component of the health workforce.
12:42So I can talk more about that later,
12:45but that's kind of where we are
12:47and an on where we're headed.
12:49And it's just a real honor to be
12:52part of this work, so I'll pause.
12:54And then hand it to the next person.
12:59Great, thanks so much Christina pull up the
13:03slide for our next panelist. Here we go.
13:09So it's my pleasure to
13:11introduce Doctor Luke Davis,
13:12who's an associate professor of
13:14Epidemiology of microbial diseases
13:16at the Yale School of Public Health,
13:19as well as an associate professor
13:21of medicine and pulmonary
13:23critical care and Sleep Medicine.
13:25At the yield curve medicine.
13:27Doctor Davis.
13:29You know has worked substantially
13:31in many parts of the world,
13:34but specifically you know his work
13:37using translational research and
13:39implementation science to improve
13:40diagnostic evaluation in case finding for TB,
13:44which is obviously we know that is
13:47a leading cause of death in LMI CS.
13:51He teaches graduate course in
13:53implementation science and mentor
13:55students at the Yale School of Public Health.
13:59And has been in a leading role in
14:02international research training
14:03programs in LMS,
14:05so look over to you.
14:08Thank
14:09you so much so it's really a
14:10pleasure to be together today.
14:12I think so Tracy, for joining I
14:14always enjoy the Department of Mental
14:16Health Day is a chance to reconnect
14:18with colleagues and hear about all
14:20the great work that's going on.
14:22I'll just talk maybe for 5-5 minutes or
14:25to 7 minutes or so on our experiences
14:27working Uganda and I want to present
14:29that through the lens mostly of our work
14:32in implementation science and talk a
14:34little bit about how I've come to see
14:36through the collaborations with the
14:38other members of the Yellow Uganda network.
14:40Which involved research,
14:41training, clinical care?
14:42How these three legs of a stool,
14:45so to speak?
14:46It's really important to have all of them,
14:48and I think without any of them a lot can
14:52be lossed just a little bit by my story.
14:55I started out with my interest
14:57in Global Health after finishing
14:58my internal medicine residency.
15:00I spent some time working in
15:02a Mission Hospital in Kenya.
15:04It was a very formative time for me and
15:07I think for many people around the world as.
15:10They started to see the toll that the
15:13HIV epidemic was taking in Africa,
15:16particularly on young people,
15:18and also the combined Twins
15:20endemic of tuberculosis,
15:21which has a pulmonologist
15:23or abutting pulmonologist.
15:24At that time I was extremely interested in,
15:27and after spending some time,
15:29they're working in this Mission
15:32Hospital in a rural area where we
15:35took care of many patients from the
15:38Masai areas and the cool areas by.
15:41Just felt very called to try to work
15:43in this area of understanding how
15:46to diagnose pulmonary infections,
15:48which I think are the leading cause
15:50of death of people living with HIV,
15:53tuberculosis and other causes.
15:54And after undertaking some training
15:56in Epidemiology,
15:57I had the chance to start research
15:59project in Uganda which initially
16:01was focused on diagnostics and
16:03developing new diagnostics,
16:05and this was a really important
16:07time in Uganda with regard to
16:09tuberculosis research I think.
16:11Each of your research was
16:13already well established.
16:14It was a lot of malaria research
16:16that was well established,
16:17and a number of Yale faculty have
16:20been involved in those activities.
16:21But the growth of the tuberculosis
16:23research gave us an opportunity,
16:25I think,
16:26to understand all the needs
16:28that exist in that area.
16:29It's a very challenging infection in
16:31some ways more challenging than HIV.
16:33I know that Jerry Friedland likes
16:35to say that in the field of TV,
16:38people move at the pace of TV
16:40and we're trying to.
16:42Try to move more at the
16:44pace of replication of HIV.
16:45That is more quickly to get more
16:47solutions and after a number of
16:49years working in diagnosis in the
16:51process of trying to set up some
16:53field sites and in rural Uganda
16:55through a site that was some work
16:57that was in collaboration with
16:59Doctor Smeal Creek came to recognize
17:01that a lot of what we need to do to
17:04improve care of TV.
17:05We already know how to do it,
17:07it's just a gap between knowing and doing.
17:09And I came to that recognition
17:11that in setting up sites.
17:13In finding that a lot of people
17:15had the idea that there needed to
17:18be more education of providers at
17:20the front lines in rural areas.
17:22But when you went and talked to them,
17:25they knew the guidelines for tuberculosis.
17:27They knew how to manage it,
17:29what they did not have
17:31were reliable supplies,
17:32revival workflows,
17:32and in working in such systems
17:34being overwhelmed overtime,
17:36their motivation became sapped and
17:37so became interested in this field
17:39of implementation science and in
17:41collaboration with my colleague,
17:43Doctor Achilles Katamba.
17:44Who is a medical doctor and
17:46epidemiologist and investigators
17:47from another other US universities.
17:50We set up our research project
17:52called the Uganda TV Implementation
17:54Research Consortium where we try
17:56to work closely with and you got
17:59a national tuberculosis program
18:01an with local health facilities
18:03to try to identify what are
18:05national priorities for diagnosis,
18:07treatment and prevention of tuberculosis
18:09and how can we come in and contribute
18:13in an interdisciplinary way.
18:14Understanding the gaps and
18:16how to close those gaps,
18:17and this is the field of
18:19implementation science.
18:20Implementation Science is a term that
18:22I think is gaining a lot of interest.
18:24I think many of you are aware
18:26that at Yale we have in the school
18:28Public Health Center for methods
18:30and implementation prevention
18:31Sciences in the School of Medicine,
18:34and we have the Yell Center for
18:36implementation science and we also
18:38have a very active student group
18:40called Implementation Science
18:41Group at Yale that is helping kind
18:43of drive this research agenda.
18:44For Dan,
18:45it's really one of the exciting
18:47things about implementation.
18:49Science is that rather than staying
18:50in our silos as pulmonologists as
18:53epidemiologists as biostatisticians,
18:54we're opening up the gates and looking
18:57to other branches of science and saying,
19:00where can we borrow methods?
19:02Where can we build collaborations
19:04with individuals who can help address
19:06these challenges so the chance
19:08to work with engineers to come
19:10up with better diagnostic tests?
19:12The chance to work with our colleagues
19:15in social and behavioral Sciences and.
19:17The other social Sciences,
19:19including economics and sociology
19:21and anthropology,
19:22to try to understand behavior,
19:24try to understand costs.
19:26Try to understand truly how the social
19:29determinants of health really drive,
19:32the barriers that we see and
19:35seeking access to diagnostic.
19:36Excuse me.
19:37Diagnostic services for TV in Uganda
19:40for treatment and prevention.
19:43And shortly after getting some
19:45of those projects going,
19:46we also found the need to build
19:49the capacity of our teams that
19:51were carrying out that work.
19:53A lot of passionate young medical officers,
19:56laboratory technicians,
19:57even social science students,
19:58public health students were involved
20:00in our projects and we started
20:03to realize that maybe the older
20:05model of training everybody to be,
20:07say, a principal investigator,
20:09wouldn't be the most efficient approach.
20:11But then,
20:11if we cast a wide net and give
20:14people opportunity to pursue training
20:16so they became specialists able to
20:19contribute to multidisciplinary teams,
20:21that that might help us build better
20:24capacity for implementation science
20:25and so with funding from the Fogarty
20:28International Center starting in around 2010.
20:30We are a little bit after 2012.
20:33We started training scholars who are
20:35pulmonary complications of AIDS research
20:38training program and that's been a
20:40very successful program that's allowed
20:42us to partner with some of the other.
20:45Faculty here at Yale and many faculty
20:47in other areas who have interests
20:49in HIV and can link those two
20:51implementation science and working.
20:53Also at the institutional level to try
20:55to offer courses for not just students
20:57but also people who are in practice
21:00through an executive model where people
21:02can bring an idea that they need to
21:04carry out for their work at the national
21:07TV program or the Ministry of Health,
21:10or maybe for an employee with
21:12an implementing partner,
21:13they have a implementation
21:14problem that they want to address.
21:16And that by working through this curriculum
21:19they can hopefully come up with protocols,
21:22grant applications,
21:23and finish projects that can
21:25be collaboratively developed.
21:27The last piece I think in that stool.
21:30I've talked a little bit about research,
21:32implementation research.
21:33I've talked a little bit about training,
21:36implementation, research,
21:36training.
21:37The last piece is what I like to
21:40call implementation practice and
21:41in clinical medicine that could be
21:43thought of as quality improvement,
21:45evidence based medicine and public health.
21:47It could be thinking about how do we
21:50get the services and the practices that
21:53people need put into practice and not just.
21:57Journal somewhere,
21:58or even in the guideline.
21:59How do we go that next mile?
22:02And it's a great challenge.
22:03I think we can look to the model
22:05of HIV where there has been large
22:08scale funding from the US government
22:10from the Global Fund for AIDS,
22:12Tuberculosis,
22:12and Malaria in Uganda to build
22:14an incredible capacity and.
22:16And there is interest in using that
22:18HIV clinical capacity of a HIV
22:20clinics and ARTA clinics to add on
22:22care for non communicable diseases.
22:24That my colleague Jeremy Shorts
22:26is working on.
22:27We are very interested in non
22:29communicable primary diseases,
22:30tuberculosis of course,
22:31and I think that will be the next
22:33milestone in the future is how can
22:35we bring together clinical care and
22:38public health through implementation
22:39practice and that will require
22:41kind of more partnerships.
22:43And I think getting people interested
22:45in putting funding towards us.
22:46There's a lot of interest in research.
22:49There are a lot of young ugandan's who
22:51want to pursue careers in research,
22:53but we want them to do that without
22:56giving up on providing service.
22:58To end users to being in the clinics
23:00to providing their leadership
23:02capability to make sure that care can
23:04be delivered at that last mile without.
23:07I think I'll stop my comments and
23:09look forward to hearing the other
23:11presenters and hopefully having
23:13some conversation at the end.
23:16Yeah, so before I go to the
23:19next speaker next panelist,
23:21I will amplify what buffer
23:23ribbon put in the chat box.
23:25Please feel free to add your questions
23:28etc in the chat box in the in the QA
23:32box etc so that you know we can ask
23:35these questions from our panelists
23:38when we move to the next stage.
23:41The next panelist is Doctor Evelyn Hirsch.
23:45She's an assistant professor of medicine and,
23:49as in, is in, is a rheumatologist.
23:52She's also chief the Chief of Rheumatology
23:56at VA Connecticut healthcare system.
23:59She has her focus has been specifically
24:01an largely on integrating biomedical
24:04and behavioral research methods
24:06to improve outcomes of rheumatic
24:09and musculoskeletal disease.
24:11In countries in economic transition.
24:15And the major emphasis of this body
24:17of research has focused on mechanisms,
24:20Epidemiology and prevention of
24:22strategies of for osteoporosis among
24:25individuals with HIV in China,
24:26for example,
24:27as well as projects on other in
24:29other low resource settings and other
24:32models of secondary osteoporosis,
24:34and she has had a longstanding
24:37commitment to medical education and
24:39global health research training Evelyn.
24:45Thanks so much. Sad and thanks to
24:48everyone for inviting me to participate
24:50in this fantastic forum today.
24:52So let me just share my screen.
24:59Create and what are you seeing? I
25:02think if I go
25:04this way right that right?
25:07Yep OK so as Asad mentioned,
25:10I'm a rheumatologist specializes
25:12in musculoskeletal or immune
25:15conditions and I'm going to talk
25:18about a couple of things today.
25:21I'm going to talk about a few
25:23programs that we've been working on
25:25over the past several years that
25:27focus on training and capacity
25:29building in the area of rheumatology,
25:32and particularly in rheumatology
25:33research and and how these programs
25:35have branched out to intertwine with
25:37broader global health programs here,
25:39and I'd like to mention a new
25:42program that's coming down the road,
25:44which I hope others in the global
25:47health community here at Yale
25:49will be excited to be a part of.
25:51So just to give you a little
25:55bit of background,
25:57I think this is a common theme among
26:01many non communicable diseases globally,
26:04which is that there really
26:07has been in rheumatology,
26:09a significant lack of workforce
26:12and data and awareness among
26:16practitioners as well as public health.
26:19Missions and also patients about
26:22rheumatic diseases and so different.
26:25Cities may be at different
26:27points along the spectrum,
26:29but for rheumatology right now there
26:31is a significant shortage of awareness,
26:34information and training with regards
26:36to global rheumatology and so this is
26:39in stark contrast to what the you know
26:42numbers are showing us about global
26:44burden of musculoskeletal diseases.
26:46I don't think the the burden of rheumatic
26:50autoimmune conditions is well quantified,
26:52but in terms of muscoskeletal disease to WHO?
26:55Has recognized that the burden of
26:59disability for musculoskeletal
27:00disease is the leading cause
27:02and as well as chronic pain.
27:04So a few colleagues then I have been
27:08working closely with both the American
27:10College of Rheumatology and also the
27:13NIH Fogarty Global Institute for
27:15International Center and Niams to
27:18really try to bring more attention to this,
27:22and this is a figure from a
27:25paper we've just submitted.
27:27And is under review that demonstrates
27:29this vicious cycle that occurs
27:31when you have a group of conditions
27:34that there's a shortage in the
27:36workforce and patients are not
27:38getting access to care because of the
27:40shortage of workforce leading to,
27:42you know,
27:43under recognition of the mechanisms
27:45underfunding of trying to understand
27:47what the actual burden is,
27:49and continued misdiagnoses and so
27:50this is a number of individuals
27:53that start out with the diagnosis.
27:55The true number that are being recognized
27:58at the end of the day are really a time.
28:02A proportion,
28:03and this is closely linked with.
28:07So that's the backdrop of the health
28:09system where where medical access
28:12and services are being offered,
28:14and so policy and funding and
28:17infrastructure for research and
28:19education training play a critical role
28:22in trying to break this vicious cycle.
28:25And so this is sort of the challenge that
28:29our group has taken on an and hopes to,
28:33you know, make a change in going forward.
28:37So to.
28:39With that backdrop,
28:40I'll talk a little bit about a
28:43program that we've had in the
28:45rheumatology section at Yale.
28:47This started my work,
28:48as Todd mentioned his weekend osteoporosis,
28:51and as a global health.
28:54You know, as someone interested
28:56in global health since my medical
28:58school days back when I was
29:00training a lot of the global health
29:02training programs and infrastructure
29:04was really in the field of HIV,
29:07and so that's where my background came from.
29:09But when I became a rheumatologist,
29:12I was very interested in the overlap
29:14being sort of the synergistic
29:15problems of chronic infection and in
29:17chronic disease within patients who
29:20have longstanding chronic illness.
29:21And so a lot of my work focuses
29:24on osteoporosis and fractures.
29:26Among patients with HIV and so
29:29that brought me through a couple
29:32of different funding mechanisms
29:34that brought me to a partnership in
29:37China where I've worked since 2012,
29:40where where I'm part of a large,
29:44multicenter national program that
29:46looks at the impact of chronic HIV
29:49and antiretroviral therapy on the
29:52musculoskeletal health of patients.
29:54And while I was there, I became.
29:57Good friends with many colleagues
30:00in the rheumatology Department.
30:02Of course,
30:03I was thrilled to take part in their
30:06clinical rounds and, you know,
30:08get to meet their young trainees
30:10who are very bright and enthusia
30:12stick and we eventually ended up
30:15setting up this exchange program
30:17with medical students in China at
30:20picking in Medical College to come
30:22to Yale for two months in the summer
30:26to do an exchange program and.
30:28Part of it was of course to
30:31understand the medical system and
30:32medical education here,
30:34but also a part of it was to develop
30:36which I thought was important,
30:39was to develop some research training
30:41experiences that they weren't necessarily
30:43getting back in their medical programs.
30:45So you can see,
30:46these are pictures that I think a
30:48picture is worth 1000 words that these
30:51are some of the trainees that have
30:54participated over the years since 2016.
30:56It's just a few each summer.
30:59And I'll show you sort of the.
31:02You know the objectives of
31:04their work in the next slide,
31:06but you can see they've been able to
31:09participate in different kinds of activities,
31:12including getting to know New
31:14Haven and our famous pizza.
31:16But this has expanded over time,
31:18so it started out with the
31:21medical students from China,
31:23but it's expanded over time.
31:25We've had Yale students,
31:26undergrad medical students,
31:27and also alumni recent graduates who've
31:30been interested in work in China,
31:32and so they've.
31:33Obtained local,
31:34so the Chinese students obtain a
31:36local scholarship from there to
31:38come here and then in the Yale,
31:40students have obtained local
31:41funding to go to China or some of
31:43them who don't have the.
31:45You know, they don't end up going physically,
31:47but they still collaborate on a
31:49project and so you can see this
31:51is on the left bottom corner.
31:53This is a picture of a dinner
31:55with some of the Chinese visiting
31:57scholars were here mixed in with
31:59some of our own trainees here from
32:01Yale and some faculty as well.
32:03That's been really fun.
32:05We've also been able to expand
32:07to have some junior
32:08faculty who do exchanges and also now through
32:11the global HealthEquity Scholars Program.
32:13We've also included my early experiences
32:15in Global Health, took place in Peru,
32:18and so we've been very happy to set up a
32:21global HealthEquity Scholar site there,
32:23and you can see in the center
32:25panel this is Diego Cabrera.
32:27He came to Yale for a month last year at the
32:31beginning of his fellowship and was able to.
32:34Participate in a similar
32:37series of activities and so.
32:39You know when I think about this program and
32:42what some of the objectives are, you know.
32:45Concretely the participants are participating
32:47in summer didactic training that's available
32:49at Yale and clinical research and methods.
32:52I work with them to develop their
32:54research question of interest.
32:56Most of them go back and have a thesis just
32:59like our medical students have a thesis.
33:02They do as well,
33:03and so they use this opportunity to think
33:06about what their thesis project will be.
33:08An they perform a systematic.
33:10Literature review,
33:11which you know is a really valuable
33:14experience to them.
33:16They participate in summer clinical lectures.
33:20In rheumatology as well as in general
33:22medicine and they really get to
33:24learn about health care delivery
33:26in medical education in the US.
33:28Some part of that is through
33:31some shadowing experiences,
33:32but part of that is also through
33:34other fantastic lectures that
33:36are happening on campus.
33:37About you know medical education,
33:39about health,
33:40comparative health systems,
33:41and finally and one of the most important
33:43parts is engagement with other trainees,
33:46both local and international and
33:48in terms of some of.
33:50You know the things that we
33:52try to balance in this program,
33:55are you know the balance between
33:57didactic and hands on experience,
33:59and this is with regards to research methods.
34:02So really,
34:03you know,
34:03pushing them to think about developing
34:06a research question and how they would
34:08design their project around that question,
34:11we bounce between the experience you know,
34:13being shadowing or or in
34:15classes versus deliverables.
34:16You know, actually writing a protocol,
34:19for example, structured.
34:20Calendar versus time for, you know,
34:22independent meetings with,
34:24you know faculty or other student
34:26trainees who may be doing work that's
34:28of particular interest to them.
34:30And finally,
34:31a combination of mentored and peer learning.
34:33So there's so much that I find
34:36trainees learn from each other.
34:38And sometimes you know they're
34:39more willing to talk about,
34:41certainly obstacles with each other,
34:43and so I think that having the
34:46forum of students,
34:47both active students but alumni of
34:49you know who have been through.
34:51This exchange as well,
34:53it's been a really valuable forum.
34:57Uh, so uh?
34:58One of the things before I move on is
35:01that you know we're looking forward
35:03to hoping to expanding that program.
35:06Not just dermatology,
35:07but but to trainees in other
35:09specialties as well,
35:10and so that's one of the things that,
35:13in terms of future directions,
35:14you know I've been talking
35:16with the Office of Global
35:17Medical Education.
35:18Of course, because of Covid,
35:20so his plans have been on hold.
35:22But you know one thing that we think
35:25would be fantastic is to be able to,
35:27you know, brought in this
35:29experience that we've developed
35:30through the rheumatology program.
35:31To those who have, you know,
35:33other areas of interest as well.
35:36So the second program I'd
35:38like to talk about briefly is
35:40one that has not started yet,
35:43and this is the one that's
35:45coming down the line.
35:46This is called the China Medical Board
35:49Global Health Leadership Development
35:50Program and it will launch next
35:53year because we're not quite ready
35:55this year with the pandemic yet,
35:57but this is a partnership
35:59with the China Medical Board,
36:01so this is a Rockefeller Foundation
36:04endowed organization that
36:05strives to build capacity in.
36:07Professional education Policy
36:08Research and global health,
36:10and they have a strong focus on
36:14trainees in China and Southeast Asia.
36:18But because of the increasing presence
36:20that China has had in International
36:23Development and particularly in
36:25healthcare infrastructure development,
36:27one gap that has been recognized
36:30is that although there's a lot of
36:34expertise in building healthcare
36:36infrastructure in terms of,
36:38you know,
36:39trying to there really has been
36:42less expertise in the area of
36:45building sustainable public
36:46health and research partnerships.
36:49And so it's been exciting to be part of this.
36:53You know, not just yell,
36:55but also the London School of
36:57Hygiene and Tropical Medicine.
36:59We've been collaborating with
37:00them to create this program.
37:02Which will, you know,
37:04train young public health
37:06professionals and and health
37:07professions students from China to
37:09work in lower middle income country
37:11settings and part of their program.
37:14It will be modeled very closely.
37:16Actually after the global
37:18HealthEquity Scholars program said.
37:20I think Albert Co and Elsea wonder
37:22for all of their collaboration and
37:24input during the development process
37:26and also stand for month for his
37:29incredible support and guidance
37:31and so this program will bring
37:33trainees here to yell or to London
37:36for up to three months and then
37:38for the for the next nine months.
37:41Minimum is not in months.
37:43They will spend on the field really
37:46learning how to implement, you know,
37:48working closely with mentored.
37:50Sites to to learn about research
37:52but also program implementation
37:54depending on the background of
37:56this color and so this program.
37:58Like I said,
38:00it's just in the early administrative
38:02development stages now,
38:03but we're going to be excited to
38:06reach out to all the faculty who do
38:09amazing work around the globe to to see,
38:13you know if there are sites would be,
38:16you know,
38:17suitable for for participating
38:18in this program is.
38:20Would be interested in if they have
38:23opportunities so we have a few states
38:25that we've already been talking with,
38:28but we just we think there's a lot
38:31of opportunity here and I think
38:33you know from our perspective
38:35it's also important to really see
38:37the opportunities where you know
38:39the US is not the only funder
38:42of global development work,
38:43but that there you know in the world
38:46there are many potential sources
38:48and how we can work together.
38:51And how we can build the bridges that
38:53can really help provide you know,
38:55the support to do all the important
38:59work that needs to be done.
39:01And finally, I would be remiss if
39:04I didn't talk about engine and many
39:07of my colleagues in engine are part
39:10of this call Ann and I do want
39:12to talk about it because we are.
39:15We've been working on.
39:16This is the Yale Network for
39:18Global non communicable diseases.
39:20It's one of the faculty networks at
39:22the Yale Institute for Global Health
39:24and and we are really passionate about
39:27tackling different chronic disease issues,
39:30whether it's local or.
39:31International,
39:32but in communities where you know
39:35there's a real need for for this,
39:38and we think that sorry.
39:41Sorry.
39:46Sorry my son has to go back
39:47on his zoom class now so.
39:51So what I wanted to say about this is that
39:55so we were founded in 2015 and it's a.
39:59It's a Inter disciplinary group from
40:01different parts of the School of
40:04Medicine and the School of Public
40:07Health and we've had not just you know,
40:10faculty doing work in in our different sites,
40:13but also trainees and this picture
40:16down in the center lower Picture
40:18Panel is of two of our trainees.
40:21One from Ugandan went from Yale who
40:24worked on a project that was funded
40:26by one of Byg attacked awards in 2018,
40:29and we are very much looking forward to,
40:32and so I think one of the things
40:34that we find so important is the
40:37synergies that come from working in a
40:40multidisciplinary group and working with
40:42faculty and trainees across the spectrum.
40:44And one of our next phases
40:46will be expanding engine.
40:48It's been a little bit on hold
40:50because of the pandemic and then.
40:53People being pulled in many
40:55directions but but in May we will be,
40:57you know,
40:58trying to open this up and really invite
41:00faculty across the campus with interest.
41:02And so I wanted to mention that here
41:05because we do welcome people to join.
41:07Will be sending out more notices
41:09about that going forward all right?
41:11So I think those are the main programs.
41:14I just want to highlight to give a
41:16sense of you know what we've done
41:19and where we think we're going
41:21and how we hope to engage with.
41:23You know other people on this call and
41:26beyond in terms of capacity building,
41:28thanks.
41:31Thanks. So our next panelist
41:36is Doctor Christine Garia.
41:39She is a faculty member in
41:42emergency Medicine at the School of
41:45Medicine and her interests center
41:47on non communicable diseases,
41:50specifically on barriers to care
41:53and community based interventions
41:55with a particular focus on Africa.
41:58You know, past work has focused on
42:01health disparities amongst minority
42:03populations in the US and community
42:06based participatory research,
42:07which is particularly well
42:09suited for this kind of work.
42:12She was also a senior contributor
42:14to the first ever national study on
42:17non communicable diseases in Kenya,
42:20in which you know this study used a
42:23WHO validated national cross sectional
42:26study framework to assess the burden of.
42:29A burden and risk factors of NCD's,
42:32Ann and has contributed to work
42:35globally at the intersection
42:37of emergency care and chronic
42:39non communicable diseases.
42:41So over to you,
42:43Christine.
42:46Alright, just a moment. Give so much.
43:00Alright, I hope everyone can see my screen.
43:02OK so thank you for that kind introduction.
43:04I will try to be brief.
43:06I know we were given about 7
43:08minutes so I'll try to skip through.
43:10But again, I'm really just delighted
43:11to be here with this really esteemed
43:13panel and all the guests I can see.
43:15I think we have Doctor
43:17Frank Ninja back with us.
43:18Hi Frank, so excited to get
43:20through and hopefully get to
43:21some some questions at the end.
43:23These are some of my disclosures.
43:25Many things to Gli,
43:26the predecessor to wide ygh for
43:28this award that covers some of
43:30the work I'll be talking about,
43:32and the second grant covers
43:35some of my my current work.
43:37And of course,
43:38like Luke I I did want to start
43:40with a personal story which
43:42really informs what I do.
43:43Today.
43:44I was born in the US but raised
43:45in Kenya and then returned to
43:47the US for higher education and
43:49of course have stayed on at.
43:51Yale is a faculty member.
43:52After filling, finishing fellowship.
43:53But I now do most of my academic work.
43:56Actually in Kenya,
43:56which is also where the majority
43:58of my own global health capacity
44:00building efforts to occur.
44:02And in these kinds of
44:03talks, always like to give credit,
44:05because I really wouldn't be here today
44:07if it weren't for the amazing mentors
44:09and sponsors who've done their own
44:11individual capacity building in me.
44:12And it really comes full circle
44:14in terms of what these people
44:17have done in me thinking about my
44:19science and my role as an academic.
44:22And so just so we're on the same page,
44:25I wanted to share this definition
44:27that I feel encapsulates my own
44:30research capacity building efforts,
44:31which include thinking about both
44:34the individual and the institutional
44:36development in some of these countries
44:38with the aims of improving skills
44:40and ultimately hopefully increasing
44:42the quality research outputs.
44:44So, as was mentioned in my introduction
44:46and some of my capacity building has
44:49revolved around peer mentor ship.
44:51This is just an example from the Kenya
44:53Ministry of Health Project where I was
44:55working with some members from the
44:57government as well as community partners
44:59who do work on non communicable diseases
45:01in Kenya and as a senior collaborator.
45:04Of course I was working alongside
45:06these different team members who
45:07had varying levels of expertise in
45:09academic writing and research and
45:11so while I was excited to obviously
45:13contribute to four out of 10 of.
45:15These papers from this really impact study.
45:18I was even more keen and really
45:20encouraged to be working alongside
45:22them to conduct actual sub analysis
45:24and to write some of these papers.
45:27I've also had the opportunity to target
45:29junior faculty and research scientists
45:31both in Kenya and across the continent.
45:35And this has primarily been through
45:37conferences and symposia lectures on
45:39research and and also through developing
45:41leading an lecturing in a research workshops.
45:43So these are just a couple of research
45:46workshops that I've recently been
45:48invited to design and implement.
45:50One of them was with the emergency
45:53Medicine Kenya Foundation.
45:54Another was with the Kenya Society
45:56for Hematology and Oncology
45:57in collaboration with NCI,
45:59and the third one was last year via Zoom.
46:02As you can imagine.
46:04With the African Conference on
46:05Emergency Medicine and this is just
46:07an example of our impact to text.
46:09Might be a bit small,
46:11but we had nearly 300 participants
46:12that signed up for that pre Symposium
46:14workshop from across the continent.
46:16And so it was really delightful to
46:18see that there was some relevance and
46:21interest to be able to attend the
46:23conference workshop and it was well received.
46:26And then finally I think closest to my heart,
46:29and I think like it's been alluded
46:31to from some of the other panelists,
46:33I really mentoring of trainees and
46:35these junior people who are still
46:37early and budding in their careers
46:38is what I'm really passionate about
46:40and what that's looked like for me
46:42is really just being intentional
46:44with every project that I'm on.
46:46Every study that I'm a peon to really
46:48think about how to incorporate them.
46:51And So what are some of my outcomes?
46:53Well,
46:53these are two particularly good examples.
46:55I think of two separate groups of
46:57students I've closely mentored for
46:58the past three to four years around
47:00two different research projects.
47:02The group of young men on the left
47:04graduated Med school a couple of years ago,
47:07and so did the young woman on the right.
47:09The young man I actually met
47:11at a conference in Germany,
47:13a global conference there,
47:14and we started working on a
47:16project shortly thereafter.
47:17In 2018, at Presidents always
47:18inaugural trip to Africa,
47:20for which I was so lucky to be one of
47:22two yellow faculty delegates to attend,
47:24I was able to invite them to an event
47:26with him, and of course he would.
47:28They were just delighted to
47:30to meet President Salvey,
47:31the young woman on the right.
47:32I coincidentally actually
47:33met at the same event,
47:34and they actually came up to me
47:36and asked if I would mention them.
47:38And of course, I said, sure,
47:40and so some of our outcomes.
47:41Well,
47:42we actually have two different
47:43articles right now in press,
47:44one with applause,
47:45one and one with after the African
47:47Journal of Emergency Medicine.
47:48The young men highlighted in the
47:50picture you can see underlined
47:51and similarly for the young women
47:53and we continue to stay in touch.
47:55I've written letters of
47:56recommendation for them.
47:57They've gone to a variety of positions.
47:59This is just an example
48:00of one of the trainees,
48:02Thomas,
48:02who messaged me about a month ago
48:04because he wants to go into surgery
48:06and he went on to publish this paper
48:08and the surgical Journal which he
48:10was obviously very excited about
48:12and one of the people who is not
48:14featured in the other pictures but
48:16was actually a member of both of the papers.
48:18Oh,
48:19and that was funded by the Heck Talbar award.
48:21Is this young woman a doctrine bother wambua,
48:24and she was actually able to come to Yale.
48:27And this is actually a picture from
48:29an event organized by an Kellett.
48:31Thanks,
48:31Anne,
48:32with a few other trainees who are
48:34on campus at the time and she's
48:36going on actually to do residency
48:38in emergency medicine in Tanzania.
48:40You know,
48:40rest in peace to to their president today,
48:43but she's going to be going back to Kenya.
48:46Actually,
48:46as the second ever emergency
48:48medicine trained consultant.
48:49In the country which I'm just
48:50so delighted for,
48:51and I'm happy to play a very tiny role and.
48:54As far as there being a sort of a
48:56method to the madness with onboarding
48:57and mentoring these Chinese,
48:59I do have a system I'm not going
49:00to spend a lot of time with it
49:02now on it now because of the time,
49:04but I'm happy.
49:05I'm just I wanted to put this
49:06slide up just to make it available
49:08to others if they're interested
49:09in thinking about going through
49:10this or or if we have time to
49:13talk about it in the Q&A session.
49:16And then the last thing I was
49:18asked to mention
49:19was this final effort,
49:20which is an organization called Kenyan
49:22Doctors USA that I founded in late 2019,
49:25and my objective in starting this
49:26organization was really to augment
49:28some of the individual work that I've
49:30been doing around clinical research
49:32and educational capacity building,
49:33and really just given more of a
49:35framework in an infrastructure and to
49:37allow for other partnerships outside
49:39of just my own individual work.
49:41And so I co-founded it with
49:43some colleagues in the US,
49:44another one who actually happens
49:46to be at Yale.
49:47In surgical residency and we partner
49:50with organizations in Kenya with
49:51similar missions and did so with
49:53the Medical Student Association of
49:55Kenya and we're fortunate enough
49:57to be awarded a consortium of
49:59universities for Global Health.
50:01Tom Hall Grant in late 2020,
50:03and so we have the aims of using this
50:05grant to implement the first ever
50:08national Medical student Journal called
50:10Repub and also to design an implement,
50:13a parallel curriculum that will
50:15do some research training for
50:16students across the country.
50:18And as a third compliment to that
50:20intervention to do some internal
50:22mentorship for the peer review team.
50:25So we'll have senior consultants and
50:27faculty as senior viewers and medical
50:30students as your viewers and of course,
50:32will evaluate each of
50:34these three interventions.
50:36And the last thing for future work
50:38I've been working with a couple
50:40of colleagues actually in the
50:41call for the past couple years,
50:43sort of interrupted by covid,
50:44is to implement and NCD research capacity.
50:47Building intervention for clinicians.
50:48Scientists like the ones I've mentored on
50:50my own, maybe through a D43 if available,
50:52or another grant opportunity.
50:55And so just in closing for me,
50:57you know what?
50:58What motivates me and hopefully
51:00motivates others on the call that
51:02might be thinking about doing more
51:03of their own capacity building is
51:05really this global citizenship.
51:07I think that has been so evident
51:09over the past year,
51:10especially in its importance.
51:11Just an ethical obligation to advancing
51:13research opportunities equitably.
51:14And, of course, selfishly.
51:16I think,
51:16as we all know,
51:18there's this personal enrichment and
51:19fulfillment from getting to establish these
51:21relationships and watching people grow.
51:23And then the academic success that.
51:25I think does come out of establishing
51:27and building these relationships and
51:28the various work that comes from
51:30that and so with that I will stop and
51:33I'll be happy to take any questions.
51:34Thank you.
51:36Thank you so a few things.
51:38You know there are a few questions out there
51:41and I'll add a couple of my own questions,
51:45but I really appreciate everyone providing an
51:48overlapping but perspective on a few themes,
51:51but also their own distinct experiences.
51:53I think I think that shows the richness
51:56of global health capacity building
51:58that is happening across Yale,
52:00especially around the three
52:02Health Sciences schools.
52:04So a couple of questions look,
52:06there was a question for you to say you know,
52:10to talk about, you know a few examples
52:13of how you have seen implementation.
52:16Science approach is paying off in ways
52:19that might not have been possible,
52:21for example or slower.
52:23You know if traditional research
52:25methods had been used.
52:29Right, thanks? I mean,
52:30I think traditionally the model
52:32of research development is that of
52:34a pipeline where stage one stage,
52:36two stage three and implementation
52:37only comes in as a concern at the end.
52:40And I think Covid is provided many examples.
52:43The vaccine success probably the best one
52:45of the advantage of trying to move forward,
52:48and I think there's both successes
52:49and failures in that arena in terms of
52:52understanding implementation earlier and
52:53so from a methodological perspective
52:55we talk about hybrid studies where we
52:57are looking from the very beginning at.
53:00Not only what is the effectiveness of
53:02the interventions were developing,
53:04but how acceptable they are,
53:05and I've just seen that accelerate
53:08so much in my field,
53:10in diagnostics and around 2008 I had
53:12a chance to participate in an expert
53:14group panel at the becho to guide
53:17TV diagnostic policy.
53:18At that time there had been exactly 1
53:21recommendation and TB Diagnostics in
53:23the in the previous time immemorial,
53:25and since that time I think we're
53:28up to something like 20. Different.
53:32Statements now,
53:33and that acceleration really has
53:35benefited from just what I'm talking
53:36about now.
53:37Having people think not only about
53:39what's the diagnostic performance,
53:40but what are the profiles that
53:42we're looking for.
53:43What are the experiences that patients have?
53:45How do clinicians use those to make
53:48decisions so that setting just one
53:49brief example and there's lots of
53:51more specific examples from the
53:53different work that many of my
53:55colleagues have done in Uganda?
53:57So that's excellent,
53:59so there's another interesting
54:00question at any one of you can take it,
54:03or multiple people can briefly answer the
54:05question that comes from stende instead.
54:07Worm and sort of.
54:09You know there are different
54:11models of global engagement.
54:13And that there's a you know,
54:16especially in the context of yields
54:19footprint honestly being smaller
54:20than many other peer institutions.
54:23And we do not have as many large
54:26grants like PEPFAR USAID projects,
54:29you know, large project program
54:31project grants as an institution,
54:33and that's not restricted to global health.
54:36That is true,
54:38especially in comparison with our enormous
54:41success as an institution in getting.
54:43Other NIH and other really
54:46competitive grants, and so.
54:47So how do we any talks about how do
54:52we go about building that footprint?
54:55Should we sort of align these
54:58interests around a specific
55:00topic area or a specific country
55:03so we have presence in Liberia,
55:05Uganda, Pakistan, etc.
55:07You know several places etc.
55:09Or should we just forgo this and but
55:12overall focus on like institutionally,
55:15you know what direction should we go in?
55:19And or we should let the investigator
55:21and collaborator collaborator
55:22driven things percolate,
55:23and then see how things get
55:25aligned and so and so forth.
55:27So would love to hear people starts I,
55:30you know,
55:31I have some perspective on this as well,
55:33which in the interest of time
55:35I will refrain from expressing.
55:37You know,
55:37a lot of you on this panel
55:40know some of those thoughts,
55:42but but I think I'm genuinely interested
55:44in hearing what the panelists
55:46have to say around this topic.
55:48So Christina you were raising your hand.
55:51Well, I was. I have two kind of
55:54ways to think about this. One is.
55:57Anne. We at that this is what
55:59Assad alluded to at the beginning.
56:03So over the past year and a half,
56:05the team, that of which I'm a part at
56:08Yale University Librarian Vanderbilt,
56:10has been working on applying for
56:12a $15 million USAID grant to do
56:14capacity building work in Liberia,
56:16and we were recently notified that
56:18we've been recommended for funding,
56:20which is very exciting.
56:21An in the process of doing that,
56:24I learned that it at Yale.
56:26There is only one other USAID grants
56:29admitted in the last five years.
56:31Which was really surprising,
56:32and so I think this speaks to
56:35the point that Stan is raised.
56:37This is another mechanism of funny,
56:39very different from NIH in
56:41every imaginable way.
56:42But you know,
56:43part of what I think has put us in a
56:46position to be successful is that we
56:48had this very strong trusting working
56:51relationship with our partners in Liberia,
56:54particularly Doctor Don,
56:55whom I mentioned briefly
56:56in my introductory slides,
56:57who is very, very senior.
56:59She was a Minister of Health.
57:01Now she's a.
57:02Basically a vice chancellor at the University
57:04of Liberia overseeing all of Health Sciences.
57:07So I think we might want to think
57:09differently about our existing partnerships.
57:11I mean,
57:11there's no chance at all that I
57:13alone would be positioned to get
57:15any kind of grain of this size,
57:17but because we were so closely
57:19working with these partners in
57:20Liberia and have such a strong
57:22team really trusting team and
57:24also partners at Vanderbilt.
57:25And we just have worked together
57:27so well for such a long time.
57:29We had that to offer and I
57:31think Yale has more of that.
57:33And can go for these kinds of grants.
57:36Maybe then we realized which
57:38just really quickly on the other.
57:40Thing I was going to say,
57:42as sod knows very well why Igh is
57:44actively working toward building
57:45this capacity at Yale through
57:47the faculty networks,
57:48Faculty Support Initiative,
57:49thinking creatively about what's
57:51coming down the line at some of
57:53the big funders and how we can
57:55position ourselves strategically
57:56to go for some of those awards.
57:58So in the interest of time,
58:00I'll stop there,
58:01but I think I think there's a lot
58:03that we can do to stems question
58:05to make a larger footprint.
58:07Building on the partnerships
58:09and expertise we already have.
58:11So maybe since you mentioned that
58:12very briefly, in 30 seconds,
58:14can you sort of elaborate on the
58:16faculty support initiative and how
58:17did it that some of the things that
58:20will be offered through that did that
58:22help you with this specific brand?
58:24Or what are some of the you know
58:26where things are going with
58:28the support services that are
58:30available for faculty that
58:31are submitting large grants?
58:32Sure, so through the
58:33Faculty support initiative,
58:34we're offering opportunities
58:35as I briefly mentioned,
58:36for people to get support,
58:38there's the faculty network,
58:39which is led by my colleague.
58:41Jeremy Schwartz scuse me,
58:43but we're also offering
58:44consulting Grant Consulting,
58:46which I was able to use as a Guinea pig,
58:49which worked out very well for
58:51large grant awards were doing grant
58:54searches where we just launched
58:56a website with all different
58:58kinds of resources for faculty,
59:00and so we're trying a multifaceted
59:02way of elevating faculty
59:03communications for faculty to help
59:05position people for success here.
59:07So out of five miss anything, feel free.
59:12No, this is this is good.
59:14You know, I think.
59:15Thanks for being brief.
59:17So for more details people couldn't go
59:19to the Yale Institute for Global Health
59:21website and get more information about
59:24both faculty networks that are that buy in.
59:26Coordinated by Jeremy Schwartz and the
59:29Faculty Support Initiative that is led
59:31by Christina Talbert Slagle who's here.
59:33So were you raising your hand or we
59:36just stretch stretch?
59:37Yeah yeah no I was just going to
59:39very briefly comment in response to.
59:42Guns question, and I think that you know.
59:46From the perspective of engine
59:48and and Christine and Tracy
59:50and Jeremy and Nikki Haley,
59:51I'm not sure if she's on this.
59:54They've all been key in.
59:56Sort of the developmental
59:58process of this network.
01:00:00And I think that's you know, sort of.
01:00:03One of the things that brings us
01:00:05together is that we really respect,
01:00:07and, you know,
01:00:08appreciate all the individual
01:00:10investigator driven projects.
01:00:11But we really also find the value
01:00:13of the synergies that come together
01:00:15when we are together as a group,
01:00:17and we're trying to think you know,
01:00:20beyond the individual countries
01:00:21and projects. I think
01:00:22that the group has been able to, you
01:00:25know, use this network,
01:00:26what you know to both focus on country,
01:00:29specific topic specific projects,
01:00:30but also. You know,
01:00:32think about how how we can be broader,
01:00:35and so this is sort of like a small
01:00:38model of what stands talking about,
01:00:40which is, you know,
01:00:42more the PEPFAR USAID type grants.
01:00:44But, but I would say that, you know,
01:00:47Yale doesn't have to give up the you know,
01:00:50rich investigator, driven,
01:00:51you know, type of work and success.
01:00:54You know, in pursuing these,
01:00:56these larger collaboratives ether,
01:00:57you know, I think that we should be,
01:01:00as Christina said, like.
01:01:02Benefiting from that rich
01:01:04experience to to kind of try to
01:01:06take our impact to the next level.
01:01:08It's just I think,
01:01:09the experience that you know
01:01:10from our networks perspective.
01:01:12I think with, you know,
01:01:14speak to that kind of vision.
01:01:16So yeah, so I will before we wrap up.
01:01:18I'll just give last question to Christine.
01:01:22I will then wrap up in the
01:01:25interest of time so you see there
01:01:27is a lot of you know your work.
01:01:30You uniquely qualified based on your
01:01:33experience and your work in terms of
01:01:36looking at equity and both in the US.
01:01:38But obviously global health work
01:01:40ethically done is sort of sits
01:01:42on a bed of understanding of
01:01:44inequities between countries,
01:01:45but also there's an increasing recognition.
01:01:48There has been there that even in MI seas
01:01:51there are structural disadvantages that are.
01:01:54Several subgroups have of the population.
01:01:57There are 20 different ways of being poor.
01:02:03ETC and so.
01:02:04Any thoughts on lesson learns that
01:02:06can cross fertilize our thinking both
01:02:08in the US and in LMS ease so so any
01:02:11quick thoughts before we wrap up?
01:02:13Yeah, just a quick quick comment
01:02:15on Alpha focus on
01:02:16gender because of the extent of time of time.
01:02:19I know it's odd you and I have
01:02:21talked about this in the past.
01:02:23I mean, I'll give a plug I think so I know
01:02:26you're thinking about this intentionally.
01:02:27I will also give a plug for women leaders in
01:02:30global health or women left global health.
01:02:32Excuse me, which I'm a cohort member
01:02:35and part of that I think is really.
01:02:37Affecting how we think about systems
01:02:38change also individual change and
01:02:40actually has a leadership development
01:02:41program they think is really going to
01:02:43breakthrough some of these barriers across
01:02:45country and a few other organizations.
01:02:46Women's group women lead women
01:02:48in global health.
01:02:48I think we're trying to think about this,
01:02:50but I think I think we have a
01:02:53potential way to think about this.
01:02:54For Tegic Lee offline side in
01:02:56terms of what can yell do in terms
01:02:58of affecting that strategically,
01:02:59there are a lot of different.
01:03:00Again, I've mentioned a few.
01:03:02The big ones that I think are doing it well.
01:03:04CJ as well I think as well.
01:03:07So what can we do as an institution
01:03:10to do this a bit better to advance
01:03:13women in particular
01:03:14equitably with their male counterparts,
01:03:16so that's excellent.
01:03:17So before I sort of wrap up and
01:03:20say a few things around this,
01:03:22Melanie Scion from surgery had a
01:03:24sort of comment slash question about
01:03:26implementation sized office hours Melanie.
01:03:29Let's connect offline.
01:03:30If there is a critical mass of people
01:03:33who are there, so there's something
01:03:35that ygh can potentially support.
01:03:37And work with various partners.
01:03:39Obviously you know with their
01:03:41engagement and interest,
01:03:42but if there is a critical mass of
01:03:44people who need that kind of input,
01:03:47help, support, etc,
01:03:48we can always connect offline.
01:03:50But to wrap up, look this is.
01:03:53A time I would say exciting time for
01:03:56global health because there is broader
01:03:59recognition out of a lot of this
01:04:02crisis around COVID-19 that exposed
01:04:04inequities within and between countries.
01:04:07There is a recognition that
01:04:09I have never seen before.
01:04:11The public health and global health
01:04:14broadly including clinical care
01:04:15for under resourced populations
01:04:17has always recognized that these
01:04:20inequities are in acceptable.
01:04:21But there is a broader recognition and
01:04:24when there is a broader recognition.
01:04:27There's an opportunity to act the
01:04:29way we act matters and the way we
01:04:33act as an institution ethically,
01:04:35sustainably.
01:04:35An impactful E would be determined by
01:04:38you know whether whether or not we are
01:04:41strategic and thoughtful about this,
01:04:43and I have a lot of confidence that
01:04:45the critical mass of people who are
01:04:48working within the year ecosystem
01:04:50on these topics bring that level of
01:04:53thoughtfulness and expertise to the
01:04:55topic and the sense of compassion.
01:04:58That which bodes well for yelan and
01:05:00frankly a lot of the emerging in
01:05:02your efforts build on the strong
01:05:04foundation provided by different earlier
01:05:07initiatives and ongoing initiatives,
01:05:09just like the one in the
01:05:11Department of Medicine.
01:05:12And I would single out.
01:05:15You know Tracy and and others who are in
01:05:19the current leadership of that initiative.
01:05:23But also my friend Oscar Rustica
01:05:26and he and others before alongside
01:05:29him played a huge fundamental role
01:05:33to creating that critical mass of
01:05:36initiatives that provide a platform us
01:05:40to build the build and expand what?
01:05:45What what you know has to bring to
01:05:47the table in this very important area.
01:05:49So with that, I'll wrap up the session.
01:05:53Great,
01:05:53thank you so much.
01:05:55Sad for moderating a wonderful session.
01:05:57Thank you also to doctors Talbert,
01:05:59Slagle, doctor, Shay, Doctor,
01:06:00Davison, Doctor and Gloria for your
01:06:02thoughtful comments and for sharing
01:06:04your amazing work with all of us.
01:06:06I know all of you well but but as I have
01:06:09said I learned quite a bit from today's
01:06:12presentation as well and look forward
01:06:14to moving forward together with you.
01:06:16Just as one last plug for our
01:06:19final Global Health Day event,
01:06:20I'm going to share our slide tonight.
01:06:23We have our fifth annual.
01:06:25Refugee health education conference.
01:06:26Physical and mental health of
01:06:28refugees the COVID-19 update.
01:06:29This QR code will take you directly
01:06:31to the website where you can register
01:06:34to attend or you can visit the link.
01:06:36We look forward to seeing you there.
01:06:39This will be our final event for Global
01:06:41Health Week and Global Health Day of 2021.
01:06:44So thanks so much to everyone for joining
01:06:47us and I look forward to seeing you soon.
01:06:50Take care.