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Yale Students Finish First at Emory Global Health Case Competition

March 28, 2024
by Fran Fried

A team of students from the Yale Institute for Global Health (YIGH) won the annual Emory Morningside Global Health Case Competition, which took place March 21-23 on the Emory University campus in Atlanta. It was the second time in three years that a team representing YIGH has won this prestigious event, the largest of its kind in the world.

The competition featured 31 teams from around the world that were asked to come up with innovative, multidisciplinary solutions to real-world global health problems. This year, the case challenge was “Tackling India’s Twindemic: Accelerating integrated diabetes mellitus-tuberculosis care to end TB.”

“In winning the Emory case competition, this talented group of Yale students, drawn from across the university, demonstrated the critical, creative, and strategic thinking that is needed to address the world’s most pressing health challenges,” said Dr. Michael Cappello, MD, interim director of YIGH and professor and chair of the Department of Epidemiology of Microbial Diseases at the Yale School of Public Health (YSPH). “The Yale Institute for Global Health is proud to have sponsored the team’s participation in Atlanta, which we hope will further inspire their continued efforts to make the world a better place.”

“This win makes two in the last three years, so it’s very significant,” added YIGH Deputy Director Michael Skonieczny. “We’re really excited and proud of what the team has achieved. The case competition is a great venue for students to work together. The value is that this is pertinent training for them. What excites me is the kind of experience and skills it builds.”

The winning YIGH team, which earned $6,000 for first prize, consisted of Lindsay Walker, MSN ’26, the team’s captain; William Zhang, MPH ’24 (chronic disease epidemiology); Felicia Annan-Mills, MPH ’25 (social and behavioral sciences); Noemi Guerra, BS ’24; and Teimur Kayani, MD ’24, MPH ’25 (chronic disease epidemiology).

In winning the Emory case competition, this talented group of Yale students, drawn from across the university, demonstrated the critical, creative, and strategic thinking that is needed to address the world’s most pressing health challenges.

Dr. Michael Cappello, MD, YIGH Interim Director

Their solution – called Akanksha, a Sanskrit word meaning ambition – focused on screening for latent TB among diabetic populations in India and empowering community health workers.

Screening would be done by clinic health workers, using an antigen-specific TB skin test (TBST), which Walker said is more reliable than the PPD tuberculin skin test (TST), and less expensive and less prone to instability than interferon gamma release assay (IGRA) blood tests. (The Serum Institute of India has developed its own version of TBST, called Cy-TB.)

Walker said that during their research, the team was inspired by community health workers in India, called accredited social health activists (ASHAs). “These workers travel to remote places, visit people in their homes, and work with clinics to provide health screening and education,” she said. “They are historically underpaid, and recently there have been news stories highlighting their fight for increased wages and recognition as government employees.”

The Yale team chose to implement their project in the city of Guntur, in the state of Andhra Pradesh, because of its dedicated ASHA community, government clinics with comprehensive primary healthcare services, and expanding urban population. Their plan would provide mobile phones to ASHAs; reinforce workers’ training on a government patient data mobile app and an educational app for TB, train workers to read TBSTs, and involve them in TB treatment initiation and adherence.

In addition, “We supplemented ASHAs income to their requested level with our funding,” Walker said. “We created a detailed budget and cost-benefit analysis, and delivered our presentation in a concise and compelling manner.”

Kayani elaborated further: Once a patient tests positive for latent TB, ASHAs would deliver a once-weekly regimen for 12 weeks of isoniazid and rifapentine, a recently developed medication combination he said is far more patient-friendly than the traditional methods of once-daily isoniazid or rifampin for 3-4 months. ASHAs would then perform virtual observed direct therapy through the team-provided phones for medication adherence via Ni-kshay, a government-sponsored TB tracking and educational app.

From the Yale community, Walker cited the assistance of Jason Abaluck, professor of economics at the School of Management, in helping the team calculate and present a cost-benefit analysis; and Dr. Luke Davis, MD, YSPH associate professor of epidemiology (microbial diseases), who shared his knowledge of the developing TBST and its growing interest for use in high risk countries.

The Yale team advanced to the Emory competition by triumphing over four other teams on February 17 at the YIGH Global Health Competition. There, students had to pitch innovative solutions for managing non-communicable diseases amid the current humanitarian crisis in Sudan. Their winning solution, Cooling as a Solution (CaaS), centered around deploying “EcoFrost” coolers for transporting diabetes medication and “Frio Wallets” to help maintain the insulin temperature for up to four weeks. In both competitions, teamwork was paramount.

“One key element to the Yale team’s success, I believe, was our team cohesion and ability to leverage and complement our individual strengths,” Zhang said. “Both at the YIGH Global Health Competition and at Emory, our team adopted a lean and iterative process to ideation, held fast under time pressure, and was impressively nimble at thinking on-the-spot in Q&As. I’m proud that everyone challenged themselves, that we learned and had fun, and that we created lasting connections through this opportunity.”

Submitted by Fran Fried on March 28, 2024