The UNC Institute for Global Health and Infectious Diseases (IGHID) and the UNC Gilling’s School of Global Public Health (GSGPH), will present a hybrid symposium on Friday, February 16, featuring research from MD/PhD students, doctoral candidates, postdoctoral fellows and junior faculty from global sites around the world, starting in Bioinformatics 1131. A symposium guide can be found here.
“We invite anyone interested in global health studies and practice to join us as we introduce an impressive array of global health research,” said Suzanne Maman, PhD, the associate director of education for the Institute for Global Health and Infectious Diseases and the associate dean for Global Health in the Gillings School of Global Public Health. “These topics reflect many new insights and solutions for illness and disease that will help shape the future of practice.”
The 2nd Annual Global Health Scholars Symposium will showcase the work of 43 scholars through research presentations and dynamic exchanges. Two recurring themes will focus on innovation in healthcare delivery and efforts to understand and eliminate malaria. Michael Herce, MD, MPH, and Jon Juliano, MD, MSPH, assistant directors at the Institute for Global Health and Infectious Diseases, explain.
The Future of Health Care Delivery
Q: Healthcare delivery is effective when care is aligned with local context, whether it’s in North Carolina or around the world. How do we get what we know works to the people that haven’t had access to it, and prove that it can be done?
“This question applies to COVID in North Carolina just as much as it does the treatment and prevention of HIV in sub-Saharan Africa. As COVID taught us, you can have the best vaccine, but that doesn’t mean people are going to get the vaccine if they don’t trust the healthcare system, or have never had access to health care,” explained Herce, assistant professor of infectious diseases, and director of implementation science at the Centre for Infectious Disease Research in Zambia (CIDRZ).
“This is what we think about and study as global health researchers, often using tools from implementation science to address global health inequities. Sometimes this might involve using task-shifting to empower local community health workers to do more during a patient encounter. Or, it could mean a new model of service delivery, for example, that reaches more women engaged in sex work by taking pre-exposure prophylaxis for HIV out of the clinic, to places where women meet their clients, like brothels or bars.”
Q: What will we learn about healthcare delivery in global health?
“Breakout sessions will introduce a variety of studies that identify the barriers and the facilitators to delivering health services for major global health problems, along with new strategies to bring critical services to the people who need them most. From identifying missed opportunities to screen for cancer, to making better use of clinic data to improve malaria treatment, these sessions will explore the lived experiences of the people we serve globally at UNC and new approaches to improve their health.
“The future of global health delivery can best be described as having someone who you know and trust provide you the best care possible, how and when you prefer to receive it, no matter where you live in the world. Research in implementation science and global health delivery is based on reciprocal innovation and partnership, so that knowledge flow is bidirectional, and this includes bringing innovations in practice back to the U.S. to improve healthcare in North Carolina.”
Taking Stock of Malaria, Pursuing Elimination
Q: Between May and August, 2023, there were nine cases of locally acquired malaria in the U.S., the first cases in 20 years. Malaria poses a threat to nearly half of the world’s population, particularly in Africa, with 80% of malaria deaths in the region among children below 5 years of age. How vulnerable are we to malaria in the U.S.?
“Most malaria cases diagnosed in the U.S. are imported, usually by persons who travel to countries where malaria is endemic (regularly occurring),” explained Juliano, professor of infectious diseases and epidemiology.
“Multiple risk factors, including changing climate and extreme flooding, suggest that local malaria outbreaks in the U.S. could continue to pose a public health threat. And many states are engaged in surveillance activities and mitigation efforts to reduce the possibility of local transmission.”
Q: What are the challenges as researchers pursue elimination in other parts of the world?
“We are entering a period of great concern about the effectiveness of antimalarial drugs in East Africa. The emergence of partial artemisinin resistance in multiple countries in the Rift Valley raises concerns about the long-term utility of these first line agents.
“Rapid diagnostic tests are used in Africa to detect specific parasite proteins in the blood; however, parasites are evolving now that lack the genes for these proteins, becoming invisible to the tests. The first-line malaria treatment recommended by the World Health Organization is a combination therapy involving artemisinin-based drug compounds, which are very effective in preventing death and reducing transmission. But the mutations now detected in Africa provide resistance to artemisinin.
“One breakout session will be dedicated exclusively to malaria, and will introduce significant extensions of studies that are underway to understand the emergence and spread of mutations. UNC is either leading or supporting studies in Rwanda, Uganda, Tanzania, the Democratic Republic of the Congo and Ethiopia.”
The 2nd Annual Global Health Scholars Symposium will begin at 9:15 am and end at 12 pm on Feb. 16. The agenda can be accessed here, as well as a list of topics and presenters.