Closing the Gap in Healthcare: Morehouse School of Medicine Addresses Disparities in Global Health

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Closing the Gap in Healthcare Morehouse School
of Medicine Addresses Disparities in Global Health
Eve J. Higginbotham, M.D. Dean and Senior Vice
President for Academic Affairs
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Morehouse School of Medicine Addresses
Disparities in Global Health

• Why now?
• What are we doing?
• Where are we involved?

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Morehouse School of Medicine Addresses
Disparities in Global Health

• Why now?
• The World Is Flat (T. Friedman)
• Increasingly interconnected
• Significant levels of global migration
• Increased threat of communicable diseases e.g.
  HIV/AIDS, SARs, avian influenza, and
  multidrug-resistant microorganisms

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Morehouse School of Medicine Addresses
Disparities in Global Health

• Why now?
• Strong interest among medical students nationally

Drain et al. Acad. Med., 2007
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Morehouse School of Medicine Addresses
Disparities in Global Health

• Why now?
• High correlation with our core mission at MSM
• To serve the underserved

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Global Health in Medical Education A Call for
More Training and Opportunities

• in developed countries, primary care physicians
  must meet the needs of the medically underserved
  and uninsured, who suffer increased disease
  morbidity and whose needs could be better
  addressed if health care professionals had a
  better understanding of global health.
• Drain et al, Acad. Med., 2007

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Morehouse School of Medicine Addresses
Disparities in Global Health

• Why now?
• What are we doing?

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Morehouse School of Medicine Addresses
Disparities in Global Health

• Why now?
• What are we doing?
• Define the scope

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Three Domains of Competency in Global Health
Education Recommendations for All Medical
Students

• Burden of Disease
• Travelers Medicine
• Immigrant Health

Houpt et al, Acad. Med., 2007
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Morehouse School of Medicine Addresses
Disparities in Global Health

• Why now?
• What are we doing?
• Define the scope
• Research
• Education
• Patient Care

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Dr. Jonathan Stiles - Malaria

• Infects 300-500 million globally, killing 2
  million
• 15 of fatalities due to cerebral malaria
• Dr. Stiles studies the role of pathogens in brain
  development
• Has identified biomarkers that can predict the
  severity of such cerebral diseases as malaria
• This discovery can ultimately lead to early
  detection and facilitate treatment of cerebral
  malaria

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Dr. Jorge Benitez - Cholera

• Bacterial disease connected to contaminated
  drinking water
• Exists in epidemic proportions in Africa.
• Research focused on the pathogenesis of cholera
• Development of live cholera vaccine
• Findings so far indicate that live cholera
  vaccines can deliver foreign antigens to induce
  cross protection against a broad spectrum of
  pathogenic organisms.

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STDs and HIV/AIDS

• Major medical and social importance worldwide
• Debilitating or life-threatening consequences
• Chlamydia trachomatis and Herpes simplex virus
  type 2 (HSV-2) - among the most commonly
  occurring STDs in the world.
• UNAIDS has reported that as many as 80 million
  Africans could die of AIDS by the year 2025.
• Public health significance enormous
• Current medical opinion is that an effective
  vaccine offers the best approach to protect the
  greatest number of people from these infections
  and their consequences.

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Dr. Francis Eko Ghost Vaccines

• Focused on developing vaccines against Chlamydia
  and HSV-2
• Based on the novel recombinant Vibrio cholerae
  ghost (rVCG) platform technology.
• Inherent adjuvant properties
• Capable of simultaneously delivering multiple
  antigens from the same or different pathogens to
  the immune system.

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Dr. Vincent Bond and Dr. Michael Powell - HIV

• Testing a new hypothesis on the cause of AIDS
• Could lead to a vaccine that will block the
  ability of the HIV to cause damage
• One of the proteins produced by virally infected
  cells called Nef is directly responsible for
  killing cells of the immune system, resulting in
  HIV becoming AIDS
• Will lead to a more complete understanding of the
  many roles of this key viral protein, HIV-1 Nef
• Currently, the theory is being tested in
  primates.
• If the theory is confirmed, then someday,
  individuals infected with HIV could remain
  infected, but would not suffer the loss of immune
  cells commonly associated with infection with
  HIV.

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Dr. Kofi Kondwani - HIV

• Collaborating with a Senegalese company and
  tribal elders
• Study traditional African herbal medicine that
  seems to block HIV infection
• Expects to elucidate the active compounds present
  in the traditional medicine
• Goal is to effect a reduction of 2.5 million new
  cases in 3 years.

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Dr. Stiles and Dr. Eko - Trypanosomiasis

• Collaborating on using the rVCG platform to
  design a candidate vaccine against African
  trypanosomiasis.

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Education
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MPH Program International Health Track

• Led by Dr. Kwak Danso
• Prepares graduates to work in
• Policy and program positions
• Governmental and non-governmental organizations
• Includes
• Inter-cultural Communication and Health
• Chronic and Re-emerging Diseases
• Womens Health Development
• Managing the Health Sector in Developing
  Countries

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Cultural Competency

• Dr. Kofi Kodwandi
• National Center for Primary Care
• CRASH Course in Cultural Competency Skills
• Cultural competence vs. Cultural competencies
• From Cultural sensitivity to Cultural
  effectiveness
• Cross-cultural vs. multi-cultural
• Cultural diversity
• Cultural humility

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Dr. Yolanda Wimberly STDs/HIV

• Dynamic Web site to help educate her third- and
  fourth-year medical students about STDs and
  HIV/AIDS
• Leads the students in community based screenings
  throughout the year

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Patient Care
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Dr. Eileen Yancey HIV/AIDS

• Studies high risk behavior and HIV/AIDS
  prevention
• Primary focus to identify the key behavior and
  belief variables that are significant
  determinants of high risk HIV behavior among
  African American men and women residing in the
  coalition communities of the Morehouse School of
  Medicine Prevention Research Center
• Develop and implement a HIV risk reduction
  intervention that is culture and gender sensitive
  to African American men and women within these
  communities.

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Morehouse School of Medicine Addresses
Disparities in Global Health

• Why now?
• What are we doing?
• Where are we involved?

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Morehouse School of Medicine Addresses
Disparities in Global Health

• South Africa (Department of Pediatrics)
• Ghana (Undergraduate Medical Education)
• Jamaica (NCPC)
• Kenya (Nairobi Womens Hospital, Dept. of Surgery)

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Morehouse School of Medicine Addresses
Disparities in Global Health

• Why now?
• Significant burden of disease
• It is what MSM does best
• What are we doing?
• Significant level of activity in the area of
  Infectious Diseases
• Where are we involved?
• Primarily Africa and the Caribbean for now
• Open for new opportunities to collaborate

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Hippocrates

• Wherever the art of medicine is loved, there
  also is love of humanity.

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• Our World, Our Task On this vulnerable and
  interconnected planet, the physicians mission of
  healing must extend beyond bordersthe borders of
  nations, the borders of clinics and laboratories,
  and the borders that separate individuals.

HMS Alumni Bulletin, Summer 2006