1 / 18

Emerging Opportunities in Global Health

Emerging Opportunities in Global Health. Andres G. (Willy) Lescano, PhD, MHS, MHS Associate Professor , Universidad Peruana Cayetano Heredia Adjunct Professor at Tulane, Wake Forest , Johns Hopkins and Texas Medical Branch University

duff
Download Presentation

Emerging Opportunities in Global Health

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. EmergingOpportunities in Global Health Andres G. (Willy) Lescano, PhD, MHS, MHSAssociateProfessor, Universidad Peruana Cayetano Heredia AdjunctProfessor at Tulane, Wake Forest, Johns Hopkins and Texas Medical BranchUniversity Head, Emerge , EmergingDiseases and ClimateChangeResearchUnit Sponsoredby training grantNIH/FIC D43 TW007393

  2. El burro por delante(a bit aboutmyself) • Quantitative ID fieldepidemiologist • Workedfornearly 25 years, mostly in Peru: PRISMA NGO, Cayetano University and NAMRU-6 • Research in parasites & emerginginfections. Epicapacitybuilding(~115 publications, H-index: 18) • Interests: emergingdiseases & climatechange, parasiticinfections, surveillance & outbreak response

  3. Peru’spotential and role • High ecologic/pathogendiversity. LargeAmazonicregion • Intense travel, migration and tourism • No emergingdiseasesacademicreference center, onlypublic (INS) and internationalone (NAMRU-6) • Multiple, recently emerged/diagnosedpathogens • Little exploredvectors and reservoirs

  4. Experience in outbreak investigations

  5. Outbreak Investigation Training • Hands-on, five-day classroom-based course • >1600 students from 15 countries trained in >40 courses • Standardized, validated curricula in multiple formats & languages • Collaborates with Ministries of Health, PAHO/WHO, CDC & USAID • Served as model for multiple other training programs

  6. Steps of anoutbreakInvestigation(CDC 3030g, Reingold 1998) • Establishtheexistence of anoutbreak • Verifythe diagnosis • Define and identify cases • Performdescriptiveepidemiology • Determine whois at risk • Develophypotheses • Evaluatehypotheses • Refine hypotheses and conductadditionalstudies • Implementprevention and control measures • Communicatethefindings

  7. Diverse, excitingopportunities“Just come” • Clinicalrotations, withresearchcomponents • Field and laboratoryresearch • Withuniversities, research centers orNGOs • Medical missions, includingsurgicaloreven non-medical • MSF, academic, faith-based • Publichealth: surveillance, outbreakinvestigation & response, programevaluation • Workingwiththe host country government

  8. Stay and commit • Mostproductiveifstaying a long time, avoidvoluntourism • Verydifficult in earlycareerstage • Try to establish a long-term line of research and buildonit • Do as I say, not as I do • Commit to a few places, build local capacities and establishlong-termpartnerships

  9. Don’t be a ‘two-weekwonder’ • Can’tlearnorachievemuch in short stays • Havereasonableexpectations and don’t be animposition • “Ittakessixmonths to findwherethebathrooms are, and twoyears to startbeingproductive” • Try to learn and alwaysaskhow to be of help

  10. Medical missions & “voluntourism”* • Clear benefitfortraveler, lessclear to host • Are theyaddressingneeds (Sanchez JF 2015) • Do theyhaveanimpactonthebeneficiariesor host populations? • Are they a cost-effective? • Do theyerodethe trust on and use of existingservices? http://cmajblogs.com/voluntourism-call-it-a-spade-and-use-it-carefully/

  11. Some personal/closeexperiences • “Just come” • Being there* • “Physician-researcher Robert H. Gilman believes every discovery has its place” * • “Thepeoplehereneed me like a hole in their head” ** * http://magazine.jhsph.edu/2007/Fall/features/being_there/ ** http://magazine.jhsph.edu/2012/spring/features/la-familia-gilman/page-1/

  12. Criticisms& Challenges* • Lack of bidirectionality and reciprocity: inequality of resources in senders/hosts • Risks & costs to students • Cultural shock & sensitivity • Resources of host institutionsstrainedby unilateral flow *Crump & Sugarman, JAMA 2008 Bozinoff et al, Medical Education 2014

  13. What has changed • Greaterdiversity of fields of application • Manyprograms, opportunities and support

  14. TheAmericas, workin progress • More research and internationalstudents • Veryfewprograms and centers • Implementingthe concept isnotautomatic

  15. Outbreaks: be a disease detective • Unconventionalepidemiologicalstudies: • Requirepromptdesign & execution, smallsamplesize, public & politicalpressure • Responsibilityof Ministries of Health, understandtheirexpectations and your role • Threekeyquestions: agent, source& mechanism Euro Surveill 12(11):E071122.4 CDC “Solvetheoutbreak” app www.cdc.gov/mobile/applications/sto/

  16. JoinourPeru Field EpicourseAugust 6-16, 2018

  17. Thank you

  18. Any questions? willy.lescano@upch.pe +51 94761-9799

More Related