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Greetings!
More than 33 million people in the world are living with HIV, including 1.5 million in North America (UNAIDS). Tomorrow is World AIDS Day, a time when the world reflects on the tragedy and injustice that exists in the world, particularly in sub-Saharan Africa where the disease is most prevalent. Take the opportunity tomorrow to educate yourself on this deadly disease. Also, read Chikoti's inspirational story of loss and perseverance.
Until next week,
Geelea Seaford and Everyone at DGHI |
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New Guidelines for Global Health Training Aim to Minimize Potential Pitfalls
Duke Global Health Residency/Fellowship Pathway | With the growth in global health training programs around the world, it has become increasingly vital to ensure these programs are ethical and accomplishing their intended goals: to improve global health and not become part of the problem. To help achieve this goal, faculty members from three universities have released a set of guidelines for ethically responsible global health training in international settings.
The Working Group on Ethics Guidelines for Global Health Training (WEIGHT) was led by faculty at Duke University, Johns Hopkins University, and Tumaini University in Tanzania. The guidelines are published today in the December issue of American Journal of Tropical Medicine and Hygiene. The group includes leaders in global health and ethics from North America, Europe, Africa, South America and Asia.
The goal of the guidelines is to help minimize the potential pitfalls of global health training programs for trainees, sponsors and sending and receiving institutions. Such pitfalls can be especially problematic in poor nations, which can include placing substantial burdens on host institutions and have negative impact on patients, the community and local trainees.
"The worst-case scenario is that a host institution in a poor country carries the cost and bears unintended negative consequences of training people who do not contribute to improvements in global health now or in the future," said John Crump, associate professor of medicine in the Division of Infectious Diseases and International Health at Duke University Medical Center. Crump is also a member of the Duke Global Health Institute and site director of the Kilimanjaro Christian Medical Centre-Duke Collaboration in Moshi, Tanzania.
Collectively, the WEIGHT guidelines address the need for long-term, well-structured programs between partners that derive mutual benefit, ensure a comprehensive accounting for costs, and ensure trainee preparation, mentorship, supervision and safety. 
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Duke, National University of Singapore Agree to Second Phase of Medical Education and Research Collaboration
Duke University and the National University of Singapore have agreed to a second five-year plan to expand the growth and development of the Duke-NUS Graduate Medical School. The venture will strengthen Duke's contribution as a research and educational partner and position Singapore as a global hub of biomedical expertise. The agreement is a tribute to the remarkable success of the first phase of the 2005 collaboration which led to the opening of the Duke-NUS Graduate Medical School (Duke-NUS). Since the inaugural class of 26 students arrived in 2007, Duke-NUS has more than doubled its enrollment, drawing top students and distinguished faculty from around the globe. It will graduate its first class of medical doctors in 2011.
The Duke-NUS experiment has flourished in its first five years of rapid growth, with partners citing a commitment to its fundamental vision and its unique approach to medical instruction. The school's educational design is based upon Duke's innovative model, one that focuses on independent study and research within a context of small group discussions and interactive learning opportunities.
"This is a very important day for Duke and for our partners in Singapore," said Victor J. Dzau, MD, Chancellor for Health Affairs and CEO of the Duke University Health System.
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Duke Med Student Makes Appeal on World AIDS Day
Chikoti Mibenge | Few people understand what it's like to lose a parent to AIDS and then, against all odds, pursue a promising career in medicine. Duke medical student and Zambia native Chikoti Mibenge lost her parents when she was 17 and 19 years old. But with the support of family and friends who invested in her future, she has worked hard to live the fairy tale she refers to as the "American dream." This World AIDS Day (Dec. 1), Mibenge is calling on the Duke community to help support several causes that are important to her, one originating in Zambia and one here at Duke.
Defying all odds, Mibenge had a strong support system who helped her excel, eventually bringing her to Duke as a medical student. After completing high school in Zambia, Mibenge was chosen by the Zambian National Committee to represent Zambia in Italy for two years as a United World College Scholar. With her heart set on coming to the US for college, she was awarded a scholarship to attend Wellesley College where earned a degree in biological chemistry. When she decided to go to medical school, it was Duke that stood out above the rest.
"I was discouraged by the limited number of international students that received any financial assistance. Duke University made a difference," said Mibenge. "With the help of fellowships, grants and loans I am finally closer to the end of my very long journey out of Zambia that makes me the physician I always wanted to be."
According to UNAIDS, an estimated 16 million children under the age of 18 have lost one or both parents to AIDS. The number of orphans in some sub-Saharan African countries exceeds half a million, and this includes Zambia. The needs of AIDS orphans are as immediate as their next meal and as extended as access to education, guidance and care through their teenage years.
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 Global Health News
WHO: The World Health Report-Health Systems Financing & The Path to Universal Coverage
The World Health Organization's member states have set themselves the target of developing their health financing systems to ensure that all people can use health services, while being protected against financial hardship associated with paying for them. In this report, the World Health Organization maps out what countries can do to modify their financing systems so they can move more quickly towards the goal of universal coverage and sustain the gains that have been achieved. The report builds on new research and lessons learnt from country experience. It provides an action agenda for countries at all stages of development and proposes ways that the international community can better support efforts in low income countries to achieve universal coverage and improve health outcomes.
The Lancet: A Litmus Test for Health Systems Strengthening
National health systems need strengthening if they are to meet the growing challenge of chronic diseases in low- and middle-income countries. Authors of this paper report the factors that limit countries' capacity to implement proven strategies for chronic diseases relate to the way in which health systems are designed and function. Most chronic diseases are neglected in the dialogue of health systems, despite the fact that non-communicable diseases (most of which are chronic) will account for 69% of all global deaths by 2030 with 80% of these deaths in low- and middle-income countries. Efforts to scale up interventions for management of common chronic diseases in these countries tend to focus on one disease and its causes, and are often fragmented and vertical. Evidence is emerging that chronic disease interventions could contribute to strengthening the capacity of health systems to deliver a comprehensive range of services-provided that such investments are planned to include these broad objectives. Because effective chronic disease programs are highly dependent on well-functioning national health systems, chronic diseases should be a litmus test for health-systems strengthening. |
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