NIH, Fogarty discuss health inequities at Consortium of Universities for Global Health (CUGH) annual meeting

March / April 2018 | Volume 17, Number 2

Dr. Roger I. Glass speaks from a podium labeled CUGH 2018, slide projected in the background
Photo courtesy of CUGH

Fogarty Director Dr. Roger I. Glass updated CUGH attendees
on the Center's activities to mark its 50th year of advancing
global health science.

CUGH meeting attendees explore research displays and demonstrations in a conference room
Photo courtesy of CUGH

More than 1,800 academics, practitioners and policymakers
attended the CUGH annual meeting exploring health inequities.

At least half of the world's population lacks access to health services, the WHO Director-General told attendees of the Consortium of Universities for Global Health (CUGH) annual meeting. Financial barriers and stigma prevent many from receiving treatment and that must be addressed, said Dr. Tedros Adhanom Ghebreyesus. "Good data is the crucial starting point for reducing health inequities," he said. "Identifying where health inequities exist is essential for reducing them." WHO has developed a health equities assessment toolkit to help countries identify underserved populations and track progress in improving access.

The CUGH conference, titled "Health Disparities: a Time for Action," brought together more than 1,800 participants from around the world who are engaged in global health activities.

In a plenary panel, Fogarty grantee Dr. Patty Garcia presented a case study of an outreach program she developed to provide cervical cancer screening in Peru, which she said is one of the most inequitable countries in terms of health services. She and her colleagues at the University of Cayetano Heredia developed a plan to deploy trained volunteers to reach out to women living in a slum near the Lima airport to inform them about cervical cancer. The lay workers also provided simple diagnostic tests that the women could self-administer at home and then drop off in collection boxes, where they were picked up and processed in a lab. With more than 2,000 women participating, 49 cases of cancer were discovered and referred for treatment. "Women loved self-testing in their own home and getting results by text message," Garcia said.

Climate change is exacerbating health inequities, as increasingly severe storms, drought, wildfires and heatwaves disproportionately impact those living in low- and middle-income countries, according to Dr. John Balbus, a senior advisor at the NIH's National Institute of Environmental Health Sciences (NIEHS), who led a conference session on the topic. He suggested authorities plan climate-ready health systems that are "resilient in the face of extreme events, and they need to be prepared for the kinds of shifts in infectious diseases, for the kinds of changes in morbidity and mortality that we've seen in heat waves."

Dr. John Balbus speaks from a podium labeled CUGH 2018, slide projected in the background
Photo courtesy of CUGH

Climate change disproportionately impacts people in low-
and middle-income countries, said the NIH's Dr. John Balbus,
during a panel session he led.

Health can also be improved by public policies, such as those governing food labels, sugar taxes and nicotine regulation - issues explored by a panel of participants from the Lancet-O'Neill Institute Commission on Global Health and the Law. John Monahan, a Fogarty board member and on the faculty of Georgetown University, said the Commission's upcoming report is designed to get more health professionals and lawyers working together to alleviate suffering and advance health equity. "Law is ultimately a tool for justice," he said.

Ways to strengthen support for female leaders in global health was the discussion topic for a panel of academics and scientists, including Fogarty's director. The conversation focused on possible actions such as cultivating institutional change, addressing cultural barriers, increasing visibility for women to help them progress in their careers and developing flexible work models. "I believe we need a shift in what we think leadership is and what that can look like," said Stanford University professor Dr. Michele Barry, who recently hosted a conference on the subject.

Dr. Jeffrey Blander speaks from a podium labeled CUGH 2018 in a conference room
Photo courtesy of CUGH

Former Fogarty Fellow, Dr. Jeffrey Blander, discussed how his
early foreign research experience informs his work as PEPFAR's
chief innovation officer.

To encourage early-career scientists to pursue a global health career track, alumni of Fogarty's Global Health Fellows and Scholars Program discussed their experiences and presented the results of their work. One former Fogarty Fellow, Dr. Jeffrey Blander, is now chief innovation officer at the President's Emergency Plan for AIDS Relief, or PEPFAR. His work is about disruption, he said. "For example, what can you do without electricity?" One of his projects, which involved developing field tests for strep, has increased diagnoses and reduced hospital visits.

Fogarty's director applauded Blander, his peers and their faculty mentors. "This fellowship program is extraordinary in the way in which it's enriched your understanding of other cultures and enhanced your ability to work with people with different belief systems," said Glass. "This is the best investment we've made in the last 15 years - seeding the next generation of global health leaders."

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