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Consortium of Universities for Global Health (CUGH) 2021 annual meeting explores COVID-19 and health equity

March / April 2021 | Volume 20 Number 2

Side-by-side screenshot of Dr. Anthony Fauci speaking with Dr. Michele Barry during the 2021 virtual CUGH annual meeting.
Photo courtesy of CUGH

COVID-19 was the main topic of the CUGH annual meeting, including
during this interview with NIH’s Dr. Anthony Fauci, conducted by
Stanford University’s Dr. Michele Barry.

The global coronavirus pandemic dominated discussions at the Consortium of Universities for Global Health (CUGH) first virtual annual meeting. “COVID-19 has exploited and exacerbated many of our world’s social and economic inequalities,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus in opening remarks. Nearly 1,900 attendees from more than 100 nations participated in the three-day conference that was preceded by 30 topical satellite sessions.

Investments should be made to increase the scientific capacity of lower-income regions and countries so they can test and produce vaccines against COVID-19, said Dr. Anthony Fauci, director of the NIH’s National Institute of Allergy and Infectious Diseases. “This is not something that’s going to go away in one year. It will have to go away for the entire planet before we can feel comfortable that we are out of danger.”

Scientists and policymakers need to be a beacon of truth and a source of evidence-based knowledge on COVID-19, he said. “You have to go by your conscience and maintain your integrity - once you lose it, you’re done.”

Fauci encouraged students with the slightest inclination to pursue careers in global health. “It certainly is a very gratifying choice of a life.”

More advice was given to early-career scientists during a panel discussion of NIH leaders. Trainees should consider identifying potential mentors by studying publicly available information in the NIH Reporter database to see what’s going on in a specific country or research topic, suggested Dr. Diana Bianchi, who leads the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). “Seek mentors in the area that you are interested in, in the kind of scientist you’d like to become, maybe even the kind of scientist you’d like to eclipse,” offered Dr. Joshua Gordon, director of the National Institute of Mental Health (NIMH). Students should also look for opportunities to conduct research overseas, said Fogarty Director Dr. Roger I. Glass. “Those field experiences are really life-changing.”

The COVID-19 response has benefited from leveraging global networks that were built through previous NIH investments, the discussants noted. For instance, NICHD is using scientists with machine learning expertise to see if artificial intelligence can predict which children who test positive for the virus will need treatment “because they can turn on a dime” and quickly deteriorate, said Bianchi. COVID-19 has also caused NIH to look inward to speed progress and award critical funding more quickly, observed Dr. Bruce Tromberg, who leads the National Institute of Biomedical Imaging and Bioengineering. “It’s all about introducing innovation in the process as well, so this example has shown us that we can go faster. We can be impactful and we can do better.”

NIH-funded advances made in low-resource settings often hold valuable lessons for the United States. Bianchi said a global network her institute supports to improve maternal and child health demonstrates the benefits of personal
contact. “The workers who are a part of that network have frequent contact with the women during their pregnancies and after they deliver. They are collecting data but also providing information and support - that’s something that’s sorely lacking in the U.S.” Similarly, an NIMH project known as the “friendship bench,” designed to task-shift mental health care from professionals to specially trained community members, was developed in Zimbabwe and is now being adapted for use in New York City. “They’re finding this really improves access to care and reduces stigma,” said Gordon.

As research becomes more complex, the need for data analysis capabilities in LMICs has increased, which is why NIH is starting a major initiative in Africa, said Tromberg. “The idea here is to support a continental network to develop tools, build on many years of NIH investments and take us another step forward.”

A cadre of emerging global health leaders also shared their efforts to advance science. Six previous participants of Fogarty’s Global Health Fellows and Scholars program presented research on diverse topics such as air pollution exposure, dengue diagnostics and HIV-associated cognitive impairment. For Dr. Adaeze Wosu, the opportunity to conduct research in Uganda taught her about leadership, collaboration, patience and perseverance. “I challenged my own perspectives and assumptions and gained a deeper understanding of research ethics.”

Strategies to address global health inequities were explored in a pre-meeting satellite session, co-hosted by Fogarty. A fundamental shift in approach and underlying assumptions is required, according to Dr. Lisa Adams of the Geisel School of Medicine at Dartmouth. “We really need to make sure that we strive to understand the context, the historical legacies of the places where we work - and this is true whether they are across an ocean or across town.” Research partnerships should enable reciprocal learning and there should be recognition of the burden hosting trainees places on LMIC hosts, she added. “We need to put our relationships under the microscope and give them critical review and honest appraisal. We need to understand the historical and colonial legacies of the places where we work to be able to bring equity to the partnerships we engage in.”

Global cancer research and control was the subject of a side meeting hosted by NIH’s National Cancer Institute (NCI). Despite numerous NCI-funded advances, they are not accessible to all, said NCI Director Dr. Ned Sharpless. “We should acknowledge this progress that we’ve seen over the last five decades has not been equitably delivered to all people everywhere.”

Climate change was explored during a session organized by the NIH’s National Institute of Environmental Health Sciences. There’s a huge gap between the evidence-base for action and actual practice, according to NIEHS’s Dr. John Balbus. “If there was ever a time, place and subject where we need to be able to apply our knowledge as swiftly and surely as we possibly can, it’s now, here, in the realm of climate change in health.”

Finally, the science of stigma reduction was discussed by a panel coordinated by Fogarty’s Center for Global Health Studies. The conversation examined various aspects of stigma and best practices to reduce it. The session grew from a trans-NIH effort to develop a cross-cutting agenda that transcends disease, population and geographic silos.

Videos of satellite sessions are available to all and recordings of meeting sessions are accessible to conference registrants at cugh.org.

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