TAG: "Global health"

Breakthrough in managing yellow fever disease


UC Riverside-led research could lead to antiviral therapeutics, better diagnostics.

Ilhem Messaoudi (right) is an associate professor of biomedical sciences in the UC Riverside School of Medicine. (Photo by L. Duka)

By Iqbal Pittalwala, UC Riverside

Yellow fever is a disease that can result in symptoms ranging from fever to severe liver damage. Found in South America and sub-Saharan Africa, each year the disease results in 200,000 new cases and kills 30,000 people.  About 900 million people are at risk of contracting the disease.

Now a research team led by a biomedical scientist at UC Riverside has determined that the yellow fever virus, a hemorrhagic fever virus, replicates primarily in the liver. Therefore, other organ failures that often follow in people with the disease are due to secondary effects.

When the virus targets the liver, it replicates rapidly causing significant damage to liver cells. In the process, inflammatory cytokines – proteins secreted by cells especially of the immune system – are made in massive amounts, which soon gain access to the blood stream.  These cytokines are most likely responsible for the damage to distant organs, the research team’s findings suggest.

The research team also identified a clinical parameter that could greatly help in managing yellow fever cases.

“Yellow fever causes severe loss of lymphocytes,” said Ilhem Messaoudi, an associate professor of biomedical sciences in the UC Riverside School of Medicine, who led the research project. “This process, called lymphopenia, occurs before any measurable changes in liver enzymes can be detected – that is, about a day or so before we see changes in the liver. It could provide an earlier clinical outcome measure of subsequent disease severity, giving doctors a good prognostic tool for offering more aggressive supportive care for these patients.”

Study results appear today (Nov. 20) in PLOS Neglected Tropical Diseases.

The research, performed on rhesus macaques (currently, the best model for studying human yellow fever infection) at Oregon National Primate Research Center, is the first study on yellow fever in non-human primates in more than 20 years.

“Yellow fever is truly a neglected tropical disease,” Messaoudi said. “Even though it continues to cause fatality, it remains understudied. While it is true there is a highly effective vaccine, it remains extremely challenging to get comprehensive vaccine coverage in sub-Saharan Africa and Latin America.  Moreover, the vaccine works well if you are between one and 55 years old.  It is not safe for babies or the elderly, who could develop yellow fever from the vaccine.”

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Are children better off than they were 25 years ago?


UCLA publishes comprehensive analysis of children’s rights around the world.

Jody Heymann, UCLA

Twenty-five years ago this month, the countries that compose the United Nations reached a landmark agreement that laid the foundation for much-needed strengthening of children’s rights and protections in nearly every country around the world.

Today, the Convention on the Rights of the Child remains the only formal global effort to improve children’s rights and the most widely ratified human rights treaty in history. Only three U.N. member nations have not ratified the treaty: Somalia, South Sudan and the United States.

“The Convention on the Rights of the Child is a promise from our global community to all children,” said Dr. Jody Heymann, founding director of the World Policy Analysis Center and dean of the UCLA Fielding School of Public Health. “Everyone deserves to know whether their country is fulfilling that promise and how it compares to other countries facing similar opportunities and constraints.”

To mark the 25th anniversary of the CRC on Nov. 20, the center assessed 190 U.N. countries’ progress toward fulfilling the CRC’s commitment to children in critical areas such as the right to education, protection from child labor and child marriage, and discrimination of children with disabilities.

How are the world’s children faring?

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Global dietary choices show disturbing trends


UC Santa Barbara professor co-authors paper that examines global impact of what we eat.

David Tilman

The world is gaining weight and becoming less healthy, and global dietary choices are harming the environment.

Those are among the findings of a paper co-authored by David Tilman, a professor in the UC Santa Barbara Bren School of Environmental Science & Management, and Michael Clark, a graduate student at the University of Minnesota, where Tilman also is a professor. In “Global Diets Link Environmental Sustainability and Human Health,” published today (Nov. 12) in the journal Nature, the researchers find that rising incomes and urbanization around the world are driving a global dietary transition that is, in turn, diminishing the health of both people and the planet.

“These dietary shifts,” they write, “are greatly increasing the incidence of Type 2 diabetes, coronary heart disease and other chronic non-communicable diseases that lower global life expectancies.”

The paper is the first to show the global links among the elements of what Tilman refers to as the “tightly linked diet–environment–health trilemma.”

“Previous analyses have looked at the effects of diet in individual countries, but we are the first to examine the global impacts on both human health and the environment of diet as it is now and as it is becoming,” he says. “We gathered information on dietary trends and environmental impacts for 90 percent of the global population. Our data let us see how diets, health and the environment have been changing and where they are going.”

“Some of what we found is not surprising, but the global implications are frightening,” Tilman adds. “Most of us have heard that some diets are healthier, that eating too many calories is bad for you and that red meat harms the environment. We were surprised at how rapidly and consistently diets were changing around the world, how massively this would impact global health and how much it would increase global greenhouse gas emissions and the destruction of tropical forests and other ecosystems.”

Unhealthful diets linked to urbanization

The links between urbanization, increased wealth and unhealthful diets are clear, Tilman explains. When a country industrializes, the transition from a traditional rural diet to one that includes more processed meats and more empty calories can occur quickly. “People move to cities, leaving behind their own gardens where they grew fruits and vegetables,” Tilman said. “They’re working in a factory 12 hours a day, six or seven days a week, so they need food that’s cheap and fast. The cheapest, fastest food you can get is filled with starch, sugar, fat and salt. Almost overnight, they go from a healthy diet to one that has way too many calories and leads to diabetes and heart disease.”

Also, because people tend to eat more meat as they become wealthier, much of the expected 100-percent increase in crop production that will be required by 2050 would be used to feed not humans but livestock. To do that, much more land will need to be cleared, with the result that more habitat will be lost, more species will likely become extinct and increased runoff of agricultural fertilizers and pesticides will degrade streams, rivers, lakes, groundwater and oceans.

Alternative diets offer health benefits

Tilman suggests that hope — and help — lie in the widespread adoption of alternative diets that offer substantial health benefits and could reduce global agricultural greenhouse gas emissions, reduce land clearing and resultant species extinctions and help prevent a variety of diet-related chronic noncommunicable diseases.

Comparing conventional American omnivorous diets to the Mediterranean diet, a pescetarian diet (in which fish is the only animal protein) and a vegetarian diet, the compiled research showed that the three alternatives to the omnivorous diet decreased Type 2 diabetes by 16 to 41 percent, cancer by 7 to 13 percent and morality rates from coronary heart disease by 20 to 26 percent. Moreover, the authors show that these alternative diets could reduce global greenhouse gas emissions from food production by about 40 percent below what they would be if dietary trends continued.

To reach their conclusions, the researchers gathered all published life-cycle assessments covering “cradle to farm gate” greenhouse gas emissions for production systems of food crops, livestock, fisheries and aquaculture — some 500 studies, of which about 220 were useful. They also gathered 50 years of data for 100 of the world’s more populous nations to analyze global dietary trends and their drivers, using that information to forecast future diets should past trends continue.

To quantify the effects of alternative diets on mortality and on Type 2 diabetes, cancer and chronic coronary heart disease, they summarized results of eight major long-term studies on diet and health. Finally, they combined those relationships with projected increases in global population to forecast global environmental implications of current dietary trajectories and calculate the environmental benefits of diets associated with reduced rates of chronic noncommunicable diseases.

“Better diets are the solution to these big problems,” Tilman says. “Only better diets can prevent a massive global epidemic of chronic noncontagious disease. These same diets would also protect the environment. Since big food companies produce so much of what is eaten, we need them to be part of this solution. By developing, producing and advertising foods that are healthy and tasty, these companies can help their customers, the earth and their bottom line. It is a niche waiting to be filled.”

Tilman wonders if unhealthy foods laden with fats or sugars might grow into a health issue somewhat like smoking. “Throughout history, foods that tasted good were almost always healthy but scarce. Now we have thousands of inexpensive manufactured foods that taste good because of an overabundance of sugar, fat or salt but are bad for us. What is the ethics of selling such foods now that we know how bad they are for heath and the environment?”

The research generated a number of nuanced findings about the environmental impacts of various dietary choices. The following are among them:

  • While the difference in greenhouse gas emissions for animal-based versus plant-based foods is well known, emissions per gram of protein for beef and lamb are about 250 times those of legumes; pork, chicken, dairy, and fish have much lower emissions;
  • Twenty servings of vegetables have fewer greenhouse gas emissions than one serving of beef.
  • Fish caught by trawling, which involves dragging fishnets along the ocean floor, can have three times the emissions of fish caught by traditional methods.
  • And among cereal grains, rice has five times the emissions per gram of protein as wheat.

These and other facts demonstrate that there are many diets that are both good for the environment and healthy.

While Tilman does not expect to see quick societal changes in diet, he hopes that the paper will be seen by the right people who can influence the food supply and that it “can encourage people to think about this challenge and have a dialogue it.”

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L.A. leaders to celebrate UCLA Health/CTI lab in China


Advanced medical lab to open in Shanghai early next year.

Los Angeles Mayor Eric Garcetti will escort a delegation of Los Angeles leaders in tourism, business and medicine to China to attend a Nov. 19 ceremony celebrating UCLA Health’s partnership with Centre Testing International (CTI), a Chinese firm, to launch an advanced medical laboratory in the Zhabei district of Shanghai.

The new facility, to be named the UCLA Health/CTI Medical Laboratories, is expected to open in early 2015.

“Our laboratory will bring UCLA’s state-of-the-art clinical diagnostic testing and pathology expertise to China to support pharmaceutical companies’ local clinical trial programs, and offer advanced diagnostic services and companion testing at the highest international standards,” said Dr. Serge Alexanian, the facility’s chief medical officer.

The partnership advances UCLA Health’s international outreach efforts aimed at strengthening Sino-U.S. relationships in order to enhance patient care around the world. It also acts as a bridge between Chinese patients, research and development professionals and world-class pathologists from UCLA.

“Los Angeles is a hub for medical excellence and innovation, and the UCLA Department of Pathology is on the cutting edge of clinical testing,” said Garcetti.  “Through this partnership with CTI, UCLA can share its expertise with fellow scientists while improving health care and the quality of life for the people of China.”

The partnership is the first between a Chinese company and a U.S. academic medical center to create a specialized laboratory in China. The 25,000-square-foot facility will offer genetic and molecular diagnostics and other sophisticated tests that exceed the scope of the average lab in China. UCLA pathologists will train Chinese lab specialists to accurately interpret the tests with an information-technology platform that will generate reports in both Mandarin and English.

“This joint venture is founded on UCLA’s desire to build strong global relationships that improve the health of people and communities through education, research and service,” said Michael Burke, director of international development for UCLA Health. “UCLA has a genuine interest in elevating the level of medicine around the world.”

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Betting big on women, girls


Melinda Gates explains Gates Foundation’s strategy to lift countries out of poverty.

Melinda Gates talks with NPR’s Morning Edition co-anchor Renee Montagne about the source of her passion for improving conditions for people in undeveloped countries.

By Peggy McInerny, UCLA

The Bill and Melinda Gates Foundation is betting big on women and girls to help developing countries lift themselves out of poverty, foundation co-chair Melinda Gates told a UCLA audience that filled Korn Convocation Hall on Nov. 5.

Gates sat down to talk with NPR’s Morning Edition co-anchor Renee Montagne at the 2014-2015 Arnold C. Harberger Distinguished Lecture on Economic Development of the UCLA Burkle Center for International Relations. Co-sponsored this year by UCLA’s Center for World Health and the Health and Human Rights Law Project of the School of Law, the annual event is intended to bring economic policy experts to discuss their views with UCLA students and faculty.

UCLA Distinguished Professor Emeritus of Economics Harberger, who founded and supports the lecture series, was in attendance. A pioneer in the field of development economics, he has trained scores of Latin American economists over his 30 years at UCLA, where he continues to teach.

Gates has worked assiduously to restore contraception to a major place on the global health agenda. Her efforts in this direction led to the 2012 London Summit on Family Planning, which brought together donors, national governments and the development community from around the world. The summit adopted the goal of providing contraception to 120 million women in the developing world by 2020.

Today, 15 developing nations have created national family planning action plans. “We funnel our money through those action plans,” said Gates, which includes support at both the policy and the project levels.

Yet, said the speaker, she quickly realized that contraception alone could not resolve culturally ingrained gender inequality. Soon she began to advocate a holistic approach to cultivate the “other half” of the population of developing countries and, in the process, reduce poverty levels and promote economic growth.

Gates’ focus on gender inequality has led the Gates Foundation to “bet big” on three core areas: health, decision making power and economic empowerment. Saying she saw incredible opportunities in these areas to change things for the better for women and girls, she emphasized that the contributions of many individuals to these causes could create palpable change in our lifetimes.

Gates went even further, saying that development as a whole needs to be looked at through a gender lens. She explained, for example, that agricultural projects often do not take into account that the primary farmers in many countries are women, who frequently seek to avoid cash crops because they lose power over cash resources.

Longstanding development data show that investments in women’s health and education lead to smaller families with healthier, better-educated children. Where women have economic opportunity and decision-making power over resources, more of those resources are also invested in their families, promoting overall economic development.

“We need men and boys in the conversation on all of these issues,” said Gates. Only by educating men first about how contraception and women’s access to economic resources benefit the health and well-being of their children and their wives, she emphasized can these things become culturally acceptable. Moreover, the way in which health education is delivered must be culturally appropriate and respond to gender-specific circumstances.

Focusing on solving today’s problems

The Gates Foundation, which has an endowment of $42 billion and has already disbursed over $30 billion in grants, is focused on solving contemporary problems of the present generation — and perhaps the next — said the speaker.

The development aid provided by the foundation is not intended to endure indefinitely, noted Gates. Neither is the foundation itself. She and her husband do not expect it to have a shelf life much beyond their own — perhaps 15–20 years at most. “We want to spend our energy and our lives doing this work for the problems of today’s society,” she remarked.

“We are trying to build capacity now, so we can funnel more and more resources through those mechanisms,” she explained. “[And] as we learn what mechanisms work in one area, we take them and try to apply them to other areas.”

At present, the foundation is deeply engaged in the health sector in developing countries, supporting vaccination programs, building governmental and human capacity in health care, and developing ways to measure the impact of interventions, particularly those designed to improve gender inequality.

“The way that Bill and I think about this is that the only role [of] a foundation is to be a catalytic wedge,” said Gates. That is, foundations are able to take the risks needed to prove what does and doesn’t work. “But,” she added, “it takes government money to scale those things up.”

After helping create a global Vaccine Alliance (known as Gavi) and raising replenishment funds for it among wealthy nations, the Gates Foundation is now asking developing countries to make contributions to vaccination programs in their countries. Over time, these contributions are expected to increase until the programs become fully funded by those nations.

As a result of these programs, Gates noted that the governments of Ethiopia and Nigeria had built out basic-level primary health care systems in the form of “health posts.” (Ethiopia has built 15,000 such centers.)

“With basic supplies to help people and with basic trained health workers, usually two women, you can get unbelievable changes in maternal and child mortality,” observed Gates. The big lesson of the Ebola crisis is that investing in this primary level of health care provides an institutional bulwark against contagious diseases, which she predicted would continue to arise in perhaps more virulent form, she noted.

Nigeria, for example, was able to contain Ebola because after the first cases were reported, one of its polio clinics (supported by the Gates Foundation and the Centers for Disease Control and Prevention) was transformed into an Ebola emergency response clinic. Not only was the clinic able to trace the origin and spread of the disease in the country, the government was able to distribute appropriate behavior change messages throughout the system of health posts. In contrast, Liberia’s health system rapidly collapsed in the face of the Ebola crisis, having been greatly weakened by two decades of civil war.

Participating as an interlocutor, not an observer

Gates reflected that it was a great privilege to be able to travel for the foundation and learn firsthand about the concerns of men and women in the developing world. She traced her passion to making a difference in the world to the values of her parents, who encouraged all four of their children to attend college despite the serious financial burden this goal would impose.

A practicing Catholic, Gates said she attended a Catholic high school, but sought to transfer to an academically superior school in order to get into a good college. It took a while, she said, to understand that her parents sent her to the Catholic school because they believed in its values. “I was out serving in the courthouse … in the hospital, in a school two miles down the road,” she remarked. “These very liberal nuns showed us that we could make a change in the world.”

Asked if she had gotten pushback from Catholics about her support for contraception in developing nations, Gates said she had received surprisingly little criticism from people of faith. On the other hand, she noted, push back from Rome had been expected.

Whenever she travels to a development conference, the speaker said she makes a point to stop somewhere in Africa and meet people on the ground to remind herself what the work is about. Similarly, she takes a day or two to decompress after long stays in developing countries to let the stories she has heard wash through her, experience the grief sparked by them and decide what she wants to do.

“You don’t go to these countries and not let your heart break,” she said.

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Melinda Gates: Contraception needs to be on global health agenda


Gates Foundation co-chair delivers lecture at UCLA.

Renee Montagne, left, interviews Melinda Gates (Photo by Todd Cheney, UCLA)

The world has backed away from supporting contraception in the developing world because of politics, and it’s vital to put the issue back on the global health agenda, said Melinda Gates, co-chair of the Bill and Melinda Gates Foundation, in comments today (Nov. 5) at UCLA.

The nonprofit leader was the featured speaker at UCLA’s annual Arnold C. Harberger Distinguished Lecture on Economic Development. She spoke in conversation with Renée Montagne, the co-host of NPR’s Morning Edition.

Investing in women’s health and family planning supports the whole community in sometimes unexpected ways, Gates said.

“If we invest in that lowest level, the primary health care system … you can get unbelievable changes in maternal mortality and infant mortality,” she said. “If you don’t invest in that primary health care system, you don’t have a chance when something like Ebola comes along.”

Empowering women and girls in developing countries to decide whether and when to have a child is a key part of her work at the foundation, Gates said.

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Three global health grants awarded to UC researchers


Gates Foundation projects tackle persistent global health and development challenges.

Eamonn Keogh, UC Riverside

Three University of California researchers have received Grand Challenges Explorations grants from the Bill and Melinda Gates Foundation. They are among 61 grant recipients in the initiative’s 13th round of funding, announced today (Nov. 4). Grand Challenges Explorations funds individuals worldwide to explore ideas that can break the mold in how we solve persistent global health and development challenges.

Grantees include:

Eamonn Keogh, UC Riverside, Inciting Healthy Behaviors Using a Human Computation Game. Keogh, a professor of computer science in the Bourns College of Engineering and three-time winner of a Gates Foundation grant, will work with Sang-Hee Lee, an associate professor of anthropology at UC Riverside, and Mindy Marks, an associate professor of economics at UC Riverside, on a multidisciplinary approach to explore “inciting healthy behaviors” using a cell phone based game. There are many behaviors that, especially in the developing world, people know are good for them, yet because of forgetfulness, those behaviors are not always performed, Keogh said. These include using a bed net every night to prevent mosquitoes spreading malaria, or remembering to take medicine every day.

Sandra McCoy, UC Berkeley, Priming HIV-Infected Patients to Adhere to Treatment. Together with the California Department of Public Health, McCoy, an assistant adjunct professor of epidemiology, will analyze whether behavioral priming methods such as associational cues and social influence can promote adherence to HIV treatment in Tanzania. HIV prevalence in Tanzania is high, at 5.1 percent, and poor adherence to antiretroviral therapy is a major problem due in part to long patient waiting times and stigmatizing attitudes. Behavioral priming involves using a stimulus to indirectly or subconsciously influence behavior. Her project will involve holding group discussions with HIV patients and health care workers to identify several behavioral priming strategies such as positive feedback cues on health cards, and conducting a pilot study to evaluate their effect on adherence.

Laura Jelliffe-Pawlowski, UC San Francisco, Gestational Dating at Birth by Metabolic Profile. Jelliffe-Pawlowski, an associate adjunct professor of epidemiology and biostatistics, will test whether metabolic markers taken during routine newborn screening can be used to determine gestational age by developing a dating algorithm. This algorithm could be used to determine gestational age in regions where dating is difficult, which is important for monitoring brain-related functions and development.

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South African ‘Mentor Mothers’ help improve perinatal health outcomes


Community-based interventions lead to better health outcomes in both mothers and children.

The Mentor Mother program trains women to provide health information and conduct home visits to pregnant women and to help the mothers raise healthier children.

The incidence of HIV infection in South Africa tops that of any nation in the world, with some 6 million of the country’s nearly 50 million residents infected. Sadly, young women — and particularly young pregnant women — suffer some of the highest rates of HIV infection. More than one-fourth of pregnant South African women are infected with the virus; in some communities, the infection rates are even higher.

But a new study conducted by UCLA’s Mary Jane Rotheram-Borus, the director of the UCLA Global Center for Children and Families at the Semel Institute for Neuroscience and Human Behavior, and her colleagues from Stellenbosch University in South Africa found that community-based interventions could improve the health of children in those contexts. A paper about the randomized controlled trial appears in the current edition of the journal PLoS One.

The study found that regular home visits of pregnant mothers, and later of those mothers and their infants, by specially trained lay community mothers from the “Mentor Mothers” program led to significantly better health outcomes 18 months later in both the mothers and their children.

The Mentor Mother home visiting program, developed by South Africa’s Philani Maternal, Child Health and Nutrition Project, has been in existence for the past 15 years. Mentor mothers are trained to provide health information and health intervention (such as a home visit), support mothers to improve healthy births, and to help mothers develop coping mechanisms that enable them to raise healthier children. The program currently operates at eight clinic sites in Cape Town and out of Zithulele Hospital, located in a deeply rural part of the country’s Eastern Cape region.

Among other outcomes, the study found that Mentor Mother home visits led to a 50 percent improvement by mothers in completing tasks designed to prevent mother-to-child transmission of the HIV virus, compared to mothers in the control group of the study who did not receive home visits, just clinic-based pre- and postnatal care. The virus-transmission prevention tasks included pregnant mothers knowing their own HIV status and asking their sexual partners to be tested; mothers taking anti-retroviral drugs for the six weeks prior to childbirth and during labor; babies receiving anti-retroviral drugs for at least six weeks, until they can be tested for the virus; and mothers using one feeding method (breastfeeding or formula) for the first 6 months of their infants’ life, and, when possible, exclusively breastfeeding.

In addition, the study found that mothers who received regular home visits breastfed longer and, among HIV-infected mothers, were more likely to breastfeed exclusively for six months.

“There also tended to be fewer low birth weight babies, a condition which results in life-long problems,” said Rotheram-Borus, the Bat-Yaacov Professor of Child Psychiatry and Biobehavioral Sciences and the director of the Center for HIV Identification Prevention and Treatment Services at UCLA.

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UCSF-based team awarded $8M agreement with CDC


Team includes investigators from UC Berkeley, UC Davis, UC San Diego.

A UC San Francisco-based team has been awarded a multimillion-dollar, five-year cooperative agreement with the U.S. Centers for Disease Control and Prevention (CDC) to conduct economic modeling of disease prevention in five areas: HIV, hepatitis, STI (sexually transmitted infections), TB (tuberculosis) and school health. The team, led by James G. Kahn, M.D., M.P.H., and Paul Volberding, M.D., both faculty in Global Health Sciences, is a multi-institution consortium, with 39 investigators across UCSF; Stanford University; UC Berkeley, UC Davis, UC San Diego; the San Francisco Department of Public Health, Health Strategies International, and PATH. It will be based at the UCSF Philip R. Lee Institute for Health Policy Studies.

The consortium was awarded $1.6 million for the first year and $8 million over the full project period. Called CAPE (Consortium for the Assessment of Prevention Economics), it will conduct economic analyses including costing, cost-effectiveness analysis, cost-benefit analysis, resource allocation, and return on investment.

“We are looking at five different health areas, using a range of economic methods – this breadth is very unusual for an economics project,” said Kahn. “We are also excited about collaborating with colleagues in the Bay Area and throughout California.”

The project advances the UCSF Global Health Sciences vision for research that crosses and links disease areas, and that integrates economics with basic and applied science. While CAPE’s geographic focus is the United States, modeling methods and tools can be adapted to global settings, using local data on population and disease characteristics.

CAPE is the largest award arising from the UCSF Global Health Economic Consortium, established in 2013.

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UC research spans the globe


UC’s global reach can be seen from health to agriculture to sustainability and more.

By Alec Rosenberg

From addressing the Ebola outbreak in Africa to exploring aquatic environments in Antarctica, University of California researchers span the globe to serve the public and create new knowledge.

As UC President Janet Napolitano likes to say, “UC teaches for California and researches for the world.”

UC’s global reach can be seen from health to agriculture, sustainability to tech commercialization and bridge-building efforts such as the president-led UC Global Food Initiative and UC-Mexico Initiative.

UC’s global clout is reflected in its strong showing in international rankings. UC placed four campuses in the top 20 and nine in the top 150 in the Academic Ranking of World Universities, and scored similarly in the Times Higher Education World University Rankings and the inaugural U.S. News and World Report Best Global Universities rankings.

On the front lines of global health

One sign of UC’s strength is its 62 Nobel Prizes, the latest of which was announced this month in physics to UC Santa Barbara’s Shuji Nakamura for the invention of efficient blue light-emitting diodes. Another sign can be seen in Sierra Leone, a West African nation at the center of the Ebola crisis.

UCSF’s Dan Kelly became interested in Africa as a student at Albert Einstein College of Medicine. Inspired by a roommate from Sierra Leone, Kelly co-founded Wellbody Alliance in 2006 to provide health care to the poor in that country, which had been ravaged by a decade-long civil war.

From California, Kelly watched as the epidemic progressed rapidly this summer and close friends died.

“It hit me really hard,” Kelly said. “Within 48 hours, I went to Sierra Leone. I was there 3 ½ weeks and trained 1,000 health care workers. It restored my hope.”

Working with colleagues at UCSF and a coalition of partner organizations, Kelly started a crowdfunding campaign to ramp up relief — one of a variety of UC-led efforts to tackle Ebola.

“We’ve got a long way to go,” said Kelly, who has taken a leave as a UCSF infectious disease fellow to dedicate himself full time to the Ebola crisis.

Kelly was a speaker at UCSF’s sold-out global health symposium, held Oct. 2 to celebrate the 10th anniversary of UCSF’s Global Health Sciences program.

International health research at UCSF, which got its start in the late 1980s with a small AIDS program in Uganda, now spans 600 investigators working in 190 countries. Similarly, hundreds of faculty and an increasing number of students across UC’s 10 campuses are engaged in global health, reflected by the 2009 launch of the systemwide UC Global Health Institute, the 2011 establishment of the Global Health Research, Education and Translation Program at UC Irvine and the launch this fall of a global health major at UC San Diego.

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UC San Diego launches new major in global health


Bachelor of arts in global health is a first in the UC system.

Junior Michelle Bulterys recently upped her global health minor to a major and is now double-majoring along with anthropology. She spent part of her summer in a small South African village doing research.

Undergraduates at UC San Diego will now be able to pursue a bachelor of arts in global health – an increasingly popular new field of study and urgent social concern.

Launched this fall, the program incorporates the global health minor started four years ago. Both the major and the minor are firsts in the UC system.

Tom Csordas, chair of the anthropology department, is the program’s director. The Global Health Program is truly interdisciplinary, he said, bringing together coursework and faculty from the UC San Diego divisions of Social Sciences, Biological Sciences, and Arts and Humanities, the School of Medicine, the Rady School of Management, and the Scripps Institution of Oceanography.

The word “global,” he said, refers both to geography – encompassing health concerns around the planet, at home and abroad – and also to the program’s holistic approach.

“The program balances pragmatic real-world experience with theoretical, analytic and critical skills. We aim to offer students a comprehensive introduction to the ‘hard’ and ‘flexible’ sciences that together make up the emerging field of global health,” Csordas said. “Our curriculum spans the continuum of approaches to health: medical social sciences, biological sciences, health policy and planning, epidemiology, global social processes and medical humanities.”

An important component of the bachelor’s degree, as it is with the minor, is a global health field experience comprised of 100 hours of work at a research, service or clinical site. In the case of the B.A., that fieldwork also culminates in a capstone seminar and a senior thesis, which students will present to the university community at the program’s annual Horizons of Global Health conference.

Csordas pointed out that the program is highly student-centered and closely articulated with both the university’s Global Health Initiative and with three (of four) research themes outlined in UC San Diego’s Strategic Plan: Enriching Human Life and Society, Understanding and Protecting the Planet, and Understanding Cultures and Addressing Disparities in Society.

Campus partners of the program also include the International Center, the Academic Internship Program, the Center for Iberian and Latin American Studies, the Center on Global Justice and the Blum Cross-Border Initiative.

Students are excited about the program, Csordas believes, because it affords them so many different avenues following graduation. The Global Health Program is intended, he said, to pave the way for work in health sciences, research and teaching, service-providing organizations, government or non-governmental agencies, health policy, environmental health, or law. It is also excellent preparation, he said, for advanced study in medical or graduate school.

Junior Michelle Bulterys recently upped her global health minor to a major and is now double-majoring along with sociocultural anthropology.

“It’s an incredible program,” said Bulterys, who serves on the program’s Student Advisory Committee. She cited in particular the opportunity to take classes you might “not even know about” in a more traditionally single-discipline major.

This past summer, Bulterys spent two months in South Africa doing anthropological research with a global health focus. She home-stayed with a family in the village of Hamakuya, which still struggles with the consequences of Apartheid, she said, and studied “both traditional healing practices and care-seeking behavior in a bio-Western facility.” The data her group collected were turned over to local health authorities.

Before coming to San Diego for university, Bulterys went to schools in China and Zambia (where her parents’ medical work took the family). Bulterys plans to pursue a career in medical anthropology and epidemiology. She expects she’ll seek to return abroad soon after graduating but may stay in the U.S. for a while.

“Global health has no boundaries,” Bulterys said. “It’s about interacting with the whole world.”

To learn more, visit the program website or write to Program Advisor Brittany Wright at bloy@ucsd.edu. Phone: (858) 534-7967. You can also find and follow the Global Health Program on Facebook and on Twitter.

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A global health powerhouse


UCSF Global Health Sciences marks 10th anniversary with symposium, Mission Hall opening.

Jaime Sepulveda, executive director, UCSF Global Health Sciences (Photo by Elisabeth Fall)

International health research at UCSF got its start in the late 1980s, with a small AIDS program in Uganda. A quarter-century later, it is a global research enterprise, with 600 UCSF investigators working in 190 countries.

UCSF’s Global Health Sciences now embraces all that the university has to offer: basic science, social science and clinical care, along with education and emerging areas that incorporate policy and diplomacy.

This month, Global Health Sciences celebrates the 10-year anniversary since its founding as a formal program with two major events: the opening of Mission Hall, where global health faculty will be gathered under one roof for the first time, and an international symposium on global health, featuring many of the giants in the field.

The goal of the conference is to explore what is coming next in global health, so that scientific efforts are targeted in the best way.

“As an academic health sciences university, UCSF plays a critical role in helping to set the global health agenda,” said Jaime Sepulveda, M.D., D.Sc., M.P.H., executive director of Global Health Sciences. “That’s what we’re doing with this symposium and with our day-to-day work.”

The symposium agenda sprang, in part, out of the recent Science special issue on global health. Sepulveda and UCSF Global Health Sciences were key partners in developing the issue, which includes a perspective from Sepulveda on the state of global health in 2014.

“UCSF has always been science-driven,” Sepulveda said. “That’s why our program is called Global Health Sciences. It’s an indication that we aim to bring the same rigor to this new field of knowledge that we have to all of the university’s other endeavors.”

UCSF scientists are working on major killers, like AIDS, tuberculosis and malaria, as well as lesser-known threats, like dengue, Chagas’ disease and River Blindness. They are studying how programs work – and why some work better in some places than others. And they are asking the tough questions about how to build health systems in countries that are only now becoming economically strong enough to support them.

Educators are training students at UCSF for global careers and helping clinicians around the world with massive online open enrollment courses, while researchers are mentoring young scientists abroad on research projects and training health workers through large community-based trials.

UCSF faculty are also contributing to major policy debates. Several played key roles in the Lancet Commission on Investing in Health, which laid out a 20-year plan to increase the amount spent on health in poor countries and improve access to care, while calling on the global community to expand research and development for diseases that disproportionately affect poor countries. Together, these efforts could save 10 million lives.

Most recently, Sepulveda and other UCSF faculty have added their voices to the debate over the United Nation’s Sustainable Development Goals for 2030 by urging that the sole health goal now planned for inclusion be practical, concrete and include measurable targets, such as a 40 percent reduction in premature mortality.

These efforts show the strength of Global Health Sciences as it enters its second decade. The program has attracted the leading minds in the field – most recently Eric Goosby, M.D., President Barack Obama’s former global AIDS coordinator, and Harvey Fineberg, M.D., Ph.D., former head of the Institute of Medicine – to join a growing powerhouse of global health influencers at UCSF.

“We are having a real influence in shaping global health priorities,” Sepulveda said. “It would be hard to find the same concentration of high-caliber global health leaders anywhere else in a single university.”

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