Einstein Hosts First-Ever Conference on Starting and Sustaining a Global Health Center

On November 5, 2012, Einstein’s Global Health Center (GHC) hosted a national conference that brought together administrators and faculty running prominent U.S. academic global health centers (GHC) to share their hard-won wisdom with colleagues at other institutions interested in organizing programs of their own.

Dr. Kathryn Anastos, GHC co-director, conferring with conference attendee"This is the first global health conference of its kind, because it is about the nuts-and-bolts of how to set up a global health center and all the related issues that are involved," said Jill Raufman, program manager of the Einstein GHC.

The conference, "The Essentials of Running a Global Health Center: Sharing Best Practices and Building Partnerships for the Future," featured remarks and presentations by Dr. Allen M. Spiegel, Einstein’s Marilyn and Stanley M. Katz Dean and key members of Einstein’s GHC, including co-directors Dr. Kathryn Anastos and Dr. Louis Weiss; educational alliance director Dr. Jerry Paccione; microbiologist Dr. Johanna Daily; and bioethicist Dr. Ruth Macklin. Healthcare professionals and practitioners running GHCs at Duke University, Stanford University and the University of Washington, among others, also offered insights about administrative, institutional, procedural, and regulatory hurdles while sharing take-away lessons on how to overcome them.

Common Problems

"Many academic institutions are forming global health centers and we all face similar legal, financial and regulatory issues," noted Ms. Raufman, who organized the conference. These include evaluating a potential site to ensure that students are not placed in harm’s way because of political instability, epidemic disease or other threats; instructing students and faculty on local standards of social behavior regarding romantic relationships, alcohol use and gender roles they must observe; how to establish and register a non-governmental organization or other business entity through which local staff can be hired and paid; and ensuring a GHC complies with applicable U.S. and foreign laws, regulations and tax obligations.

"This information is not easily obtainable, though it should be," said Dr. Weiss. "Getting people together to talk, to share resources and to avoid duplication of effort is part of Einstein’s institutional collaborative spirit."

Jill Raufman (center) organized the first-ever conference; she poses with Roseanne Waters (blue jacket) from Emory University and Tifany Frazer from Medical College of Wisconsin"Having people who started a global health center discuss how they made it work will help others get their own programs off the drawing board and into the field more quickly," added Dr. Anastos.

Learning from Experience

During the conference, panelists who recently launched or are in the process of developing a GHC at their medical schools also described obstacles they encountered. Problems common to many academic GHCs include lack of collaboration and information-sharing among faculty and practitioners in various disciplines who participate in global health initiatives; having to establish and enforce a shared vision for the focus and mission of the GHC; and finding a niche for a program to facilitate faculty recruitment, stoke student enthusiasm and attract grants and donations.

Attendees asked questions on a variety of basic issues, such as establishing overseas networks, vetting foreign programs, and whether export controls applied to medical equipment and supplies. A moment of levity occurred when panelists were asked how to motivate faculty to mentor students without paying them; they passed the microphone to one another like a hot potato, as each commented on a problem that is both universal and perennial.

A Shining Example

The panelists emphasized that the hallmarks of a successful global health program are capacity-building – the ability to scale up so that more students can be offered overseas opportunities and/or to add infrastructure, as well as to provide increased clinical, research or community work through a program – and sustainability.

Dr. Louis Weiss, GHC co-director, engages in dialogue with a colleague"You should be able to expand a program that starts out as a demonstration or pilot project to a region or an entire country, if it meets an ongoing need," Dr. Weiss explained. "Sustainability means that a program can go on after you leave because it has funding and local people trained to continue the work."

An example that meets these criteria is Rwanda’s Women’s Equity in Access to Care and Treatment for HIV (WE-ACTx), for which Dr. Anastos currently serves as director of research scientific capacity building. The program launched in 2004 after Rwandan women, who had been sexually assaulted during the 1994 genocide and were dying of AIDS, learned their rapists were receiving treatment to prevent the disease while in custody awaiting their war crimes trials. The original mission of WE-ACTx, to provide access to grassroots-based primary healthcare to Rwandan women and children, and education about human rights issues to patients and community groups, has since grown to include training physicians, scientists and pathologists in clinical research.

"WE-ACTx’s clinical services are standing on their own now, with Rwandans providing all the HIV care and able to get funding on their own," noted Dr. Anastos. "We expect that the scientific training will also be self-sustaining within five years."

Through the discussions and networking offered at the conference, both budding and established global health centers gained insights on maximizing capabilities and fostering sustainability as they build and support programs abroad. Planning of another conference, to be held within the next 18 months, is already underway.