Disease Surveillance Networks Initiative Global: Final Evaluation

In August 2009, the Rockefeller Foundation commissioned an independent external evaluation of the Disease Surveillance Networks (DSN) Initiative in Asia, Africa, and globally. This report covers the results of the global component of the summative and prospective1 evaluation, which had the following objectives:[1] Assessment of performance of the DSN Initiative, focused on its relevance, effectiveness/impact, and efficiency within the context of the Foundation's initiative support.[2] Assessment of the DSN Initiative's underlying hypothesis: robust trans-boundary, multi-sectoral/cross-disciplinary collaborative networks lead to improved disease surveillance and response.[3] Assessment of the quality of Foundation management (value for money) for the DSN Initiative.[4] Contribute to the field of philanthropy by:a. Demonstrating the use of evaluations in grantmaking, learning and knowledge management; andb. Informing the field of development evaluation about methods and models to measure complex networks

Trade related infections: farther, faster, quieter

Modern global trading traffics large volumes of diverse products rapidly to a broad geographic area of the world. When emergent infections enter this system in traded products their transmission is amplified. With truly novel emergent infections with long incubation periods, such as Human Immunodeficiency Virus (HIV) or variant Creutzfeld Jacob Disease (vCJD), this transmission may silently disseminate infection to far distant populations prior to detection. We describe the chronology of two such "stealth infections," vCJD and HIV, and the production, processing, and distribution changes that coincided with their emergence. The concept of "vector products" is introduced. A brief case study of HIV incursion in Japan is presented in illustration. Careful "multisectoral" analysis of such events can suggest ecologically critical pathways of emergence for further research. Such analyses emphasize the urgency of implementing safety measures when pathogens enter globally traded products

Strengthening Public Health Leadership in Africa: An Innovative Fellowship Program.

PROBLEM: The Ebola virus disease crisis in West Africa revealed critical weaknesses in health policy and systems in the region, including the poor development and retention of policy leaders able to set sound policy to improve health. Innovative models for enhancing the capabilities of emerging leaders while retaining their talent in their countries are vital. APPROACH: Chatham House (London, United Kingdom) established the West African Global Health Leaders Fellowship to help develop the next generation of West African public health leaders. The innovative program took a unique approach: Six weeks of intensive practical leadership and policy training in London and Geneva bookended a 10-month policy project conceived and carried out by each fellow in their home country. The program emphasized practice, site visits and observation of U.K. public health organizations, identifying resources, and networking. Strong mentorship throughout the fieldwork was a central focus. Work on the pilot phase began in June 2016; the fellows completed their program in September 2017. OUTCOMES: The pilot phase of the fellowship was successful, demonstrating that this "sandwich" model for fellowships-whereby participants receive focused leadership training at the start and end of the program, minimally disrupting their lives in-country-offers exciting possibilities for enhancing leadership skills while retaining talent within Africa. NEXT STEPS: On the basis of this successful pilot, a second cohort of eight fellows began the program in October 2018. The expanded African Public Health Leaders Fellowship has become a central activity of Chatham House's Centre on Global Health Security

Developing capacity in health informatics in a resource poor setting: lessons from Peru

The public sectors of developing countries require strengthened capacity in health informatics. In Peru, where formal university graduate degrees in biomedical and health informatics were lacking until recently, the AMAUTA Global Informatics Research and Training Program has provided research and training for health professionals in the region since 1999. The Fogarty International Center supports the program as a collaborative partnership between Universidad Peruana Cayetano Heredia in Peru and the University of Washington in the United States of America. The program aims to train core professionals in health informatics and to strengthen the health information resource capabilities and accessibility in Peru. The program has achieved considerable success in the development and institutionalization of informatics research and training programs in Peru. Projects supported by this program are leading to the development of sustainable training opportunities for informatics and eight of ten Peruvian fellows trained at the University of Washington are now developing informatics programs and an information infrastructure in Peru. In 2007, Universidad Peruana Cayetano Heredia started offering the first graduate diploma program in biomedical informatics in Peru

Evaluation of a joint Bioinformatics and Medical Informatics international course in Peru

Background: New technologies that emerge at the interface of computational and biomedical science could drive new advances in global health, therefore more training in technology is needed among health care workers. To assess the potential for informatics training using an approach designed to foster interaction at this interface, the University of Washington and the Universidad Peruana Cayetano Heredia developed and assessed a one-week course that included a new Bioinformatics (BIO) track along with an established Medical/Public Health Informatics track (MI) for participants in Peru. Methods: We assessed the background of the participants, and measured the knowledge gained by track-specific (MI or BIO) 30-minute pre- and post-tests. Participants' attitudes were evaluated both by daily evaluations and by an end-course evaluation. Results: Forty-three participants enrolled in the course - 20 in the MI track and 23 in the BIO track. Of 20 questions, the mean % score for the MI track increased from 49.7 pre-test (standard deviation or SD = 17.0) to 59.7 (SD = 15.2) for the post-test (P = 0.002, n = 18). The BIO track mean score increased from 33.6 pre-test to 51.2 post-test (P less than 0.001, n = 21). Most comments (76%) about any aspect of the course were positive. The main perceived strength of the course was the quality of the speakers, and the main perceived weakness was the short duration of the course. Overall, the course acceptability was very good to excellent with a rating of 4.1 (scale 1-5), and the usefulness of the course was rated as very good. Most participants (62.9%) expressed a positive opinion about having had the BIO and MI tracks come together for some of the lectures. Conclusion: Pre- and post-test results and the positive evaluations by the participants indicate that this first joint Bioinformatics and Medical/Public Health Informatics (MI and BIO) course was a success.The University of Washington AMAUTA Global Training in Health Informatics, a Fogarty International Center/NIH funded grant (5D43TW007551), and the AMAUTA Research Practica Program, a Puget Sound Partners for Global Health-funded grant

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Infecciones Emergentes: Un Desafío Regional y Mundial (texto en inglés)

ANTECEDENTES: Las infecciones emergentes se han convertido, en cierta forma debido al tipo de actividades humanas, en parte de la agenda de la salud pública mundial. Aunque históricamente éstas han permanecido ocultas, su emergencia ha sido precipitada por el progreso de los viajes y el comercio a través del mundo. OBJETIVOS: Resumir la experiencia de las Américas en la emergencia de nuevas infecciones e ilustrar la correlación de ésta con factores antropogénicos. METODOS: Revisamos, basados en la literatura existente, los principales tipos de problemas emergentes ocurridos, y evaluamos su impacto sobre las economías globales y regionales. RESULTADOS: Se han evidenciado cambios en la epidemiología de las enfermedades existentes, que incluyen la introducción de numerosas enfermedades hacia nuevas regiones geográficas. Además, nuevos agentes como el VIH/SIDA han tenido gran impacto y siguen diseminándose. En ambos casos, los viajes y el comercio han amplificado el contagio, Finalmente, también han sido importantes los cambios propios de los microorganismos, como la aparición de tuberculosis resistente. La emergencia de nuevos agentes, patrones de infección y resistencia propone tal desafío que la OPS ha trazado un plan regional para afrontarla

Infecciones Emergentes: Un Desafío Regional y Mundial (texto en inglés)

ANTECEDENTES: Las infecciones emergentes se han convertido, en cierta forma debido al tipo de actividades humanas, en parte de la agenda de la salud pública mundial. Aunque históricamente éstas han permanecido ocultas, su emergencia ha sido precipitada por el progreso de los viajes y el comercio a través del mundo. OBJETIVOS: Resumir la experiencia de las Américas en la emergencia de nuevas infecciones e ilustrar la correlación de ésta con factores antropogénicos. METODOS: Revisamos, basados en la literatura existente, los principales tipos de problemas emergentes ocurridos, y evaluamos su impacto sobre las economías globales y regionales. RESULTADOS: Se han evidenciado cambios en la epidemiología de las enfermedades existentes, que incluyen la introducción de numerosas enfermedades hacia nuevas regiones geográficas. Además, nuevos agentes como el VIH/SIDA han tenido gran impacto y siguen diseminándose. En ambos casos, los viajes y el comercio han amplificado el contagio, Finalmente, también han sido importantes los cambios propios de los microorganismos, como la aparición de tuberculosis resistente. La emergencia de nuevos agentes, patrones de infección y resistencia propone tal desafío que la OPS ha trazado un plan regional para afrontarla