2016 Update: A Lasting Solution for Healthcare in Mozambique

Mozambique highlighted on a map of Africa There is a critical shortage of practicing doctors and medical educators in Mozambique, where the life expectancy is less than 42 years and the rate of HIV infection in adults is 16%. UC San Diego is teaming with the nation’s flagship medical school to create a long-term solution.

Mozambique’s Universidade Eduardo Mondlane (UEM) and UCSD have won a five-year, $12.5-million award from the U.S. Medical Education Partnership Initiative (MEPI). The project will strengthen the nation’s medical education system by building infrastructure in several ways.


“We hope this will be a demonstration project for the rest of Africa.”
— Dr. Robert Schooley


Dr. Emilia Virginia Noormahomed, a co-investigator on the UCSD-UEM MEPI project.UEM’s principal investigator is Emilia Virginia Noormahomed, MD, PhD, a former dean of the UEM School of Medicine. Dr. Noormahomed (pictured at left) is now Assistant Professor of Parasitology at UEM and Assistant Professor of Medicine at UC San Diego.

Sam Patel, MD, Professor of Medicine at UEM and UC San Diego, is a co-investigator. In the photo below, he is pictured on the right.

View photo captions and credits

Dr. Bill Detmer, at left, demonstrates iPad mobile digital device preloaded with medical programs for doctors’ use in the hospital. Dr. Manuel Joaquim Tomás is at center and Dr. Sam Patel at right. Sam Patel, M.D., co-investigator on the MEPI project, is Professor of Medicine at UEM and UCSD. Bill Detmer, M.D., M.Sc., a MEPI project consultant, is Assistant Adjunct Professor of Clinical Informatics at the University of Virginia and President and Chief Executive Officer of Unbound Medicine.

MEPI is a joint initiative of the National Institutes of Health and the President’s Emergency Plan for AIDS Relief (PEPFAR). Under the MEPI program, UEM receives the bulk of the funding and uses it to build capacity in medical training, research, and technology.

A smaller amount of funding comes directly to UC San Diego, supporting time and travel for the partners and mentors who will help UEM meet its goals.

M. Wilson Tilghman, M.D., UCSD’s on-site faculty member in Mozambique, consults with a UEM internal medicine resident at a patient’s bedside. Instituting the use of wirelessly-accessed medical reference material in the hospital is one of the UCSD-UEM project goals.“This is an experiment in medical education for UEM and for the U.S. government,” said Robert “Chip” Schooley, MD, who is coordinating the UC San Diego side of the project. “It puts the funding into the hands of the African universities and allows them to invest it in ways that are beneficial to them.”

Dr. Schooley is Professor and Academic Affairs Vice Chair in the Department of Medicine and Chief of the Division of Infectious Diseases.

“I’m hopeful this will become a model for other kinds of aid,” he said.

Dr. Schooley and colleague Constance Benson, MD, have long experience in partnering with Mozambique and other African nations, and they have collaborated with Dr. Noormahomed in research projects for several years. Dr. Benson is Professor of Medicine, Director of the UC San Diego Antiviral Research Center, and Director of the Fellowship Program in Infectious Diseases.

The UEM-UCSD MEPI project expands some of the educational efforts that have been going on since July 2009 in the Internal Medicine Residency Program’s Global Medicine elective.

UC San Diego’s visiting faculty and residents have helped UEM adopt academic medical practices such as morning report and teaching conferences that strengthen the educational program.

MEPI biomedical informatics team members at October conference at UEM in Maputo.

MEPI biomedical informatics team members at October conference at UEM in Maputo.

The MEPI partnership relies heavily on biomedical informatics to accomplish its goals. This component of the program is led by Lucila Ohno-Machado, MD, PhD, Professor of Medicine and Chief of UC San Diego’s Division of Biomedical Informatics. The division will provide expertise for the partnership’s information technology projects.

Dr. Kathy Promer, a 2013 graduate of the UC San Diego Internal Medicine Program, is the current infectious diseases fellow at UC San Diego on rotation at UEM’s Maputo Central Hospital. In the photo below, she is standing, second from the right.

Dr. Kathy Promer (standing, second from the right), 2013 Graduate of the UCSD Internal Medicine Program and current infectious diseases fellow at UCSD on rotation at UEM’s Maputo Central Hospital.

Smartphones and iPad mobile digital devices have been deployed on the wards at Maputo Central Hospital, UEM’s primary teaching hospital and the only tertiary care center in Mozambique. With these devices, the Mozambican doctors are able for the first time to consult online medical literature at a patient’s bedside. Soon they will have immediate access to data generated by the hospital’s clinical laboratories.

“These efforts really have changed the character of the residency program at Maputo Central Hospital,” said Dr. Schooley.

Through training and partnership with UC San Diego, UEM will also increase its capacity to do operational, epidemiological, translational and clinical research. Another program goal calls for UEM to set up a biomedical informatics infrastructure and connect with SEACOM, the new fiber optic broadband internet service in South and East Africa.

Students in UEM medical school class.UEM will also take steps to enhance its support of two new medical schools recently established by the Mozambican government in Nampula and Tete. These two new medical schools were launched in the past 3 years to address the profound shortage of physicians in the country.

Another key UC San Diego figure in the project is Stephen Bickler, MD, who will work to improve the nation’s surgical capacity in rural areas via a linked MEPI project, “UEM-UCSD Surgery Partnership.” Dr. Bickler is Associate Professor of Surgery and Pediatrics.

A number of other UC San Diego faculty members will contribute to the MEPI effort as well.

Medical school class   UCSD internal medicine resident Dr. Bethany Karl

Above left, a medical school class at Universidade Eduardo Mondlane. Right, Dr. Bethany Karl on rotation at UEM’s Maputo Central Hospital. Dr. Karl graduated from the UC San Diego Internal Medicine Program in 2010 and is currently a nephrology attending. Photo courtesy of Robert T. Schooley, MD

Project leaders expect to double the number of graduating doctors in Mozambique in the next 10 years. They also hope to inspire more doctors to devote their careers to medical education.

With a greater number of highly-trained doctors and a better infrastructure to support them, Mozambique will increase its capacity to deliver health care to its citizens and to fill the faculties of two new medical schools in Nampula and Tete.

The doctors training today in Mozambique will be the specialists, medical school faculty members, and government Ministry of Health policymakers of the future.

“We hope this will be a demonstration project for the rest of Africa,” Dr. Schooley said.

Read the UC San Diego News press release about our MEPI project.

Read about the project in “The Great Beyond,” Nature magazine’s blog
for breaking news in the sciences.


Photo Captions and Credits:

Dr. Emilia Virginia Noormahomed, co-principal investigator on the UCSD-UEM MEPI project.Dr. Emilia Virginia Noormahomed, co-principal investigator on the UC San Diego-UEM MEPI project. Photo courtesy of William M. Detmer, MD, MSc.

Drs. Detmer, Tomás, and PatelDr. Bill Detmer, left, demonstrates iPad mobile digital device preloaded with medical programs for doctors’ use in the hospital. Dr. Manuel Joaquim Tomás is at center and Dr. Sam Patel at right. Sam Patel, MD, co-investigator on the MEPI project, is Professor of Medicine at UEM and UC San Diego. William M. Detmer, MD, MSc, a MEPI project consultant, is Assistant Adjunct Professor of Clinical Informatics at the University of Virginia and President and Chief Executive Officer of Unbound Medicine. Photo courtesy of Dr. Detmer.

Dr. Tilghman and Mozambican residentM. Wilson Tilghman, MD, UC San Diego’s on-site faculty member in Mozambique, consults with a UEM internal medicine resident at a patient’s bedside. Instituting the use of wirelessly-accessed medical reference material in the hospital is one of the UC San Diego-UEM project goals. Photo courtesy of Robert T. Schooley, MD.

MEPI biomedical informatics team members at October conference at UEM in Maputo. MEPI biomedical informatics team members at October conference at UEM in Maputo. From left: Lucila Ohno-Machado, MD, PhD; Eli Aronoff-Spencer, MD, senior postdoctoral fellow in infectious diseases at UC San Diego; Eng. David Bila, Network Director for the Informatics Center at UEM; Heimar de Fátima Marin, RN, PhD, Professor of Health Informatics at Universidade Federal de São Paulo; and Eng. Francisco Mabila, Director of the Informatics Center at UEM. Photo courtesy of William M. Detmer, MD, MSc.

Dr. Kathy Promer (standing, second from the right), is a 2013 graduate of the UC San Diego Internal Medicine Program and is the current infectious diseases fellow at UC San Diego on rotation at UEM’s Maputo Central Hospital.

Students in a medical school class at UEM.Students in a medical school class at UEM. Photo courtesy of William M. Detmer, MD, MSc.

A medical school class at UEM.A medical school class at UEM. Photo courtesy of William M. Detmer, MD, MSc.

UCSD internal medicine resident Dr. Bethany Karl on rotation at UEM’s Maputo Central Hospital.UC San Diego internal medicine resident Dr. Bethany Karl on rotation at UEM’s Maputo Central Hospital. Photo courtesy of Robert T. Schooley, MD.

Trademark Credit Notices:

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UC San Diego Sparks New Cancer-Focused Startup, Oncternal, with Exclusive Antibody License

Oncternal Therapeutics, a new cancer-focused biotechnology startup, has signed a wide-ranging licensing agreement with UC San Diego to develop and commercialize antibodies and antibody-related binding agents.

Oncternal is based on the pioneering research of UC San Diego scientist and clinician Thomas J. Kipps, Distinguished Professor, Evelyn and Edwin Tasch Chair in Cancer Research, and deputy director of research operations at the Moores Cancer Center on campus. … Read the Full Story from the UC San Diego Newsroom


Altman Clinical and Translational Research Building Makes Its Debut

New structure will be campus hub for advancing basic science to clinical applications —

Rising above Interstate 5 on the east campus of UC San Diego, the Altman Clinical and Translational Research Institute Building (ACTRI) officially opened its doors Friday in a ribbon-cutting ceremony under blue skies.

The new seven-story building of steel, glass and grooved concrete is home to the Clinical and Translational Research Institute (CTRI) at UC San Diego, established in 2010 as part of a national consortium of 60 medical research institutions created to energize bench-to-bedside efforts. … Read the Full Story from the UC San Diego Newsroom

CAR Trials Drive Leukemia and Lymphoma Treatment in New Direction

Experimental cellular-immunotherapy may boost body’s ability to find and destroy specific cancers —

Cancer immunology is based upon boosting the body’s own immune system to vanquish malignancies. It is among the fastest growing areas of oncology research. Researchers at UC San Diego Moores Cancer Center have launched three clinical trials to test the safety and efficacy of a novel cellular-immunotherapy that uses modified T cells – one of the immune system’s primary weapons – to treat three different types of blood cancer that often defy existing therapies.

“Lymphomas and leukemias affect thousands of Americans every year and unfortunately a good number of them die as a direct consequence of the disease progression or toxicity from existing treatments,” said Januario E. Castro, MD … Read the Full Story from the UC San Diego Newsroom


Januario E. Castro, MDDr. Januario E. Castro is the principal investigator of the three ZUMA clinical trials of the potential treatment, KTE-C19. Dr. Castro is Professor of Medicine in the Division of Bone Marrow Transplantation.
For more information about the trials, contact Amy Guzdar at (858) 822-6843 or aguzdar@ucsd.edu

Protein-Protein Interaction Activates and Fuels Leukemia Cell Growth

December 21, 2015

Findings also show how an experimental monoclonal antibody treatment inhibits growth and spread of cancer —

Building upon previous research, scientists at University of California, San Diego School of Medicine and UC San Diego Moores Cancer report that a protein called Wnt5a acts on a pair of tumor-surface proteins, called ROR1 and ROR2, to accelerate the proliferation and spread of chronic lymphocytic leukemia (CLL) cells, the most common form of blood cancer in adults.

They note, however, that these effects of Wnt5a were blocked by a humanized monoclonal antibody specific for ROR1, called cirmtuzumab (or UC-961), which inhibited the growth and spread of CLL cells in both cell lines and mouse models of leukemia. The findings are published in the December 21, 2015 issue of The Journal of Clinical Investigation. … Read the full story from the UC San Diego Newsroom


Dr. Thomas Kipps

Dr. Thomas Kipps

Thomas J. Kipps, MD, PhD, senior author of the study report, is Evelyn and Edwin Tasch Chair in Cancer Research and deputy director for research at Moores Cancer Center. He is Professor of Medicine in the Divisions of Hematology-Oncology and Bone Marrow Transplantation.

Read the study report in The Journal of Clinical Investigation (full text, UC San Diego only). J Clin Invest. doi:10.1172/JCI83535.

Cancer-associated Mutations are Common in Patients with Unexplained Low Blood Counts

November 4, 2015

Researchers use genetic tools to propose a new diagnostic category —

Patients with unexplained low blood counts and abnormally mutated cells who do not fit the diagnostic criteria for recognized blood cancers should be described as having clonal cytopenias of undetermined significance (CCUS), suggest University of California, San Diego School of Medicine researchers in a recent paper published in the journal Blood. The researchers found the condition surprisingly common in older patients with low blood counts. … Read the full story from the UC San Diego Newsroom


Dr. Rafael Bejar

Dr. Rafael Bejar

The senior author of the study is Rafael Bejar, MD, PhD, Assistant Professor of Medicine in the Division of Bone Marrow Transplantation.

Read Article Abstract

Dr. Bejar was one of 41 UC San Diego Health physicians named on the list of San Diego’s Top Doctors for 2015. The annual list is compiled by the San Diego County Medical Society and San Diego Magazine.

Forty-One Department of Medicine Physicians Named on San Diego’s 2015 “Top Doctors” List

This year’s San Diego Magazine/San Diego County Medical Society Top Doctors list includes 41 Department of Medicine faculty clinicians. View photo gallery

American Cancer Society Pilot Grants for Junior Investigators

The Moores Cancer Center is now accepting applications from junior investigators for American Cancer Society Institutional Research Grants (ACS-IRG #70-002).

Applicants must be Assistant Professors at UC San Diego, within six years of their first independent faculty appointment. Up to five pilot grants will be awarded, for up to $30,000 per award.

Applications are due electronically by 5 p.m. September 10, 2015. Grants will be awarded in December, 2015.

New Drug for Blood Cancers Now in Five Phase II Clinical Trials

Researchers at University of California, San Diego School of Medicine have established the safety and dosing of a new drug for treating blood cancers. The findings are published online July 27 in The Lancet Haematology.

The drug is a small molecule inhibitor that suppresses the activity of a signaling pathway believed to contribute to a variety of blood cancers’ eventual resistance to standard chemotherapy treatments. … Read the Full Story from the UC San Diego News Center


Catriona Jamieson, MD, PhD, Catriona H. M. Jamieson, MD, PhD is the senior author of the article reporting the multicenter study. Dr. Jamieson is an associate professor of medicine and chief of the Division of Regenerative Medicine in the School of Medicine.

Read summary of article in The Lancet Haematology

UC San Diego and GSK Collaborate to Eradicate Cancer Stem Cells, Treat Leukemia

First California institution selected to participate in GSK’s bench-to-bedside academia-industry collaboration program —

Researchers at the University of California, San Diego School of Medicine and Moores Cancer Center are working with GSK on a bench-to-bedside project to treat leukemia and other diseases by eliminating cancer stem cells. The collaboration is part of GSK’s Discovery Partnerships with Academia (DPAc) program, where academic partners become core members of drug-hunting teams. Catriona Jamieson, MD, PhD, associate professor of medicine and chief of the Division of Regenerative Medicine, will lead UC San Diego’s effort in the new DPAc team. … Read the full story from the UC San Diego Newsroom