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:

iPad is a trademark of Apple Inc., registered in the U.S. and other countries.

New Video Series Chronicles AIDS Epidemic in Tijuana

“HIV/SIDA: The Epidemic in Tijuana” focuses on UC San Diego researchers’ efforts to track and prevent the spread of HIV among the city’s most at-risk populations —

The new documentary “HIV/SIDA: The Epidemic in Tijuana” offers an unflinching look at the challenges facing researchers from the University of California, San Diego as they attempt to identify and treat people who inject drugs, sex workers, transgender women and others who are at high risk for HIV infection in Tijuana. The program, which was shot over two years, premieres Oct. 5 at 8 p.m. on UCSD-TV and can be viewed at www.uctv.tv/hiv-sida. … Read the full story from the UC San Diego Newsroom


The film features the efforts of Dr. Steffanie Strathdee, her Division of Global Public Health colleagues and a multidisciplinary, multinational team of medical professionals to trace and arrest the spread of AIDS in Tijuana.

Dr. Strathdee is Associate Dean of Global Health Sciences, Harold Simon Professor and Chief of the Division of Global Public Health at UC San Diego.

The four-part documentary, based on the book Tomorrow Is a Long Time by Malcolm Linton and Jon Cohen, premiered on UCSD-TV on October 5. It was supported by funding from the Ford Foundation.

Find more about the documentary here: HIV/SIDA: The Epidemic in Tijuana – UCSD-TV – University of California Television.

Dr. Helen King and Dr. Philipp Wiesner Present Mentored Research Study Results at Grand Rounds

Dr. Helen King

Dr. Helen King.

Dr. Philipp Wiesner

Dr. Philipp Wiesner.

Helen King, MD, and Philipp Wiesner, MD, junior residents in the categorical track of the UCSD Internal Medicine Residency Program, presented results of their elective mentored research projects at Medicine Grand Rounds on May 15.

The Internal Medicine Residency Training program offers trainees two months of elective time during their second or third year to undertake a research project under the guidance of a faculty mentor.

Dr. Helen King

Helen King, MD, Mercer University

King’s research project was “HIV Preexposure Prophylaxis: Barriers to Access for Men Who Have Sex With Men.” |  Watch the video (UCSD only)

“I have been interested in HIV medicine for some time now,” King said, “and since being a resident at UCSD have had the opportunity to have more exposure.

“I went to Dr. Davey Smith knowing that he might have some interesting projects, and he helped me get involved with the PrEPARE Study.”

Davey Smith, MD, MAS

Davey M. Smith, MD, MAS

Smith (at right), a translational research virologist, directs the Translational Virology Core of the UC San Diego Center for AIDS Research and is medical director of the Antiviral Research Center’s Early Intervention Program.

He is associate professor of medicine in the Division of Infectious Diseases.

The PrEPARE study evaluates preexposure prophylaxis for HIV in men who have sex with men, an approach in which an HIV-negative individual who is at high risk for HIV infection takes a daily HIV medication to lower his risk of infection.

“It has been proven effective in high-risk men who have sex with men,” King said. “Our study was aimed at identifying real-life barriers to accessing the medication, such as cost.”

The study pinpointed several barriers including cost and concern about side effects.

Of her research experience, King said, “I was lucky enough to work on a project that was interesting to me and to work with a great mentor.”

Dr. Philipp Wiesner

Philipp Wiesner
MD, Universität Regensburg

Philipp Wiesner presented the project “Oxidized Phospholipids in Inflammation and Atherosclerosis.” |  Watch the video (UCSD only)

“I started to work in the field of atherosclerosis in medical school,” Wiesner said. “I spent 2 years as a postdoctoral fellow and continued to work in this area during residency.

“My topic was a perfect fit, as I could continue to work in the same area in which I already had experience as well as continue to work with my previous mentors.”

Dr. Joseph Witztum

Joseph Witztum, MD

Wiesner’s primary mentor is Joseph Witztum, MD, professor of medicine in the Division of Endocrinology & Metabolism. Witztum leads the renowned atherosclerosis research laboratory that was established at UCSD by Dr. Daniel Steinberg.

Steinberg, emeritus professor of medicine and pioneering lipid researcher, was the founding head of the Division of Metabolic Diseases.

Dr. Yury Miller

Yury Miller, MD, PhD

Wiesner’s other mentors are lab members Yury Miller, MD, PhD, and Sotirios “Sam” Tsimikas, MD. Miller is associate professor of medicine in the Division of Endocrinology & Metabolism and Tsimikas is professor of clinical medicine and director of vascular medicine in the Division of Cardiology.

Dr. Sotirios "Sam" Tsimikas

Sotirios “Sam” Tsimikas, MD

Some of Wiesner’s research work, not included in his Grand Rounds presentation, recently has been accepted for publication in the Journal of Lipid Research.

Said Wiesner, “I am really glad our program gives us the opportunity to take two months off to do research. Residency is busy as it is and without this, many residents would not have the chance to get exposed to clinical or laboratory based research.”

Wiesner said it has always been his plan to have a career as an academic physician-scientist.

Presenting Grand Rounds on May 15: Dr. Helen King and Dr. Philipp Wiesner

Dr. Helen King

Dr. Helen King
MD, Mercer University

Dr. Philipp Wiesner

Dr. Philipp Wiesner
MD, Universität Regensburg

Helen King, MD, and Philipp Wiesner, MD, junior residents in the categorical track of the UCSD Internal Medicine Residency Program, will present results of their elective mentored research projects at Medicine Grand Rounds on May 15.

King’s research project is “HIV Preexposure Prophylaxis: Barriers to Access for Men Who Have Sex With Men.”  Philipp Wiesner will present the project “Oxidized Phospholipids in Inflammation and Atherosclerosis.”

The Internal Medicine Residency Training program offers trainees two months of elective time during their second or third year to undertake a research project under the guidance of a faculty mentor.

UC San Diego’s Graduate Programs Among Nation’s Best, According to U.S. News & World Report

The 2014 edition of the U.S. News & World Report’s “Best Graduate Schools” guidebook, released today, highly ranks the University of California, San Diego’s professional schools in engineering and medicine, as well as its academic Ph.D. programs in the social sciences and humanities. … Read the full story from the UCSD Newsroom


The new rankings and medical education in the Department of Medicine:

In “Best Graduate Schools 2014” from U.S. News & World Report, the University of California, San Diego School of Medicine is ranked #15 in research and #39 in primary care, with the HIV/AIDS specialty program (Division of Infectious Diseases and Owen Clinic) ranked #11.

In the HIV/AIDS specialty, the Department of Medicine offers research and clinical training via the teaching activities of the Division of General Internal Medicine and Division of Infectious Diseases. The two divisions operate a variety of clinical and research entities including the Owen Clinic, the Antiviral Research Center, the AIDS Research Institute and the Center for AIDS Research.

Dr. Victoria Ojeda Receives UCGHI Junior Faculty Fellowship Award

Dr. Victoria OjedaVictoria Ojeda, MPH, PhD, public health researcher and assistant professor of medicine in the Division of Global Public Health, has received a Junior Faculty Fellowship Program award for 2013-2014 from the University of California Global Health Institute (UCGHI).

The UCGHI Junior Faculty Fellowship Program, funded by a private donor, supports global health investigators in focused, multidisciplinary projects to develop their skills in investigation, training and leadership.

The award will support Ojeda’s ongoing work with deportees in Tijuana, Baja California, funding her project, “Tijuana Business Attitudes Toward Deportees and the Acceptability of an Employment Opportunities Program.”

Ojeda’s related Tijuana study, “Social incorporation following deportation and implications for health status and access to care,” is supported by a UCGHI GloCal Health Fellowship award she received in 2012. The GloCal Fellowship, a one-year mentored research fellowship, is a program of the National Institutes of Health Fogarty International Center and a UCGHI consortium.

Ojeda focuses her research on substance use, HIV/AIDS infection, and mental health co-morbidities in migrant populations, including injection drug users and female sex workers. Through a number of studies in Tijuana and elsewhere, she is examining how patterns of population movement, including migration and deportation, affect the transmission of HIV/AIDS and other blood-borne infections in the United States-Mexico border region.

Ojeda earned her MPH and PhD in Community Health Sciences at the School of Public Health at UCLA and completed a NIMH Post-doctoral fellowship in Mental Health Policy at the Department of Health Care Policy at the Harvard Medical School.

She is principal investigator of a five-year, NIDA-funded K01 career development project Mexican Female Migration, Substance Use, Sex work, and HIV Risks in Tijuana (Mujer Migrante). She is a research associate of the UCSD Center for Comparative Immigration Studies and a faculty member in the UCSD-SDSU Joint Doctoral Program in Global Public Health.

More Information:

Bringing Power of Prevention, Diagnosis to the People

“A Mercedes Benz isn’t designed to function in the Sahara Desert,” notes Dr. Eliah Aronoff-Spencer of the University of California, San Diego. “So why are we designing medical equipment for developing countries the same way we do for developed ones?”

It’s a question researchers at the new Distributed Health Laboratory in the California Institute for Telecommunications and Information Technology (Calit2) at UC San Diego aim to address, and eventually, to render moot. In collaboration with the UC San Diego School of Medicine and the Universidade Eduardo Mondlane (UEM) in Maputo, Mozambique, Calit2’s DH Lab is designing low-cost medical devices such as microscopes and wireless sensing devices that can be used by virtually anyone anywhere in the world to prevent and even diagnose illness. … Read the full story from the UCSD Newsroom


Co-directing the Distributed Health Laboratory is Eliah Aronoff-Spencer, MD, PhD, fellow in infectious diseases at UCSD and informatics coordinator for the Medical Education Partnership Initiative (MEPI) between UC San Diego and Universidade Eduardo Mondlane (UEM) in Maputo, Mozambique.

Eliah Aronoff-Spencer, MD, PhD with Dr. Manuel TomasThe photo at left shows Dr. Aronoff-Spencer with UEM physician Dr. Manuel Tomás (at right) on a patient ward at Maputo Central Hospital.

Dr. Aronoff-Spencer is also an organizer of the Biomedical Research Informatics for Global Health Training (BRIGHT) program, an international collaboration devoted to training the next generation of informatics researchers in partner countries.

The BRIGHT program, a Division of Biomedical Informatics project, is funded by grant D43TW007015 from the Fogarty International Center of the National Institutes of Health.

A graduate of the UCSD Internal Medicine Residency Program and Physician-Scientist Training Pathway, Dr. Aronoff-Spencer has completed a fellowship in clinical infectious disease and is now a fellow in research in infectious disease, global health informatics and decision making at UCSD. He is also a staff physician in infectious disease at the VA San Diego Healthcare System.

More information:

UC San Diego Researcher Receives $2.5 million Award from the National Institute on Drug Abuse

Davey Smith, MD, associate professor of medicine in the Division of Infectious Diseases at the University of California, San Diego School of Medicine and the VA San Diego Health System is one of three recipients of the 2012 Avant-Garde Award for HIV/AIDS research. This prestigious award, announced today by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, is intended to stimulate high-impact research that may lead to groundbreaking opportunities for the prevention and treatment of HIV/AIDS in drug abusers. … Read the full story from the UCSD Newsroom


David M. Smith, MD, MASDavey M. Smith, MD, MAS, is a physician-scientist specializing in the study of HIV transmission. He directs the Translational Virology Core at the Center for AIDS Research and the Early Intervention Program at the Antiviral Research Center at UCSD.Dr. Smith received his internal medicine residency training, including a year as chief medical resident, and his fellowship training in infectious diseases at UCSD. He earned his Masters of Advanced Studies (MAS) degree in clinical research at UCSD as well.

More about Dr. Smith’s work:

More about the award:

In the Spotlight: Global Public Health Division’s El Cuete and Mujer Mas Segura Projects

Dr. Steffanie Strathdee on El Cuete outreachAs the XIX International AIDS Conference met in Washington, DC, this month, Science highlighted the UC San Diego Division of Global Public Health’s El Cuete project and KPBS released a video and story about another of the division’s studies, Mujer Mas Segura.

Science magazine profiled the El Cuete project in a special issue, HIV/AIDS in America, released to coincide with the International AIDS Conference. Read “My Virus Is Your Virus” in Science

In the local media, KPBS interviewed Dr. Steffanie Strathdee (pictured at left above) and Dr. Jose Luis Burgos about the Changing HIV Risks in Female Sex Workers-Injection Drug Users on the Mexico-US Border study, known as Mujer Mas Segura.  Go to video story “UC San Diego Study Aims To Reduce The Risks In The Sex Trade”

Steffanie Strathdee, PhD, is Associate Dean of Global Health Sciences and Harold Simon Professor and Chief of the UC San Diego Division of Global Public Health. She directs the UC San Diego Global Health Initiative and is founding co-director of the UC Global Health Institute’s Center for Migration and Health.

Jose Luis Burgos, MD, MPH, is assistant professor of medicine in the Division of Global Public Health.

Related stories from UC San Diego and the University of California:

HIV Prevention in a Pill

UC San Diego researchers receive $5.6 million grant to test if they can keep high-risk individuals from becoming infected with virus that causes AIDS

Last year marked the 30th anniversary of the first clinical reports of AIDS, a then-mysterious and invariably fatal disease. Patients diagnosed with an HIV infection faced a looming death sentence. Most had just months to live…. Read the full story from the UCSD Newsroom


AIDS ribbon
One of three UC campuses in the project, UC San Diego will receive $5.6 million over four years. The lead investigator for UC San Diego is Dr. Richard Haubrich, professor in the Division of Infectious Diseases and Antiviral Research Center.

More about the project: