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.

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Spotting the Earliest Signs of Type 1 Diabetic Kidney Disease

JDRF network grant to fund study to find new types of diagnostic markers —

In an effort to pinpoint the earliest signs of diabetic kidney disease, researchers at University of California, San Diego School of Medicine are leading a multi-institutional international effort dedicated to finding a new breed of disease indicators.

The study, funded by a $2.5 million JDRF (formerly known as the Juvenile Diabetes Research Foundation) grant, will tap the potential of three emerging “omics” sciences to discover new ways to determine which patients are most likely to develop diabetic kidney disease. Samples from more than 2,000 type 1 diabetes patients, collected over a period of years by several medical centers around the world, will be used in the analyses. …Read the full story from the UC San Diego Newsroom


Kumar Sharma, MD, FAHAPrincipal investigator of the study is Kumar Sharma, MD, FAHA, Professor of Medicine in the Division of Nephrology. He directs the Center for Renal Translational Medicine and the Institute of Metabolomic Medicine in UC San Diego School of Medicine.

Live Long and Measure: Quest to Create Real-World Tricorder

XPRIZE teams will test Star Trek-inspired medical devices at UC San Diego —

Seeking to boldly go where medical science has not gone before, the Clinical and Translational Research Institute (CTRI) at the University of California, San Diego has been named the official testing site for the $10 million Qualcomm Tricorder XPRIZE, a global competition sponsored by the Qualcomm Foundation to develop a consumer-friendly, mobile device capable of diagnosing and interpreting 15 physiological conditions and capturing vital health metrics.

The XPRIZE competition is inspired by the tricorder medical device that debuted in the original 1966 Star Trek TV show and was frequently featured in subsequent series and movies. …Read the full story from the UC San Diego Newsroom


Dr. Gary FiresteinGary S. Firestein, MD, is director of the CTRI and dean and associate vice chancellor of translational medicine at UC San Diego.

He is professor of medicine in the Division of Rheumatology, Allergy and Immunology and served as division chief from 1998 until he stepped down in 2010 to focus on his growing responsibilities as dean of translational medicine and director of the CTRI for UC San Diego Health Sciences.

UC San Diego Named Stem Cell “Alpha Clinic”

Designation will help speed development of emerging drugs and therapies —

In a push to further speed clinical development of emerging stem cell therapies, Sanford Stem Cell Clinical Center at UC San Diego Health System was named today one of three new “alpha clinics” by the California Institute for Regenerative Medicine (CIRM), the state’s stem cell agency.

The announcement, made at a public meeting in Los Angeles of the CIRM Governing Board, includes an award of $8 million for each of three sites. The other alpha grant recipients are the City of Hope hospital near Los Angeles and University of California, Los Angeles.

“A UC San Diego alpha clinic will provide vital infrastructure for establishing a comprehensive regenerative medicine clinical hub that can support the unusual complexity of first-in-human stem cell-related clinical trials,” said Catriona Jamieson, MD, PhD, associate professor of medicine at UC San Diego School of Medicine, deputy director of the Sanford Stem Cell Clinical Center, director of the UC San Diego Moores Cancer Center stem cell program and the alpha clinic grant’s principal investigator. … Read the Full Story from the UC San Diego Health Newsroom

Hannah Carter Receives NIH Early Independence Award

CTRI Helps Launch Career of Bioengineer Hannah Carter

November 22, 2013 – With support from UC San Diego’s Clinical and Translational Research Institute (CTRI), bioengineer Hannah Carter, PhD, received the highly prestigious NIH Early Independence Award and recently began began her transition to a junior faculty position at UC San Diego.

Presently she is acquiring a research team and computational resources to delve into her project: Network approaches to identify cancer drivers from high-dimensional tumor data. … Read the full story from CTRI News & Events


Hannah Carter, PhDHannah Carter, PhD, is assistant professor of medicine in the Division of Medical Genetics. Her project is Network Approaches to Identify Cancer Drivers from High-Dimensional Tumor Data.

She is now recruiting postdoctoral fellows for her project, which is funded for five years.

Carter Laboratory website

 

Dianne McKay Receives CIRM Basic Biology Grant

Eight stem cell scientists at the University of California, San Diego have been awarded a total of $8.165 million to fund research tackling significant, unresolved issues in human stem cell biology. … Read the full story from the UC San Diego News Center


Dianne McKay, MDDianne B. McKay, MD, professor of clinical medicine in the Division of Nephrology-Hypertension, is one of the eight UC San Diego researchers to receive a Basic Biology V Award from the California Institute for Regenerative Medicine this week.

McKay is medical director of the Kidney Transplant Program at UC San Diego Health System.

Sara Browne Awarded $1M Innovation Initiative Grant

$1 Million Grant from Alliance Healthcare Foundation Awarded to UC San Diego

Dr. Sara BrowneThe Alliance Healthcare Foundation has awarded the University of California, San Diego School of Medicine a $1 million Innovation Initiative (i2) Grant to support the work of Dr. Sara Browne, associate professor in the School of Medicine’s Division of Infectious Diseases. The grant is funding groundbreaking research in the use of wireless technologies in the management of personal and public health. … Read the full story from the UC San Diego News Center

UC San Diego Researcher Receives $6.25 Million Grant

The Leukemia & Lymphoma Society has awarded Thomas J. Kipps, MD, PhD, Distinguished Professor of Medicine at the University of California, San Diego School of Medicine, with a 5-year, $6.25 million Specialized Center of Research program grant to support research on chronic lymphocytic leukemia (CLL), the most common adult leukemia in the United States. … Read the full story from the UC San Diego News Center


Dr. Thomas Kipps

Dr. Thomas Kipps

Thomas J. Kipps, MD, PhD, is the Evelyn and Edwin Tasch Chair in Cancer Research and UC San Diego Moores Cancer Center deputy director for research.

See other UC San Diego news stories about Dr. Kipps and his work.

$5.6 Million Grant Renewal Expands Research in Kidney Failure

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD) – part of the National Institutes of Health – has renewed a grant shared by the University of California, San Diego and the University of Alabama at Birmingham Schools of Medicine. The five-year, $5.64 million renewal will extend and expand research into acute kidney failure, or acute kidney injury, which kills 70 to 80 percent of patients in intensive care units who develop the disease.Read the full story from the UCSD Newsroom


Dr. Ravindra MehtaRavindra L. Mehta, MD, FACP, UC San Diego professor of clinical medicine and vice chair for clinical research in the Department of Medicine, is associate director of the UC San Diego – University of Alabama at Birmingham O’Brien Center for Acute Kidney Injury Research.

He directs the O’Brien Center’s clinical studies core with co-director Daniel O’Connor, MD. O’Connor is professor of medicine and pharmacology and co-director, UCSD Center for Human Genetics and Genomics.

UC San Diego nephrology faculty members Roland Blantz, MD, and Volker Vallon, MD, are co-directors of the pre-clinical studies core of the O’Brien Center. Blantz is distinguished professor of medicine emeritus and former chief of the Division of Nephrology-Hypertension; Vallon is professor of medicine and pharmacology.

UC San Diego nephrologist Satish RamachandraRao, PhD, assistant professor of medicine, is a co-director of the Bioanalytical Resource Core.

Ravindra L. Mehta is Director of Dialysis Programs and Clinical Nephrology for UC San Diego Health System. In the UC San Diego School of Medicine, Mehta directs the Clinical Research Enhancement through Supplemental Training (CREST) and Master’s Degree in Clinical Research programs.

In 2011, Mehta received the International Society of Nephrology (ISN) Shire Bywaters Award for his lifetime achievements in acute kidney injury.

More Information:

IDASH Projects: Protecting Privacy and Patient Rights in the Name of Scientific Progress

In the years since the best-selling book “The Immortal Life of Henrietta Lacks” made the issue of informed consent and patient privacy a national topic of conversation, scientists and clinicians have continued to struggle to develop a comprehensive methodology for collecting and sharing data from patients and research subjects without jeopardizing their rights.

The University of California, San Diego’s iDASH project aims to address some of these fundamental challenges to research progress with its most recent series of “Driving Biological Projects” (DBPs) … Read the full story from the UCSD Newsroom


Dr. Lucila Ohno-MachadoLead investigator in the iDASH project is Lucila Ohno-Machado, MD, MBA, PhD, professor of medicine, founding chief of the Division of Biomedical Informatics and associate dean for informatics and technology at UC San Diego.

Among other research and education projects directed by Dr. Ohno-Machado are the Biomedical Research Informatics for Global Health training program and the biomedical informatics component of the UC San Diego – Universidade Eduardo Mondlane Medical Education Partnership Initiative.  |  See all DBMI research projects

Dr. Ohno-Machado joined the UC San Diego faculty from Harvard Medical School in 2009. She was elected to the American Society for Clinical Investigation in 2010.

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