How Decriminalizing Drugs Might Affect the Spread of HIV in Tijuana

Richard Branson and experts debate the losing war on drugs — and its victims — at UC San Diego event —

As the 1960s came to a close, Richard Nixon famously declared a “war on drugs.” They were “public enemy number one,” the president said. Their menace demanded a full-throated federal effort of interdiction, eradication and incarceration.

The goal: No more illegal drugs. Period.

The reality: The war still rages. There are now more illegal drugs produced and consumed than ever.

If the war on drugs were one of his businesses, said Sir Richard Branson, the renowned British magnate, philanthropist and activist, it would have been shut down within a year. “It hasn’t worked at all, ever, but governments continue to ignore the facts, creating untold misery. Drug use isn’t a criminal problem. It’s a health problem.”
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Branson, who has become a major voice in the global drug policy debate, visited UC San Diego last week to participate in a panel discussion on global drug decriminalization and Tijuana’s HIV/AIDS epidemic, which is fueled in part by widespread drug use, notably the sharing of needles to inject black tar heroin. … Read the Full Feature Story from the UC San Diego Newsroom


Steffanie Strathdee, PhD

Steffanie Strathdee, PhD

The UC San Diego Global Health Institute (GHI) was a co-sponsor of the event. GHI Director Steffanie Strathdee, PhD, was moderator and host of the event.

Dr. Strathdee is Associate Dean of Global Health Sciences, Harold Simon Professor and Chief of the Division of Global Public Health in the Department of Medicine.

High Rankings for Internal Medicine Subspecialties in “Best Hospitals 2011-2012”

UC San Diego Medical CenterFour internal medicine specialties received top-50 rankings for UC San Diego Health System in the new “Best Hospitals 2011-2012” from U.S.News & World Report:

* Pulmonology (#16)
* Diabetes and Endocrinology (#25)
* Nephrology (#34)
* Cancer (#47)

Four other internal medicine specialties were high performers, scoring in the top 25 percent of those surveyed: cardiology and heart surgery, gastroenterology, geriatrics and rheumatology.

“Year by year, the Department of Medicine increases in clinical strength and breadth, and I am happy to see this strong representation in the rankings,” said Dr. Wolfgang Dillmann, Professor and Interim Chair of the department.

Dr. Wolfgang Dillmann “It is a testament to the hard work and dedication of all our clinicians, from the clinical service chiefs to the house staff, and the administrative structure that supports them.”

U.S. News evaluated the specialties on a number of points, including the availability of advanced patient care technologies and important patient services. All eight of the ranked and high-performing internal medicine specialties had high or perfect scores in those domains.

“This is one of the strengths of an academic medical center,” said Dillmann. “We offer our patients the latest developments, not only in new tools for diagnosis and therapy but also in approaches to care.”

U.S. News included 16 specialties in the rankings. Not included was HIV/AIDS care, which is ranked in a separate survey. In this year’s rankings, released in March, the HIV/AIDS program (Division of Infectious Diseases and Owen Clinic) is eighth in the nation.

U.S. News determines the “Best Hospitals 2011-2012” rankings from objective and subjective factors that vary by specialty. The factors include reputation among specialists, patient survival and safety, and care-related indicators such as nurse staffing and availability of advanced technologies.

More about the methodology >>

UC San Diego Health System also ranked in orthopedics and psychiatry and was high performing in otolaryngology, gynecology, neurology/ neurosurgery, and urology.

Read the UCSD press release >>

With a total of six top-50 specialties and eight high-performing specialties, UC San Diego Health System placed in the top 3 percent of over 4800 hospitals evaluated.

Two medical centers in the University of California system made the U.S. News “Honor Roll,” which lists the hospitals with high scores in at least 6 specialties. Among the 17 hospitals that qualified, Ronald Reagan UCLA Medical Center in Los Angeles is #5 and UC San Francisco Medical Center is #7.

Dr. Philip Lederer Receives the 2011 Lee Rickman Humanism in Medicine Award

Dr. Philip LedererPhilip Lederer, MD, senior resident in the UC San Diego Internal Medicine Residency Program, received the 2011 Lee Rickman Humanism in Medicine award at Medicine Grand Rounds on June 8.

The award is given each year to the resident who most embodies the energy and devotion of Lee Rickman, MD, a UC San Diego residency program graduate and Department of Medicine faculty member who practiced infectious disease medicine with singular passion until his death in 2003.

“Phil has that same passion,” said Elaine Muchmore, MD, residency program director, in presenting the award. “It’s with pride and enthusiasm that I introduce him as this year’s Rickman award winner.”

When Dr. Lederer graduates from the program later this month, he will join the faculty as Health Sciences Assistant Professor in the Division of Infectious Diseases and Clinical Director of the UC San Diego Department of Medicine’s Maputo Central Hospital Educational Collaboration.

Living in Maputo, Mozambique, he will be the on-site UC San Diego faculty attending for residents on global medicine elective rotation.

He will play a major role in the Medical Education Partnership Initiative (MEPI), which unites UC San Diego and the Universidade Eduardo Mondlane (UEM) in an effort to build sustainable, local capacity for educating doctors in Mozambique and southeast Africa.

In accepting the Rickman award, Dr. Lederer reflected on the 30th anniversary of the HIV/AIDS epidemic. Thirty-five million people have died of AIDS, he said, and 75 million have been infected since the epidemic began, primarily in sub-Saharan Africa.

Africa carries 24% of the world’s disease burden but has only 3% of the world’s trained medical professionals, he said.

As clinical director in Mozambique, he will direct both UC San Diego and UEM residents in their training. He will also play myriad roles in the process of strengthening the UEM training program and developing research collaborations on topics of greatest concern to Mozambique.

He concluded his remarks by introducing Drs. Clotilde Nhatave Paiva and Ermenia Miguel Muthambe, internal medicine residents from the UEM training program in Maputo who are currently on rotation here at UC San Diego.

“They are the future,” Dr. Lederer said.

About Dr. Lederer

Dr. Lederer received his MD degree from the University of Pennsylvania School of Medicine. He has sought out opportunities for service in health and social justice since 2003, when he served as a full-time diabetes educator in a community health center after he graduated from Brown University.

In 2005, he co-founded the Guatemala Health Initiative to bring together University of Pennsylvania students and Guatemalan communities in efforts to improve public health, focusing on the Tz’utujil Maya town of Santiago Atitlán.

During his residency, Dr. Lederer has completed both the global medicine rotation in Mozambique and the Global Health in Local Populations rotation in San Diego.

He is currently conducting research studies in HPV and conjunctival cancer, rapid diagnostics for tuberculosis, and bacteremia in Mozambique.
About Dr. Rickman

Leland Rickman, MD, was a UC San Diego infectious disease specialist who graduated from the Internal Medicine Residency Program here in 1983. He completed his fellowship training in infectious diseases at the Naval Medical Center San Diego and served in naval hospitals until he returned to UC San Diego to join the Department of Medicine faculty in 1990.

Dr. Muchmore met Dr. Rickman at that time.

“I was struck by his passion for teaching and for clinical care and his meticulous attention to details,” she said. “He was a font of knowledge.”

Dr. Rickman was appointed Hospital Epidemiologist and Medical Director of the Epidemiology Unit in 1993.

“He dedicated himself to being the infection control physician for the hospital,” Dr. Muchmore said. “He bird-dogged things in a way that was truly awe inspiring.”

He received more UC San Diego teaching awards than anyone in the Department of Medicine, Dr. Muchmore said. The San Diego County Medical Society’s Physician Citizen of the Year award in 2003 was one of many acknowledgments of his service to the community.

Dr. Rickman died in June 2003 while traveling in Lesotho, Africa, to train local medical personnel in AIDS treatment and prevention. In that effort, he was working with Dr. Wm. Christopher Mathews, UC San Diego Professor of Clinical Medicine and Director of the Owen Clinic.

“His loss was not only to those of us at UCSD but to the world,” said Dr. Kenneth Kaushansky, Helen M. Ranney Distinguished Professor and Chair of the Department of Medicine at the time.

Dr. Kaushansky and the residency program faculty established the Rickman award in his honor in 2003.

Appreciation and a Fond Farewell to Dr. Ken Kaushansky

Kenneth Kaushansky, MD, MACPOn July 19, Dr. Ken Kaushansky officially begins his work as Senior Vice President for Health Sciences and Dean of the School of Medicine at Stony Brook University in New York.

When he announced his departure to the faculty and staff of the UCSD Department of Medicine on June 7, he described his new position as an opportunity to implement, on a larger scale, the successful programs that the Department of Medicine has instituted under his leadership here.

He called his years at UCSD a time of “incredible transition in our faculty, our leaders, our teaching programs, and our clinical impact.”

During Dr. Kaushansky’s tenure as Helen M. Ranney Distinguished Professor and Chair, the Department of Medicine expanded from 253 to over 420 faculty members, added four divisions, and recruited 11 division chiefs. Its annual budget grew from $86 million to nearly $150 million.

Dr. Robert Schooley“Dr. Kaushansky has been an outstanding Chair for this department,” said Dr. Robert “Chip” Schooley, Professor and Chief of the Division of Infectious Diseases and Vice Chair for Academic Affairs in the Department of Medicine.“

During his eight years as Chair, the medical house staff program became one of the most highly regarded programs in the country. New divisions in Hospital Medicine, Biomedical Informatics, Geriatrics, and Global Public Health were developed and research programs thrived throughout the Department,” Dr. Schooley said.

“In response to increasing interest in international medicine among the medical house staff, Dr. Kaushansky launched the Department’s Global Medicine Residency Program in 2009,” he said.“Dr. Kaushansky worked with his counterpart at the Universidade Eduardo Mondlane to establish a model program in international cooperation that has revitalized postgraduate medical training in the Republic of Mozambique.”


Dr. Kaushansky with Drs. Marisa Magaña, Emilia Noormahomed, and Robert Schooley in Mozambique Dr. Kaushansky on a global medicine planning trip to China.Dr. Kaushansky with Drs. Marisa Magaña, Emilia Noormahomed, and Robert Schooley in Mozambique (left); on global medicine program planning trip to China (right).

Since 2002, the Department’s NIH research funding has grown from $60 million to $113.6 million. It has more than twice as many complex multi-investigator program-project grants and career development awards granted to the junior faculty and fellows.

The Department has also boosted its showing in the “America’s Best Hospitals” rankings from U.S.News & World Report. In 2002, two subspecialty clinical programs ranked in the nation’s top 50: respiratory at 9th and cancer at 41st. In the most recent rankings, five subspecialties ranked in the top 50, including one (HIV/AIDS) in the top 10.

Dr. Greg Maynard“Ken was directly responsible for building up the strength of clinical care at UCSD,” said Dr. Greg Maynard (right), Health Sciences Professor of Medicine and Chief of the Division of Hospital Medicine.

“He recruited me here about 7-1/2 years ago, and in that time, the Hospital Medicine program has grown from 4 hospitalists to nearly 30, as just one example of that.”

“Dr Kaushansky nurtured my career here at UCSD,” said Dr. Pradipta Ghosh (below left), physician-scientist and Assistant Professor of Medicine in the Division of Gastroenterology.

Dr. Pradipta Ghosh“As a product of the Physician-Scientist Training Program,” she said, “I am one of those few who enjoyed special access to this busy department chair. His doors were always open. I recall having multiple consultations with him at various stages of my career as it grew here at UCSD.

“When the time came for me to choose where to spend the first decade of my young career as an independent investigator, it was his support and a match in our visions which tilted my decision in favor of UCSD,” she said.

“His tireless efforts at instilling the physician-scientist culture here in the Department of Medicine, both from top-down and bottom-up, have paved the path for many young folks like me to craft a career for themselves as physician-scientists,” Dr. Ghosh said.

Dr. John Carethers“Ken was the reason why I eventually accepted the GI Chief job at UCSD,” said Dr. John M. Carethers (right), now John G. Searle Professor and Chair of the Department of Internal Medicine at the University of Michigan.

When Dr. Kaushansky joined the UCSD faculty, Dr. Carethers was an associate professor of medicine in the Division of Gastroenterology. Dr. Carethers became division chief in 2004

“Ken … gave me enough autonomy to help grow the GI Division, gain a GI Center grant, coordinate well with the Cancer Center and other divisions, and allowed me to grow personally,” Dr. Carethers said. “The GI Division flourished under that mantra.

“We went to a clinical service chief structure, developed a new hierarchy for our administrative staff, started a robust web site, grew our fellowship, and survived many challenges over that time because of his support,” he said.

“Ken provided invaluable advice on my career,” Dr. Carethers said. “He was a great sounding board, not pretentious; encouraging, but never overprotective. I think he understood the value of growth and opportunity, something that is hard to come by these days.”

Dr. Patricia FinnDr. Patricia Finn (left), Professor and Chief of the Division of Pulmonary and Critical Care Medicine, described Dr. Kaushansky as “a tireless advocate for his faculty.”

“He is accessible 24/7 to offer support and guidance, which is huge to a new faculty member just moving cross country,” she said.

“On a personal note, when I had barely arrived here he was already nominating me for positions and committees to help me advance my career.”

Dr. Kirk Knowlton“His integrity, fairness, and open-mindedness built an environment of trust that allowed the substantial growth of the Department of Medicine during his tenure as Chair,” said Dr. Kirk U. Knowlton (right), Professor of Medicine and Chief of the Division of Cardiology.

“I am struck by how he has been able to hold the respect of so many people with widely disparate interests,” Dr. Knowlton said.

“This included people who were fully engaged in basic science and those who were busy taking excellent care of their patients; medical students and residents and post-graduate research fellows; administrators and faculty; and others over whom he might have had influence or who crossed his path.

“The people he has worked with knew that they could count on him to represent their interests in the context of the institution’s goals in a considered and reasonable manner while at the same time maintaining his vision of the future of the Department of Medicine.”

“He is a rare breed,” Dr. Maynard said. “I guess I’d call him a quadruple threat. An outstanding scientist, a superb clinician, a great educator, and an incredible leader and administrator to boot.

“While he is not really replaceable,” he said, “he has left an enduring legacy that stresses clinical and operational excellence, as well as research contributions.”

Dr. Finn said, “In addition to [his] world-class scientific reputation, Dr. Kaushansky is most respected for his character and vision.”

“He makes his department and faculty a priority, while striving to always do the right thing for the patients,” she said. “He will be most remembered for his infectious enthusiasm, upbeat attitude, and steady, insightful guidance of students and faculty.”

“He leaves an 8-year legacy that advanced the Department of Medicine in many ways,” said Dr. Carethers, “including growing faculty, changing the way residents learn, obtaining key recruitments for division chiefs and faculty, enhancing VA relations, and being an all out cheerleader for the Department.”

On June 21, Dr. Kaushansky was honored at a farewell reception hosted by David Brenner, M.D., Dean of the UCSD School of Medicine and Vice Chancellor, Health Sciences. In his remarks there, Dr. Kaushansky expressed his appreciation for “eight and a half years of good friends, challenges, and teamwork.”

Observing that he had been involved in recruiting many of the faculty members in the room, he said, “Everything at UCSD works toward recruiting great people.”

“It’s easy, at UCSD, to build things and to make a difference,” he said. “Everybody makes everyone else stronger.”

Dr. Kaushansky praised UCSD’s “incredible richness” of people, science, teaching, and clinical programs. “I’ve never seen more devotion to the three missions,” he said.

And now he looks ahead.

“In academic medicine, you get to re-craft yourself every ten years,” he said. “I’m looking forward to my newly-found steep learning curve.”

Dr. Kaushansky was honored at a tribute from the senior leaders of the Department of Medicine on July 11. There will be a tribute from all departmental staff, faculty, and house staff on a date to be selected.

“Although one could cite metric after metric by which his unceasing efforts strengthened the Department,” said Dr. Schooley, “what many of us think distinguished his tenure most was the way in which his ‘bottom up’ style of leadership brought out the best in all of us.

“The Department will benefit for many years to come from things he set in motion – as will each of its members from what we learned from his multifaceted demonstration of scholarship, integrity, imagination and dedication to his Department.”


Drs. Ken Kaushansky and Wolfgang Dillmann   Drs. Ken Kaushansky and Wolfgang DillmannDr. Kaushansky with newly designated Interim Chair Wolfgang Dillmann, M.D.