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.

What Makes A Bacterial Species Able to Cause Human Disease?

Global effort produces first cross-species genomic analysis of Leptospira, a bacterium that can cause disease – and death – in targeted mammals, including humans —

An international team of scientists, led by researchers at University of California, San Diego School of Medicine and the J. Craig Venter Institute (JCVI), have created the first comprehensive, cross-species genomic comparison of all 20 known species of Leptospira, a bacterial genus that can cause disease and death in livestock and other domesticated mammals, wildlife and humans. … Read the Full Story from the UC San Diego Newsroom


Dr. Joseph Vinetz

Dr. Joseph Vinetz

Joseph M. Vinetz, MD, senior author of the study, is Professor of Medicine in the Division of Infectious Diseases and Director of the UC San Diego Center for Tropical Medicine and Travelers Health.

Fellow UC San Diego Division of Infectious Diseases faculty members Michael A. Matthias, PhD, and Douglas E. Berg, PhD, are the other Department of Medicine investigators in the international multi-center leptospirosis project. Dr. Berg is Professor of Medicine and Professor of Genetics, and Dr. Matthias is Assistant Professor of Medicine.

Dr. Vinetz conducts his research in tropical infectious disease in laboratories at UC San Diego and at Instituto de Medicina “Alexander von Humboldt,” Universidad Peruana Cayetano Heredia in Lima, Peru.  He focuses his work on malaria and leptospirosis.

Read the article in PLOS Neglected Tropical Diseases (Open Access)

New Drug Combination Treats Hepatitis C Patients Also Infected with HIV

Novel treatment has 97 percent success rate in co-infected patients —

Roughly 20 to 30 percent of patients with hepatitis C virus (HCV) are also infected with human immunodeficiency virus type 1 (HIV). Both blood-borne viruses share the same modes of transmission, but many HCV medications currently have significant limitations due to adverse interactions with HIV treatments. Researchers at University of California, San Diego School of Medicine report a new combination that effectively treats HCV in patients co-infected with HIV. … Read the full story from the UC San Diego News Center


David L. Wyles, MD, is lead author of the New England Journal of Medicine article that reports the results of the multi-center study. Dr. Wyles is associate professor of clinical medicine in the Division of Infectious Diseases.

Read the article online:

Wyles D.L., Ruane P.J., Sulkowski M.S., et al. Daclatasvir plus Sofosbuvir for HCV in Patients Coinfected with HIV-1. New England Journal of Medicine July 21, 2015, 10.1056/NEJMoa1503153.  Free full text

At the Nexus of Substance Abuse and HIV

UC San Diego Researcher Wins Major Award to Study New Treatments and Preventions —

Dan Werb, PhD, an internationally noted epidemiologist at University of California, San Diego School of Medicine, has been named one of four inaugural recipients of the Avenir Award, a prestigious $1.5 million research grant from the U.S. National Institute on Drug Abuse, part of the National Institutes of Health (NIH). … Read the full story from the UC San Diego Newsroom

Binational Police Program in Tijuana Targets HIV Reduction

Effort also aims to improve safety of officers —

Research consistently shows that policing practices, such as confiscating or breaking needles, are key factors in the HIV epidemic among persons who inject drugs. Police officers themselves are also at risk of acquiring HIV or viral hepatitis if they experience needle-stick injuries on the job — a significant source of anxiety and staff turn-over.

A binational team from the University of California, San Diego School of Medicine and the U.S.-Mexico Border Health Commission, Mexico Section has launched a new research project aimed at promoting prevention of HIV and other blood-borne infections. The effort is led by Steffanie Strathdee, PhD, professor and director of the UC San Diego Global Health Initiative, Leo Beletsky, JD, MPH, associate professor, and Gudelia Rangel, PhD, deputy general director for migrant health and executive secretary of the Mexico Section of the Mexico-United States Border Health Commission, in partnership with the Tijuana Police Department and Police Academy. The binational team will offer and evaluate Proyecto ESCUDO (Project SHIELD), a police education program designed to align law enforcement and HIV prevention in Tijuana. … Read the full story from the UC San Diego Newsroom


More Anti-inflammatory Genes Mean Longer Lifespans for Mammals

Mammal species with higher copy numbers of siglec receptor genes have longer maximum lifespans —

We age in part thanks to “friendly fire” from the immune system — inflammation and chemically active molecules called reactive oxygen species that help fight infection, but also wreak molecular havoc over time, contributing to frailty, disability and disease. The CD33rSiglec family of proteins are known to help protect our cells from becoming inflammatory collateral damage, prompting researchers at the University of California, San Diego School of Medicine to ask whether CD33rSiglecs might help mammals live longer, too. …Read the full story from the UC San Diego Newsroom

Cigarette Smoke Makes Superbugs More Aggressive

In lab and mouse experiments, cigarette smoke helps drug-resistant bacteria fight off the immune system —

Methicillin-resistant Staphylococcus aureus (MRSA), an antibiotic-resistant superbug, can cause life-threatening skin, bloodstream and surgical site infections or pneumonia. Researchers at the University of California, San Diego School of Medicine now report that cigarette smoke may make matters worse. The study, published March 30 by Infection and Immunity, shows that MRSA bacteria exposed to cigarette smoke become even more resistant to killing by the immune system. …Read the full story from the UC San Diego Newsroom


Laura E. Crotty Alexander, MDPulmonologist Laura E. Crotty Alexander, MD, is senior author of the study report. She is a Health Sciences assistant clinical professor in the Department of Medicine at UC San Diego and a staff physician at the Veterans Affairs San Diego Healthcare System.

Read the study abstract with link to PDF in Infection and Immunity (UCSD only)

Dr. Jamila Stockman to Receive Linda Saltzman New Investigator Award

Dr. Jamila Stockman

Dr. Jamila Stockman

Jamila Stockman, PhD, MPH, has been selected to receive the Linda Saltzman New Investigator Award, which recognizes a single outstanding new investigator in the field of gender-based violence and health.

Dr. Stockman, an infectious disease epidemiologist, is assistant professor in the Division of Global Public Health. She focuses her work on intimate partner violence (IPV) and substance abuse among low-income, underserved, vulnerable women.


Read the UC San Diego Newsroom press release


Said Dr. Steffanie Strathdee, chief of the Division of Global Public Health, “This is, without question, the most prestigious scholarly award in this field of study. Dr. Stockman’s selection indicates that she, at a very early stage in her career, is recognized as a national leader in this area.

“It is a true mark of excellence for the Division of Global Public Health, the Department of Medicine and the Center on Gender Equity and Health at UC San Diego to include Dr. Stockman among our faculty,” she said.

Steffanie Strathdee, PhD, is Associate Dean of Global Health Sciences & Harold Simon Professor and Chief of the Division of Global Public Health and Director of the Global Health Initiative.

Gender-based violence is increasingly recognized as central to health and development globally, Strathdee said.

Dr. Stockman holds a PhD in Epidemiology with a focus on infectious diseases from the Johns Hopkins Bloomberg School of Public Health and a Master’s degree in public health from the George Washington University School of Public Health and Health Services. She is an alumna of the UC San Diego National Center of Leadership in Academic Medicine.

She currently holds a UC San Diego Clinical and Translational Research Institute Academic-Community Partnership Pilot Grant for her project, “The Role of Peer Navigators and Social Support in the HIV Care Continuum: Perceptions of HIV-Positive Women.”

For the Linda Saltzman New Investigator Award, the Centers for Disease Control’s National Center for Injury Prevention and Control solicits nominations from senior investigators in the field and convenes a committee of experts to select an outstanding individual to receive this national award once every two years.  Candidates for the award have 2-10 years of experience in their field.

Fat Isn’t All Bad: Skin Adipocytes Help Protect Against Infections

When it comes to skin infections, a healthy and robust immune response may depend greatly upon what lies beneath. In a new paper published in the January 2, 2015 issue of Science, researchers at the University of California, San Diego School of Medicine report the surprising discovery that fat cells below the skin help protect us from bacteria.

Richard Gallo, MD, PhD, professor and chief of dermatology at UC San Diego School of Medicine, and colleagues have uncovered a previously unknown role for dermal fat cells, known as adipocytes: They produce antimicrobial peptides that help fend off invading bacteria and other pathogens. … Read the full story from the UC San Diego Newsroom


Dr. Richard Gallo

Dr. Richard Gallo

Richard Gallo, MD, PhD, is professor of medicine and pediatrics and chief of the Division of Dermatology.

Read Science article abstract on PubMed

Visit Dr. Gallo’s laboratory website

Dr. Karl Hostetler on Discovery and Development of Brincidofovir (DNA Viruses) and 1968(HPV 16&18) October 1

Dr. Karl HostetlerDr. Karl Hostetler presents on the topic, “Discovery and Development of Brincidofovir (DNA Viruses) and 1968 (HPV 16&18)” at Medicine Grand Rounds on October 1.

Karl Hostetler, MD, is emeritus professor of medicine in the Division of Infectious Diseases at UC San Diego.