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 Students Design Low-Cost HIV Viral Load Monitoring System for Tijuana, Mexico

A group of students from the Jacobs School of Engineering at the University of California San Diego will spend the summer trying to curb the HIV epidemic in Tijuana, Mexico.

Two teams from UC San Diego’s Engineering World Health (EWH) student organization and Global TIES program are combining forces this summer to bring a device they created to monitor viral load in HIV patients to a clinical setting in Tijuana, Mexico for testing. … Read the full story from the UC San Diego Newsroom


UC San Diego Health Department of Medicine physicians Davey Smith and Matt Strain are advising both teams of students.

Dr. Davey Smith

Dr. Davey Smith

Davey Smith, MD, MAS, is Professor of Medicine in the Division of Infectious Diseases. He co-directs the UC San Diego Center for AIDS Research (CFAR) and directs the CFAR’s Translational Virology Core.

Matt Strain, MD, is Assistant Professor of Medicine and physician in the Genomics and Sequencing Core at the UC San Diego CFAR.

No. 1 From the Start

UC San Diego Bioengineering ranked first by National Research Council since founding 50 years ago —

Bioengineers at UC San Diego have helped us understand why atherosclerosis develops and how it is impacted by blood flow. They have pioneered the development of very thin, small and flexible sensors that stick to the skin and monitor vital signs, such as the brain activity of a newborn. They also developed injectable hydrogels that can help muscle tissues heal after a heart attack.

Researchers celebrated their achievements over the past five decades and looked to the future during a three-day 50th anniversary celebration May 19 to 21. … Read the Full Story from the UC San Diego Newsroom


Shu Chien, PhD

Shu Chien, PhD

The founding chair of the UC San Diego Department of Bioengineering is Shu Chien, PhD, Distinguished Professor of Medicine in the Division of Physiology and Professor of Bioengineering. He is founding director of the UC San Diego Institute of Engineering in Medicine.

Dr. Chien is an elected Fellow of the National Academy of Inventors and the American Association for the Advancement of Science, among many honorific societies, and he received the Franklin Institute Award in November 2015.

Altman Clinical and Translational Research Institute Building Opens March 4

Stunning structure will house array of scientists and centers dedicated to speeding basic research into new treatments and therapies —

Rising above Interstate 5 on the east campus of University of California, San Diego, the Altman Clinical and Translational Research Institute Building (ACTRI), a five-sided polygon of glass, steel and grooved concrete, officially opens its doors March 4 in a ribbon-cutting ceremony.

“The building is an architectural marvel, but more important is what it represents and the work that will go on inside,” said UC San Diego Chancellor Pradeep K. Khosla. … Read the Full Story from the UC San Diego Newsroom


Dr. Gary Firestein

Dr. Gary Firestein

The director of the Clinical and Translational Research Institute at UC San Diego is Gary S. Firestein, MD, Professor of Medicine and Dean and Associate Vice Chancellor of Translational Medicine at UC San Diego.

CTRI opened in 2010 as a part of the national Clinical and Translational Science Award consortium through a five-year, $37.2 million grant from the National Center for Advancing Translational Science of the National Institutes of Health. CTRI received a $52 million renewal grant last year.

More about the activities of the CTRI

 

UC San Diego Endocrinologists Team with Pharmacists to Offer Diabetes “Tune Up” Clinic

Dr. Steven Edelman

Dr. Steven Edelman

Department of Medicine endocrinologists Steven V. Edelman, MD, (left) and Robert R. Henry, MD (below right), collaborate with Candis Morello, Pharm D, and students in the Skaggs School of Pharmacy and Pharmaceutical Sciences to offer a six-month Diabetes Intensive Medical Management (DIMM) “tune up” clinic for patients with complex cases of diabetes at the VA San Diego Healthcare System.

Dr. Robert Henry

Dr. Robert Henry

At each visit, a patient receives an hour of personalized attention to medication management, diet, exercise, controlling blood sugar levels and other necessities that may be involved in a complex case of diabetes.

The aim is to achieve glycemic control within the six-month period of the “tune up” clinic..

In a preliminary study, Drs. Morello, Evans, Henry and coworkers have assessed the outcomes of the clinic, and the findings indicate that this pharmacist-endocrinologist collaborative approach is effective.  |  Read the Study Abstract in the January 2016 issue of Annals of Pharmacotherapy  |  Read the full story from the UC San Diego Newsroom

Steven V. Edelman, MD, Clinical Professor in the Department of Medicine, directs the Diabetes Care Clinic at VA San Diego Healthcare System (VASDHS) and is an investigator in the VA Center for Metabolic Research. He is founder and director of Taking Control of Your Diabetes, a non-profit diabetes education organization. He conducts research focusing on developing and evaluating new treatments for type 1 and type 2 diabetes.

Robert R. Henry, MD, Professor in the Department of Medicine, is Chief of the VA Center for Metabolic Research and Chief of the Section of Endocrinology, Metabolism and Diabetes at VASDHS. In his research, he investigates the etiology, treatment, and prevention of obesity and type 2 diabetes.

Dr. Morello is Professor of Clinical Pharmacy and Associate Dean for Student Affairs at Skaggs School of Pharmacy and Pharmaceutical Sciences.

The study report was published online in November, 2015, and in print in January, 2016.

Distinguished Professor Shu Chien Elected Fellow of National Academy of Inventors

December 15, 2015

Two researchers at the University of California, San Diego, have been named fellows of the National Academy of Inventors.

Shu Chien, Distinguished Professor of Bioengineering and Medicine, and Michael Sailor, Distinguished Professor of Chemistry and Biochemistry, were among 168 new fellows announced by the academy today.. … Read the full story from the UC San Diego Newsroom


Shu Chien, MD, PhD

Shu Chien, MD, PhD. Photo courtesy of Jacobs School of Engineering/UC San Diego.

Shu Chien, MD, PhD, is a world-renowned researcher and inventor who has conducted pioneering investigations in atherosclerosis and hypertension. His work has brought about significant advances in the diagnosis and treatment of cardiovascular disease.

Dr. Chien is founding chair of the UC San Diego Department of Bioengineering and director of the Institute of Engineering in Medicine. In the Department of Medicine, he is Distinguished Professor of Medicine in the Division of Physiology.

Earlier in 2015, Dr. Chen was selected to receive the prestigious Franklin Institute Award and was elected a fellow of the American Association for the Advancement of Science.

UC San Diego Health Researchers Join Pancreatic Cancer “Dream Team”

November 10, 2015

International effort will seek to develop and test new therapies for deadly malignancy —

In an effort to advance research on one of the deadliest forms of cancer, University of California, San Diego School of Medicine researchers Andrew Lowy, MD, and Tannishtha Reya, PhD, have been recruited for their expertise in preclinical modeling, clinical trials and stem cell biology to join a “dream team” of international pancreatic cancer researchers.

The three-year, $12-million effort, sponsored by Stand Up To Cancer, Cancer Research UK and The Lustgarten Foundation, will pursue a three-pronged strategy to better understand and reset so-called “super-enhancers” that may be abnormally active in pancreatic tumors. Super-enhancers are bits of DNA that can cause over-expression of genetic signals, fueling cancer cell growth. … Read the full story from the UC San Diego Newsroom


Tannishtha Reya, PhD, is Professor of Pharmacology in the Skaggs School of Pharmacy and Pharmaceutical Sciences and Professor of Medicine in the University of California, San Diego School of Medicine.

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.

$5 Million ResMed Gift Supports Sleep Medicine at UC San Diego

October 29, 2015

The University of California, San Diego today announced a $5 million gift from locally based medical device company, ResMed Inc., to support sleep medicine research and care at the UC San Diego School of Medicine. The donation was made to the university in honor of ResMed’s founder and chairman of the board, Peter C. Farrell, PhD, DSc. ResMed is the global leader in pioneering new and innovative solutions for the diagnosis, treatment and management of sleep-disordered breathing, chronic obstructive pulmonary disease (COPD), and other key chronic diseases.

The funding, totaling $5 million, will establish the Peter C. Farrell Sleep Center of Excellence, in addition to the Peter C. Farrell Presidential Chair in Pulmonary Medicine. ResMed’s donation to establish the endowed chair was matched with an additional $500,000 from the University of California as part of the UC system’s Presidential Match for Endowed Chairs. … Read the full story from the UC San Diego Newsroom


Atul Malhotra, MDAtul Malhotra, MD, pictured at left, is professor and chair of the Division of Pulmonary and Critical Care Medicine and Director of Sleep Medicine at UC San Diego.

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.