U.S. Boost for African Health Systems

Charge d’Affaires Robert Scott (left) with John Palen, Senior Advisor, PEPFAR Office of Sustainability and Development
Charge d’Affaires Robert Scott (left) with John Palen, Senior Advisor, PEPFAR Office of Sustainability and Development

The United States has stepped up efforts to develop and expand models of medical education in Southern Africa following the successful completion of a five-year initiative that contributed to an increase in the quality of medical training and the advancement of cutting-edge biomedical research in the region, U.S. government officials said on Tuesday.

Addressing a press briefing on the sidelines of the fifth annual Medical Education Partnership Initiative (MEPI) symposium in Harare, U.S. government officials hailed the medical education partnership initiative, which had shifted the emphasis to a much more partner country-defined prioritization of needs in the 13 countries receiving support.

U.S. Department of Health and Human Services Principal Deputy Assistant Secretary Holly Wong
U.S. Department of Health and Human Services Principal Deputy Assistant Secretary Holly Wong

“When we consider the challenges ahead, from HIV, TB and malaria to non-communicable diseases such as diabetes and hypertension, the outlook may seem daunting, but collaborative projects such as MEPI, give us hope for the future ,” said Robert Scott, Charge d’ Affaires at the United States Embassy in Harare. “We now have well-trained, motivated clinicians and researchers who are the backbone of a functioning health system, and we will continue to cultivate these relationships and to develop similarly innovative programs that emphasize capacity-building and sustainability, if we are to achieve the outcomes we desire, and deserve.”

The MEPI symposium is being held under the theme, “Sustaining MEPI Achievements:  Leadership built, lessons learnt and partnerships created towards an AIDS-free generation.” The three-day conference provides a platform for medical scholars to share insights and success stories on applied innovations to address HIV and AIDS.

The U.S. government provided nearly $130 million over five years through the President’s Emergency Plan for AIDS Relief (PEFAR) and the National Health Institute (NHI) distributed among 13 African countries and working with medical education training institutes. MEPI has supported countries in sub-Saharan countries to develop or expand and enhance models of medical education. These models are intended to support PEPFAR’s goal of increasing the number of new health care workers by 140,000, strengthen medical education systems in the countries in which they exist, and build clinical and research capacity in Africa as part of a retention strategy for faculty of medical schools and clinical professors.

Each year, a symposium has been held to enable MEPI schools and partners to present their experiences of various aspects of the MEPI program. PEFAR, National Institute of Health, the United States Centers for Disease Control and Prevention (CDC), and other institutions play a key role in the implementation, evaluation and performance of MEPI. The representatives of these institutions share the stage with experts in medical education, research capacity strengthening, health systems during the symposium along with key stakeholders such as the African Union, African Development bank, the World Bank, Wellcome Trust are invited to share their experience.

Holly Wong, Principal Deputy Assistant Secretary at the U.S. Department of Health and Human Services (HHS) described MEPI as a “true partnership with lessons going in both directions” with the key being the partnerships U.S. health institutions have created with institutions throughout Africa. “We struggle with mainly the same issues in the United States, in particular how they can work best in very poor communities and under-resourced settings,” she said. “The MEPI program has given us some opportunity to learn some lesson that we might otherwise not have learned,” added Wong.

Ambassador Eric Goosby, who was United States Global AIDS Coordinator at the inception of the MEPI program, said that the burden of disease is shifting and challenged graduates trained through the MEPI support to prepare for new health challenges.

“As a global health community, we are going through a situation where the prediction for the type of diseases that are going to dominate is shifting from infectious diseases like HIV, TB, malaria over the next decade every modeler predicts that the non-communicable diseases such as hypertension and diabetes will be the main killer in the same countries where HIV, TB and malaria are dominant,” warned Goosby, who is also United Nations Special Envoy for Tuberculosis.

John Palen, Senior Advisor in the PEPFAR Office of Sustainability and Development at State Department said the U.S. had renewed its commitment in supporting the production of quality of medicals services and providers that deliver those services.  “Last December, during World AIDS Day, Secretary (John) Kerry announced that we will commit another $100 million over the next five years to continue to support the production of quality medicals services and providers that deliver those services,” he said.

Prior to implementation of MEPI, global health agencies reported that sub-Saharan African region addresses 25% of the global burden of disease with under 3% of the world’s health care workers. The 2009 World Health Organization Report on Scaling Up Nursing and Medical Education outlined key opportunities to improve training and retention of the health workforce in low and middle income countries. Another study, the 2010 sub-Saharan African Medical School Study (SAMSS) report, offered insight into the regional challenges facing African medical schools, and recommended infrastructure development, research opportunities, and a focus on primary care as retention strategies for both faculty and students. Building on these key opportunities, MEPI worked on strengthening educational resources and infrastructure, investing in innovative technologies, and decentralizing educational opportunities.

In Zimbabwe, MEPI has supported curriculum development for critical health challenges including HIV/AIDS, tuberculosis and malaria, ensuring that Zimbabwe’s clinicians receive the latest in evidence-based training. Through didactic training and focused mentorship, MEPI is helping Zimbabwe’s scientific leaders compete for, obtain, and manage research grants. Perhaps most importantly, through faculty development, ICT improvements, and community-based educational initiatives, MEPI Zimbabwe is increasing the proportion of medical graduates who practice in Zimbabwe, rather than seek employment outside of the country – ZimPAS © July 15, 2015.