The Uganda Cancer Institute, Mulago Hospital

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The Uganda Cancer Institute,Mulago Hospital
Denis Burkitt

• Described African Lymphoma
• Identified first viral cause of cancer (with
  Ebstein Barr)
• Described co-factors for cancer (immune
  suppression)
• Identified first successful chemotherapy with
  anti-mitotic agents
• (with Burchenal, Oettgen, Sloan Kettering)

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7-year-old boy with Burkitts lymphoma of right
mandible before and after treatment by Burkitt.
Despite Burkitts lymphoma being a common cancer
of children amenable to treatment., the disease
remains a continuing problem in the area of its
discovery!
From Davis Coakley (2006). Br J Haematology 135
(1), 1725.
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GLOBAL EXAMPLES OF GENETIC DISEASES AND DISORDERS
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Huntingtons Chorea and other Brain Disorders
This land is your land, this land is my
land,From California to the New York
island,From the redwood forest to the Gulf
Stream waters,This land was made for you and me.
Huntington's chorea, a progressive degeneration
of the nervous system    For 13 years he hung on,
until he could no longer walk nor talk nor focus
his eye nor feed himself..He died on October 3,
1967,
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A 20-year study of the world's largest family
with Huntington's disease, in Venezuela,
developing a pedigree of over 18,000 individuals
and collecting over 4,000 blood samples helped
lead to the identification of the Huntington's
disease gene at the tip of human chromosome 4.
These same blood samples have assisted in the
mapping of other disease genes, including those
responsible for familial Alzheimer's disease,
kidney cancer, two kinds of neurofibromatosis,
Amyotrophic Lateral Sclerosis(ALS), dwarfism and
others.
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How do Americans benefit from Global Health ?
Why do African American women develop more
aggressive breast tumors than Caucasians ? Poor
access to health care vs. different genetic
profile ?
Breast tumors without receptors for estrogen ,
progesterone, and HER2 (Triple Negatives )
African women gt70 African-American
39 Causcasians 16 Triple negative
tumors are more aggressive and dont respond to
the new drugs. Similar disparities in outcomes
for some other cancers
Olufunmilayo Olopade (UIC) Chicago
Science , 314592-4, 2007.
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GLOBAL EXAMPLES OF ENDURING ENVIRONMENTAL
DISASTERS
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Rhode Island Congressman John Edward Fogarty

• The Fogarty Mission
• To address global health challenges through
  innovative and collaborative programs for
  research and training
• To support and advance the NIH mission through
  global partnerships
• Science for Global Health

a man who, for more than a quarter of a
century, worked tirelessly for a healthy America,
in a healthier world.
Congressman Melvin Laird (R-WI) 1967
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The Fogarty Portfolio an Alphabet Soup
2006 68 million gt 400 grants
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Glenda Gray, Co-founder/Co-Director, Perinatal
HIV Research Unit, Chris Hani Baragwanath
Hospital, South Africa
AITRP (Aids Intnl Training Research Program
(1988-) Investing in Leaders
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Framework Program2005-2006
Glues multiple schools within a university or
universities around the topic of global
health 19 US Programs
Source Fogarty International Center, Nov. 2006
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(No Transcript)
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Fogarty Ellison Scholars 2006
24 pairs of trainees going to 16 medical
centers in the developing world
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Fogarty- Ellison Overseas Fellowshipsin Global
Health and Clinical Research
2005 Sites (4)
2004 Sites (14)
25 medical public health students spend 1 year
overseas Mentored clinical research experience
paired with local trainee
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Funding
(NIH/Other)
FIC
Human and Institutional Capacity building
Collaborative Long Term Relationships
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Health Diplomacy
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International Collaborations
Professor M.K. Bhan, Secretary of the Department
of Biotechnology negotiating agreements with NIH
on HIV, child health, eye disease, Vaccines,
emerging infections, biotechnology,
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New Advocates for Global Health
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Science, 2006
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(No Transcript)
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Presidential Initiatives in Africa
Presidents Emergency Program For Aids Research
PEPFAR 15 B 5 years
Efforts to control avian flu and emerging
infections
Presidents Malaria Initiative - PMI 1.2 B 5
years
Implementation Science
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Implementation Science
To Bridge the Know-Do Gap "There is a gap
between today's scientific advances and their
application - between what we know and what is
actually being done. Health systems are under
severe pressure and there is an urgent need to
generate knowledge for strengthening and
improving them. - The late Dr. Lee Jong-Wook
Director-General of the WHO, 2004
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We face a formidable gap between innovations in
health (including vaccines, drugs, and strategies
for care) and their delivery to communities in
the developing world.

• Research to optimize scientific advances
  facilitate their adoption in the real world
• Compelling need 14,000 deaths per day from HIV,
  malaria diarrheal disease, despite medical
  breakthroughs
• The challenge the know-do gap between
  scientific discoveries and their delivery to
  communities in need
• One size fits all approach doesnt work eg. HIV
  patients also likely have TB, malnutritionrequiri
  ng different treatment plans
• Implementation science will help determine
  scientifically tested strategies strategies that
  will work

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(No Transcript)
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Low-cost digital x-ray radiographic imaging
system

• Cost 10,000
• Digital system (no film or film developing
  chemicals)
• Potential for excellent image quality

The digital x-ray detector, X-ray Light Valve
(XLV) uses readily available materials, that
would enable manufacture in many places
throughout the world.
Dr. John Rowlands
5R01EB002352-04
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• There is no lack of technologies which could
  address the health needs of underserved
  populations, there is only an deficiency of
  devices which have been designed to meet the
  requirements of a more effective healthcare
  delivery system.
  -David Kelso, Northwestern
  Univ.

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• Student Projects
• Low power medicine refrigeration
• Medicine dosing
• IV fluid production
• Lab in a backpack
• Ventilated stove
• Low cost phototherapy lights
• IV fluid production device

Rebecca Kortum- Richards
Beyond Traditional Borders New undergraduate
courses Outreach Programs Field experiences
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NIH Delegation to India First InternationalAgree
ment for NIBIB in Bioengineering
October 2007
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Summary
Key concepts in our strategic plan
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Building Sustainable Research Capacity