Accordia Global Health Foundation and the Infectious Diseases Institute co-hosted the second annual Accordia Infectious Diseases Summit April 20-22 in Kampala, Uganda. The invitation-only event brought together global leaders in academia, government, NGOs, and industry and featured a key note address by the First Lady of Uganda.

The theme of this year’s Summit was "Building Healthcare Leadership in Africa," and focused on ways to build a strong and sustainable healthcare leadership infrastructure in Africa. Over 100 representatives from 21 countries attended.

A shift from short-term to long-term strategies

For the past several years, the world’s attention has focused on the need to arrest and reverse the growing healthcare crisis in Africa, where millions of men, women, and children are infected with or

"Africa should serve as a shining example of health leadership as a model for the rest of world." – Prof. Nelson Sewankambo

suffering as a result of infectious diseases like HIV/AIDS, malaria, and tuberculosis. However, the vast majority of efforts have been directed towards short-term projects. These are critical components in the fight against infectious diseases, but they do not address the long-terms needs of sub-Saharan Africa for a healthcare system that can effectively diagnose and treat the illnesses of today and those which may appear in the future.

Building leadership through individuals, institutions and networks

The Summit addressed the challenges and opportunities of building health leadership at three levels: individual, institutional, and networks. It featured personal perspectives from students, faculty, and patient advocates about their own experiences building leadership and management competencies as well as input from respected thought-leaders in the field. It examined successful leadership development programs and leading centers of excellence, considered the impact of culture on the attributes of effective leaders, and discussed the need for effective collaborative leadership across nations, regions, and the African continent.

A call to action

Following two days of dynamic discussions and presentations, Summit participants developed a call to action and urged an investment in leaders and leadership development at all levels. Participants recognized that institutions must be more deliberate about strategies to identify, retain, and nurture talent, including the development of accountable and transparent management structures; mentorship and evaluation approaches that provide young leaders the opportunity to lead and the incentive to take risks; and systems and policies that empower effective leadership. Looking to the future, Africa’s leading medical schools and research institutes are encouraged to work more closely with patient advocacy groups and health ministries to link organizational priorities to the greatest needs of society and to develop better tools to measure the critical impact of leading institutions on health outcomes. Finally, the global community is urged to work within existing institutions to develop leadership capacity that is focused on long-term strategies and rooted in practical realities and to provide core funding to support the cost of excellence within these institutions.

In June, Accordia will release a report informed by the Infectious Diseases Summit that includes an in depth look at the three Summit tracks and explores ways in which their interconnectivity could drive unique opportunities to expand the impact of healthcare leadership in Africa.

Click here to view photographs from the 2009 Summit.

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"Every day 6,000 children will lose a parent to AIDS. At the Infectious Diseases Institute, we are not only treating patients, we are saving families. Over 8,000 mothers, fathers, and family members are receiving lifesaving antiretroviral therapy through IDI. IDI’s research, training and clinical care programs are focused on creating a new generation in sub-Saharan Africa free from the burden of infectious diseases." J. Moses Ceaser Photography TOP

Accordia believes that building healthcare leadership capacity in Africa is
essential to overcome the burden of infectious diseases such as HIV/AIDS,
malaria and tuberculosis. At the Accordia Infectious Diseases Summit 2009, which we co-hosted with the Infectious Diseases Institute in Uganda in April, it became evident that there is strong global interest in this topic. The Summit was a high-energy meeting that explored development of a new generation of healthcare leadership in Africa through cross-sector initiatives aimed at individuals, institutions and networks.

Focusing on permanent solutions

Advancing leadership development in Africa

Join us as we change the course of human history

In addition to the Summit, Accordia continues to strengthen our core programs at IDI. The best practices and models of care and training being established at IDI have proven to have far-reaching impact, as many programs have begun to be adopted at the national and regional level. We continue to be proud of and inspired by IDI’s many contributions.

Accordia’s programs are made possible because of the support of our friends and generous donors. Please consider making a commitment to Accordia and the work we are doing in sub-Saharan Africa. Visit www.accordiafoundation.org to discover how you can support our efforts today.

  President, Accordia Global Health Foundation

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Strengthening Training Capacity in Nigeria In February, IDI hosted a group of twenty top infectious disease specialists from Nigeria for a 3-week customized course designed to help participants hone their training and program management skills, update the Nigerian national ART training curriculum, and further define the vision for a West African Infectious Diseases Institute. The course was a critical element of a public-private partnership between ExxonMobil and PEPFAR Nigeria, in which Accordia and IDI both play major roles. The physicians who attended this customized "Master Trainers Course" took time away from their leadership posts within government, universities, and other training organizations throughout Nigeria to spend uninterrupted time with their Ugandan colleagues and IDI’s management and training teams. The first week of the course was a Program Management module, part of a new collection of course offerings at IDI but tailored for the Nigerian participants’ specific needs and focused on the concept of a West African Infectious Diseases Institute modeled on Makerere’s IDI. Week Two took the participants through IDI’s new Advanced ART module for physicians with prior training in ART management. The final week was devoted to building training skills among the participants — a "Train the Trainers" module focused on curriculum development skills and new approaches to adult education. As part of this training, participants were asked to "refresh" Nigeria’s national ART training curriculum. New national guidelines were incorporated into the revised curriculum, and a course outline and comprehensive set of lectures were collaboratively created. Each of the Nigerian "Master Trainers" will go on to train other Advanced Qualified Trainers in Nigeria as part of this important collaboration to build national training capacity.TOP

IDI Trainee Improves HIV Care in Local

"Compassion and kindness," she said. Three
simple words softly spoken. Yet, powerful
and clear. It wasn’t a statement necessarily about herself, but a response to the question: "What does it take to be an effective healthcare worker in the HIV community in Africa?" Brilliance, to understand an incredibly complex and debilitating disease with equally challenging drug regimens? Mental toughness, to endure the heartbreaking stories undoubtedly communicated on a daily basis by patients? Optimism? No. Compassion and kindness. The response itself spoke volumes about Dr. Olivia Kharono, a clinical officer at the Joint Clinical Research Center (JCRC) in Mubende who recently completed training in advanced HIV/AIDS care and prevention at the Infectious Diseases Institute in Kampala.

Improving Patient Care through Training

Since graduating from Fort Portal School of Clinical Officers in 2005, Dr. Kharono has worked in areas heavily impacted by HIV/AIDS. Clinical officers, nurses and other mid-level practitioners are increasingly taking on tasks conventionally assigned to doctors, as they outnumber them by 6:1 in these settings. Recognizing the need to increase her skill set and better address the needs of her patients, Dr. Kharono sought out training at the Infectious Disease Institute in 2008. IDI was one of the first training centers to offer training in advanced HIV/AIDS care and prevention to clinical officers. "There were several reasons both personally and professionally I chose to attend IDI. First, I wanted to improve the quality of life for my patients. I also wanted to perfect my clinical skills by learning drug regimens and toxicities in order to prescribe medicine. Because of IDI, I do that now for my patients and am a more effective practitioner."

A Holistic Approach to Treatment

In a clinic like JCRC, Mubende, which treats over 6,383 patients and has initiated ART for over 1,652 of them, more trained professionals improves the quality of the clinic overall. "At IDI, I learned to really take time with patients; to put down the pen and really listen. And I have used the training to pass on information to my colleagues. We are task-shifting what we know to others so we can manage more activities. In that way, the whole health center improves."TOP

Drama Group Supports Prevention
Activities at IDI

Above: Charles Kasumba, the Music, Dance & Drama Trainer at IDI, rehearses with the MD&D group before a local performance. (Photography by Charles Steinberg)

The Creativity Initiative at the Infectious Diseases Institute is a patient-led initiative designed to build a network of care supporters and volunteers who promote adherence to HIV treatment and help members gain entrepreneurial skills to enable them to become self-sufficient. A critical component of the Creativity Initiative is its strong, professional drama group. The group’s members work to help their audiences develop an understanding of the issues related to HIV/AIDS, support prevention activities, and help reduce the stigma that so many infected individuals and their families encounter.

Reaching out to the local community

The IDI Music, Dance, and Drama Group (MD&D) consists of twenty-five individuals attending IDI and the IDI-supported Kampala City Council Clinics. The group has a repertoire of songs and skits that involve numerous messages of prevention and adherence. So far, they have performed before over 6,000 people in schools, communities, and at IDI.

An HIV positive Ugandan finds hope

Happy Ainomugisha is one of the members of the drama group. Despite her name, she has had a difficult life. Many of her relatives perished in the murder of hundreds of members of a local religious movement, and she moved from southwestern Uganda to Kampala to find employment. After getting to the capital and finding a job in a small pharmacy, she learned that she was HIV-positive and began getting treatment at IDI, where her health stabilized. But when her employer discovered her health status, Happy was fired – only to find out later that her employer was also living with HIV.

The MD&D Group performs in the IDI clinic.
(Photography by Cindy Sadler)

Knowing that stigma was the cause of her loss of employment, Happy vowed to do everything
she could to fight stigma. She was selected to join the IDI Music, Dance, and Drama group in May 2008, and says that since she became a member of the group, she has had "no more misery." She goes on, "In the drama group we share life experiences, we chat and laugh together as brothers and sisters, get peer counseling, and educate the public. Through drama I have decided to spend my life supporting and educating others about the dangers of HIV/AIDS. May God bless all the people who support us."

Teaching others through music and dance

The MD&D group will continue to participate in community sensitization exercises in and around Kampala, helping the community to gain a better understanding of how to prevent HIV/AIDS, or of how to live with the disease in a healthier and more positive manner.TOP

Building a Comprehensive Tuberculosis Program at IDI

An IDI doctor examines an x-ray of a tuberculosis patient. (Charles Steinberg Photography)

A legacy of TB research

Uganda has always been at the forefront of new research on TB. Clinical research on TB in Uganda began during the pre-AIDS era with multi-center trials defining the basic guidelines of short-course chemotherapy. When the AIDS epidemic emerged, Uganda become the site of the first randomized controlled trials of treatment regimens for TB in HIV, and treatment of latent TB infection (preventive therapy). Academic Alliance members Roy Mugerwa, Bob Colebunders, Jerry Ellner, Moses Joloba and Harriet Mayanja-Kizza are all internationally recognized for their research in TB in Uganda, as is IDI Head of Research, Dr. Yuka Manabe.

IDI team leads new charge on TB

There are now exciting new developments in IDI’s TB Research Program. Academic Alliance members Philippa Musoke and Harriet Mayanja-Kizza are leading a public-private collaboration to build clinical trial sites for future TB vaccines in two districts of Uganda. Dr. Bob Colebunders is heading an international consortium to study the pathogenesis of TB immune reconstitution syndrome (IRIS). And Dr. Manabe is working with the Foundation for Innovative Diagnostics (FIND) to compare the promising new technique of LED microscopy, and a new magnetic bead concentration method for the more rapid diagnosis of pulmonary TB.

TB working group establishes best practices in new clinic

To address immediate concerns in the IDI Clinic and develop a best practices model, IDI opened a Tuberculosis Clinic in December 2008 under the direction of Dr. Manabe, IDI Head of Clinical Services Andrew Kambugu, and other members of the recently formed TB Working Group. Suspected or confirmed TB patients are triaged immediately to an outdoor waiting area, with the help of HIV-positive "peer educators." Patients are then evaluated and counseled by medical officers and nurses in an outdoor clinic, greatly reducing the risk of TB transmission. The TB Clinic will soon implement fluorescence smear microscopy and provide TB cultures for all suspected cases. Data captured through the use of newly standardized clinic forms will be an invaluable resource for new research, and IDI is working with the Ugandan National TB and Leprosy Program to reinforce guidelines for the diagnosis and management of suspected TB cases throughout the country.

Training to target medical officers

IDI’s Training Program is also part of this comprehensive approach to overcoming the challenge of TB. A new course on advanced TB management is under development, and will join the training program portfolio this year. The course will target medical officers throughout sub-Saharan Africa, and will include new diagnostic techniques, emerging treatment guidelines, and novel research approaches.

Contributing to the prevention of TB

Treating and preventing tuberculosis is a crucial element in the fight against infectious diseases and IDI is poised to emerge as a national and regional leader in TB clinical management, training, and research. TOP

Summit Convenes Global Health Leaders

TOP: (LEFT) Ugandan First Lady, MP, and Minister of State for Karamoja, the Hon. Janet Museveni and Accordia Chairman Dr. Hank McKinnell. (CENTER) Director of Johns Hopkins
University Center for Global Health, Dr. Tom Quinn; Summit Moderator, Teri Riddle; Professor of the London School of Hygiene & Tropical Medicine, Dr. Keith McAdam. (RIGHT) Director of
Botswana-UPenn Partnership, Dr. Oathokwa Nkomazana.

CENTER: (LEFT) Accordia Vice President, Prof. Nelson Sewankambo. (CENTER) Chief of Party of the ENHANSE Project, Dr. Jerome Mafeni; Associate Director of Corporate Responsibility &
Philanthropy Pfizer Inc, Lebo Taunyane. (RIGHT) Accordia Executive Director Carol Spahn and Vice President of the Abbott Fund Jeff Richardson.

BOTTOM: Panel Participants (left to right): Associate Professor, Makerere University School of Public Health, Dr. Fred Wabwire-Mangen; Deputy Dean, Makerere University School of Public
Health, Dr. William Bazeyo; Co-Founder, Global Health Education Consortium, Dr. Anvar Velji; Board Member, Association of African Business Schools, Jonathon Cook; Professor & Director,
Center for Global Health Clinical Education, Johns Hopkins University, Dr. Robert Bollinger; Director for Capacity Building, AMREF, Peter Ngatia.

(Charles Steinberg Photography) TOP

CONTACT US

Accordia Global Health Foundation
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Washington, DC 20005
phone 202-534-1200
fax 202-534-1220
info@accordiafoundation.org
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