Accordia friends and supporters gathered in New York on November 17th to celebrate progress that has been made by Accordia and its many partners towards the goal of reducing the burden of HIV/AIDS, malaria, and tuberculosis in Africa. This year’s event began with a symposium, featuring some of the world’s foremost authorities in infectious diseases, including a keynote address by Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease, and a panel discussion that included former director of the Centers for Disease Control and Prevention, Dr. Julie Gerberding and former global AIDS coordinator, Ambassador Mark Dybul.

Following the symposium, Dr. Anthony Fauci was presented Accordia’s Global Health Leadership Award for his tremendous leadership in the fight against current and emerging infectious disease epidemics. Dr. Fauci has been one of the world’s most vocal champions of increased investment in global health and much of his research now serves as the basis for the world’s current understanding of the human immune response and its regulation, areas of the utmost relevance to research in HIV/AIDS and its opportunistic infections. Dr. Fauci is a key advisor to the White House and the Department of Health and Human Services on global AIDS issues and on initiatives to bolster preparedness against emerging infectious disease threats.

During his keynote address, Dr. Fauci discussed the increasing globalization of infectious diseases research and linked it to improvements in diagnostics and care techniques. He stressed the importance of research in developing effective responses that are relevant in sub-Saharan Africa and urged the United States and other countries to continue to increase their funding commitments to medical research while also investing in effective treatments.

The symposium also featured presentations by Dr. Andrew Kambugu, head of Treatment, Prevention, and Care at the Infectious Diseases Institute (IDI) in Kampala, Uganda, and Staffan Landin of the internationally acclaimed Gapminder Foundation. Dr. Kambugu gave attendees a local perspective, speaking of his own experiences and thanking Accordia, the Academic Alliance, and the many mentors who contributed to his growth and development as an infectious disease expert, and who made a personal impact on his ability to effectively serve the more than 15,000 patients now under his care. Dr. Kambugu called for the ongoing development of human resource capacity building through training and mentorship.

Staffan Landin put the current crisis into the perspective of the history of infectious disease in Africa. Gapminder, a Swedish NGO, is noted for using animated, interactive graphics and statistical time series data. Landin’s presentation helped to deconstruct the myth of the “African AIDS epidemic” by showing that the impact of the disease is extremely varied within countries and across the continent. The clear message was that it is necessary to develop and implement strategies and programs that address the unique circumstances of affected populations.

Visit our website to watch the video of the event.

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2009 A Celebration of Partnership

(Gary Henry Photography)

TOP: (LEFT) Dr. Anthony Fauci, Accordia Board Member Dr. Julie Gerberding, Dr. Andrew Kambugu, and Accordia Board Member Ambassador Mark Dybul respond to audience questions. (CENTER) Dr. Jeff Sturchio of the Global Health Council and Accordia Board Member Robert Mallett (RIGHT) Carol Spahn, Executive Director, Accordia; Don Holzworth, Accordia Board Member; and Dr. Warner Greene, President, Accordia.

CENTER: (LEFT) Guests from the Infectious Diseases Institute in Kampala, Uganda: Peter Okwi, Leah Thayer, Dr. Umaru Ssekabira, and Dr. Andrew Kambugu. (RIGHT) Ambassador Mark Dybul; Dr. Hank McKinnell, Chairman, Accordia; Dr. Anthony Fauci; and Dr. Julie Gerberding

BOTTOM: (LEFT) Accordia Board Members Hiro Ogawa and Joseph Feczko. (CENTER) Dr. Jeff Sturchio, Ambassador Mark Dybul, and Dr. Warner Greene estimate the average birth rate in Gapminder's interactive game, facilitated by Staffan Landin. (RIGHT) His Excellency Professor Perezi K. Kamunanwire, Ambassador of Uganda; NBA All-Star Dikembe Mutombo; and His Excellency Ruhakana Ruganda, Representative of Uganda to the United Nations.

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Improving sub-Saharan Africa’s research capacity is a key part of Accordia’s fight against infectious diseases. By supporting cutting-edge research in the region, medical improvements that are immediately relevant in resource-limited settings emerge. To date, 39 research programs have been undertaken at IDI that focus on finding the best ways to prevent and treat HIV, tuberculosis, and other conditions that disproportionately affect health in the region. TOP

2009 has been an exciting year for Accordia Global Health Foundation. We have much to celebrate as we look back on our work and accomplishments. But we also recognize how much still needs to be done as we pursue our goal of overcoming the burden of infectious diseases by building healthcare capacity and strengthening academic medical institutions in Africa.

This year, the Infectious Diseases Institute (IDI) celebrated its 5th anniversary. Founded by Accordia, in partnership with Pfizer Inc, the Academic Alliance, and Makerere University, IDI is now an internationally recognized center of excellence in sub-Saharan Africa. It has trained almost 5,000 medical professionals in advanced diagnosis and treatment and provides treatment to about 15,000 patients throughout Uganda; it is also nurturing a new generation of African academic physicians, helping to develop their research and leadership skills.

Accordia’s 2009 Infectious Diseases Summit convened participants from over 20 African, European, Asian, and North American countries to consider ways to build healthcare leadership in Africa. Their ideas and enthusiasm have spread well beyond the Summit, through presentations on the Summit’s recommendations to international health organizations and with the wide distribution of Building Healthcare Leadership in Africa: A Call to Action. That report was released at a Washington, DC event at which representatives from Accordia, the World Bank, the State Department’s Office of the Global AIDS Coordinator, the Global Health Council, and BroadReach discussed its findings and considered future options.

We recently hosted Accordia’s annual Celebration of Partnership. This year’s event began with a symposium on the increasing globalization of health that featured Accordia’s 2009 Health Leadership Award recipient, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, as well as other experts. I urge you to visit Accordia’s website to view the symposium presentations and the spirited discussion which followed.

As we approach the end of this very eventful year, I want to thank you. Accordia’s friends and supporters are essential in helping develop and expand programs that are making an important difference in the lives of tens of thousands of Africans. Accordia is strengthening communities and saving lives—but we could not do it without you.

  Warner C. Greene, MD, PhD
  President, Accordia Global Health Foundation

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Nurse Uses Holistic Approach to Caring for Patients

Mitterrand Kiirya began to dream of working in medicine when he was six years old. “I saw people hurting and I wanted to stop pain, to alleviate pain. That was my concern,” he recalls. Today, as an RN and medical counselor at IDI, Mitterrand is living that dream.

Conducting Innovative Research

Mitterrand manages a National Institutes of Health-sponsored research study that compares the effects of anti-retroviral drug regimens that are designed to treat HIV-related Kaposi’s Sarcoma. Caused by a virus, Kaposi’s Sarcoma is one of the most common types of cancer among people living with HIV. The clinical trial, which began in May 2007, has seen positive results thus far in treating the cancer.

Going Above and Beyond

Watching his mother, who is also a nurse, Mitterrand loved the personal relationships that nurses can develop with patients, and he is convinced that this close interaction that addresses patients’ mental and emotional needs is as important as the provision of medical care. In addition to nursing certification, Mitterrand is trained in medical counseling. He uses a holistic approach to care to address issues that affect a patient’s well-being and makes it his goal to ensure that patients leave with a smile on their faces.

To further improve the quality of care for the 100 IDI patients in the study, Mitterrand visits participants at their homes, both in Kampala and up-country in the rural districts. Mitterrand explains that adherence to the drug regimen is vital for ensuring success and avoiding drug resistance. Since many participants live far from IDI and are often too weak to travel, Mitterrand and his team take medicine to their homes.

“By visiting patients, we can better monitor progress or any compounding issues. This extra effort gives patients confidence in their caregivers and the study and helps battle many of the psychological roadblocks to drug adherence.”

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IDI Celebrates 5 Years, Plans to Expand

On October 20, 2004, the Infectious Diseases Institute (IDI) officially opened its doors. Over the past five years, it has become a true center of excellence in sub-Saharan Africa, continuously expanding its services and outreach. Today, IDI continues to grow and innovate, serving the healthcare needs of the people of Uganda and Africa.

IDI was launched as a result of the visionary leadership of fourteen physician scientists from North America, Europe, and Africa. This “Academic Alliance” created Accordia Global Health Foundation, which, in partnership with Pfizer Inc and Makerere University, established IDI. The Institute builds healthcare capacity through training, mentoring, research, laboratory services, and prevention activities. Their efforts are saving lives and strengthening communities throughout Africa.

The success of IDI's training and treatment model has far surpassed what its founders originally dreamed. Services and programs have expanded throughout Kampala, into rural districts, and to post-conflict zones in the north of the country. As a result of this success, the original IDI facility is overcrowded, and project offices are scattered across the Makerere campus in rented spaces. To assure that its programs are as effective as possible, IDI hopes to soon construct a second building to house many of its non-clinic functions and consolidate other activities.

Recently, Makerere University awarded land to IDI for this expansion, and the planning process for a new building that will combine state-of-the-art technology to support IDI's research and training operations, a large conference space to support university needs, and interactive gathering spaces to support collegial interaction and collaboration has begun.

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IDI Provides HIV/AIDS Services to Rural Communities

Patients waiting for care at a rural clinic in the Kiboga District. (Edward Echwelu Photography)

Recently, at a health clinic in the rural district of Kiboga in central Uganda, only one nurse was available to care for all arriving patients. He was conducting exams, providing counseling, and running laboratory tests. He, alone, was there to handle any emergencies—whether or not he was fully trained to address them. One of the clinic’s other two staff members was at a training session; the other was ill. And one of the four positions at the clinic was vacant.

Addressing Challenges

Africa’s rural health centers, in particular, face staggering staffing challenges every day. Kiboga officials estimate that there are only 300 health workers to care for the almost 300,000 people in the district—only 47% of positions are filled in the district’s clinics and hospitals. In contrast, the United States has over 6,000 healthcare workers for every 300,000 people.

Inadequate staffing is one of many problems impeding the delivery of adequate healthcare in rural Uganda. Clinics struggle with extremely limited resources, poor infrastructure, inadequate facilities, and inaccurate or incomplete medical records and data systems. Further exacerbating the difficulty of providing services to patients with infectious diseases in rural settings are expensive and complex diagnostics, care techniques, and drug regimens.

Improving rural care is vital

Around 60% of Africans live in non-urban areas. Therefore, winning the fight against infectious disease requires that this population is tested, counseled, and receives ongoing treatment. In 2008, IDI launched a program to build healthcare capacity in two underserved districts, Kibaale and Kiboga, which represent a combined population of about 800,000 people. The Kibaale-Kiboga Project (KKP) originally targeted 10 health facilities—five in each district—to strengthen existing systems and implement new services for HIV/AIDS prevention and care, including tuberculosis (TB) management. The first year proved so successful that IDI is expanding the project to an additional 11 sites in the two districts by April 2010, as well as 3 additional underserved districts by Lake Albert.

A multi-level approach

In partnership with the districts’ health officials, IDI is identifying the areas of greatest need and the best ways to implement effective changes. According to a Kiboga health official, the rural districts’ greatest challenges are providing consistent healthcare and medicine, reaching individuals who live in remote areas, and building and maintaining proper facilities.

The KKP team is training healthcare workers and community volunteers to fill some of the staffing gaps in counseling and testing, data management and record keeping, home-based care, and TB and HIV management. Additionally, facilities are receiving basic laboratory equipment, health kits, and stocks of drugs and other supplies.

Community involvement and mobilization is a key element to improving HIV/AIDS services in rural settings. The KKP team is targeting the local markets, schools, social events, and community radio stations to promote HIV counseling and testing; initiating community interventions; recruiting volunteers to encourage their neighbors to get counseled and tested; and using the districts’ newly-formed Music, Dance, and Drama Troupes to engage audiences.

Since its launch in September 2008, the KKP team has trained hundreds of workers and provided HIV testing and counseling to over 50,000 people in more than 275 communities, improving lives and building a stronger healthcare system for Uganda.

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U.S. Global AIDS Coordinator Ambassador Eric Goosby Visits IDI

On June 23, 2009, Dr. Eric Goosby was sworn in as Ambassador at Large and Global AIDS Coordinator for the U.S. Department of State. In this role, Ambassador Goosby is responsible for the United States’ international efforts to prevent and treat HIV/AIDS. He also oversees the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which has helped deliver improved care and treatment to thousands of HIV-positive people globally.

Ambassador Goosby is a pioneer in the fight against HIV/AIDS, with 25 years of experience in treating patients and creating effective interventions throughout the world. When HIV/AIDS first emerged in the United States, Ambassador Goosby worked on the front lines, treating patients at San Francisco General Hospital.

Ongoing Commitment to Uganda

Shortly after taking his current office, Ambassador Goosby visited Uganda to discuss his vision for the future of PEPFAR. Recognizing Uganda’s historic role in fighting AIDS in Africa, Ambassador Goosby met with Ugandan President Museveni and other leading health officials to express his commitment to strengthening PEPFAR’s partnership with the Government of Uganda. During his trip, he toured some PEPFAR-supported sites, including the Infectious Diseases Institute (IDI), where he expressed his admiration for the growth of the Institute and its impact.

Ambassador Goosby, while praising the work that has already been done, has also named his priorities for improving PEPFAR. They include: focusing on HIV prevention, creating strong country partnerships, ensuring that HIV/AIDS initiatives are country owned and led, strengthening health systems, and helping scale-up effective programs and interventions.

Calls IDI a model institution

Prior to joining the Department of State, Ambassador Goosby served as CEO and Chief Medical Officer of The Pangaea Global AIDS Foundation. There, he was actively involved in HIV/AIDS efforts throughout the developing world—including the development of the Infectious Diseases Institute. Pangaea was an early partner in helping to launch IDI and was instrumental in the construction process. The organization oversaw the project, ensuring that it was completed on time and within budget. Pangaea staff also helped build the financial, legal, administrative, and managerial structures needed to support IDI’s training and treatment programs.

In a June hearing before the Senate Foreign Relations Committee, Ambassador Goosby said, "I have been fortunate enough to work firsthand with partners across Africa during my time with Pangaea, and have engaged in projects that have created sustainable, tangible results. In Uganda, Pangaea partnered with academia and the private sector to help create one of the leading regional HIV/AIDS training, research and infectious diseases clinics on the continent, the Infectious Diseases Institute (IDI). The IDI provides high quality treatment for HIV/AIDS patients while simultaneously using the clinic as a platform for training physicians, nurses and other health care workers, conducting research, and developing models of integrated HIV/AIDS prevention and care that are widely applicable throughout Africa."

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CONTACT US

Accordia Global Health Foundation
1101 14th Street NW, Suite 801
Washington, DC 20005
phone 202-534-1200
fax 202-534-1220
[email protected]
www.accordiafoundation.org

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