E. Albert Reece, MD, Phd, MBA Vice President for Medical Affairs, The John Z. and Akiko K. Bowers Distinguished Professor and Dean, School of Medicine

     

          The School of Medicine has long been committed to exporting its best practices in healthcare delivery and biomedical research to the rest of the world through collaborations with other medical centers and research institutions through our state-of-the-art telehealth and telemedicine technologies.

We have a large group of internationally-recognized clinicians and scientists who do groundbreaking research in basic, clinical and translational science, and we believe strongly in sharing their expertise with the rest of the world, where appropriate. Our faculty carry out epidemiologic, clinical and laboratory research, and work with local public health officials in many countries around the world (see table).

Indeed, the school has a long history of significant contributions to global health through research, health care delivery, outreach and public policy. Some of our initiatives are well-known, such as the center for vaccine development’s (CVD) work in creating and testing vaccines for some of the world’s most vexing infectious diseases, such as malaria and avian flu. Likewise, the work of our institute of human virology in treating and preventing AIDS is recognized the world over.
Other School of Medicine initiatives are lesser-known, however, such as the department of pediatrics’ research into neonatal and infant infections in India, and our burgeoning research programs in protecting against bioterrorism and sequencing the genomes of major pathogens.

Although our contributions are significant, they can never be enough. For example, recent advances in medicine and technology have fueled unprecedented opportunities for improved health outcomes and extended life expectancy across the globe. Unfortunately, there has not been an equitable distribution in the allocation of these precious healthcare resources. Moreover, highly preventable diseases, such as whooping cough, measles, and malaria, which are now extremely rare in developed countries, are still raging in developing countries, leaving paths of death and destruction in their wake. Even more troubling, many developing countries lack the necessary capacity to implement even the most basic of these life-saving medical interventions. When you factor in the global shortage of adequately trained healthcare workers, the situation is extremely dire.

Over one million Africans die of malaria each year, hundreds of thousands of whom are children. It continues to be the leading killer of the world’s poorest children. Undaunted, our faculty work tirelessly to make an impact on this untenable situation and are making progress. For example, our researchers recently found that an anti-malaria medication that had previously lost its effectiveness as a first line treatment for malaria has somehow regained its effectiveness (New England Journal of Medicine 355:1959-1966, 2006). Chloroquine was removed from government health facilities in Malawi in 1993 after it proved ineffective at treating malaria in more than 50 percent of documented cases. However, our recent study showed that the malaria parasite has once again become susceptible to chloroquine, and the medication can potentially be used in combination with other therapies to treat the disease effectively in the future.

We also recently received a $23.7 million grant from the National Institutes of Health for our vaccine and treatment evaluation unit (VTEU) to conduct clinical trials for promising vaccines and therapies for such diseases as malaria, dysentery, cholera and typhoid fever that affect primarily people in developing countries. The CVD’s VTEU has been testing vaccines for the federal government for over 30 years to prevent a wide array of infectious diseases that affect children, adults and the elderly. These are but two examples of ground-breaking work School of Medicine faculty are doing to help alleviate suffering around the globe.

Developing countries also face some of today’s most complex medical challenges, such as emerging infectious diseases like Ebola and avian flu. These diseases require novel research, technology and clinical approaches. We are leading the way in vaccine-based efforts to fight these diseases. For example, we conducted clinical trials to test the first cell culture-based pandemic influenza vaccine to see if it will provide immunity faster and more reliably than the vaccines that are currently produced in eggs. The study was also the first test in the U.S. of a whole virus vaccine for avian flu, which could produce a stronger response by the immune system.

Additionally, chronic diseases such as diabetes and cancer represent an increasing burden in resource-poor environments, since they require long-term management of patient information for optimal care outcomes. Yet the health care delivery systems and practitioners in the developing world face considerable challenges in implementing the necessary health management information systems.
Telemedicine provides critical access to medical care for remote populations, and is used to diagnose, review patient information, conduct research and manage chronic conditions. Our telemedicine capabilities in the center for health disparities and program in trauma have demonstrated significant expertise in the use of advanced telecommunications technology for health care delivery and clinical consultation for remote application in reaching underserved populations in the U.S. This knowledge, applied in the context of global health, offers a significant contribution to the field and to the future health of our global community.

Similarly, distance learning is a powerful tool for expanding the number of health professionals trained throughout the world. We are already a national leader in the field of distance learning. With its existing relationships in global health, the current distance learning infrastructure can respond to the shortage of trained health care workers in developing countries and improve capacity and skill building through remote training programs. Both of these areas must be expanded upon if we are to participate more fully in the global healthcare arena.

Through our focus on infectious disease, telemedicine and technology, international health and workforce development, geographic medicine, and bioterrorism research, the University of Maryland School of Medicine is playing an increasingly critical role in fostering opportunities to strengthen and build new partnerships at home and abroad and to respond to the challenges of global health. Working collaboratively with others, we are having an impact and indeed making a difference worldwide.

Country	PI	Department	Title	Sponsor
Mali	Kotloff, Karen	CVD	Mali Immunization Training Initiative	Merck
Malawi	Laufer, Miriam	CVD	Molecular Epidemiology of Drug Resistant Malaria	NIH / NIAID
Bangladesh, Gambia, India, Kenya, Mozambique, Tanzania, Goteborg, Chile, Pakistan, Mali	Levine, Myron	CVD	Multi-Center Severe Diarrheal Disease Burden and Etiology Study	Bill and Melinda Gates Foundation
Chile	Levine, Myron	CVD	Live Attenuated intranasal Vaccine Against RSV and PIV3 in Health 1-9 Year Old RSV and PIV3 Seropositive Children	Medimmune
Chile	Levine, Myron	CVD	Safety Study of Menactra® (Meningococcal [Groups A, C, Y and W 135] Polysaccharide Diphtheria Toxoid Conjugate Vaccine) when Administered with Other Pediatric Vaccines to Healthy Toddlers	Sanofi Pasteur
Mali	Levine, Myron	CVD	Hib Conjugate Vaccine in Infants in Mali, West Africa	Bill and Melinda Gates Foundation
Bangladesh, Gambia, Kenya, Mali	Nataro, James	CVD	New Technologies in Diagnosis of Enteric Disease	Bill and Melinda Gates Foundation
Malawi	Plowe, Christopher	CVD	Clinical Trial of Chloroquine Combinations in Malawi	NIH / NIAID
Malawi	Plowe, Christopher	CVD	TS Prophylaxis and Drug-Resistant Malaria in Malawi	NIH / NIAID
Malawi	Plowe, Christopher	CVD	A Longitudinal Study of Chloroquine as Monotherapy or in Combination w/ Artesunate, Azithromycin or Atovaquone-Proguanil to Treat Malaria in Children in Blantyre, Malawi	Pfizer Incorporated
Mali	Plowe, Christopher	CVD	Pediatric Clinical Trials of the WRAIR-GSK Malaria Vaccine FMP2.1/AS02A	US Army Med Res & Dev Command
Mali	Plowe, Christopher	CVD	Malaria Vaccine Trials in Mali	NIH / NIAID
Mali	Plowe, Christopher	CVD	Malaria Research Training in Mali	NIH / Fogerty
Mali	Tapia, Milagritos	CVD	Meningitis Vaccine Project (MVP) Vaccine Trial	Prog for Approp Tech in Health
Mali	Tapia, Milagritos	CVD	Efficacy, Safety & Immunogenecity of RotaTeq Among Infants in Asia & Africa	PATH
Egypt	Hirshon, Jon Mark	Emergency Medicine	Injury Prevention Research Training in Egypt	NIH - Fogerty
Egypt	El-Kamary, Samer	Epidemiology & Preventive Medicine	Towards Understanding the Morbidity of HEV Infection	University of Cincinatti
Germany	El-Kamary, Samer	Epidemiology & Preventive Medicine	Evaluation of Silymarin & Management of Acute Viral Hepatitis	Madaus GMBH, Germany
Australia & China (Hong Kong)	Berman, Brian	Integrative Medicine	Functional Bowel Disorders in Chinese Medicine	NIH / NCCAM
Brazil, Caribbean	Blattner, William	Medicine / IHV	IVH/UMB AITRP in the Caribbean and Brazil	NIH - Fogerty
Brazil, Caribbean, Nigeria	Blattner, William	Medicine / IHV	IHV UMB AITRP in Brazil, the Caribbean & Nigeria	CDC
Nigeria	Blattner, William	Medicine / IHV	HIV/AIDS Prevention, Care & Treatment in the Federal Republic of Nigeria	CDC
Nigeria	Blattner, William	Medicine / IHV	Collection of Serum Specimens Suitable for Validation of Assays w/ HIV-1	CDC
Nigeria	Blattner, William	Medicine / IHV	Peer Educators Impact on HIV Medication Adherence Doris Duke	Charitable Fnd
Nigeria, Haiti, Guyana, Rwanda, Zambia, Kenya, Tanzania, Uganda	Redfield, Robert	Medicine / IHV	PEPFAR	CDC / HRSA
Egypt	Silverman, Henry	Medicine/Epidemiology	Internation Research Bioethics Training Program: Egypt	NIH - Fogerty
Vietnam	Kaljee, Linda	Pediatrics	Gender Relations, Sexual Behaviors & Perceived HIV Risk	NIH / NIAAA
Vietnam	Kaljee, Linda	Pediatrics	Intergration & Adaptation of HIV & Alcohol Risk ...	NIH / NICHD
India	Panigrahi, Pinaki	Pediatrics	Prevention of Neonatal Infection in the Indian Community	NIH / NICHD