Inaugural Symposium

Delivering Health Globally Examining the Challenges and Opportunities in the 21st Century

Mohammed Bin Rashid Academic Medical Center Dubai Healthcare City Dubai, United Arab Emirates

ghd-dubai.hms.harvard.edu

The Center’s Region

The Center addresses some of the most pressing health challenges in the region by focusing on research, medical education and training that promises to improve healthcare delivery systems and patient outcomes for diseases prevalent in the United Arab Emirates, Middle East, North Africa and neighboring regions. The Center also provides opportunities for faculty and students to pursue research related to the delivery of existing or new interventions that can cure or prevent disease, specifically in the following priority areas: and , infectious disease, mental health, and surgery.

Dear Colleagues,

Welcome to the inaugural symposium of the Center for Global Health Delivery–Dubai. We are extremely honored to have you join us for this event, which is being held under the patronage of His Highness Sheikh Mohammed Bin Rashid Al Maktoum, Vice President and Prime Minister of the UAE, and Ruler of Dubai.

Delivering Health Globally: Examining the Challenges in the 21st Century is the launching point for exchange of ideas focused on some of the most pressing issues we confront as scientists, educators, and practitioners committed to improving global health delivery. We have convened global experts on diabetes and obesity, surgical care, infectious disease, and mental health. Today’s symposium will focus on the challenges we face in health care delivery, including building local capacity for research and strengthening health system capacity to deliver comprehensive care.

Participants in this symposium are known for their outstanding vision and service in the field of global health. I encourage each of you to use this symposium as an opportunity for discussion—with our speakers and each other—about how best to advance our collective global health agenda.

Thank you for joining us for this symposium. I look forward to engaging in conversation with you over the years to come.

Sincerely,

Salmaan Keshavjee Director

Agenda

Welcome, Salmaan Keshavjee

Greetings from

. Harvard Medical School, Jeffrey Flier and David Golan . Dubai Healthcare City, Amer Sharif . World Bank Group, Jim Yong Kim

The work of the Center, Salmaan Keshavjee

The role of universities building capacity in the region, Richard Mills

Harvard Medical School’s role in building capacity globally, Ajay Singh

Break

The Center’s areas of focus and introduction of speakers, Salmaan Keshavjee

. Diabetes, Merri Pendergrass . Infectious disease, Zarir Udwadia . Mental health, Anne Becker . Surgery, Lubna Samad

Global health in the 21st century, Paul Farmer

Discussion, Salmaan Keshavjee

Closing remarks, Salmaan Keshavjee

Dinner and photo exhibit

Director of the Center

Salmaan Keshavjee, MD, PhD, ScM

Dr. Keshavjee is the Director of Harvard Medical School’s Center for Global Health Delivery–Dubai. He is also Associate Professor of Global Health and Social Medicine at the Department of Global Health and Social Medicine at Harvard Medical School and Associate Professor of Medicine in the Division of Global Health Equity at Brigham and Women’s Hospital.

Dr. Keshavjee has been leading the Harvard Medical School Center for Global Health Delivery–Dubai since 2014. Dr. Keshavjee is a physician and social anthropologist, and a leading expert on the treatment of drug-resistant TB and the anthropology of health policy. He is the author of Blind spot: How neoliberalism infiltrated global health, which is based on his PhD research in Central Asia (Tajikistan). He has worked extensively with the - based non-profit Partners In Health on the treatment of drug-resistant tuberculosis. Since 2000, Dr. Keshavjee has conducted clinical and implementation research in Russia with Partners In Health, leading the research component since 2005. In 2006-2008, he was also the Deputy Director for Partners In Health Lesotho, launching the first community-based treatment program for multi-drug resistant TB/HIV co-infection in sub-Saharan Africa. His research has resulted in a number of manuscripts of global clinical and policy significance.

Dr. Keshavjee has been engaged in transforming global policy discussions around the treatment of drug-resistant TB. In 2005, he became a member of the World Health Organization/Stop TB Partnership’s Green Light Committee for MDR-TB Treatment, serving as Chair from 2007 to 2010. He has worked to develop alternate mechanisms for drug procurement, technical assistance delivery, and program implementation. Dr. Keshavjee is leading an initiative at Harvard Medical School that convenes scholars and practitioners to deploy proven strategies to achieve zero deaths from TB.

In addition to his research and policy work, Dr. Keshavjee is also an active member of Harvard’s teaching faculty. When on service as an attending physician at Brigham and Women’s Hospital, Dr. Keshavjee teaches residents, interns, and medical students. He also co-teaches (along with Drs. Paul Farmer, Arthur Kleinman, and Anne Becker) a general education course for undergraduates at Harvard College, and is a guest lecturer on TB and health systems for several courses at Harvard Medical School and the Harvard School of Public Health.

Speaker Biographies

Anne E. Becker, MD, PhD, SM

Dr. Becker is the Maude and Lillian Presley Professor of Global Health and Social Medicine at Harvard Medical School, where she also serves as Vice Chair of the Department of Global Health and Social Medicine and member of the Leadership Council of the Harvard/MIT MD-PhD Program. An anthropologist and psychiatrist, Dr. Becker has been lead investigator on a series of studies demonstrating the relationship between media exposure and eating pathology in the indigenous population of Fiji. With research funding from the US National Institutes of Health, Dr. Becker has investigated the impact of rapid economic and social transition on eating pathology, suicide, and other youth health risk behaviors in Fiji, as well as the impact of a school-based youth mental health intervention in central Haiti. Dr. Becker is founding and past Director of the Eating Disorders Clinical and Research Program at Massachusetts General Hospital, an associate editor of the International Journal of Eating Disorders, past president of the Academy for Eating Disorders, and served as vice chairperson of the American Psychiatry Association’s Council on International Psychiatry. Dr. Becker is also past co-editor-in-chief of the journal, Culture, Medicine and Psychiatry and serves on the editorial boards of Anthropology & Medicine and the Harvard Review of Psychiatry. She received the 2013 Price Family Award for Research Excellence from the National Eating Disorders Association and in 2014 received the Mentorship Award in recognition of “Exceptional Mentorship of Women Faculty” at Massachusetts General Hospital. Paul E. Farmer, MD, PhD

Dr. Farmer is Kolokotrones University Professor and Chair of the Department of Global Health and Social Medicine at Harvard Medical School, Chief of the Division of Global Health Equity at the Brigham and Women’s Hospital in Boston, and co-founder of Partners In Health. He also serves as UN Special Adviser to the Secretary-General on Community Based Medicine and Lessons from Haiti. Dr. Farmer and his colleagues have pioneered novel, community-based treatment strategies that demonstrate the delivery of high-quality health care in resource-poor settings. He has written extensively on health, human rights, and the consequences of social inequality. Dr. Farmer is the recipient of numerous honors, including the Margaret Mead Award from the American Anthropological Association, the Outstanding International Physician (Nathan Davis) Award from the American Medical Association, a John D. and Catherine T. MacArthur Foundation Fellowship, and— with his PIH colleagues— the Hilton Humanitarian Prize. His most recent books are In the Company of the Poor: Conversations with Dr. Paul Farmer and Fr. Gustavo Gutierrez; Reimagining Global Health: An Introduction; and To Repair the World: Paul Farmer Speaks to the Next Generation.

Jeffrey S. Flier, MD

Dean Flier became the 21st Dean of the Faculty of Medicine at in 2007. He is also the Caroline Shields Walker Professor of Medicine at Harvard Medical School. Dean Flier is an endocrinologist and a leading authority on the molecular causes of obesity and diabetes. His research has produced major insights into the molecular mechanism of insulin action, the molecular mechanisms of in human disease, and the molecular pathophysiology of obesity.

Dean Flier has authored more than 200 scholarly papers and reviews. An elected member of the Institute of Medicine and a fellow of the American Academy of Arts and Sciences, his honors also include the Eli Lilly Award of the American Diabetes Association, the Berson Lecture of the American Physiological Society, and honorary doctorates from the University of Athens and the University of Edinburgh. He was the recipient of the 2003 Edwin B. Astwood Lecture Award from the Endocrine Society and, in 2005, he received the Banting Medal from the American Diabetes Association, its highest scientific honor.

David E. Golan, MD, PhD

Dean Golan became Dean for Basic Science and Graduate Education at Harvard Medical School (HMS) in 2014, after serving as Dean for Graduate Education since 2008. He is a professor in the HMS Department of Biological Chemistry and Molecular Pharmacology, where his laboratory applies biophysical and cell-imaging methods to the study of membrane proteins in blood cells. He is also the George R. Minot Professor of Medicine at HMS and Senior Physician in the Department of Medicine at Brigham and Women's Hospital and the Dana-Farber Cancer Institute, where he sees patients as a practicing hematologist and clinician-teacher. Dr. Golan founded and directed the core course in pharmacology in the New Pathway curriculum at HMS from 1989 to 2006. He currently co-directs a translational pharmacology course in the Therapeutics Graduate Program, the Leder Human and Translational Medicine Graduate Program, and the Master’s Program in Clinical and Translational Investigation at HMS. These courses’ guiding principle is that drug mechanisms are best understood in the context of the physiological, biochemical, and pathophysiological pathways on which the drugs act. By translating this principle into his course design, Dr. Golan has provided thousands of Harvard students with a foundation for lifelong learning in pharmacology and therapeutics. Dr. Golan is Editor-in-Chief of Principles of Pharmacology: The Pathophysiologic Basis of Drug Therapy, 1st Edition (2005), 2nd Edition (2008), and 3rd Edition (2011), and co-editor of the Principles of Pharmacology Workbook (2008). The 3rd Edition of Principles of Pharmacology won First Prize in Pharmacology in the 2012 British Medical Association Medical Book Award competition. In his role as Dean for Basic Science and Graduate Education, Dr. Golan advises and assists the Dean of the Faculty of Medicine on the articulation, design, and implementation of a strategic vision for HMS’s basic and social science enterprise, including cross-departmental, cross-school, and cross-institutional initiatives and collaborations. He also oversees the PhD and MMSc programs at HMS and he works closely with the Dean for Medical Education to oversee the MD-PhD and Health Sciences & Technology programs. He directs the Program in Graduate Education, which brings together leaders of graduate education at HMS, the Harvard School of Public Health, and the Harvard School of Dental Medicine. He also chairs the HMS Division of Medical Sciences, directs the Harvard Therapeutics Graduate Program, and coordinates the design, development, implementation, and oversight of the master's degree programs at HMS. Dean Golan also serves as Special Advisor to the Dean of the Faculty of Medicine on HMS’ global programs. In this role, he works with HMS and Harvard University in strategizing and designing HMS’ global education programs and research collaborations.

Jim Yong Kim, MD, PhD

Dr. Kim is the 12th President of the World Bank Group. Soon after he assumed his position in July 2012, the organization established goals to end extreme poverty by 2030 and to boost shared prosperity for the bottom 40 percent of the population in developing countries. Dr. Kim is a physician and anthropologist. Before joining the World Bank Group, he served as President of Dartmouth College and held professorships at Harvard Medical School and the Harvard School of Public Health. From 2003-2005, as Director of the World Health Organization’s HIV/AIDS Department, he led the “3 by 5” initiative, which set out to reach the first-ever global goal for AIDS treatment. In 1987, Dr. Kim co-founded Partners In Health, a non-profit medical organization now working in poor communities on four continents. He received a MacArthur “Genius” Fellowship and has been recognized as one of America’s “25 Best Leaders” by U.S. News & World Report.

Richard Mills, JD

Mr. Mills became the Executive Vice President at Dartmouth College in September 2013. He is responsible for the management and coordination of the administrative operations of Dartmouth College, including financial, facility, human resources, and other administrative operations. In this capacity, Mr. Mills ensures Dartmouth’s administrative resources are allocated appropriately throughout the institution and administrative services are delivered in an efficient and effective manner. He reports directly to the College President and works closely with the Provost and Deans to plan and manage Dartmouth's strategic initiatives in a number of areas. As such, he has responsibility for the coordination of all administrative and business matters with the academic, research, and administrative missions and programs of Dartmouth and for promoting communication between and among administrative and academic units in support of Dartmouth priorities and initiatives.

Prior to joining Dartmouth, Mr. Mills held the position of Executive Dean at Harvard Medical School where he was the senior administrative officer with oversight of finance, facilities, human resources, information technology, communications and external affairs, and other business operations. Before joining Harvard Medical School, Mr. Mills was the principal of a strategic consulting firm, served as a department director and as senior staff Counsel at the Massachusetts Water Resources Authority, and was a litigation attorney at the Boston firm of Posternak, Blankstein & Lund.

Merri Pendergrass, MD, PhD

Dr. Pendergrass is Professor of Medicine at the University of Arizona and Diabetes Program Director for the University of Arizona College of Medicine. She is an endocrinologist with a long-standing interest in determining better diabetes management strategies and applying these strategies to improve diabetes outcomes and enhance patients’ experiences. Her research focuses on practice change and how to assess and improve the quality of diabetes healthcare delivery. Her role at the University of Arizona is to foster innovation within the institution and disseminate these approaches regionally, nationally, and internationally.

Dr. Pendergrass joined the University of Arizona after serving since 2008 as vice president and national practice leader for the Diabetes Therapeutic Resource Center® of Medco Health Solutions, Inc. (a pharmacy benefits management company in Fort Worth, Texas, ranked 36th on the 2012 Fortune 500 list, recently acquired by Express Scripts, Inc.). Her responsibilities included developing, implementing and evaluating the diabetes care strategy delivered by Medco’s diabetes specialist pharmacists. During this time she also maintained a clinical practice in diabetes and at Parkland Memorial Hospital and was on the faculty of the University of Texas Southwestern Medical School in Dallas.

Prior to joining Medco, Dr. Pendergrass was associate professor of medicine at Harvard Medical School in Boston, and was director of the diabetes program at Brigham and Women's Hospital, Boston, where she also was interim chief of the Section of Diabetes and Metabolism and associate clinical chief, Division of Endocrinology, Diabetes and Hypertension.

Dr. Pendergrass has also served as director of the Diabetes Program at Medical Center of Louisiana in New Orleans, where she was on the faculty of Tulane School of Medicine and worked as a physician with Tulane University Medical Center and New Orleans Veteran’s Administration Medical Center.

Dr. Pendergrass was principal investigator on multiple diabetes-related studies funded by the U.S. National Institutes of Health, the U.S. Centers for Disease Control and Prevention and the Juvenile Diabetes Foundation. She is the author of numerous scientific journal articles and is a reviewer for several professional journals, including Primary Care Diabetes; Metabolism; the Journal of Diabetes and Its Complications; Diabetes, Obesity and Metabolism; and Diabetes Care. Dr. Pendergrass serves on the advisory board of Nature Reviews Endocrinology. She has been an invited speaker at numerous national and international meetings and conferences.

Lubna Samad, FCPS, MRCS

Dr. Lubna Samad is a consultant pediatric surgeon dedicated to improving access to quality surgical care for those that need it the most. She trained in medicine at the Aga Khan University, and in pediatric surgery at the National Institute of Child Health in Pakistan and the Leicester Royal Infirmary in the UK. Her work in public sector hospitals in Pakistan has informed her understanding of the many individual, social and institutional barriers that result in poor access to quality surgical care.

Dr. Samad joined Indus Hospital at its inception in 2007 and has served as Chair of the Indus Hospital Research Center since 2010. She represents the Indus Hospital Center for Global Surgery on the Executive Committee of the G4 Alliance. She is currently leading the design and implementation of several surgical care delivery and patient safety initiatives at the Indus Hospital, and working to establish new initiatives in South Africa and Ethiopia. Dr. Samad is a Lecturer at the Harvard Medical School Center for Global Health Delivery–Dubai.

Amer Sharif, MBBS, MSc

Dr. Amer Ahmad Sharif drives medical education at Dubai Healthcare City (DHCC), the world’s largest free zone dedicated to healthcare. He is responsible for the development, implementation and evaluation of Education and Research, one of DHCC’s four core areas of operation along with Healthcare, Investment and Regulatory. In his capacity, he manages entities under the Mohammed Bin Rashid Academic Medical Center, DHCC’s dedicated academic complex, which is home to Al Maktoum Medical Library, and the Khalaf Ahmad Al Habtoor Medical Simulation Center. The Mohammed Bin Rashid University also has within it the Hamdan Bin Mohammed College of Dental Medicine which offers masters’ programmes in collaboration with the Royal College of Surgeons of Edinburgh.

Dr. Sharif also advises on medical education events and conferences at the Mohammed Bin Rashid Academic Medical Center, and played an integral part in launching in 2014 the UAE Clinical Simulation Conference to introduce simulation training in medical education in the region in collaboration with the Society in Europe for Simulation Applied to Medicine.

Prior to joining DHCC in March 2013, Dr. Sharif was the Director of Healthcare Operations— Hospital Services Sector, Dubai Health Authority. He dedicated a substantial portion of his 10-year tenure to medical education and research projects in workforce development, serving in various roles including Health Systems Advisor, Director of Human Resources, and Director of the Department of Continuing Education.

Dr. Sharif is the project lead for the upcoming Mohammed Bin Rashid University of Medicine and Health Sciences commencing September 2016, an institution that will offer undergraduate and postgraduate programmes in various disciplines. Dr. Sharif has authored and published several papers with a focus on the challenges of the UAE’s health system and health policy.

Ajay K. Singh, MBBS, MBA, FRCP

Dr. Ajay Singh is Associate Dean of Global and Continuing Education and Executive Director of the Dubai Harvard Foundation for Medical Research, both at Harvard Medical School. He is also Director of the Master’s in Medical Science in Clinical Investigation at Harvard Medical School.

Dr. Singh completed his undergraduate and medical training in England at University College School of Medicine. He moved to Boston in 1987 for his clinical and research renal fellowship at Tufts-New England Medical Center in 1992 and joined the faculty at Tufts. In 1998, he joined the Brigham and Women’s Hospital as Clinical Director of the Renal Division and Associate Professor of Medicine at Harvard Medical School. He is also Director of Postgraduate Medical Education in the Department of Medicine at the Brigham and Women's Hospital.

Dr. Singh’s interests are in clinical research— with a particular focus on the anemia of chronic kidney disease— and in education. He is the author of over 150 original contributions and review articles, as well as author/editor of 11 books in nephrology. Dr. Singh is a Fellow of the Royal College of Physicians in London UK and has an MBA from Boston University.

Zarir F. Udwadia, MD, DNB, FRCP (London), FCCP (USA)

Dr. Udwadia is a consultant chest physician at the Hinduja Hospital, Breach Candy Hospital, and Parsee General Hospitals in Mumbai, India. A post-graduate of the Grant Medical College, Bombay, he spent five years training in various centers of excellence in the UK including Sir John Crofton's former TB unit in Edinburgh and the prestigious Brompton Hospital, London. He has a special interest and expertise in drug-resistant TB. About 7,000 patients pass through his busy clinic annually, a number of whom are MDR-TB patients referred by colleagues from all over India.

TB remains Dr. Udwadia’s overriding passion. He has lectured widely on TB including guest orations before the British Thoracic Society, the European Respiratory Society, the International Union Against TB, the American College Chest Physicians, the Harvard School of Public Health, and the Royal Society of Medicine, London. Dr. Udwadia has over 100 peer-reviewed publications and is co-author of Principles of Respiratory Medicine published in 2011 by Oxford International Publishers. He was the TB section editor for the journal Thorax. Dr. Udwadia’s 2011 report of the first patients in India with Totally Drug-Resistant TB attracted intense media and medical interest from across the globe. Drug-resistant TB became a national issue, and the Indian health authorities responded by declaring TB a notifiable disease and increasing the budget and staffing for TB care in Mumbai.

Life, Challenges and Hopes …a photo exhibit focusing on issues faced by many communities in Asia, the Middle East, and Africa— including climate change, the aging population, conflicts, refugee crises, urbanization, rapid globalization, structural violence— and on the efforts toward the solutions.

Bangladesh-born Shehzad Noorani is a documentary photographer with a deep interest in social issues. He grew up poor in Pakistan and later immigrated to Canada. Noorani has covered major stories resulting from man-made and natural disasters in Afghanistan, Iraq, Iran, Sudan, Sri Lanka, and Bangladesh. Other assignments for agencies like UNICEF have taken him to over 30 countries. Noorani received the Mother Jones International Award for Documentary Photographer for his film ‘Daughters of Darkness’; he also received an honorable mention by the National Geographic Magazine for his project ‘The Children of Black Dust,’ where he documented children inhaling millions of fine carbon dust particles from breaking batteries throughout the day. Notes