A new leader for the health sciences

Emory has named Fred Sanfilippo, a health sciences leader and transplant immunologist from Ohio State University, to head its academic and health care enterprise.
     Sanfilippo joins Emory as executive vice president for health affairs, CEO of the Woodruff Health Sciences Center, and chairman of Emory Healthcare. He succeeds Michael Johns, who became university chancellor this fall.
     At Ohio State, Sanfilippo was senior vice president and executive dean for health sciences and CEO of the university’s medical center. He also served as dean of the OSU College of Medicine and Public Health from 2000 to 2006. He began his medical career in 1979 at Duke, where he taught pathology, immunology, and experimental surgery. In 1993, he joined Johns Hopkins University School of Medicine, serving as Baxley Professor of Pathology, pathologist-in-chief of Johns Hopkins Hospital, and chair of pathology in the medical school. He was recruited by Johns, then dean of Hopkins’ medical school.
     After Johns joined Emory in 1996, the health sciences gained momentum by aggressively expanding its facilities and growing its research efforts in a number of areas, including predictive health and global health. Last year, Sanfillipo was a keynote speaker at Emory’s predictive health symposium. He helped launch a similar program at Ohio State.
     “Fred Sanfilippo will be a driving force as he continues the momentum of the health sciences at Emory,” says Johns. “He is joining an academic center with the greatest potential in the nation, surrounded by the best people anywhere.”

Ambassador for global health research

Ruth Berkelman, an expert in preparing for the threat of emerging infectious diseases, is among the newly named ambassadors in the Paul G. Rogers Society for Global Health Research.
     Established in 2006 by Research! America, the society includes 51 leaders in medical and global public health research. The group is charged with building a national discussion about the need to assign a high priority to global health research and meeting with opinion leaders and decision-makers to convey that message throughout the nation.
     “The rapid emergence of diseases, such as extensively drug-resistant tuberculosis in more than 35 countries, illustrates the critical need for global health research supported by both the public and private sectors,” says Berkelman, director of the Center for Public Health Preparedness and Research at the RSPH. “Such research can assure that large-scale health programs are well implemented and that further progress is made in diagnostics, vaccines, and other strategies to improve the health of those in impoverished nations as well as prevent the emergence and spread of disease throughout the global community.”
     Prior to joining the RSPH in 2001, Berkelman served as assistant surgeon general of the U.S. Public Health Service and as deputy director of the National Center for Infectious Disease. In her role at Emory, she directs research teams, training programs, and student response teams and collaborates with local, state, and federal public health leaders, other academic medical centers, and business leaders to prepare to respond to biologic and other threats.
     She is the second Rogers ambassador to be appointed from Emory. Jeffrey Koplan, vice president for academic health affairs for the Woodruff Health Sciences Center and director of the Emory Global Health Institute, was inducted into the inaugural class of the Rogers Society in 2006. The society is named for former Florida congressman Paul Rogers, a renowned advocate for research to improve health.

A watershed moment

Too often, creating clean water supplies and functional sanitation systems have been separate enterprises. The result can be wasteful, and often disastrous.
     With endowments from one of the founding fathers of the RSPH, Emory has taken on the challenge of bringing safe water and sanitation to all parts of the world. That effort is now being led by Christine Moe, who was recently named the Eugene J. Gangarosa Chair and director of the Center for Global Safe Water at Emory. The center is a collaboration involving the CDC, CARE, and other partners.
     An associate professor in the Hubert Department of Global Health since 2000, with joint appointments in the departments of Epidemiology and Environmental and Occupational Health, Moe is an eminent scholar on the environmental transmission of infectious diseases, such as noroviruses, and on sanitation and health. In 2006, she and her colleagues received the World Bank Development Marketplace Award for their groundbreaking sanitation project in Bolivia.
     “She is a giant in her field,” says Gangarosa, professor emeritus of global health. Three years ago, he and his wife Rose pledged support to endow two academic chairs: the Eugene J. Gangarosa Chair in Safe Water and Sanitation and the Rose Salamone Gangarosa Chair. Both chairs will share the same dual focus and support the Center for Global Safe Water at Emory. The second chair is yet to be awarded.
     “Between 2 and 5 million people, predominantly children, die each year of diseases caused by water and sanitation issues,” says Gangarosa. “This is a public health issue that encompasses the whole global village. The lack of safe water and sanitation undermines the sustainability of any other public health or development efforts, including education, food safety, economic development, gender equality, and geopolitical stability.”
     Moe and RSPH colleague Rick Rheingans have worked for the center since its inception in 2003. In her role as director, Moe plans to guide the center’s work in applied research, evaluation of water and sanitation projects, and training students and international collaborators. She credits Gangarosa with the vision for joining Atlanta experts in water, sanitation, engineering, and hygiene to tackle the safe water and sanitation problem.
     “Dr. Gangarosa initiated a series of meetings among scientists at Emory, CDC, CARE, The Carter Center, and Georgia Tech to work together on water, sanitation, and hygiene problems around the world,” says Moe. “Through his persistence, vision, and financial generosity, these meetings evolved into the Center for Global Safe Water. This coalition of academic and government scientists and NGO workers is unique in the water and sanitation field.”
     Prior to Moe’s appointment, the Center for Global Safe Water was led by James Hughes, former director of the National Center for Infectious Diseases and an assistant surgeon general in the U.S. Public Health Service. Hughes, who holds joint appointments in medicine and global health, will continue to serve as a senior adviser to the center and assist in developing partnerships and collaborative research.
     Like Moe, Hughes shares a special bond with Gangarosa. Their relationship dates back to 1973, when Hughes began his public health career as an epidemic intelligence officer at the CDC. It was Gangarosa who encouraged Hughes to pursue international training in waterborne diseases. That training contributed to Hughes becoming one of the nation’s leading epidemiologists in control of infectious diseases.—Valerie Gregg

Students expand partnership with Mexico

When eight RSPH students set off for Mexico City last spring, they took a well-traveled route. For several years now, RSPH researchers have engaged in cross-border collaboration with their colleagues at the Instituto Nacional de Salud Publica (INSP). Mexico’s premier public health research center, INSP is located in Cuernavaca, about an hour south of the capital.
     But with the creation of Emory’s Global Health Institute this year, new funding has allowed Reynaldo Martorell, Woodruff Professor and chair of the Hubert Department of Global Health, to support new initiatives. Among them is a student exchange called The Compañeros Project, named for the word “partners” in Spanish. Conceived of by RSPH students Kristin King and Maureen McDonald, the exchange—Rollins students to INSP in the spring, INSP students to Rollins in the fall—offers aspiring investigators an opportunity to learn about the public health system of a country intimately connected to, and affected by, their own.
     “We wanted to start a dialogue between students and investigators that could lead to thesis or even career opportunities down the road,” says King, who, along with McDonald, is a member of the Emory Global Health Organization (EGHO), the student group sponsoring the exchange. “It’s also about immersing ourselves in Mexican culture. That has a lot to do with issues of health and access to services.”
      Students heard lectures from key investigators who presented studies currently under way on HIV/AIDS, under-nutrition, lead poisoning, cervical cancer, diabetes, and obesity—the many maladies affecting the Mexican population. Among the presentations was an impact evaluation of “Oportunidades,” the government’s much imitated anti-poverty program, and clinical trials of a vaccine targeting four types of HPV (human papillomavirus), the cause of cervical cancer, which has killed more than 85,000 Mexican women over the past 20 years. RSPH students learned about the health risks—namely increased exposure to HIV—posed by migration.
      More than a series of lectures, the program offered students other experiences as well. A tour of government offices, such as the Center for Epidemiological Surveillance and Disease Control, Mexico’s version of the CDC, and the Office of Social Security, provided the big picture of public health in Mexico. But there was also the day the RSPH group accompanied INSP students to the small town of Huitzilac to interview community leaders to help carry out a needs-assessment survey.
      The fact that the RSPH students were all fluent in Spanish, a requirement for participation in Compañeros, made those encounters all the more enriching. “I think it shows that we’re invested in this,” says McDonald, who returned to INSP this past summer to assist in a study of maternal mortality in four hospitals. “We’re there to learn and we’re equal partners.”
     Indeed, as INSP students arrive in Atlanta this fall, the RSPH is ready to reciprocate. —Patrick Adams, 08MPH

Patrick Adams is an MPH candidate in global health and a participant in The Compañeros Project. To learn more about the project, visit www.sph.emory.edu/gh/insp_exchange/index.php.

Growing AIDS research

A major new grant enables RSPH and other Emory researchers to continue to mitigate the suffering caused by the AIDS epidemic.
     The NIH recently awarded a five-year $8.5 million grant to the Emory Center for AIDS Research (CFAR), based in the RSPH. With the grant comes renewal of Emory’s designation as an NIH CFAR site, one of 18 such sites in the nation.
     “Our opportunities to translate research into practice are unsurpassed,” says Dean James Curran, Emory CFAR principal investigator and co-director (administration and HIV policy) with Carlos del Rio (clinical science and international research) and Eric Hunter (basic science and translational research).
     The new grant supports the continued growth of AIDS research in five core areas: biostatistics, social and behavioral science, clinical research, immunology, and virology/drug discovery.
     In the years since the Emory CFAR was established, total HIV/AIDS research funding increased nearly threefold, from $23 million in 1996 to $59 million in 2005. Today, the CFAR umbrella encompasses 120 investigators from Emory, Georgia Tech, and Morehouse School of Medicine who collaborate in clinical, prevention, vaccine, and basic science research.
     RSPH researchers are part of this effort. Behavioral scientists Gina Wingood and Ralph DiClemente have designed three evidence-based HIV interventions that have been included in the CDC’s behavioral intervention programs. Susan Allen, professor in the Hubert Department of Global Health, established the world’s largest cohort of HIV discordant couples in Rwanda and Zambia. Also, three of Emory CFAR’s core units—biostatistics, social and behavioral sciences, and administration—are based in the RSPH

The rewards of teaching

Rob Stephenson joined the RSPH faculty three years ago because he missed teaching. He definitely came to the right place. Stephenson is the first recipient of the Early Career in Public Health Teaching Award, presented by the Association of Schools of Public Health and Pfizer Inc.
     An assistant professor in the Hubert Department of Global Health, Stephenson was honored for teaching excellence as a classroom instructor, mentor, and global health practice trainer. He honed his skills as a teacher at Johns Hopkins, where he helped develop and teach a summer institute on reproductive health and assisted several countries in designing public health courses and curricula, and as lecturer in demography and research methodologies at Southampton University and the University of London. He also designed and taught courses for mid-career professionals in Luxembourg, India, Nigeria, and Pakistan.
     In the classroom, Stephenson steps back so that students can test their skills and ideas to gain the confidence they need to tackle public health issues.
     “I try to avoid the didactic approach where I stand and teach,” he says. “I want them to learn from each other as much as they learn from me.”
     Stephenson takes special pride in advising students on their master’s theses. For the past two years, nine of his students have presented their work at the annual Population Association of America meeting.
     “I love working one on one with students and taking them on that journey,” he says. “I’m there to guide them, not tell them what to do. I’m a sounding board to make their ideas work.”

Making chronic disease a priority

Health policy expert Ken Thorpe is part of a national effort to put chronic disease on the agenda as a key health care issue in the 2008 U.S. presidential election. Thorpe joined former U.S. Surgeon General Richard Carmona, Mark McClellan, former administrator of the Centers for Medicare and Medicaid Services, and other leaders to launch the Partnership to Fight Chronic Disease in Washington, D.C., earlier this year.
     According to the CDC, chronic diseases are responsible for seven out of every 10 deaths in the United States, causing more than 1.7 million deaths a year. Chronic diseases are also the primary drivers of U.S. health care costs, accounting for more than 75% of the $2 trillion spent each year on health care.
     “Any serious proposal to reform our health care system must address preventable chronic diseases,” says Thorpe, Woodruff Professor and chair of the Department of Health Policy and Management at the RSPH. “Our nation’s premier business, labor, health care, and community organizations are dedicated to making chronic diseases such as asthma, diabetes, heart disease, and cancer the No. 1 health care priority for policy-makers and presidential candidates.”
     Thorpe also believes that reforming state health coverage policies and investigating coverage options at the national level will be important issues during the presidential campaign.
      Cost controls, he notes, are the key to success of any national or state health reform program. The long-term affordability and sustainability of the health care system depend on removing administrative costs from the system, changing the delivery of health care services for the chronically ill, and increasing investments in public health programs targeting health conditions such as obesity that account for the majority of cost inflation.
     Additionally, Thorpe recommends overhauling the fee-for-service payment system currently used by Medicare, noting that such a system does not adequately permit an integrated delivery model that includes preventive care, outpatient services, and follow-up reminders that keep people healthy and significantly reduce physician office and ER visits.
     “Right now, we have a fragmented, independent, unconnected system,” Thorpe told a group of health officials recently. “But a fragmented fee-for-service approach to pay for continuum of care doesn’t really make sense.”
     Medicare should be modernized, he notes, and incentives given to physicians who reduce a patient’s long-term problems. He also advocates cost-cutting measures for employers who provide health insurance to their employees.