Moving Medical Education in Sub-Saharan Africa Toward a Sustainable Future

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Sub-Saharan Africa bears 24 percent of the world’s disease burden, but has just three percent of its health workforce. Training — and retaining — physicians on the continent has been an ongoing challenge. Impoverished health systems, the world’s highest prevalence of HIV/AIDS, and the constant lure of emigration take heavy tolls on the graduates of the 160 medical schools in sub- Saharan Africa.

Recently, the National Institutes of Health (NIH) tapped the School of Public Health and Health Services to serve as the coordinating center of its Medical Education Partnership Initiative (MEPI), a $12.5-million, five-year project to increase medical education capacity at 12 participating medical schools in sub-Saharan Africa. Researchers Fitzhugh Mullan, M.D., Murdock Head Professor of Medicine and Health Policy, and Seble Frehywot, M.D., M.H.S.A., assistant professor of Health Policy and of Global Health, will serve as principal investigators on the project. They will assist medical schools from 12 countries in enhancing the quantity, quality, and retention of their graduates.

MEPI emerged from the 2008 reauthorization of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which included a mandate to train 140,000 new health workers in Africa over five years. Through the initiative, the NIH seeks to expand medical education and build health care capacity to combat HIV/AIDS, while also creating a workforce that can address other local health problems across the spectrum of diseases.

“It is vital that we develop medical and research capacity in sub-Saharan Africa so that advances can be quickly adapted for local use,” said NIH Director Francis Collins, M.D., Ph.D., when announcing MEPI. “This program will not only strengthen medical education to produce much-needed caregivers, but will also generate well-trained researchers.”

GW will work with the participating medical schools to establish baseline assets and needs. “We want to get a sense of how their educational engines function in terms of the training they offer, numbers of people trained, and where their graduates practice,” explains Mullan.

Following the initial assessments, GW and its local partner, the African Center for Global Health and Social Transformation, led by Francis Omaswa, M.D., will develop technical support plans that address the specific needs of each school. GW will link the schools to resources and expertise to enhance their basic and clinical science teaching.

Communication is an essential aspect of the project. GW will establish an electronic platform to support information sharing, mutual curricular projects, and data collection between the participants. In addition to regular site visits to each school, the GW team will coordinate an annual symposium for the participants.

Despite the challenges presented by the scale of the project, Mullan and Frehywot recognize the enormous potential MEPI offers for both analysis and contribution. “Assisting these institutions is a rare opportunity to conduct educational service and, if we succeed, impact the medical education systems of an entire continent,” Mullan says.

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