Health Equity Symposium Banner Global Health Equity Symposium

Novartis in Africa Infographic

Novartis in Africa Infographic

Follow Us

FacebookTwitter

Overview

nibrIt has been a long standing challenge to help the developing world to battle disease, and while examples of progress have been made, including the eradication of smallpox, and the near eradication of polio, developing nations are still disproportionately burdened by infectious diseases that devastate lives and livelihoods, and put a continuous drag on struggling economies.

Some nations are making progress in public health, but a new unexpected burden of chronic, non-communicable diseases has emerged with changes in lifestyle and increasing life expectancies – including diabetes, cancer and asthma. Healthcare systems in these resource-limited regions are ill-prepared to deal with the long term needs of a population trying to treat and manage these conditions.

How do we create a new scenario in which every nation in the developing world has the power to improve the health of its population in the face of these challenges? Innovative solutions exist, but not necessarily where we have been looking for them until now.

In this year’s Health Equity Symposium, we challenged the common global division of labor in innovation, in which biomedical research is undertaken in industrialized countries ‘for’ developing countries, while technology and results are transferred ‘to’ the developing countries. The symposium focused on a new, more effective approach of increasing science and technology capabilities within the developing world. By building an infrastructure of research spaces, organizational capabilities, and a highly skilled workforce of scientists and clinicians, we ensure a path toward more sustainable, locally informed creative solutions.

NIBR logo

Topics

Presentations and panel discussions addressed the following topics:

  • Scientific capability development as a bidirectional effort. What industrialized and developing nations can learn from each other
  • Two visions: the future of basic science and clinical research in Africa
  • An in-depth discussion with the audience exploring innovative solutions to infrastructure building and capabilities development
  • Emerging challenges – dealing with the rise of chronic diseases in Africa and the developing world
  • African genome projects – optimizing treatment for genetically diverse populations
  • What lessons can be learned from previous efforts to eradicate disease?
  • Scientific and medical capability building – from historical context to enlightened future
NIBR logo

Symposium Media Archive  

Welcome and Introductory Remarks
Brigitta Tadmor, PhD, Vice President and Global Head, Education, Diversity & Inclusion and Health Policy, Novartis Institutes for BioMedical Research (NIBR)

Video
 Bio


Keynote Speaker
Lord Nigel Crisp, member of UK House of Lords, former director of the UK National Health Service
Author of “Turning the World Upside Down: The Search for Global Health in the 21st Century” and former director of England’s National Health Service, Lord Crisp has a truly unique vision for health care in the 21st century. It is a vision that seeks not only to right the disparities of health between nations, but to bring home the lessons learned when solving medical challenges in the developing world. So in regions where surgery is not an option, for example, treating the condition of clubfoot with physical therapy has proven to be successful. Such alternate approaches can also contribute to reducing medical costs in the West. In Lord Crisp’s world, capability building is bidirectional.

Video
 Bio, Slides

Envisioning a Future for African Science
John Gyapong, MBChB, MSc, PhD, FGCP, Pro-Vice Chancellor of University of Ghana
The future health of all African nations depends on the ability of each nation to develop an infrastructure for conducting scientific research, to invent new technologies and discover new medicines that help solve the most challenging problems of the region. The most important part of that new research infrastructure is a deep pool of well trained African scientists, connected by an open network of collaboration between laboratories, nations and continents. Dr. Gyapong speaks about the timely importance of African scientists making their presence felt.

Video
 Bio, Slides


Envisioning a Future for African Clinical Research
Bernhards Ogutu, MBChB, MMed, PhD, Chief Research Officer, Kenya Medical Research Institute
While infrastructure for basic research in Africa remains thin, the state of clinical research is, to put it generously, nascent. In order for African researchers to translate their laboratory discoveries into treatments that benefit the population, the infrastructure for conducting clinical trials and fulfilling the requirements of regional and international regulatory authorities must be built from the ground up. Dr. Ogutu describes the education and infrastructure required to build clinical research capability within Africa, using as an example the Phase I Initiative now underway at the Kenya Medical Research Institute.

Video
 Bio, Slides

H3-D – Fully Integrated Drug Discovery & Development in Africa
Kelly Chibale, PhD, FRSSAf, Professor of Organic Chemistry, Cape Town University and Founder & Director of the Drug Discovery and Development Centre (H3-D)
In order for diseases that primarily affect the African population to receive more focused scientific attention, African researchers must take a more active role in integrated modern drug discovery. This requires harnessing modern pharmaceutical industry skills and expertise - including medicinal chemistry, biology, pharmacology as well as drug metabolism and pharmacokinetics studies. Yet African nations will have to build these capabilities in the context of limitations in financial resources, skilled manpower, and access to technological platforms. This presentation will introduce the University of Cape Town Drug Discovery and Development Centre (H3-D) - a model for integrated drug discovery in Africa - its current project portfolio, and the efforts to set up the technology platforms required to enable drug discovery, from screening hits to preclinical testing.

Video
Bio, Slides


Panel Discussions - Building Capabilities in Research and Early Clinical Development
Moderator:
Timothy Rebbeck, PhD, Professor of Epidemiology, Director of the Center for Genetics and Complex Traits, Director of the Laboratory for Molecular Epidemiology; Associate Director for Population Science of the Abramson Cancer Center, University of Pennsylvania

Panelists:
Kelly Chibale, PhD, FRSSAf, Professor of Organic Chemistry, Cape Town University and Founder & Director of the Drug Discovery and Development Centre (H3-D)
Lord Nigel Crisp, member of UK House of Lords; former director of the UK National Health Servic
John Gyapong, MBChB, MSc, PhD, FGCP, Pro-Vice Chancellor of University of Ghana
Bernhards Ogutu, MD, PhD, Chief Research Officer, Kenya Medical Research Institute

Video


AORTIC - Cancer Research and Clinical Pathology in Africa
Timothy Rebbeck, PhD, Professor of Epidemiology, Director of the Center for Genetics and Complex Traits, Director of the Laboratory for Molecular Epidemiology; Associate Director for Population Science of the Abramson Cancer Center, University of Pennsylvania
With the increase of lifespan, changing demographics and lifestyle, cancer is set to become a greater problem in Africa than many infectious diseases in the coming decades. Dr. Rebbeck introduces the African Organization for Research and Training in Cancer (AORTIC) program, and its efforts toward increasing laboratory and pathology research capabilities within multiple countries of the region.

Video
 Bio, Slides


Reflections on the Development of Relevant Science and Research in Medicine in Africa
Sir Eldryd Parry, KCMG, OBE, MD, FCRP, Founder of THET (the Tropical Health and Education Trust)
Sir Eldryd presents an historical and personal review of the development of clinical research and education in sub-Saharan Africa. He reflects upon decades of history in the quest to overcome the burdens of disease, and how this has evolved within the political framework of the time. While infectious and, increasingly, non-communicable diseases are still dominant across Africa, the seeds of success can be seen in examples of effective and relevant collaborative efforts, past and present, which enable us to embrace a vision of stronger, sustainable healthcare systems throughout Africa.

Video
 Bio, Slides

The Neglected Epidemic - The Rise of Chronic Diseases in the Developing World
Daniel Arhinful, PhD, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana; Principle Partner, UK-Africa Partnership on Chronic Diseases
In 2010, 69% of deaths in Africa were related to infectious diseases. However, in the next 10 years, Africa is projected to face the most dramatic explosion in chronic conditions out of all the continents across the globe. What plans and efforts are in place to balance these needs for the people of Africa? Dr. Arhinful discusses how Africa, in partnership with Western nations, can adapt and respond to the gradual shift toward more chronic diseases.

Video
 Bio, Slides


Treating Chronic Disease in Africa
Somwe wa Somwe, MD, MMed, Head of the Pediatric Intensive Care Unit (PICU) School of Medicine, University of Zambia
The burden of non-communicable diseases is increasing in many sub-Saharan countries, yet patients with non-communicable diseases (such as asthma, cardiovascular disease, or cancer) are often poorly treated or not treated at all. Launched in 2006, the Zambora project is aimed at correcting this imbalance, and improving the quality of life for asthma patients in Zambia. The project takes on the task from three angles: 1) studies are conducted to determine the knowledge and perception of asthma treatment and control among patients in Lusaka, 2) healthcare professionals are trained to make more accurate diagnoses of asthma in patients, and to administer the appropriate medications, and 3) asthma treatment and management algorithms are being developed, along with procedures to ensure adequate distribution and access to inhaled medications. The Zamboro project can be considered a template for addressing the challenges of managing chronic diseases in Africa.

Video
 Bio, Slides

Personalized Medicine for a Global Population
Michèle Ramsay, PhD, Professor of Human Genetics and Interim Director of the Sydney Brenner Institute for Molecular Bioscience, National Health Laboratory Service and University of the Witwatersrand, Johannesburg, South Africa
The genomic era presents us with a detailed catalogue of genetic diversity across world populations and therefore we can begin to explore what we have in common and how we differ. The complexity of population structure, particularly among Africans and admixed populations, together with changing environmental influences create an interesting dilemma toward the concept of personalized medicine to serve a global population. Increasing cross-disciplinary research in developing countries will best identify the threats and serve the health needs of a region, appropriately informing public health interventions.

Video
 Bio, Slides

Lessons in Eradicating Diseases
Donald R. Hopkins, MD, MPH, Vice President for Health Programs Carter Center International Task Force for Disease Eradication
Having a vaccine or effective treatment in hand is only one prerequisite for a successful effort to eradicate a disease. The history of smallpox eradication and two recent campaigns that are close to eradicating Guinea worm disease and polio illustrate social, logistical, political and cultural considerations that must also be taken into account. By becoming the first eradication program to succeed without a vaccine or curative treatment, and the first to eradicate a parasitic infection, Guinea worm eradication will broaden the scope of eradication efforts. The International Task Force for Disease Eradication at The Carter Center has identified other potential candidates for eradication, and has advocated strongly for the bi-national effort now underway to eliminate malaria and lymphatic filariasis from the island of Hispaniola (Haiti and the Dominican Republic) by 2020. Some important lessons from eradication programs can be adapted to improve the control of many other diseases.

Video
 Bio, Slides

Closing Comments
Mark Fishman, M.D., President, Novartis Institutes for BioMedical Research (NIBR)

Video
 Bio

2013 Health Equity Symposium Posters

The following posters highlighting capacity-building programs and initiatives in Africa will be available for viewing throughout the day. Authors will be available to discuss these programs and address questions during breaks.

Poster Topics

Identifying Genetic Alterations in Breast Cancer Samples from Nigerian Women
Breast cancer remains the leading cause of cancer-related death in women around the world. Routine classification by immunohistochemistry, which drives the treatment of breast cancer in Western countries, is a challenge for African health care providers due to lack of or inadequate infrastructure for collecting biopsies and assessing hormonal status of breast cancer. Therefore, it is common practice for clinicians in Africa to treat breast cancer patients with hormonal therapy alone, rather than treat patients based on the genetic profile of their disease. In an effort to improve treatment options for breast cancer patients in Africa, NIBR established a research collaboration with the Broad Institute (BI), the University of Chicago (UC), and two teaching hospitals in Nigeria, the Lagos State University Teaching Hospital (LASUTH) and the University College Hospital (UCH) of the University of Ibadan to genetically profile and analyze breast cancer samples from Nigerian women and, in parallel, build a sustainable translational research infrastructure in Nigeria. View poster.

Drug Discovery and Development Center (H3-D) in Cape Town, South Africa
H3-D is a drug discovery and development center at the University of Cape Town designed to bridge the gap between basic science and clinical research on communicable and non-communicable diseases that affect Africa. The center aims to train and develop a new generation of African scientists with skills in integrated modern drug discovery. Novartis and H3-D have established a strategic alliance that includes scientist exchange programs and financial support from the Novartis Research Foundation for training grants and infrastructure upgrades. The scientist exchange program allows H3-D scientists to experience state-of-the-art technologies at Novartis facilities as well as develop their leadership and communication skills. It also provides an opportunity for Novartis scientists to share their expertise with scientists at H3-D. Through these collaborations, Novartis will gain insight into medical problems and healthcare issues on the African continent. Moreover, the impact of these collaborations are anticipated to result in continental empowerment, a necessary step on the path to global health equity. View poster.

Scientific Education Initiatives: Drug Discovery Workshops in Africa
Education is a fundamental component of the scientific capacity- and capability-building efforts of Novartis in Africa. NIBR has partnered with local scientific organizations or institutions to create and offer drug discovery workshops in Ghana and Zimbabwe in 2012. The goal of these workshops is to share our drug discovery knowledge and expertise with African scientists and encourage biomedical research to address local healthcare concerns. NIBR scientists who serve as faculty have an opportunity to expand their cultural understanding, gain first-hand insights about local healthcare challenges and experience innovative solutions to challenges rarely faced in the developed world. These shared learning experiences hold the promise of creating effective partnerships with the goal of improving patients’ lives in Africa. View poster.

Eliminating Rheumatic Heart Disease amongst Children in Zambia: A Registry Study
Rheumatic heart disease (RHD) has been practically eradicated in wealthy nations, but in the developing world the disease remains a major cause of morbidity and mortality, particularly in children and young adults. Although the disease burden of RHD has yet to be fully understood, populations in sub-Saharan Africa are believed to be disproportionately affected. RHD is one of the few truly preventable chronic diseases, and can be treated effectively with prophylactic penicillin when diagnosed echocardiographically in an early, clinically silent stage. In this project with the University Teaching Hospital in Lusaka, and the Ministry of Health in Zambia, we will screen 10,000 children for RHD at public schools in Lusaka using echocardiography, we will develop an electronic registry to document disease prevalence and monitor RHD patients, we will build community awareness about strep throat, rheumatic fever and RHD and the importance of penicillin prophylaxis to prevent RHD-related morbidity and mortality – with the ultimate goal of eliminating RHD in Zambia. View poster.

Building Capacity & Capability in Africa through Scientific Internship & Fellows Programs
Science in Africa has entered a period of rapid growth and leaders see science and technology as the keys to progress, making it a high priority on the development agenda. In this context and as part of the company’s effort to address medical needs around the globe, Novartis is building scientific and clinical capacity in Africa through partnerships with local universities and research centers. The aim of these efforts is to expose scientists and clinicians from emerging countries to drug discovery and development expertise at Novartis, while at the same time educating our researchers to the practice of science and medicine in Africa. The Basel Summer Internship and Cambridge Visiting Fellowship are two programs designed to learn from each other while training the next generation of scientists. Working with our partners in Africa, we will be able to find solutions to medical problems in ways that are best suited to the African continent. View poster.

Building Chemistry Capabilities in Kenya
Novartis initiated a Fellows program for African academic scientists in 2010, providing a nine-week industrial immersion experience at NIBR Cambridge. Through their scientific projects and activities, the Fellows learn new laboratory techniques, discuss experimental design with NIBR scientists and enhance their scientific communication skills. The Fellows’ time in our laboratories has a lasting and wide-reaching influence on teaching and research activities when they return to their universities. As chemistry is an essential discipline in the drug discovery process, it has been a focus area for several visiting African Fellows and their NIBR scientific mentors. In particular, computational chemistry has minimal requirements and is ideally suited as an area for scientific capacity building in Africa. Additionally, extending chemistry capabilities in African laboratories to assist natural products research is of interest. Thus, in 2012, two NIBR chemists traveled to Kenya to deploy equipment, train scientists in its use, deliver medicinal chemistry seminars, strengthen relationships with former Fellows and build new connections. View poster.

Phase I initiative – Expanding Early Clinical Capabilities in Africa
Early phase (Phase I) clinical trials generate essential information on a drug’s safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) and are generally conducted in healthy subjects. Due to genetic, dietary, and environmental factors that influence drug effects, it is important to examine these drug properties in all subject populations, including Africans. Although several facilities in Africa are capable of conducting later phase clinical trials, there is a dearth of sites that can conduct early phase trials. The goals of the Phase I Initiative are to understand the challenges involved in conducting clinical trials in Africa including cultural influences and local regulatory requirements, to assist clinical research centers in Africa to expand their capabilities in the execution and management of Phase I trials, and to build sustainable partnerships with these centers to conduct Phase I clinical studies in the development of drugs to treat diseases that affect African populations. View poster.

Master of Vaccinology Program: An Extensive Educational Partnership & Unique Training Opportunity
The Novartis Vaccines Academy and the University of Siena, Italy, joined efforts to introduce a postgraduate course, the “Master Program in Vaccinology and Pharmaceutical Clinical Development” in 2009. The course, fully in English, is designed to cover all aspects of vaccinology and clinical research, including: Epidemiology, Vaccine Prevention, Public Health, Health Economics, Immunology, Vaccine Research, Clinical Development methodology, Regulatory Affairs, Pharmacovigilence and Pharmaceutical development process. Twenty-two students from 18 developing countries have already graduated and many have returned to their home institutions. These graduates are among the first of many who we expect will continue to build vaccinology capabilities in Africa. View poster.

Capability Development in Mathematical Modeling & Simulation to Benefit Healthcare in Africa
Africa has a high burden of communicable diseases, including Malaria, HIV/AIDS and Tuberculosis while simultaneously dealing with non-communicable diseases like Cancer, Cardiovascular Disease and Diabetes. Modeling and Simulation (M&S) methodologies have been shown to be of value to patient care for these healthcare problems. However the scientific capabilities to apply these techniques are not widely available in Africa and emerging countries. The purpose of this communication is to: (1) make the case for capability development in Modeling & Simulation in Africa; (2) provide examples of specific programs; (3) highlight the importance of academia-industry collaboration; and (4) share these ideas with a view to solicit collaborators and partners. View poster.

The Role of Clinical Epidemiology to Understand and Address Africa’s Disease Burden
The essential first step to combatting any healthcare problem is to understand its scope. In Africa, basic epidemiological information on disease burden is lacking. This problem is further amplified by the shortage of skilled epidemiology researchers, which is an important obstacle that has to be addressed. Stakeholders in such epidemiological information include government ministries and payors responsible for resource allocation; and pharmaceutical executives and health research scientists planning intervention strategies. This communication will: (1) motivate that understanding the disease burden is essential to address any healthcare problem; (2) highlight the challenges of getting reliable epidemiological data in Africa; (3) describe the University of Stellenbosch, MSc (Clinical Epidemiology) program; and (4) describe how student projects can have the potential for benefitting specific country’s needs in Africa. View poster.

A Vaccine Against Fatal Invasive Salmonella Disease for Africa
The Novartis Vaccines Institute for Global Health (NVGH) in Siena, Italy, focuses on developing vaccines for neglected infectious diseases of impoverished communities, while building capacity in developing countries. An important neglected disease, against which NVGH is developing a vaccine, is invasive nontyphoidal Salmonella (iNTS). This is the most common form of bacterial bloodstream infections in sub-Saharan Africa, and is caused by types of Salmonella, particularly Typhimurium and Enteritidis, that are different from those responsible for typhoid fever. iNTS is devastating for Africa, where 500 per 100,000 African children per year are infected and 20-25% of cases are fatal. Current challenges include prompt diagnosis and antibiotic resistance. In collaboration with partners throughout Africa, including Kenya, Malawi and South Africa, NVGH has developed prototype vaccines against iNTS. Preclinical studies indicate that these prototype vaccines lead to the production of a strong immune response with the potential to protect African children against this often fatal form of Salmonella disease. View poster.

Welcome and Opening Remarks
Mark Fishman, M.D., President, Novartis Institutes for BioMedical Research

Video


Symposium Keynote – A Comprehensive Perspective on Health Equity: Lessons from Evidence Based Reform in Mexico
Julio Frenk, M.D., Ph.D., MPH, Dean, Harvard School of Public Health; Former Minister of Health, Mexico
Dr. Frenk was the Minister of Health and founding director-general of the National Institute of Public Health in Mexico, one of the leading institutions of health education and research in the developing world. He also served as an executive director of the World Health Organization (WHO), where he focused on bringing scientific evidence to bear on health policy. As Minister of Health of Mexico from 2000 to 2006, Dr. Frenk pursued an ambitious agenda to reform the nation's health system, with an emphasis on redressing social inequality.

Video
 Bio

Chairperson’s Opening Remarks
William R. Sellers, M.D., VP & Global Head of Oncology, Novartis Institutes for BioMedical Research

Video


Using Genetics to Improve Breast Cancer Outcomes and Reduce Health Inequities
Olufunmilayo (Funmi) Olopade, M.D., Walter L. Palmer Distinguished Service Professor in Medicine and Human Genetics, University of Chicago
Women of African descent have an overall lower prevalence of breast cancer than white women, but because the profile of their cancers are different (typically ER-, PR-, HER2- or "triple negative") they have a higher mortality rate. Here we examine the biological origins of disparity in health care outcomes, as well as the ways in which biology can affect sociological issues such as the need to adapt screening and therapeutic protocols, and redefining the meaning of access to quality care for minority groups.

Video
 Bio, Slides


The Biological Foundations of Disparity in Prostate Cancer Disease and Treatment
Stefan Ambs, Ph.D., MPH, Senior Investigator & Head, Breast and Prostate Unit Senior Investigator, Center for Cancer Research, National Cancer Institute
Despite scientific gains, not all segments of the U.S. populations have equally benefited from the advances in the understanding of cancer, leading to cancer health disparities among disadvantaged populations. Although some minority groups experience significantly lower rates of certain cancer types than the majority of the U.S. white population, other ethnic populations, particularly African-Americans, experience higher cancer incidence and mortality rates. We are examining the relative contribution of medical history and lifestyle factors, common genetic variations, and differences in tumor biology to the cancer health disparity in prostate and breast cancer that exists between African-Americans with European-Americans. Our research is aimed to identify risk factors that contribute to the aggressiveness of these two cancers among African-American patients.

Video
 Bio, Slides


Diversity, Disparities, and Cancer Research at Memorial Sloan-Kettering Cancer Center
Carol L. Brown, M.D., FACS, Director, Office of Diversity Programs; Associate Attending, Department of Surgery Memorial Sloan-Kettering Cancer Center
The Office of Diversity Programs at Sloan Kettering has three major areas of focus: clinical care, research, and training. In the area of clinical care, we're working to improve the Center's screening, diagnosis, and treatment programs to ensure they reach medically underserved populations. The research component ensures that medically underserved and minority populations participate in clinical trials and promotes collaboration and communication among basic and clinical researchers at Memorial Sloan-Kettering and other institutions investigating cancer health disparities. The third focus, training, seeks to increase representation of minority faculty at Memorial Sloan-Kettering, including both research scientists and clinicians This presentation will review our experience with diversity and disparities research and inclusion of minority and medically underserved populations in the cancer research program of a leading NCI-designated comprehensive cancer center.

Video
 Bio, Slides

Chairperson’s Opening Remarks
Mark Keating, M.D., VP & Global Head of Cardiovascular and Metabolic Diseases, Novartis Institutes for BioMedical Research

Video


The Global Landscape of Disparity in Cardiovascular and Metabolic Diseases
Charles Rotimi, Ph.D., Director Center for Research on Genomics and Global Health, National Institutes of Health
The mission of the Center for Research on Genomics and Global Health is to advance research into the role of culture, lifestyle, genetics and genomics in health disparities. A key focus of the research is on obesity, hypertension and diabetes, which together account for more than 80% of the health disparity between African Americans and European Americans. Ongoing studies are being conducted in several African countries and the United States, including the Africa America Diabetes Mellitus (AADM) study, the Howard University Family Study, the Genetics of Obesity in Blacks Study, the Black Women’s Health Study, and the Engagement of African Communities for the International HapMap Project. We are currently engaged in the first genome-wide scan of an African American cohort of more than 2000 participants. Since much of the work internationally involves vulnerable populations, we are also studying issues related to informed consent in genetic studies.

Video
 Bio, Slides


Taking an Integrated Course of Action to Address Obesity and Diabetes in Asian Americans: From Bench to Bedside to Community
William Hsu, M.D., Assistant Professor, Harvard Medical School, Medical Director Asian Clinic, Co-director Asian American Diabetes Initiative, Joslin Diabetes Center
Metabolic diseases such as obesity and diabetes have become a global phenomenon. Despite having a lower body weight, Asians and those of Asian descent living in Western countries are disproportionately impacted by diabetes. The rising prevalence of metabolic diseases in Asians not only have concrete biologic basis, but occurs in cultural context that are relevant to its pathogenesis. Preventive and treatment strategies must take into account physiologic, behavioral and cultural factors. It is this intersection of physiology and culture in the context of a community that serves as the critical starting point in addressing disparities in healthcare.

Video
 Bio


Lessons from Bidil
Charmaine Royal, Ph.D., Associate Research Professor, Duke Institute for Genome Sciences & Policy
Bidil was the first drug approved by the FDA specifically targeted to a racial group. Initially meant to address disparities in cardiovascular therapy for individuals of African descent, the commercialization of the drug encountered obstacles traced forward to social issues and back to fundamental scientific and clinical research strategies. This presentation examines the important lessons that can be drawn from the development and commercialization of this drug to inform the development and commercialization of a new generation of drugs serving unmet medical needs of minorities.

Video
 Bio, Slides

A Transdisciplinary Approach to Addressing Health Disparities
Moderator:
Timothy Rebbeck, Ph.D., Professor of Epidemiology, University of Pennsylvania School of Medicine
Panelists:
Armin Weinberg, Ph.D., Professor & Director Center for Chronic Disease Research, Baylor College of Medicine
Sarah Gehlert, Ph.D., Professor of Racial and Ethnic Diversity, Washington University in St. Louis
William Hsu, M.D., Assistant Professor, Harvard Medical School, Medical Director Asian Clinic, Co-director Asian American Diabetes Initiative, Joslin Diabetes Center
Charles Rotimi, Ph.D., Director of the Center for Research on Genomics and Global Health, NIH

Health disparities are likely caused by the complex interactions of biology, behavior, social circumstances, access to care, and other post-diagnosis factors that influence clinical outcomes. Elimination of health disparities is a critical public health need: It has been estimated that the complete elimination of health disparities during the 1990’s would have saved five times more lives than were saved by technological innovations in health care over the same period. Because the causes of these disparities are complex, solutions that will eliminate these disparities may require teams of researchers, clinicians, and community members that can achieve the following:

  • Integrate the biological, genetic, behavioral, and population sciences to provide novel insights about health disparities.
  • Develop innovative new models & methods that can simultaneously account for multiple factors and multiple levels.
  • Translate these research findings into interventions and policy that will reduce disparities.
  • Involve affected communities in addressing these disparities.

Thus, an important focus of translational research in health disparities should involve multidisciplinary teams and have the potential to develop translational interventions that will have a significant impact on reducing or eliminating health disparities.

Video
 Bio, Slides

Chairperson's Opening Remarks
Peter Finan, Ph.D., Executive Director, Developmental and Molecular Pathways, Novartis Institutes for BioMedical Research

Video


Developing a Platform for Genomic Medicine in Mexico
Gerardo Jimenez-Sanchez, M.D., Ph.D., President of the Working Party in Biotechnology, Organization for Economic Cooperation and Development (OECD), and Senior Partner at GBC Group, Mexico
Mexico initiated the development of a platform for genomic medicine in 1999, as a part of its efforts to improve healthcare of the Mexican population and join the knowledge-based economy. Most Mexicans are Mestizos resulting from admixture of Amerindian, Spaniard and African populations. The admixture process has led to particular genomic ancestry structure. To optimize the use of human genome information to improve healthcare in Mexicans, we are systematically evaluating genomic variability of the Mexican population. We are including additional Mexican Amerindians and increasing SNP density to better understand the admixture process in Mexicans, and develop more suitable tools to analyze the genetic bases of complex diseases in this population. In addition to the construction of a haplotype map of the Mexican population, other projects in progress include those related to the genomic basis of diabetes, obesity, cardiovascular disease, and cancer. A recent evaluation of the first 10 years of this project showed sustainable progress towards the construction of such platform for genomic medicine in Mexico.

Video
 Bio, Slides


Establishment of a Biobank and Pharmacogenetics Database of African Populations
Collen Masimirembwa, M.D., Ph.D., Director, African Institute of Biomedical Science and Technology, Zimbabwe
In the areas of genomics, pharmacogenomics and biobanking, developed countries are already way ahead compared to developing countries. There are, however, emerging efforts to ensure that Africa becomes part of this biomedical revolution. In 2003 (the year the first draft of the human genome was published), led by African scientists in the diaspora and those working in Africa, the African Society of Human Genetics was established to provide a platform on which the wealth of information and research opportunities accruing from genomic and genetics research could be discussed for the benefit of Africa. At the same time, the African Institute of Biomedical Science and Technology established a Consortium for Biobanking and Pharmacogenetics/genomics research in African populations to research on the impact of genomics on the discovery, development and optimal clinical use of medicines in Africa. Here we will report on efforts to establish a Biobank and results of our recent studies in pharmacogenetics-guided dose optimization in the use of anti-retrovirals in African populations.

Video
 Bio, Slides


Expression Differences by Continent of Origin
Adam Davis, Ph.D., Assistant Professor, Morehouse School of Medicine
Cross-population expression studies are fraught with the well-known variability in the biology as well as the increasingly documented intrinsic biases of expression patterns of immortalized cell lines. Technical bias may affect many genes in concert, thus causing spurious correlations in clinical data sets and false associations between genes and clinical variables. The study of the transcriptome in groups with different ACOO is particularly problematic in that most of these studies are performed on Epstein–Barr virus (EBV) immortalized cell lines. To address this apparent inconsistency, we applied a novel approach to accentuate population-specific gene expression signatures.

Video
 Bio, Slides

Chairperson's Opening Remarks
Alison Schecter, M.D., Executive Director, Translational Medicine, Novartis Institutes for BioMedical Research

Video


Diversity in Human Embryonic Stem Cell Lines
Noah Rosenberg, Ph.D., Associate Professor of Human Genetics, Ecology & Evolutionary Biology, and Biostatistics, University of Michigan
Human embryonic stem-cell research has the potential to lead to new methods of drug discovery, insights into mechanisms of disease, and eventually, cellular therapies. The eventual benefit to patient populations may depend partially on the population diversity of the stem-cell lines that are available for research and clinical use. Here we discuss an effort to characterize the population ancestry of the human embryonic stem cell lines most commonly employed in current biomedical research. The presentation concludes with a discussion of issues surrounding the incorporation of lines of diverse ancestry in research on human embryonic stem cells.

Video
 Bio, Slides


Diversity in Tissue Biobanks
Carolyn Compton, M.D., Ph.D., Director of the Office of Biorepositories and Biospecimen Research (OBBR) National Cancer Institute
Human specimens such as blood and tissue samples are the foundation of translational biomedical research. Much work is required to improve the quality of biospecimens and the way they are stored and annotated, and efforts are underway at the National Cancer Institute to support biobanks. An important issue to consider is the diversity of the samples in storage, and the efforts employed to recruit donors of diverse ethnic origins. Such diversity will become necessary to ensure that basic and translational research is not skewed to any particular group.

Video
 Bio, Slides

EDICT (Eliminating Disparities in Clinical Trials)
Armin Weinberg, Ph.D., Professor & Director Center for Chronic Disease Research
Baylor College of Medicine

It has been known for decades that members of certain populations are medically underserved due to many factors, such as age, gender, race, ethnicity, language, and geographic location. These populations also remain “underrepresented” in our nation’s clinical trials, often resulting in clinical research that does not assess how treatments may affect members of specific populations differently. Addressing any national health concern requires a systematic approach, one that provides assistance not only directly to individuals, but also promotes change at community, local, state, and national levels.  This is the underlying strategy of the EDICT Project which brought together representatives from the public, private and nonprofit sectors to propose thoughtful and viable policy solutions to the problem of under-representation of certain populations in clinical trials.

Video
 Bio, Slides

Panel – The Business Case for Health Equity
Panel Moderator: Armin Weinberg, Ph.D., Professor & Director Center for Chronic Disease Research, Baylor College of Medicine
Panelists: Susan S. Night, JD, LLM, Ph.D., Senior Health Policy and Ethics Fellow, Baylor College of Medicine
Richard L. Dockins, M.D., Preventative Medicine Specialist, ExxonMobil Corp.
Collen Masimirembwa, M.D., Ph.D., Director, African Institute of Biomedical Science and Technology, Zimbabwe
Gerardo Jimenez-Sanchez M.D., Ph.D., President of the Working Party in Biotechnology, Organization for Economic Cooperation and Development (OECD), and Senior Partner at GBC Group, Mexico

There are numerous approaches to achieving health equity, many of which have been addressed in this Symposium. However, such efforts do not occur without a cost which must be considered within the overall mission and budget of any organization. This panel offers a perspective on the costs associated with reducing the gap in health disparities and health inequities and the returns on such an investment.

Video
 Bio, Slides

NIBR logo