AMPATH began 30 years ago as a partnership between Indiana University and Moi University and Moi Teaching and Referral Hospital in Kenya and has grown to include a dozen leading academic health centers in North America. In addition to creating one of the world’s largest and most successful HIV care and control programs, AMPATH is working with the government of Kenya and Kenyan Ministry of Health to create a sustainable health care system in western Kenya including treatment for non-communicable diseases such as hypertension and diabetes as well as various types of cancers and other chronic diseases.
What is your background in global health?
I was born in Scotland and lived in France for the first six years of my life. Even at this early age, having an international experience led to a desire to explore the world. I completed most of my education in the US, and ultimately spent eight years at Brown University earning both my undergraduate and medical degrees. In 2001, I went to Kenya for the first time as a student at Brown. This was around the time that the HIV program was first being conceived by Joe Mamlin and that experience had a huge impact on my life and career plans.
I became very interested in HIV and tuberculosis and after returning from Kenya, I completed my 4th year longitudinal clinic in the TB clinic in Rhode Island with Dr. Jane Carter. During post-graduate training, I sought every opportunity to return to Kenya and served as the AMPATH Team Leader in 2006-07, and then returned to Boston to complete a fellowship in infectious diseases. I returned to AMPATH in Kenya full-time in 2012 with my wife, Jessica. Since that time, our family has grown to include three children who are very much a part of the larger “AMPATH and IU family.”
Three decades of global health leadership: Joe Mamlin, Bob Einterz and Adrian Gardner in Kenya
What makes IU’s efforts in global health unique?
The Indiana University Center for Global Health (IUCGH) has created unique opportunities for successful engagement in health care delivery, education and research. AMPATH, IUCGH’s signature program in Kenya, is one of the most successful international academic partnerships in the world and has attracted praise from leaders of the National Institutes of Health, the World Bank, the World Health Organization, the United States Agency for International Development, and countless other organizations involved in global health. One of the core principles of this partnership is an authentic effort to improve health services for the local population in Kenya, embodied by the motto “Leading with Care.” This long-term, institutional commitment to sustainable health service delivery creates an environment that hosts high-quality educational and research opportunities for North Americans and Kenyans. The outcomes and lessons learned from this partnership can be applied globally and even locally within the United States.
What are your aspirations for the IU Center for Global Health?
My goal is to ensure the continued growth of Indiana University and the IU School of Medicine’s national and international reputation as a global health leader by growing our work in all three of our mission areas: care, training and research. We are poised to grow the AMPATH model in other geographic regions which will create additional opportunities for research and education. With the support of our university partners, we are actively pursuing innovation within the Kenya partnership, particularly regarding health systems and models of universal health coverage which have the potential to be a model not only for Kenya, but for other parts of the world. The global health research program is prepared to expand through leadership of existing research networks such as IeDEA (International epidemiology Databases to Evaluate AIDS) and Global Network, building strong linkage with the Indiana Clinical and Translational Sciences Institute (CTSI), and expanding opportunities for young investigators. These opportunities, combined with our unique global health residency track, aid the university and IU School of Medicine in recruiting and retaining high-quality medical students, residents, and faculty engaged in global health training and research and assist us in raising philanthropic support for all of these activities.
What excites you about the work you and your colleagues are doing in Kenya?
What initially appealed to me about AMPATH was the opportunity to personally interact with some of the world’s most vulnerable citizens and to be able to impact individual lives with relatively limited resources. That personal connection is still very important to me, but my interest has evolved into building a health system that is broader than the HIV program and that can eventually be sustained by the Kenyan government and domestic health funding. AMPATH is well-positioned to demonstrate this model of population health on the ground, not only because of our successful HIV effort, but also because we have the trust of the community. Patients know that the clinicians and facilities will be there when they are needed.
We also have to demonstrate to our funders and donors that their interest (HIV care, diabetes treatment and prevention, maternal child health, etc.) will ultimately be more successfully addressed as part of a broader health system. If we don’t provide economic empowerment to patients and build out the system, then individual efforts are not going to be sustainable for the long-term.
Clinical interaction with patients is still very important to me, and I have continued to run a weekly HIV resistance clinic at Moi Teaching and Referral Hospital and to round on the wards both in Kenya and Indianapolis. Many of the solutions we have created in partnership with our Kenyan colleagues are very applicable to resource-limited situations in the U.S. as well.
What makes AMPATH special?
AMPATH’s philosophy of leading with care is one of the things that makes us unique among other institutions and agencies doing this type of work. We look at the needs of the people we are trying to serve and create programs that are responsive to community needs rather than responding to the next grant application that comes down the line. We think about those needs in 20, 30 and 40 year increments.
Part of that philosophy is the belief that an academic health center better serves its population because of the health system’s connection to an academic institution. Because of this, we have a commitment to continue to build the capacity of the Kenyan Ministry of Health care system to provide specialty and sub-specialty care and build the capacity of Moi University School of Medicine to train professionals who will eventually take on leadership roles in the country.
The unique collaboration between North American academic institutions as part of the AMPATH consortium is also a vital part of AMPATH’s success. The involvement of the consortium members is truly complementary, with every academic institution bringing their own expertise and perspective. No single institution can bring that and it translates to a much more comprehensive resource.
The views expressed in this content represent the perspective and opinions of the author and may or may not represent the position of Indiana University School of Medicine.
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