Dean's Message - May 2008

Dear Colleagues:

The School of Medicine has long been committed to exporting its best practices in healthcare delivery and biomedical research to the rest of the world through collaborations with other medical centers and research institutions through our state-of-the-art telehealth and telemedicine technologies.

We have a large group of internationally-recognized clinicians and scientists who do groundbreaking research in basic, clinical and translational science, and we believe strongly in sharing their expertise with the rest of the world. Our faculty carry out epidemiologic, clinical and laboratory research, and work with local public health officials in many countries around the world (see tables below).

Indeed, the school has a long history of significant contributions to global health, through research, healthcare delivery, outreach and public policy. Some of our initiatives are well-known, such as the Center for Vaccine Development's (CVD) work in creating and testing vaccines for some of the world's most vexing infectious diseases, such as ma-laria and avian flu. Likewise, the work of our Institute of Human Virology in treating and preventing AIDS is recognized the world over.
Other School of Medicine initiatives are lesser-known, however, such as the Department of Pediatrics' research into neonatal and infant infections in India, and our burgeon-ing research programs in protecting against bioterrorism and sequencing the genomes of major pathogens.

Although our contributions are significant, they can never be enough. For example, recent advances in medicine and technology have fueled unprecedented opportunities for improved health outcomes and extended life expectancy across the globe. Unfortunately, there has not been an equitable distribution in the allocation of these precious health-care resources. Moreover, highly preventable diseases, such as whooping cough, measles and malaria, which are now extremely rare in developed countries, are still raging in developing countries, leaving paths of death and destruction in their wake. Even more troubling, many developing countries lack the necessary capacity to implement even the most basic of these life-saving medical interventions. When one factors in the global shortage of adequately trained healthcare workers, the situation is extremely dire.

Over one million Africans die of malaria each year, hundreds of thousands of whom are children. It continues to be the leading killer of the world's poorest children. Un-daunted, our faculty work tirelessly to make an impact on this untenable situation and are making progress. For example, our researchers recently found that an anti-malaria medication that had previously lost its effectiveness as a first-line treatment for malaria has somehow regained its effectiveness (New England Journal of Medicine, 355:1959-1966, 2006). Chloroquine was removed from government health facilities in Malawi in 1993 after it proved ineffective at treating malaria in more than 50 percent of documented cases. However, our study showed that the malaria parasite has once again become susceptible to chloroquine, and the medication can potentially be used in combination with other therapies to treat the disease effectively in the future.

We also recently received a $23.7 million grant from the National Institutes of Health for our Vaccine and Treatment Evaluation Unit (VTEU) to conduct clinical trials for promising vaccines and therapies for such diseases as malaria, dysentery, cholera and typhoid fever that affect primarily people in developing countries. The CVD's VTEU has been testing vaccines for the federal government for over 30 years in an effort to prevent a wide array of infectious diseases that affect children, adults and the elderly. These are but two examples of ground-breaking work School of Medicine faculty are doing to help alleviate suffering around the globe.

Developing countries also face some of today's most complex medical challenges, such as emerging infectious diseases like Ebola and avian flu. These diseases require novel research, technology and clinical approaches. We are leading the way in vaccine-based efforts to fight these diseases. For example, we conducted clinical trials to test the first cell culture-based pandemic influenza vaccine to see if it will provide immunity faster and more reliably than the vaccines that are currently produced in eggs. The study was also the first test in the US of a whole virus vaccine for avian flu, which could produce a stronger response by the immune system.

Additionally, chronic diseases such as diabetes and cancer represent an increasing burden in resource-poor environments, as they require long-term management of patient information for optimal care outcomes. Yet the health care delivery systems and practitioners in the developing world face considerable challenges in implementing the neces-sary health management information systems.

Telemedicine provides critical access to medical care for remote populations, and is used to diagnose, review patient information, conduct research and manage chronic conditions. Our telemedicine capabilities in the Center for Health Disparities and Program in Trauma have demonstrated significant expertise in the use of advanced telecom-munications technology for health care delivery and clinical consultation for remote application in reaching underserved populations in the US. This knowledge, applied in the context of global health, offers a significant contribution to the field and to the future health of our global community.

Similarly, distance learning is a powerful tool for expanding the number of health professionals trained throughout the world. We are already a national leader in the field of distance learning. With its existing relationships in global health, the current distance learning infrastructure can respond to the shortage of trained health care workers in de-veloping countries and improve capacity and skill-building through remote training programs. Both of these areas must be expanded upon if we are to participate more fully in the global healthcare arena.

Through our focus on infectious disease, telemedicine and technology, international health and workforce development, geographic medicine and bioterrorism research, the School of Medicine is playing an increasingly critical role in fostering opportunities to strengthen and build new partnerships at home and abroad and to respond to the chal-lenges of global health. Working collaboratively with others, we are having an impact and indeed making a difference worldwide. 

In the relentless pursuit of excellence, I am

Sincerely yours,

 E. Albert Reece, MD, PhD, MBA
Vice President for Medical Affairs, University of Maryland
John Z. and Akiko K. Bowers Distinguished Professor and
Dean, School of Medicine

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