The Global Health Research Pathway

Mission

Our mission is to train the next generation of pulmonary and critical care physician-scientists with a focus on global lung health using basic, clinical/translational, policy and implementation science approaches.

Our Rationale

There is a tremendous global burden of acute and chronic pulmonary and critical care disease. Of the ten leading causes of death worldwide, four are related to pulmonary medicine. Tuberculosis remains the leading cause of death due to a single infectious agent, and emerging epidemic viral pulmonary disease is a major threat in Africa as well as East Asia and globally. The ongoing Covid-19 pandemic illustrates directly the global risk for pandemic pathogens and the risks associated with regarding health of patients in any one country in isolation.

Chronic respiratory disease including biomass and tobacco-related airways disease and critical illness are also receiving increased attention globally both in terms of burden of disease and as an identified knowledge gap.

Despite this enormous need there are few programs to train Pulmonary Critical Care physicians in global health and global health research methods. Our program at Columbia University has several unique advantages that we have leveraged to create a Global Health Research Pathway (GHRP).

Training

GHRP fellows are expected to be focused, motivated and productive. The GHRP is a 4-year pathway within the pulmonary and critical care fellowship training program with specific experiences offered each year of fellowship training. Fellows interested in pursuing the GHRP will apply for a position during their second year of fellowship. One to two trainees per year may enter the GHRP. Prior international clinical or research experience is typical but not necessarily required for fellows interested in the GHRP. During fellowship, GHRP fellows are expected to submit abstracts, present at international conferences, write papers, and apply for mentored and independent funding.

Clinical and research exposures locally at the Mailman School of Public Health, specific labs at the College of Physicians and Surgeons, and through the New York City Department of Health and Mental Health (DOHMH) are available during the clinical years. Working with Divisional leadership, GHRP fellows will identify mentors and projects within the Pulmonary, Allergy and Critical Care Medicine Division or Columbia University Mailman School of Public Health.

During the 3rd year, fellows in the GHRP will attend epidemiology and population health courses at Columbia University Mailman School of Public Health. Fellows in the GHRP are also required to complete a core course in Global Health (Introduction to Global Health). For GHRP fellows with appropriate research training and well-developed research methods for their project, travel to foreign sites during their 3rd year is encouraged to initiate their research and gather preliminary data.

The majority of the 4th year is devoted to international research, analysis of collected data and/or further coursework. This is a non-ACGME accredited year and is tailored to each GHRP fellow’s specific needs.

GHRP fellow’s progress will be formally reviewed bi-annually by the T-32 Executive Committee to ensure the GHRP fellow is on a trajectory that will lead to a successful research experience including typically pursuing NIH funding. Support will be through mentorship, bi-annual formal programmatic review, and training grant support.Research Opportunities and Resources

Opportunities for research include the East Africa Training Initiative (EATI), Tuberculosis Trials Consortium (TBTC)Centre for AIDS Programme of Research in South Africa (CAPRISA), the Africa Health Research Institute (AHRI), Centre Hospitalier Universitaire De Kigali (CHUK), and the Uganda Virus Research Institute (UVRI), as well as additional opportunities through the Columbia University Mailman School of Public Health. GHRP faulty have ongoing international research in South Africa, Ethiopia, Uganda, Brazil, as well as multinational collaborations. Areas of focus include, viral pathogen discovery, severe acute respiratory illness including Covid-19 research in Africa as well as Brazil, , tuberculosis, chronic respiratory disease, and biomass associated lung disease. Methodological approaches include clinical and molecular epidemiology, translational research, implementation science, and health policy.

Research Faculty 

Director, Global Health Research Pathway
Max O'Donnell, MD, MPH
Affiliation: Columbia University School of Medicine
Interests: TB, SARI, viral respiratory infection
 

Affiliated Faculty

Barnabas Bakamutumaho, MD
Affiliation: Uganda Virus Research Institute
Interests: Viral respiratory diseases in Uganda, emerging infectious diseases, epidemiology, translational science

Nesri Padayatchi, MD
Affiliation: Centre for the Aids Programme of Research in South Africa
Interests: Drug-resistant TB in South Africa, TB-HIV co-infection, clinical epidemiology

Barun Mathema, PhD
Affiliation: Epidemiology, Columbia University Mailman School of Public Health
Interests: Infectious disease genomics, TB transmission, epidemiology

Rachel Moresky, MD, MPH, Director, International Emergency Medicine Fellowship and sidHARTe Program
Affiliation: sidHARTe - Strengthening Emergency Systems, Department of Population and Family Health, Columbia University Mailman School of Public Health; CU International Emergency Medicine Fellowship Emergency Medicine - Columbia University College of Physicians & Surgeons
Interests: Strengthening acute care Systems in LMICs, emergency care systems health policy, acute care task sharing training in LMICs

Yael Hirsch-Moverman, PhD
Affiliation: ICAP  and Epidemiology, Columbia University Mailman School of Public Health
Interests: Implementation science, prevention of childhood TB, adherence to treatment, mHealth for infectious diseases, TB/HIV in Lesotho and Ethiopia

Paulin Banguti, MD
Affiliation: College of Medicine and Health Sciences (CMHS), University of RWANDA (UR); Rwanda Society of Anesthesiologists
Interests: Critical care evaluation and training

Publications

  1. O'Donnell MR, Padayatchi N, Daftary A, et al. Antiretroviral switching and bedaquiline treatment of drug-resistant tuberculosis HIV co-infection. Lancet HIV 2019;6:e201-e4.
  2. Cummings MJ, Tokarz R, Bakamutumaho B, Kayiwa J, Byaruhanga T, Owor N, Namagambo B, Wolf A, Mathema B, Lutwama JJ, Schluger NW, Lipkin WI, O'Donnell MR. Precision surveillance for viral respiratory pathogens: virome capture sequencing for the detection and genomic characterization of severe acute respiratory infection in Uganda. Clin Infect Dis 2018.
  3. Collaborative Group for the Meta-Analysis of Individual Patient Data in MDRTBt, Ahmad N, Ahuja SD, …, O'Donnell MR, … et al. Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: an individual patient data meta-analysis. Lancet 2018;392:821-34.
  4. Schluger NW, Sherman CB, Binegdie A, et al. Creating a specialist physician workforce in low-resource settings: reflections and lessons learnt from the East African Training Initiative. BMJ Glob Health 2018;3:e001041.
  5. CM Eckhardt, MJ Cummings, KN Rajagopalan, S Borden, ZC Bitan, ...O’Donnell MR
    Evaluating the efficacy and safety of human anti-SARS-CoV-2 convalescent plasma in severely ill adults with COVID-19: A structured summary of a study protocol for a randomized …
    Trials 21 (1), 1-3Schluger NW. Tuberculosis Elimination, Research, and Respect for Persons. Am J Respir Crit Care Med 2019;199:560-3.
  6. T Akhvlediani, SM Ali, DC Angus, YM Arabi, S Ashraf, JK Baillie, ... MJ Cummings, MR O’Donnell
    Global outbreak research: harmony not hegemony. The Lancet Infectious Diseases 20 (7), 770-772