Institute Initiatives

The Duke Global Health Institute (DGHI) promotes excellence in global health research by supporting current Duke initiatives and by promoting new scholarship,knowledge, and technology in the area of global health.

At the core of the Institute’s research efforts are our Signature Research Initiatives (SRIs) on emerging global health themes. These SRIs engage faculty from multiple Duke schools and departments and address major current issues in Global Health from a broad, interdisciplinary perspective. DGHI expects to provide start-up funds and infrastructure support in these areas, both at Duke and to our collaborating institutions abroad.

As of July 2008, the Duke Global Health Institute has identified six Signature Research Initiatives:

• Obesity and Cardiovascular Disease
• Global Aging
• Gender, Poverty and Health
• Emerging Infectious Diseases
• Global Environmental Health
• Health Systems Strengthening

Obesity and Cardiovascular Diseases:

In addition to the widely recognized epidemic of obesity and heart disease in the U.S., rates of cardiovascular disease are growing dramatically in India, China and other transitional economies in Asia and Latin America, and also in urban populations in sub-Saharan Africa. Cardiovascular disease may be related to increasing rates of obesity, diabetes, and hypertension in these areas. Duke faculty from many different disciplines and schools have great expertise in these areas; the challenge is to build upon this expertise to launch an SRI that addresses the problems of cardiovascular disease, obesity, diabetes, and hypertension in the international context. DGHI is actively collaborating with the Duke Clinical Research Institute (DCRI), The Duke Heart Center , and Duke Translational Medicine Institute (DTMI) to develop interdisciplinary projects in this field.

The first faculty working group to convene under this initiative is addressing the problem of global pediatric obesity. These faculty, from the Social Science Research Institute (SSRI), Sanford Institute of Public Policy, School of Medicine, and the Faculty of Arts & Sciences, began meeting in 2007 to assess ongoing research and developing future priorities in global pediatric obesity. The next step for the working group members is to stretch beyond current research and generate project ideas for pilot funding that integrate two or more disciplines in the social, clinical, and biomedical sciences.

DGHI is currently recruiting a faculty member at the Assistant, Associate or Full Professor level to lead this Strategic Research Initiative. Download full job description.

Global Aging:

In many parts of the world, thanks to advances in technology, economics, and healthcare, people are living longer lives. However, this achievement poses significant challenges. Few countries have adequately oriented their health and social services to meet the needs of their aging populations, or even know how to do so. Duke has expertise related to the demographic, genetic, biological, and clinical aspects of aging and the organization of health services for the elderly, including the longstanding Center for the Study of Aging and Human Development , and the recently established Duke Population Research Institute . Current research by DGHI affiliates includes projects such as Visual Impairment, Treatment and Effects for the Elderly, and Demographic Analysis of Healthy Longevity in China.

A Global Aging working group, comprised of Duke faculty from across disciplines, has been meeting monthly during 2008. Currently they are examining available panel and cross-sectional data on cognition to compare the health status of populations across countries, and conceptual models such as a cumulative deficit index to predict and compare health across populations. These methods, used by faculty across Duke, form the foundation of research to be carried out by Institute members.

Gender, Poverty and Health:

Poverty has long been recognized as a major determinant of health. Women are disproportionately represented among the world’s poor, comprising over 70 percent of the 1.2 billion people living in poverty. Race and ethnicity are also important factors that influence health in the U.S. and across the world. We believe that efforts to promote global health cannot be successful unless they address these sources of inequality.

Duke faculty in the Arts and Sciences , Schools of Divinity , Environment and Medicine , the Sanford Institute of Public Policy and the Center for Health Policy , are already conducting research in these areas. Much of the research was initially focused in the U.S., but there is a rapidly expanding international focus as well.

DGHI has convened an interdisciplinary faculty working group, led by new DGHI faculty member, Dr. Kim Blankenship, to focus efforts in this area. The group aims to identify areas of related strength at Duke, future research priorities, and mechanisms and activities for supporting ongoing work at Duke as well as generating new research that promotes health by addressing the interconnections of poverty and gender inequality. The first activity of the working group will be a symposium in August, 2008 for members to discuss and receive feedback on their related research.

Emerging Infectious Diseases:

The study of Emerging Infectious Diseases includes research on infectious diseases whose incidence has increased in the past few decades and threatens to continue increasing. These diseases can be caused by newly identified microorganisms such as SARS, rapid spread of infectious diseases to new areas and populations (e.g. AIDS or West Nile virus) or the re-emergence of known diseases such as malaria and TB due to drug resistance or a breakdown in healthcare and public health systems.

Duke has a broad array of global health research activities investigating emerging infectious diseases. Key collaborators in this effort include the Duke University Human Vaccine Institute , the Center for AIDS Research , the Southeastern Regional Center for Emerging Bioterrorism , DCRI , the Duke Infection Control Outreach Network (DICON), the Duke Endocarditis Database, and Duke-NUS Graduate Medical School in Singapore. Duke University investigators play a widely recognized leadership role in HIV vaccine development and treatment through the Center for HIV/AIDS Vaccine Immunology (CHAVI), AIDS Clinical Trials Group (ACTG) , and Infant Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) networks. Outstanding facilities and laboratories are available to study a range of emerging infections, and through Duke-NUS, the field logistics to study emerging viral infections in Asia.

Led by DGHI faculty member Dr. Chris Woods , this SRI will include faculty involved in clinical and laboratory-based research, as well as those studying economic and social factors related to emerging infectious diseases. A working group will convene in September 2008.

Global Environmental Health:

Environmental factors cause or influence an array of conditions that contribute to illness and death. Worldwide, an estimated 13 million deaths could be prevented each year if the environment was healthier. Unsafe water, indoor and outdoor air pollution, and the effects of climate change (e.g. flooding, microbial proliferation, drought, increase in vector borne diseases, impaired crop, livestock and fishery production and associated loss of livelihood leading to poverty and adverse health) deserve the greatest attention. Because this issue touches human lives in so many ways, we need interdisciplinary research to document the extent of these problems and to develop and assess interventions that alleviate them.

There are a number of research groups at Duke working in environmental health, particularly at the Nicholas School of the Environment , the Nicholas Institute for Environmental Policy Solutions , the Center on Global Change , and the departments of Biology and Pediatrics. The Global Environmental Health research agenda may include: 1) assessing various systems to provide clean water; 2) evaluating the impact of programs to reduce air pollution on childhood asthma; 3) building climate models to predict seasonal or climate-dependent epidemics; 4) undertaking studies to determine which types of ecosystem changes trigger the emergence of vector borne diseases; and 5) assessing the vulnerability and adaptation to climate change among populations in low- and middle-income countries.

DGHI and Duke University’s Nicholas School of the Environment and Earth Sciences are currently recruiting a tenured Associate or Full Professor to lead their efforts in Global Environmental Health, including this Signature Research Initiative. Download full job description.

Health Systems Strengthening:

Every year, millions of people die from preventable or treatable diseases, not because of lack of knowledge, but because poor countries often lack the necessary health systems expertise, analytic capability, information, and research capacity to deliver effective and affordable interventions. Improvements in areas such as human resources for health, performance measurement, and financing could greatly build capacity and health systems infrastructure. This could ultimately reduce health disparities around the world. Researchers are learning lessons in a few major areas of human resources for health: imbalance in a workforce structure; difficulties relating to a centralized workforce structure; worker motivation; and human resource management. Out-migration of trained professionals (“brain drain”) is also of enormous concern. Systematic data on the extent of the issue are lacking and filling this data need is of primary importance.

DGHI plans to research issues of health systems strengthening in collaboration with partners from the Duke University Health System , School of Medicine , School of Nursing , and the Fuqua School of Business as well as through our connection to the Duke-NUS Graduate Medical School in Singapore. DGHI has and continues to develop relationships with academic institutions across the world, including the Kilimanjaro Christian Medical College in Tanzania, Strathmore Business School in Kenya, University of the Witwatersrand in South Africa, and Makerere University in Uganda, to strengthen this global research initiative. These partnerships will help DGHI explore health system design, human resource needs, management, financing, policy, and performance measurement.

The Duke Global Health Institute is currently recruiting a faculty leader to further develop its SRI on Health Systems Strengthening in low and middle income countries with special emphasis on ways of strengthening their design, manpower needs, resource management, financing, and performance measurement. Download full job description.

Read the report, "Private Health Sector Innovation in Response to the Human resources for Health Global Crisis" completed by DGHI and the Fuqua School of Business Health Management Sector program.