Interdisciplinary research on health policy at Duke dates to the 1981 founding of the Center for Health Policy Research and Education, which became known for producing evidence-based guidelines for clinical care. But those efforts began to take on a more global focus in 2002, when center director Kathryn Whetten expanded their research program on the experiences of people living with HIV to several countries. In 2009, Whetten formed the Center for Health Policy & Inequalities Research, which has carried on the legacy of addressing health disparities experienced by vulnerable communities in the U.S. and globally. The center works to integrate promising interventions into health practice and provide policymakers with sound evidence to inform new laws and regulations.
Duke’s incoming Class of 2008 began their college careers by reading Mountains Beyond Mountains, the story of Duke alumnus and global health pioneer Paul Farmer and his work delivering healthcare to the poor. The selection of Tracy Kidder’s book for Duke’s third summer reading program reflected a goal to inspire students to be bold thinkers and question injustices in the world around them. It also set the stage for formalizing Duke’s global health efforts with the launch of the institute two years later.
Building off a nearly 20-year history of international collaboration, Duke professor Ralph Corey founded the Hubert-Yeargan Center for Global Health (HYC) to provide more opportunities for medical trainees in the U.S. and other countries to gain international experience and bidirectional learning. In 2008, HYC launched the Global Health Pathway, which allows medical residents and fellows to conduct global health research while pursuing DGHI’s Master of Science in Global Health degree.
A year before DGHI’s official launch, Duke President Richard Brodhead created the Global Health Initiative to map out the university’s plan for research and education in the emerging field. This led to the development of two key pieces of Duke’s global health education – the global health Focus seminar for first-year students and a global health certificate, both of which debuted in 2006. The first graduating class from the certificate included 43 students from 17 different majors, an early sign of the cross-campus appeal of the global health curriculum.
In laying the groundwork for the establishment of the Duke Global Health Institute, Duke’s 2006 strategic plan outlined a unique vision for the university’s leadership on global health issues. It envisioned a nimble, flexible organization that worked across disciplinary boundaries to bring broad expertise to bear on the world’s complex health challenges. Thus, the institute was formed not within a school, but to foster interdisciplinary collaboration across the many areas that influence health. Today, the institute includes faculty from eight Duke schools who explore the interconnection of health and the environment, policy, engineering, and social and cultural factors that drive disparities in health outcomes.
Students in Duke’s new global health Focus seminar traveled to Costa Rica as part of the program’s first global health-related field experience, a precursor to the institute’s experiential learning programs that followed. The trip, which took place over spring break, featured visits with indigenous healers, midwives and representatives of a non-governmental organization working on human-centered birthing policies, as well as a trip to a coffee plantation to learn about the experiences of agricultural workers and fair trade practices.
When Duke launched DukeEngage, an ambitious program to involve students in immersive service learning, DGHI researchers helped establish one of its first partner locations, working alongside community health organizations in Haiti. The 89 undergraduate students who participated in DukeEngage’s pilot run in summer 2007 helped establish the university’s signature program in civic engagement, which has now supported projects in more than 80 countries. DukeEngage has also become a gateway for students to explore interests in global health, inspiring many to continue globally focused engagement through DGHI’s own experiential learning programs.
In this year, students in DGHI professor Robert Malkin’s biomedical engineering lab came up with the first design of the Pratt Pouch, a heat-sealed foil packet that holds a single dose of antiretroviral medication that mothers can give to newborns to prevent transmission of HIV. The pouch, named for Duke’s Pratt School of Engineering, was one of the first of several global health innovations to spring from Malkin’s lab. The student-driven approach to innovation also inspired DGHI teams that have produced novel low-cost devices to aid in cervical cancer screening and pediatric surgeries.
Fifteen students arrived at Duke in fall 2009 to form the first cohort of DGHI’s Master of Science in Global Health program. They were, in many ways, entering uncharted territory. At the time, only a handful of universities offered graduate-level degrees in global health, and Duke’s brand-new degree was even more distinctive for its interdisciplinary nature. Hailing from five countries and representing a range of academic backgrounds, that first cohort helped shape a program that still stands out for its flexibility and diversity of experiences and perspectives.
The Medical Education Partnership Initiative (MEPI) wasn’t the first collaboration between Duke and Tanzania’s Kilimanjaro Christian Medical Centre (KCMC). But the training grant, awarded in 2010 by the National Institutes of Health’s Fogarty International Center, opened a new door in the deepening partnership. Through MEPI, Duke researchers began working alongside Tanzanian partners to nurture clinical and research skills among a new generation of Tanzanian medical students, many of whom have gone on to lead their own research programs. It was the first of nine NIH-funded training programs designed by DGHI faculty, addressing needs for advanced training in critical areas such as mental health, emergency medicine and cardiovascular care.
In a unique alliance of academic and industry interests, Duke joined with the World Economic Forum and McKinsey & Company to form Innovations in Healthcare, a nonprofit organization that works to scale up healthcare innovations that have high potential to expand access to affordable care. Led by DGHI professor Krishna Udayakumar and comprising a global network of healthcare innovators, the organization’s efforts laid the groundwork for the launch in 2016 of the Duke Global Health Innovation Center, an academic branch of the wider partnership that supports healthcare and policy innovation through applied research and education.
Field experience has long been a hallmark of DGHI’s educational programs, most of which require students to complete some form of experiential learning. But the launch of the Student Research Training (SRT) program in 2011 gave undergraduate students a new option: to work as part of a team on an intensive community-based research project. The six SRT projects that kicked off in that year were the first at Duke to take a team approach to global engagement, creating a model that would influence the development of initiatives such as Duke’s Bass Connections program.
In a shared office in Trent Hall, DGHI biostatisticians Liz Turner and Alyssa Platt began what would become the Research Design & Analysis Core (RDAC), a service that supports global health scholars in designing, carrying out and analyzing data-driven research. Now comprising more than 10 data experts, RDAC has become instrumental to the institute’s ability to attract and complete research involving high-level data analysis. The team has also advised hundreds of global health students on research methodology and design.
Based on the strong interest among undergraduate students in the global health certificate, DGHI and the Trinity College of Arts & Sciences in this year began offering global health as a co-major. Since its debut, students have paired global health with more than 40 different majors at Duke, including popular options such as biology and public policy, as well as more unusual combinations such as visual arts and Romance studies.
The first patients were admitted to a new cardiac care unit at Moi Teaching and Referral Hospital in Eldoret, Kenya, the first unit of its kind in the region. Supported financially and operationally by Duke’s Hubert-Yeargan Center for Global Health, the center’s opening was a critical step in a long-running effort to enhance cardiovascular training and care in Kenya, which marked another milestone in 2019 with the launch of a cardiovascular fellows training program at Moi.
DGHI professor Nimmi Ramanujam launched the Center for Global Women’s Health Technologies to make cancer prevention, diagnosis and treatment more accessible and more effective for women worldwide. The center has led the development of promising technologies that advance prevention and treatment of breast and cervical cancer.
It was no accident that when Duke Kunshan University welcomed its inaugural class of students in August 2014, global health was among its first degree offerings. DGHI faculty had been engaged in research in China since 2009, working alongside Chinese universities and health ministries to expand access to essential healthcare in one of the world’s largest countries. Duke professor Shenglan Tang formed DKU’s Global Health Research Center the same year the university opened, creating a platform for collaborative research and training. Today, many students in DKU’s global health master’s program spend a semester at DGHI, taking global health courses and working closely with DGHI researchers.
The announcement of a $20 million gift from The Bill & Melinda Gates Foundation came at a pivotal moment in DGHI’s development. The gift comprised two equally vital assets – a $10 million addition to the institute’s endowment and a $10 million challenge fund, which allowed the institute to match gifts from new donors. The injection of cash helped the institute recruit new faculty and expand experiential learning opportunities for students. And it didn’t hurt to showcase Melinda Gates, a Duke alumna and influential voice on global issues, among those who were singing the praises of the institute’s work.
At the World Innovation Summit for Health in Qatar, DGHI professor Gavin Yamey announced the launch of the Center for Policy Impact in Global Health, an innovative policy laboratory addressing critical challenges in the financing, organization and delivery of global health. The center engages with governments and health organizations to drive evidence-based policy change.
In this year, DGHI launched the Center for Global Reproductive Health to foster new research and policies on sexual and maternal health issues such as family planning, cervical cancer prevention and safe motherhood. Led by associate professor Megan Huchko, the center has forged strong collaborations to improve cervical cancer education and screening in rural communities in Kenya and Uganda.
At Webuye County Hospital in northwestern Kenya, Duke researchers helped design and equip a laboratory to advance diagnostic and research skills among local clinicians. Built from a converted shipping container, the lab, known as the Partnership for Education and Academic Research Laboratory, or PEARL, became the latest development in a longstanding partnership among DGHI, Moi University and Webuye to enhance care and treatment of infectious diseases such as malaria.
Duke’s partnership with the National University of Singapore (NUS) has produced many innovations in medical research and training, including the formation of Singapore’s only graduate medical program, the Duke-NUS Medical School. In 2019, that institution joined with SingHealth, the country’s largest health provider. To launch another new venture, the SingHealth Duke-NUS Global Health Institute (SDGHI). Initially led by DGHI’s founding director, Michael Merson, SDGHI is advancing collaborative research projects in areas such as emerging infectious diseases, health systems and care for the elderly, deepening Duke’s connections on global health projects across Southeast Asia.
DGHI’s Graduate Certificate in Global Health was offered for the first time to students enrolled in Duke master’s degree programs. The expansion of the certificate, which had previously been available only to doctoral students, creates new opportunities for graduate students in engineering, nursing, environmental sciences and other fields to add a global health component to their programs.
In this year, DGHI professors formed two new research centers to address gaps in access to surgical and emergency care in low-resource settings. The Global Emergency Medicine Innovation and Implementation Research Center (GEMINI) focuses on training and data-based research to improve emergency and trauma care in countries such as Brazil, Tanzania and India, while the Center for Global Surgery and Health Equity coordinates efforts to advance access to surgeries and enhance surgical care around the world.
DGHI convened a meeting among partners in several East African countries to explore new avenues for collaboration on research and bilateral training. The workshop, hosted at the University of Global Health Equity in Rwanda, is part of a vision to deepen partnerships with the university co-founded by Duke alumnus Paul Farmer, as well as to forge stronger ties between DGHI’s partner institutions in the region.
The many faculty and students at Duke who are examining issues related to mental health are as diverse as the field itself, including psychologists, psychiatrists, nurses, policy experts, epidemiologists, biostatisticians and physicians across multiple specialties. The Center for Global Mental Health was formed to bridge the gap, creating a hub to connect those who are working to understand and reduce mental health disparities and improve access to effective mental health care.