Typically, you’d find Subhashini “Shubha” Chandrasekharan, assistant research professor of global health, on campus teaching a global health and genomics course, researching the commercialization and implementation of noninvasive prenatal genetic testing technologies or leading an interdisciplinary Bass Connections team.
But last fall, she headed to Washington DC to embark on a new challenge: an American Association for Advancement of Science (AAAS) Science and Technology Policy Fellowship with USAID’s Global Development Lab. We recently talked with Shubha about her experience in the fellowship program.
DGHI: Tell me about the fellowship program.
Chandrasekharan: The program was started in the 1970’s with a twofold purpose: first, to bring more science expertise into the government sector to help guide public policy decision-making, and secondly, to give scientists an opportunity to participate in policy making and engage in public service. Over the years, the program has grown to more than 150 fellows per year. Fellows can pursue either the congressional track, which is one year, or the executive branch track, which one to two years. I’m in the executive branch track for two years.
DGHI: How did you become interested in the fellowship?
Chandrasekharan: I was really interested in looking at global health from an international development perspective and getting more involved in policy making. I wanted to gain a broader understanding of the policy implications of trends in development, especially in the area of technology, and be able to engage with policy issues more productively. My hope was to work in either the State Department or USAID.
DGHI: Tell me about your projects in the fellowship.
Chandrasekharan: I work in the USAID U.S. Global Development Lab, which is a relatively new entity that was created to accelerate development impact through science, technology, innovation and partnership. I’m part of the Development Informatics team within the Lab’s Center for Digital Development.
When I first started, I was involved with my team’s contributions to the U.S. Global Development Lab’s Ebola recovery initiative in Guinea, Sierra Leone and Liberia. The approach centers around four main strategies for creating and strengthening health information systems within these countries: supporting the Ministries of Health in these countries through technical assistance, helping build capacity for local engineering support for health information systems, connecting frontline health workers and building better, interoperable health information systems in these countries.
Early on, my main project was to work with a team to collect ideas from experts and key stakeholders about how to help these countries build interoperable health information systems with components that can “talk to each other.” We initiated this process with a Broad Agency Announcement, and we received hundreds of responses. From the respondents, we selected a group of people to participate in a two-day co-design workshop to conceptualize new solutions. I created the agenda for the workshop and then shepherded one of the concept notes that came out of that workshop through the process of further development, refinement and scientific review.
I’m now leading a project to develop best practices for using responsible approaches for data collection, use, storage, management and release in digital development programs. The information we’re now able to collect, share, analyze and store so easily presents new challenges in protecting the privacy and the safety individuals, particularly the vulnerable, disempowered and disenfranchised people in many low- and middle-income countries (LMICs). Once these guidelines are developed, we plan to share them with USAID’s implementing partners as they think through data collection and use in development projects involving digital technologies.
DGHI: How do you see your work in the fellowship dovetailing with your research at DGHI?
Chandrasekharan: The issues of privacy and security and the varying perspectives about the harms and benefits of data are not new to me. In fact, I was drawn to this project because of my experience in genomics and genomics policy. Privacy issues around genomics and genetic data—for example, who owns that data and who has rights to that data—are still highly debated questions in that field.
I’ve also been exploring the intersection of digital health and genetic services in my research. mHealth has helped health systems, clinicians and health workers bridge the accessibility gap for many primary care services, but that’s not the case with genetic services such as newborn screening and prenatal screening. I’m interested in exploring how we can leverage digital health to more effectively embed genetic services and related support services into public health systems.
The fellowship is helping me learn about some of the health information systems in LMICs, how they’re being used and what the challenges and successes have been, which will inform my research in the future.
DGHI: What’s been your biggest takeaway from the fellowship so far?
Chandrasekharan: I would say my big takeaway is realizing that technology is only one part of a solution. We also need to understand the context, capacities and inequities in access and power within the developing world in order to devise effective, well-rounded solutions. It’s really essential to understand that more deeply, and it strengthens my interest in using participatory and qualitative approaches in my research. We need to ask questions like, “What actually happens when we implement a technology?” “Who uses it?” “Why?” Or “Why not?” And “Why isn’t it having the intended effect?” “Why can’t it scale?”
DGHI: What have you enjoyed most about the fellowship?
Chandrasekharan: I’m energized by what I’m learning. I’ve worn a research hat most of my life, and it’s interesting to try on the hat of someone who gets to the ground and actually has to put policies to work. You’re not answering a research question—at the end of the day, you really have to make a difference in someone’s life. Research sometimes does that, but many times it stops at answering a question. After that, it becomes someone else’s job to implement and scale solutions and figure out the nitty-gritty details.
Learn more about the AAAS Science and Technology Policy Fellowship Program.
I’ve worn a research hat most of my life, and it’s interesting to try on the hat of someone who gets to the ground and actually has to put policies to work.Subhashini Chandrasekharan