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THIS IS WHAT GLOBAL HEALTH LOOKS LIKE

from Columbia Public Health 2023-2024

from Columbia Public Health 2023-2024, page 6

Just the Facts

Twenty years after it was founded, ICAP at Columbia University keeps reaching for more impact.

In 2003, the world was in despair over HIV/AIDS. At the time, the crisis in sub-Saharan Africa was devastating individuals, families, and communities—as it had been for years. Many were skeptical that anything could be done to save the millions of people living with HIV in some of the world’s poorest countries. But Wafaa El-Sadr, MD, MPH ’91, MPA, had cared for patients with HIV in New York City’s Harlem community, and she firmly believed that not only could a lot be done, but also that it must be done.

This simple but world-changing conviction led to the birth of ICAP, a global health center—situated at Columbia Mailman School of Public Health—that would go on to help change the face of the HIV crisis across the globe. “When ICAP came into the country, we really needed to scale up treatment,” recalls Rejoice Nkambule, MPH, deputy director of health services at the Ministry of Health of Eswatini, one of the African countries most affected by HIV/AIDS. With funding from the U.S. President’s Emergency Plan for AIDS Relief (founded the same year as ICAP), ICAP worked shoulder-to-shoulder with ministries of health and partners from government, academia, and civil society to strengthen health systems and train nurses, midwives, doctors, laboratory workers, and data managers in countries across the region—including Eswatini.

At left, in Angola, a mother living with HIV and her child receive care. Above (1) ICAP's founder and director, Wafaa El-Sadr, visits a clinic in Kenya. (2) Outside a hospital in Ethiopia, a doctor tests people for COVID-19 to help control the spread of the virus. (3) The Population-Based HIV Impact Assessment (PHIA) Project, led by ICAP, is the gold standard in capturing the state of HIV epidemic response in 15 countries and counting.

“ICAP has been a very effective partner that has helped us grow our response to the epidemic,” says Nkambule, who has seen her country make dramatic strides toward ending its epidemic in the past 20 years.

Today, ICAP works in 40 countries, designing and implementing some 180 innovative projects designed to strengthen health systems, increase access to health services, and enhance the capacity to respond to a range of health threats. From its roots in global HIV response, ICAP has grown to focus on an expanding list of other health challenges—from tuberculosis and malaria to COVID-19 and mpox—while advancing maternal and child health and setting its sights on increasingly urgent new health challenges, such as antimicrobial resistance and the health effects of climate change and forced migration.

“Two decades after we first got off the ground, ICAP finds itself more needed than ever,” says ElSadr.“While much has been accomplished, so much more is yet to be done.”

(1) In Lesotho, nurses trained by ICAP bring care to isolated residents by riding horseback over rough terrain. (2) An ICAP-trained healthcare worker in Tajikistan talks with a person living with HIV about how to stay well. (3) In New York City, ICAP conducts critical public health research, such as a study on the impact of the mpox virus. (4) A transgender sex worker in Panama gets information on PrEP (pre-exposure prophylaxis), an important HIV-prevention method. (5) A technician in a molecular lab extracts blood samples for testing in Burundi. (6) An ICAP analyst in South Sudan reviews data to guide effective health interventions.

(7) The HIV Coverage, Quality, and Impact Network (CQUIN) fosters knowledge-sharing among 22 countries in sub-Saharan Africa.