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PARTNERS IN HEALTH International collaborations in Medicine, Dentistry, Nursing and Pharmacy

office for global health


PREFACE Our activity in the global health arena is built on the firm base of the Học Mãi Foundation’s work in Viêt Nam

Linking up with global partners is one of our key priorities at the University of Sydney Division of Medicine, Dentistry, Nursing, and Pharmacy. By collaborating with our region, and internationalising our education, research and student experience, we can strengthen the capacity of us all to improve human health.

In March 2007, we decided to build on our success in Viêt Nam by creating the Office for Global Health, which was tasked with applying the same strategy to our international relations with other neighbouring countries. This booklet outlines some of our achievements in the region, and the relationships we have built, to date.

Yet, while we have achieved a great deal through our many self-funded initiatives, it is through the support of AusAID, the WHO and other major funding bodies that we have been able to expand our impact and create lasting, systemic change in partner countries.

Our activity in the global arena is built on the firm base of the Học Mãi Foundation, which began life in 1998 as a student exchange with Hanoi Medical University in Viêt Nam.

Importantly, our achievements are only made possible by engaging closely with partners, especially in our nearest regions. Relationships are the foundation of everything we do. First we build collaborative partnerships; the work we do flows from them and the priorities of the partner country or institution.

Professor Bruce Robinson Chair – Medicine, Dentistry, Nursing and Pharmacy Division University of Sydney

In 2001, that program was formalised with the creation of a charitable foundation, which has gone on to make broad-ranging contributions to improving medical education in Viêt Nam. Our work through Học Mãi is based on a network of partnerships with government, academia and hospitals as well as individual doctors, nurses, dentists and other practitioners.

We work closely with our University’s wider international endeavour through the Office of the Deputy Vice-Chancellor (International), which provides support and internal funding mechanisms such as the International Program Development Fund.


Contents “Our relationships are the foundation for everything we do. First, we build collaborative partnerships. The work we do then flows from them – and the priorities of our partner countries.”

04 introduction 06 CAMBODIA & LAOS 08 china 10 india 12 INDONESIA 14 SUB-SAHARAN AFRICA 16 TIMOR-LESTE 18 Viêt Nam 20 Funding Partnerships


4 INTRODUCTION

Above, Dental Clinic in Cambodia Left, Clinical Skills Workshop, Dili National Hospital, Timor-Leste

The University of Sydney schools of medicine, dentistry, nursing and pharmacy comprise the largest groupof health and medical researchers in Australia. In 2007, the Office for Global Health was established to harness this unique resource in order to forge longterm partnerships in our region.

more traditional partners in Europe and North America. As we look to the future of these academic partnerships, we believe it is important to continue to find ways to work more closely with government and others seeking similar goals. Universities have an important role to play in our societies – in developing globally competent graduates, faculty and citizens but also in tackling some of the most challenging problems of our region.

Our relationship managers focus on creating strategic links between our health academics and students, and key regional partners. They also support collaborations across our comprehensive institution through the Office of the Deputy Vice-Chancellor Associate Professor Lyndal Trevena (International). In less than five years, Director, Office for Global Health we have seen an increase in joint funding and publications with these partners and greater breadth and depth in the collaborative work we undertake together. We have also seen a natural progression to multilateral collaborations within our region, leveraging our geographic advantage, as well as with


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6 CAMBODIA & LAOS Vice-Director, National Paediatrics Hospital, ViceRector and Dean, Faculty of Medicine, University of Health Sciences Cambodia

South-East Asia is an important focal point for the University of Sydney and for our collaborations in health. We have long-established links in Viêt Nam and are in the process of expanding our relationships to neighbouring Cambodia and Laos. Collaborations are underway with key Cambodian universities and institutes. We are undertaking several education and research projects with the University of Health Sciences in Phnom Penh, including the development of a postgraduate course in oral surgery and a study on how pharmacies can help tackle tuberculosis. Our staff are also conducting a pilot study on rheumatic heart disease in the children of rural Cambodia with local and international partners including the National Institute of Public Health in Phnom Penh.

In addition, we are pursuing a number of health training initiatives with highlevel partners in Cambodia. We have partnered with the Ministry of Health and two leading hospitals to roll out the International Postgraduate Paediatric Certificate, a course of continuing medical education for doctors working in child health, across the country. We are also in discussions with the Ministry and WHO about assisting and advising on the development of robust national exams for final year students in medicine and other health disciplines, as well as training in techniques of practical assessment.

Furthermore, Cambodia’s Institut Pasteur du Cambodge is a partner in the newly established South-East Asia Infectious Disease Research Network, a University of Sydney initiative which aims to build the capacity of infectious disease institutes to conduct research into emerging diseases via research symposia and collaboration. Our links with Laos are at an early stage of development. We recently began a relationship with Vientiane’s University of Health Sciences, with the aim of initiating wider teaching and research collaborations and a student exchange using the University as a base. Another goal in Laos is to facilitate the entry of Institut Pasteur Laos into the SouthEast Asia Infectious Disease Research Network.


8 CHINA Conducting health surveys in Shaanxi Province

Partnering with China in research is a top priority for the University. We are the fifth most frequent collaborator with China in science, in terms of joint publications1, with the majority of those publications being in medicine. Our partnerships are mutually beneficial: they strengthen the research capacity of our Chinese partners while giving us exposure to some of China’s best scholars. China’s policy of developing a small number of key universities into worldclass institutions has dictated our own strategy, which is based on linking with the elite “China 9” universities. We have high-level relationships with Fudan, Shanghai Jiao Tong, Peking and Xi’an Jiao Tong Universities, all China 9 institutions.

1 China Global Research Report, Thomson Reuters, 2009

In several major collaborations, we are playing an exciting role in helping to improve health outcomes for the world’s most populous country. For example, in a major partnership with Fudan University and its affiliated hospitals, we are working with China in their development of a system of primary care. In another project at Fudan, Sydney is sharing its worldrenowned expertise in tobacco control to develop culturally appropriate solutions for reducing smoking in China (a nation where 57 per cent of physicians smoke). A third collaboration at Fudan with important implications for development focuses on child and maternal health and nutrition.

A wide range of other research partnerships are underway with Shanghai Jiao Tong University through our Joint Research Initiative in areas ranging from obesity and diabetes, through to infectious diseases and cancer. Improving health education is another area of interest: our School of Nursing has delivered an undergraduate unit on cancer nursing at Shanghai Jiao Tong University which is now being translated for self-delivery; nursing has only recently emerged as a university discipline in China. Student exchanges are another vehicle for us to play a role in improving health. Through the China Scholarships Council scheme, Sydney Medical School regularly hosts Chinese PhD students, exposing them to Western approaches to medical research. We are also developing our own medical students’ ability to partner with China through student exchanges.


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Into the future, we aim to cement links in western China in-line with China’s Western Development Strategy. We are developing a strong relationship with Xi’an Jiao Tong University, the only China 9 university in the west, and a research collaboration on nutrition and child and maternal health is underway there. We are also keen to widen our engagement with the Chinese government. We have started discussions with the Ministry of Health’s Human Resources Development Centre on how our expertise might help China boost its rural health care delivery. Notably, China’s first Vice-Minister of Health holds an honorary professorship at Sydney and studied transplantation here.

Above, University of Sydney medical student Owen Lee on the job at Renji Hospital, Shanghai Left, China Scholarship Council PhD candidate Zhang Ning at the bench in Sydney


10 INDIA Low-tech cervical cancer screening education programs in rural villages, Tamil Nadu in partnership with RUHSA, Christian Medical College Vellore

India is another priority partner for the University and our health research. Our work there is broad-ranging; India’s rapid development means that health conditions associated with both developing countries and more affluent nations are widespread.

sexually transmitted infections (STIs), especially HIV, and also benefit from India’s expertise in public health. Our Sexually Transmitted Infections Research Centre (STIRC) has now trained two cohorts of 10 fellows from PHFI and associated centres in an intensive STI/HIV program. Leveraging Our work in India is underpinned by off that program, which was funded partnerships with leading institutions by an AusAID ALA Fellowships grant, at national and state levels. The Indian STIRC is working with the PHFI to Council of Medical Research, Sydney develop an International Professional Medical School and the University of Certificate in STIs/HIV. The long-term Sydney-based George Institute for goal of the project, which is funded Global Health support joint projects by an AusAID PSLP grant, is to extend between Australia and India. Current research collaborations focus on obesity the certificate to regional institutes – fostering widespread, sustainable and diabetes in adolescence, road improvements in STI prevention and traffic injuries and maternal and child health, with a possible expansion of our management. research focus to cover communicable Our staff are also engaged in a number diseases. of major partnerships both rurally and at a state level, such as our Tamil Nadu Our strong relationship with the Public cancer prevention project funded by Health Foundation of India (PHFI) another PSLP grant. This innovative allows us to share our expertise in

partnership with the Christian Medical College (CMC), Vellore, aims to help health care providers improve access to low-tech cervical cancer screening and treatment for rural women; a secondary aim in development is to assist health workers in educating rural women through a mobile phone information system. In the state of Maharashtra, we are focused on expanding our research relationship with the Maharashtra University of Health Sciences starting with sharing expertise in different aspects of cancer.


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AusAID funded Fellows from the Public Health Foundation of India undertaking a Short Intensive Professional Program in STI/HIV in Sydney – 2010 Below, mother and child of Bangladesh

EXPANDING ACROSS SOUTH ASIA We have also broadened our impact from India across South Asia. For example, through the South Asia Infant Feeding Research Network, which is funded by AusAID and UNICEF, the School of Public Health is teaming up with top South Asian research organisations to improve infant feeding practices. Extending into Bangladesh, Nepal, Pakistan and Sri Lanka as well as India, the network facilitates high quality research to determine the best public health interventions for reducing deaths among children under five (a key Millennium Development Goal). We are also forging links with Nepal’s Patan Academy of Health Sciences, which trains young Nepalis for community health work in rural regions. Two delegates from Patan are participating in a University of Sydney South Asia Health Leaders training scheme to develop future leaders in primary and community health. Funded by an AusAID ALA Fellowships grant, the scheme will build the capacity of Nepal as well as India to provide evidence-based primary health care, particularly in rural communities. Our partnerships with the Patan Academy and the rural department of CMC Vellore also enables the exchange of medical students between Sydney Medical School and Patan which facilitates placements at its various health centres and exposes students to global learning.


12 INDONESIA Our WHO-funded project is evaluating Indonesia’s plan for tackling highly pathogenic avian influenza

Indonesia is a vital partner in Australia’s efforts to control the spread of emerging infectious diseases. As a result, a number of our health partnerships have focused on this important area of concern. The partnerships are all mutually beneficial: we learn from Indonesia’s experience of infectious diseases, while exchanging our own expertise on surveillance and preventing disease outbreaks. The Sydney Institute for Emerging Infectious Diseases and Biosecurity (SEIB), which is partnered with Indonesia’s Eijkman Institute for Molecular Biology and Hasanuddin University, is a key vehicle for us to foster collaborative research and training in this area. SEIB is also working with the University of Indonesia to share our experiences in biosafety and biosecurity and mutually develop our strengths. The partnership has involved the exchange of a number

of researchers and hospital staff between our two institutions. We are also building relationships with Indonesia’s National Institute for Health Research and Development (NIHRD) with a view to potential collaboration such as laboratory twinning to strengthen influenza diagnostics. Another major collaboration in this field is a WHO-funded research collaboration which is evaluating the progress of Indonesia’s national plan for tackling highly pathogenic avian influenza. The multidisciplinary project unites medical anthropology, epidemiology and vet science experts from the University of Sydney with medicine and agriculture specialists from the University of Udayana in Bali and the University of Mataram in Lombok. It offers the prospect of making long-term improvements to Indonesia’s bird flu prevention strategy.

We are also involved in training and research partnerships across a range of other health issues. Beyond the issue of emerging infections, we have recently partnered with AusAID via an ALA Fellowships grant to bring together fellows from Gadjah Mada University and the Indonesian Ministry of Education to discuss an initiative aimed at tackling childhood obesity in East Asia.


“Visits to the facilities at the University of Sydney and Westmead gave us a comparison to improve education and services at our hospital in terms of infectious diseases.� Dr Fera Ibrahim & Dr Anis Karuniawati university of indonesia


14 SUB-SAHARAN AFRICA

While our partnerships in Africa are at an earlier stage than those in Asia, we are playing a meaningful role in improving health and development thanks to emerging relationships in several countries.

Program in HIV to fellows from Zambia, Botswana and South Africa, aimed at improving the public health response to infections by strengthening the local skill base. Health professionals from Liberia, Mozambique, Nigeria, Uganda, Ethiopia, Malawi, Sierra Leone, At the request of WHO and with Botswana and South Africa have also the University of Nairobi, we have undertaken postgraduate degrees at facilitated the establishment of a Partnership for Research and Capacity- Sydney Medical School, including our Master of Science in Medicine (STD/ Building for Abandonment of Female Genital Cutting. An African Coordinating HIV) degree, in a scheme funded by Centre in Kenya will serve as a base for AusAID. research, policy-making and the training We are also partnering with the of health workers. The aim is to expand University of Nairobi and Kenyan the scheme across the region. Ministry for Health to help local health authorities address non-communicable Tackling HIV/AIDS and STIs is a top diseases more effectively; and with priority for the region, which accounts Ghana’s Ministry of Education and for over 70 per cent of the world’s two of its leading universities to AIDS-related deaths. Our Sexually improve health education. We also Transmitted Infections Research offer our medical students exchange Centre (STIRC), with the assistance opportunities at Uganda’s Makerere of an AusAID ALA Fellowships grant, University and South Africa’s provides a Short Intensive Professional

Stellenbosch University, increasing their ability to partner with Africa into the future. Looking ahead, we plan to extend our links with universities and health ministries in the region, especially in Ghana and South Africa, following the recommendations of the recent Senate enquiry to increase Australian engagement in Africa. We are also involved in establishing a network to foster greater cooperation between Australian and African universities.


“I am glad to say that I am prepared to contribute extensively to the development of my country’s health sector.”

Teta Lincoln Master of International Public Health graduatE


16 TIMOR-LESTE Critical Care Skills Workshop at National Hospital Guido Valaderes, Dili

Public address by President Jose Ramos Horta at the University of Sydney

Health and health workforce development in Timor-Leste is a special priority of Sydney Medical School. Our presence there is founded on robust ties with the Ministry of Health. We also have strong links with a number of incountry institutions and organisations. Our relationship with Timor-Leste began in 2007 when we sponsored two East Timorese medical students to study in the University’s medical program. Following this, we met with the Ministry of Health to determine which areas of the health system we might be able to assist in. Building workforce capacity, especially in critical care, was identified as a priority, paving the way for a series of AusAID-funded practical based critical care skills and “train the trainer” workshops developed in conjunction with the Ministry and the hospitals. In 2009, in collaboration with the Ministry, we launched the successful

Timor-Leste Health Leadership program, which provides promising health professionals with short-term training in Australia at the University, partner hospitals and relevant organisations. Two cohorts of Fellows have gone through the program which is funded by an ALA Fellowships grant. The program has been identified by the health minister as valuable for TimorLeste in developing future leaders in health. Another project, also driven by the priorities of the Timor-Leste government, aims to strengthen the capacity of the National Laboratory to identify disease pathogens through twinning with the laboratories of Sydney Medical School. We have also taken the first step towards developing a health education collaboration with Universidade Nacional Timor Lorosa’e which will enable us to work closely with both

the national university as well as the government to further develop the health workforce in Timor-Leste. We are also currently completing our first research collaboration in Timor-Leste on primary health care which looks at the nation’s primary care outreach program in the villages. The Minister for Health, a researcher himself, believes there is further room for fruitful research partnerships and, as a newly-appointed Adjunct Professor of our University, will continue to be involved with ongoing research.


“One of the specific things I want to implement once I go back to my country is strengthening [TB] prophylaxis therapy for children under five years old.� Caetano Gusmao ALA Fellow, Timor-Leste


18 Viêt Nam 2011 ALA Fellows at Northern Clinical School

The University of Sydney has a long track record of success in pursuing joint health projects in Viêt Nam. Our work is made possible by a network of relationships extending from Viêt Nam’s Ambassador to Australia and his counterpart in Viêt Nam, to the Viêt Namese health and education ministries, to key academic institutions including the University of Medicine and Pharmacy, Pham Ngoc Thach University of Medicine and Ha Noi Medical University. We also work closely with leading hospitals across Ho Chi Minh City, Ha Noi, Dien Bien Phu and DaNang. Many of the projects we do are facilitated by Học Mãi, a foundation based at the University which has worked in Viêt Nam since 1997. Học Mãi supports a range of health care education and research ventures, each of which is formulated in response to the priorities of our Viêt Namese partners.

A flagship scheme is the Viêt Namese Health Professionals program, which gives health professionals from various disciplines the opportunity to observe health care delivery in Australia. Initially self-funded and open to just five participants, the program has now been extended to 25 participants thanks to many AusAID ALA Fellowships grants.

children through health care education in Dien Bien Phu.

We also offer a range of in-country health education and “train the trainer” programs. For example, last year, in collaboration with Viêt Namese colleagues, Sydney Nursing School developed a UNFPA-funded midwifery curriculum to improve midwifery education and patient outcomes in Viêt Nam.

Our priority for the future is boosting Viêt Nam’s capacity to conduct its own health research. Through our Building Research Capacity program, we are giving Viêt Namese health professionals exposure to international standards of medical research. We also offer seed grants and mentoring to novice Viêt Namese researchers, and Học Mãi have held an annual conference on “improving Viêt Nam’s health care through research” for each of the past three years.

Học Mãi has had a long-standing relationship with Dien Bien Phu province facilitated a number of years ago by Her Excellency, Professor Marie Bashir. Building on that success, we have applied for an AusAID PSLP grant to improve mortality rates for women and

Our capacity to assist can be limited by funding shortfalls, however; for example, we were invited by the Viêt Namese government to help rewrite its national curriculum for nursing in English but could not proceed due to lack of funds from Viêt Nam and Australia.


20 Funding Partnerships China Scholarship Council Joint PhD Scholar, Li Na with her University of Sydney supervisors Below, HE Professor Marie Bashir, Chancellor of the University of Sydney with AusAID funded 2011 Health Leaders Program Fellows from Timor-Leste, India and Nepal Opposite page, Phan Quoc Huy, 2011 ALA Fellow

The Office for Global Health seeks sustainable, long-term relationships with our in-country partners. To deliver and develop our programs of engagement, we work with a number of funding partners to leverage existing funds. To date, our funding partners have included: Academic Consortium 21, Atlantic Philanthropy, AusAID, Australia Awards (Department of Education, Employment and Workplace Relations), Australia-China Council (Department of Foreign Affairs and Trade), Australian Embassy – Hanoi, Australian Youth Ambassadors for Development, China Scholarship Council, International Project Development Fund (University of Sydney), Myer Foundation, Shanghai Jiao Tong University, UNFPA (United Nations Population Fund), WHO, Worldwide Universities Network.


Office for Global Health T +61 2 9351 5993 F +61 2 9036 7124 E ogh@sydney.edu.au sydney.edu.au/global-health

office for global health

Produced by the Office for Global Health, Sydney Medical School, the University of Sydney, October 2011. The University reserves the right to make alterations to any information contained within this publication without notice.

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