Academic medical centers have often been the site for innovation in health issues. Their academic nature tends to allow for larger studies that go beyond specific health conditions; the attached clinics are a means of immediately testing their studies. Such centers are fairly common in western society, but are not as prevalent in many parts of Africa. This is how a need for clinical teaching faculty at the Moi University School of Medicine, Eldoret, Kenya, and three internists (specialists in internal medicine) at the University of Indiana seeking a relationship with a sub-Saharan medical school, came together to form a cooperation. Formally named the Academic Model Providing Access to Healthcare, or AMPATH, in 2001 the consortium has expanded to include the Moi Teaching and Referral Hospital, as well as many other North American medical universities. It is now one of the largest HIV treatment programs in sub-Saharan Africa.
Though quite ineffective during its first ten years (between the start of the original collaboration in 1990 and 2000 not a single person had been treated with antiretroviral therapy), the pace picked up in 2001 when the method of approach was revisited. The system is now far better structured, and health services and education programs are in full swing, supported by the Kenyan government. AMPATH claims to have directly treated over 120,000 patients. As The Global Journal has previously reported, the developing world has many unique challenges not seen elsewhere. Societal stigmas, infrastructure issues, financial problems, and a lack of health education occur in the west, but the problems here are quite different from those in sub-Saharan Africa. The AMPATH approach has been quite effective at dealing with healthcare delivery under these conditions.
Dr Robert Strother of the Indiana University School of Medicine, is now extending the model to oncology (the topic of his presentation at the upcoming Geneva Health Forum). Cancer is a rising threat in the world, with 64 percent of deaths occurring in low- and middle-income countries. At the current rate, if issues around resources and education are not tackled in these regions, 70 percent of the world’s cancer cases could occur there. The cost of implementing an effective cancer awareness and treatment program is immense, but can be brought within reach thanks to programs such as AMPATH.
AMPATH-Oncology is already in action. It is a trans-disciplinary collaborative program that provides many treatment, screening, and palliative services. Its very efficiently implemented collaborations with clinics and government, in the form of a hub-and-spoke model, mean complex cases can be seen by fewer physicians, while external clinics carry out routine care. Social services (providing education and even a motor-pool - a transportation system) make patients far more likely to complete their treatment. Though still not cheap in the region, the $400-$1000 charge makes treatment much more affordable.
AMPATH is a good example of how restructuring existing resources can have immense yields. Moreover, it is also a demonstration of effective cross-continental collaboration in dealing with pandemic health problems. As the world transitions to a more globalized society, where a British car is actually designed in Germany using parts from Asia and assembled in Canada, the international nature of AMPATH is an illustration of how health issues will be dealt with in future.
(Photo © 2012 Geneva Health Forum)
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