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An Eye On International Health

November 26, 2002

Heather Heilman

hheilman@tulane.edu

Ten years ago, there was no such thing as an international health and development department at Tulanes School of Public Health and Tropical Medicine, though a patient and dogged student might have been able to piece together a program of study in the area.

Today, the Department of International Health and Development is the largest program in the School of Public Health and Tropical Medicine, rivals the size of the equivalent department at Johns Hopkins Univeristy, and brings in more external grants than any department in the university except for the Department of Medicine.

More than that, it is taking on an ever-growing role in setting the worldwide public health agenda. Faculty members have international reputations in the fields of reproductive health, nutrition and emergency management. But, across the board, the departments biggest strength is in program evaluation. International donors are increasingly demanding evidence that their money is being put to good use, that the programs theyre funding make a demonstrated impact, said Robert Magnani, chair of the department that was founded in 1993 by Bill Bertrand, now executive director of the Payson Center for International Development and Technology Transfer.

Those who manage large international public health initiatives typically have little experience in evaluating the effectiveness of a program. But thats something Tulanes international health faculty has in spades. For example, one of our faculty members, Kate McIntyre, essentially redesigned the way the World Health Organization monitors and evaluates its malaria program, Magnani said. She did such a good job they asked her to do the same for their tuberculosis program.

This fall the department received several significant grants that involve evaluating large international public health projects. Dominique Meekers is the principal investigator on a $4.4 million grant from the United States Agency for International Development as a part of its Health Communication Partnership.

The goal is to examine the effectiveness of health communicationfrom mass media to school curricula to pamphlets given away in clinicsin USAID projects across the globe. And a $3.9 million grant from the Centers for Disease Control and Prevention will allow Tulane researchers to oversee, evaluate and assist the agencys Global AIDS Project in several countries, most likely in southern Africa. Carl Kendall will lead that project. Just last month UNICEF called Magnani asking for help in evaluating a new global program.

Anastasia Gage, associate professor of international health and development, will likely lead this effort, he said. He attributes his departments success to being in the right place at the right time. We had an edge in the area of program evaluation just when donors started to get serious about it. These tend to be large, big-picture projectsMagnani notes that his last major project involved working in 17 different countries. But one of his goals for the future is to balance that kind of work with more tightly focused National Institutes for Health-sponsored research.

The USAID and CDC work has just grown so fast that were probably less diversified than we were five years ago, he said. He also wants to build relationships with public health schools in developing countries, particularly with the Hanoi School of Public Health in Vietnam. We think Vietnam is going to be the next great success story in Asia, both from the development point of view and the health point of view, he said. Its exciting, and we would like to play a role in that. Another goal is to develop an interdisciplinary center for adolescent health research.

The current generation is going to determine the fate of the AIDS epidemic in many developing countries, he noted. Theyll either make it to adulthood without contracting AIDS in large numbers or theres going to be major problems down the road for these countries in the health and development sectors.

Heather Heilman can be reached at hheilman@tulane.edu.

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