Confronting Challenges in Global Child Health

Published on in Children's Doctor

A Reflection on Global Pediatric Infectious Disease Research Training

The 2014 Ebola epidemic made clear what those in the global health community have long known: We all have a vested interest in confronting neglected diseases and strengthening global health systems. In much of the world, children and adolescents face an acute threat from infectious diseases. From our perspective in Philadelphia, we might not appreciate the incredible burden of diarrheal diseases, malaria, HIV, and TB on children in developing countries. As a pediatric infectious disease (ID) fellow at The Children’s Hospital of Philadelphia, I have been fortunate to be able to pursue global health research in Botswana, working with our collaborators to confront major causes of child and adolescent mortality in this setting.

With the support and flexibility of both the ID and Pediatrics divisions at CHOP, I have had the opportunity to spend part of my fellowship with CHOP’s Global Health Program in Botswana as part of the Botswana-UPenn Partnership. My current research projects explore adolescent HIV and TB, as well as childhood gastroenteritis, with an emphasis on defining opportunities to improve outcomes. It has been wonderful to work with inspiring and excellent Batswana researchers and public health practitioners, collaborators from other academic institutions, and the Centers for Disease Control and Prevention to engage in these major challenges in global child health. Meanwhile in Philadelphia, I am studying the management of children with malaria and have helped develop tools to evaluate fever in returning travelers.

It must be emphasized that I could not have pursued this unique training experience without support from the Melissa Ketunuti Memorial Global Health Fund. I had met Melissa while considering an ID fellowship at CHOP and was immediately struck by her kindness, as well as her passion for global health. As a dedicated pediatrician and researcher, she worked to improve health for vulnerable children in Botswana and around the world, and she continues to inspire me to be a better clinician and child advocate.

Infectious diseases and global health are compelling because there are always important multidisciplinary contributions to make. Awareness of social context is critical. In the disproportionate burden of neglected diseases in settings of poverty and violent conflict we see the manifestation of social injustices and the need for global health equity. The global health community has much to offer to the broader discussion and understanding of disease processes, not only at the individual or clinical level, but also in the broader social and public health context.

With the benefit of my unique fellowship, I am excited to move into the highly evolving field of global infectious disease research. The partnerships formed in this work are invaluable, and tackling complex problems in global health requires a diverse network of dedicated people. It’s critically important that we support our colleagues around the world who may encounter emerging infectious diseases on the front lines, often in very constrained health systems. Let us be moved by the memory of the physicians and healthcare workers who lost their lives in the 2014 Ebola outbreak—may we honor their work with a greater resolve to confront the challenges of global health.

References and Suggested Readings

Boozary AS, Farmer PE, Jha AK. The Ebola outbreak, fragile health systems, and quality as a cure. JAMA. 2014;312(18):1859.

Farmer PE, Furin JJ, Katz JT. Global health equity. Lancet. 2004;363(9423):1832.

Mugele J, Priest C. A good death—Ebola and sacrifice. N Engl J Med. 2014;371(13):1185-1187.