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HMS Partners with Rwanda Ministry of Health

Global-health delivery specialists and clinician-teachers will help strengthen sustainable national health care system

By JAKE MILLER
November 20, 2012

Harvard Medical School has partnered with the Ministry of Health in Rwanda as part of a U.S. academic consortium comprising the new Rwanda Human Resources for Health (HRH) Program. This consortium includes more than a dozen of the top medical, nursing and public health schools in the United States. This national effort in Rwanda, led by the Ministry of Health, has been supported by Partners In Health (PIH), the Clinton Health Access Initiative, the Global Fund to Fight AIDS, Tuberculosis and Malaria and the U.S. Government. Faculty from HMS, Brigham and Women’s Hospital, and Boston Children’s Hospital will support Rwanda’s growing medical and educational capacity and help establish a world-class, self-sustaining national health care system there.

“We are thrilled to support the development of a sustainable health care system in Rwanda,” said Jeffrey S. Flier, Dean of HMS. “Global health is a priority of Harvard Medical School and our affiliated institutions, Brigham and Women’s and Boston Children’s Hospital among them, and Rwanda has seen remarkable health care achievements over the last two decades. This is an exciting time to be part of such a transformative project.”

Strengthening health delivery systems in Rwanda. Bec Rollins photo courtesy of Partners In Health

Rwanda has accomplished a remarkable turnaround, especially in health care. In the last decade, in spite of the AIDS epidemic that grips much of Africa, life expectancy in Rwanda has risen from age 48 to 58. In the last five years, deaths of children under five have fallen by half.

“Rwanda is transforming its health care system by dramatically improving the quantity and quality of health professionals through the Rwanda HRH Program,” said Rwandan Minister of Health Agnes Binagwaho.

“With the support of Harvard Medical School, Brigham and Women’s Hospital and Boston Children’s Hospital, many faculty and students will increase their clinical and academic training capacity,” said Binagwaho, who is also an HMS senior lecturer on global health and social medicine. “Together, we will revolutionize Rwanda’s health care system and develop unprecedented global health opportunities at Harvard and its affiliate institutions. Harvard will act to improve three important aspects of service delivery: building capacity to deliver academic training for Rwandan faculty members, improving the quality of resident physicians that Rwanda will produce, and finally dramatically improving the in-service training for all nurses and physicians at site locations where they will be based. We look forward to working with the world-class physicians in Rwanda.”

HRH will build on those systems and partnerships—including strengthening HMS’s existing relationship with the nation—over the course of a planned seven-year project to develop a high-quality and sustainable health care system in Rwanda.

“This is the boldest effort I've seen to make good on a central promise of global health: that the fruits of science serve everyone, especially those who bear the highest burden of disease,” said Paul Farmer, the Kolokotrones University Professor at Harvard University and chair of the HMS Department of Global Health and Social Medicine. Farmer is also co-founder of PIH and chief of the Division of Global Health Equity at Brigham and Women’s.

The HRH Program will send U.S. faculty members to Rwanda, where there is a shortage of health care workers. Faculty will work with local institutions, colleagues, and trainees to train the next generation of doctors, clinicians, medical educators, nurses and midwives. The goal is to expand and improve the health care workforce so it can be sustained without foreign aid by the time the program concludes in 2019.

The Department of Global Health and Social Medicine at HMS will coordinate the School’s partnership with the Rwandan Ministry of Health. Working with faculty from Brigham and Women’s and Children’s, HMS will send up to the equivalent of 16.75 full-time faculty to Rwanda for the first year of the program, including surgeons, anesthesiologists, internal medicine specialists and pediatricians.

“Many of our Brigham and Women’s Hospital physicians, nurses and staff have already formed deep and lasting connections with our colleagues in Rwanda in various hospitals and clinics through several existing programs,” said Betsy Nabel, Brigham and Women’s president and professor of medicine at HMS. “We are extremely pleased to support this vital new effort to help Rwanda develop a self-sustaining national health care system.”

“We are pleased to participate in this important initiative to build Rwanda’s capacity to deliver high-quality health care by training the next generation of pediatric and anesthesia specialists,” said James Mandell, CEO of Children’s. “Boston Children’s Hospital is committed to improving the health of children worldwide, and we look forward to working in partnership with our Rwandan colleagues.”

PIH began working in Rwanda in 2005, providing care and helping to develop health care systems in underserved regions of the country. In recent years, the HMS Department of Global Health and Social Medicine has collaborated with the Ministry of Health to offer a Rwanda-based version of the Global Health Delivery course offered jointly by HMS and HSPH to train future health leaders from both developing and developed nations. The Cancer Center of Excellence at Butaro Hospital was launched this summer in rural northern Rwanda with help from HMS faculty, PIH and the Dana-Farber/Brigham and Women’s Cancer Center.

For these and other reasons, Rwanda has become a showcase for the possibilities of equitable global health delivery.

“The Government of Rwanda, the U.S. government, the Clinton Health Access Initiative, and the universities in the consortium have each made major commitments to building Rwanda’s capacity to deliver high-quality care through training the next generation of specialty and sub-specialty providers—and thus strengthening our collective ability to deliver care globally,” said Farmer.

In addition to these clinical faculty members, HMS will contribute specialists in global health delivery who will collaborate with colleagues at the National University of Rwanda’s School of Public Health. In addition to guiding mentored research projects on monitoring, evaluation and implementation for students from Rwanda and HMS, the global health specialists will work with Rwandan colleagues to develop a masters program in global health delivery that parallels the MMSc program in Global Health Delivery launched by HMS earlier this year. Corrado Cancedda, HMS instructor in global health and social medicine and instructor in medicine at Brigham and Women’s, is the principal investigator for the grant.

Funding for the program comes from PEPFAR, USAID and the Global Fund to Fight AIDS, Tuberculosis and Malaria, a multinational public–private health financing institution.

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