Public Health

Jenn DeHaan | Fort Knox News

FORT KNOX, Ky. – About 150 Transition Assistance Program personnel from the 60 Army TAP centers around the world connected with one another over a three-day biannual training symposium Sept. 27-29 at Fort Knox.

The Transition Assistance Program, which is headquartered at Fort Knox, is the agency that helps Soldiers successfully transition into the civilian sector after separating from the Army. According to Stacie Provine, TAP strategic communication director, the agency provides critical instruction, training and resources to help service members and their Families make that shift.

Provine said representatives from nationwide companies also spoke at the symposium to inform attendees about ways their organizations can help Soldiers.

“We also have people from different businesses here to talk about the different hiring programs they offer for veterans,” said Provine. “They come in here and speak, and our TAP folks can take that information back with them and share it with their Soldiers.”

This year’s symposium featured opportunities for TAP counselors, administrators and managers to share best practices, network with one another, and learn ways to improve how they can better serve Soldiers and Families with their transition from Army life to civilian life.

“By coming together, we can share the tricks of the trade or what’s the best thing to do,” said Provine. “Just all being under the same roof where we can talk directly with each other is so beneficial.”

Throughout the symposium, TAP personnel participated in numerous trainings and teambuilding exercises. Provine expressed that the enthusiasm the attendees consistently expressed was a testament to the dedication and passion they have for serving the military community.

“We need to take care of the Soldiers who first take care of us,” said Provine. “They’re out there fighting for us, so when they come back, we need to be fighting for them and make sure they’re set up for success.”

On average, TAP supports about 100,000 transitioning Soldiers from all components each year.

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Editor’s note: For more information about TAP services, visit https://www.armytap.army.mil/.

OSTRAVA, Czech Republic — Reserve Citizen Airmen with the 433rd Airlift Wing’s 68th Airlift Squadron, Joint Base San Antonio-Lackland, Texas, and the Marine Light Attack Helicopter Squadron – 773, Det. Alpha, Naval Air Station Joint Reserve Base New Orleans, Louisiana, participated in the 22nd annual NATO Days and 13th Czech Air Force Days air show Sept. 17-18.

This year, the 68th AS and the HMLA-733 Det-A helped represent U.S. participation and capabilities by displaying their respective assets; the U.S. Air Force C-5M Super Galaxy aircraft and two U.S. Marine helicopters, the Bell AH-1Z Viper and Bell UH-1Y Venom.

Several U.S. Air Force dignitaries were also in attendance during the NATO Days air show, including Maj. Gen. Bryan Radliff,10th Air Force commander, Naval Air Station Fort Worth Joint Reserve Base, Texas.

“The purpose of our visit here is to ensure that we have deliberate, professional and personal relationships with our NATO partners,” said Radliff. “The Czech Republic gave us the opportunity, through this air show in Ostrava, to showcase the capabilities of the U.S. Air Force and the great talents that Reserve Citizen Airmen bring to the total force.”

U.S. Marine Gunnery Sgt. Danny Abrego, HMLA-733 Det-A quality assurance chief, said the members of his unit were excited to be in attendance for the out-of-country experience and training.

“The Marines are excited to get a taste of being in a different country,” said Abrego. “It’s not something we get to do consistently, so it’s great to have the training to improve our capabilities and deployment readiness.”

In the three days leading up to the air show, Reserve Citizen Airmen had opportunities to interact with the local community by participating in outreach events. They visited students at local schools and visited the Library of Ostrava – American Center and spoke with members of the U.S. embassy and local officials.

Lt. Col. Peter Stipetich, 68th AS aircraft commander and U.S. Air Force representative, said the unit’s participation in these community engagement events cultivated a solid relationship with our partner nations.

“The experience is two-fold; crew members are exposed to local culture by visiting locals and answering a multitude of questions ranging from airplanes to personal life in the U.S.,” said Stipetich. “The locals also share their own similar stories and express their appreciation through smiles and handshakes. It is that little something that leaves the crew fulfilled and completes the mission with fond memories.”

NATO Days was sponsored by the Jagello 2000 Association and, according to the NATO days organization website at https://www.natodays.cz/, the air show is the largest and most significant security show in Europe.

Petr Zlatohlávek, Jagello 2000 Association senior project director, said his organization aims to raise awareness among the general and professional public about security policy and transatlantic relations.

“Our organization runs, what we call, public diplomacy projects or defense diplomacy projects,” said Zlatohlávek. “The organization is the primary Czech subject of public diplomacy in the security policy field and promotes the Czech Republic’s membership in NATO. It also participates in projects focusing on the European Union.”

Zlatohlávek said he considered the event an enormous success as this year’s attendance was over 110,000, following two years of low numbers due to the COVID-19 pandemic.

With its start in 2001, NATO Days’ intent was to present the local Czech and international community with its capabilities through demonstrations and static displays in the realm of security assets. In addition, the show also highlighted the resources of their partner nations, including the United States. The United States armed forces’ participation in NATO Days began in 2006.

BRUNSWICK, Mo. — The U.S. Army Corps of Engineers, Kansas City District, the State of Missouri, and the Brunswick-Dalton Drainage District partnered to sign a Feasibility Cost Share Agreement for a feasibility study on the Brunswick / Left Bank, River Mile 246 area on Sept. 28, 2022, in Brunswick, Missouri.

This signing signified the first formal step in the partnership for the Brunswick / L246 FSCA Missouri River Flood Risk and Resiliency Study, which is a spin-off of the Lower Missouri River Basin System Plan, a larger study that involves four states – Nebraska, Iowa, Kansas and Missouri.

The System Plan will reassess how USACE operates the lower Missouri River Basin and offer different flood risk and resiliency options for the river as a whole that have the best federal interest. The spin-off study conducted in Brunswick will offer flood risk and resiliency options specific for the area where the Grand River flows into the Missouri River.

“What is unique about the System Plan, is the direction given to us by the four states and Congress to comprehensively look at the Lower River as a whole in a large-scale, coordinated plan, but also not wait to take action on the project areas where there may be opportunities now. Here in Brunswick is the first area where we may be able to improve flood resiliency,” Col. Travis Rayfield, Kansas City District commander, said.

In October 1991, the First National People of Color Environmental Leadership Summit brought together close to 300 Black, Latino, American Indian, Pacific Islander, Asian American, and other activists of color to elevate the environmental justice movement, which aims to address the inequitable distribution of environmental risks among vulnerable populations. The movement was founded by people of color with an explicit emphasis on securing “political, economic and cultural liberation that has been denied for over 500 years of colonization and oppression.”

The summit was a defining moment in the environmental justice movement’s history. There, leaders outlined the movement’s mission and, in doing so, established a clear connection between environmental justice and public health, highlighting inequities in environmental factors that affect health—such as access to clean air, land, food, and water; the right to a safe and healthy work environment; protection from toxic/hazardous waste; and more.

From the summit emerged a defining document: the 17 Principles of Environmental Justice. These principles outlined the movement’s demands and emphasized its intersection with the environmental drivers of health.

Thirty years after the 1991 summit, the principles that emerged are as important today as they were when published, as environmental injustice remains a core cause of health inequities that disproportionately affect communities of color and low-income communities. As an initial example, tree coverage—which reduces air pollutants and improves health in multiple other ways—has been found to vary by neighborhood population demographics, with greater coverage and health benefits in Whiter, wealthier neighborhoods. Furthermore, today communities of color and low-income communities are disproportionately exposed to the increasing harmful health effects of climate change, which poses a greater threat to communities without the infrastructure and resources to protect themselves from and rebuild after harmful weather events.

The geographic distribution of federal and state infrastructure projects is also an issue of environmental justice. A report on environmental racism from 1987, four years before the summit, found that race was “the most significant among variables tested in association with the location of commercial hazardous waste facilities” nationally; at the time, “three out of every five Black and Hispanic Americans lived in communities with uncontrolled toxic waste sites.” As Ramon Jacobs-Shaw discussed in a Forefront article, the Dakota Access Pipeline placement less than a mile north of the Standing Rock Sioux Reservation is a modern-day example of environmental racism: “when marginalized racial and ethnic minority communities are disproportionately burdened by environmental hazards (such as oil pipelines) compared to more privileged groups.”

Environmental justice has become more visible in recent years, but much remains to be done. To more effectively address the historical and contemporary environmental inequities that cause health inequities, policy makers should revisit the mission and key goals of the environmental justice movement, as captured in the Principles of Environmental Justice, and apply this seminal framework to environmental policy making. Taking a cue from and building on community-led initiatives, policy interventions should target the connection between health inequities and environmental injustice in accordance with the needs and perspectives of the communities they impact. Focusing on this intersection provides an opportunity for more impactful, far-reaching change than would be possible by addressing health and environmental problems separately.

In this article, I will outline how the Principles of Environmental Justice can inform policy and support community empowerment work by focusing specifically on two frameworks present in the Principles of Environmental Justice: participatory and distributive justice.

Where To Target Interventions

To advance health equity, environmental interventions must be rooted in environmental justice. While there are several levels at which environmental injustice needs to be addressed, I propose a focus on the points at which disparities in distribution of environmental benefits or burdens translate into disparities in health.

Many are familiar with the river analogy about the social determinants of health, in which people suffering from poor health are triaged out of a river because something upstream is making them sick. This ominous upstream infector represents the social determinants of health, while the people pulling patients out of the river represent the modern medical system.

I offer a different analogy for the relationship between environmental and health injustice: a tree with roots, a trunk with branches, and fruit growing at the tips.

In this analogy, the roots represent the underlying causes of environmental injustice, namely racism and income inequality. These are the unseen drivers that allow exploitation of powerless people and natural resources, and they are the foundation on which the tree grows. The trunk and branches of the tree represent where power and wealth are stored and distributed. The trunk signifies where decisions about resource distribution are made, and the branches illustrate communities that need resources to thrive. Finally, the fruit on the tree represents the outcome of the resource distribution across branches. Some branches will produce bunches of plump fruit; others will produce fewer, smaller fruits; and some will produce no fruit. Some branches will be so weak that they cannot survive the next harsh winter, while others will grow stronger every year.

Environmental injustice transforms into health injustice at the point when power and wealth can be wielded to improve or protect the environment—in the trunk—but are instead routed away from struggling populations—weak branches—to those that are already thriving—strong branches already bearing fruit. Those weak branches then grow weaker still.

To address the intersection of environmental and health justice located in the tree trunk, the decision-making power lodged there needs to be shared with the communities who will be affected by the outcomes of those decisions. Thus, interventions targeted at this section must be rooted in participatory justice. To address the intersection of environmental justice and health justice located in the branches, the effects of decisions made in the trunk need to be distributed equitably—this doesn’t mean that every branch receives the same resources every year, but that every branch receives what it needs to thrive and produce fruit equally to the other branches. Interventions targeted at this section of the tree must be rooted in distributive justice.

Rooting Interventions In Justice

As framed by the Principles of Environmental Justice, advancing environmental equity through interventions rooted in participatory and distributive justice will improve public health.

Participatory Justice

Participatory justice is about fair participation in decisions that could create problems or solutions for people. This means reallocating decision making, typically held by people who historically hold power in society, to the people affected by the decisions, typically the people disproportionally without power in society. Participatory justice is a central part of the environmental justice movement, as outlined by several of the Principles of Environmental Justice:

• Environmental Justice demands the right to participate as equal partners at every level of decision making, including needs assessment, planning, implementation, enforcement, and evaluation.
• Environmental Justice affirms the fundamental right to political, economic, cultural, and environmental self-determination of all peoples.
• Environmental Justice must recognize a special legal and natural relationship of Native Peoples to the US government through treaties, agreements, compacts, and covenants affirming sovereignty and self-determination.

To ensure participatory justice in the decision-making and policy-making processes that impact communities’ physical and social environments, representatives from these groups need to be more than “at the table”; they need to be the actual decision makers. This starts with representatives from affected groups increasing their understanding of the policies about and outcomes of unequal distribution of resources and projects that can harm the environment and increase health risks among communities. Achieving participatory justice must include empowering community leaders to become knowledgeable about the environmental justice issues in their localities and the solutions that could work for their communities.

Efforts to bolster participatory justice are underway in many communities through self-empowerment initiatives. For instance, the Deep South Center for Environmental Justice is a resource for environmental justice research, education, and health and safety training for environmental careers with a goal of developing “leaders in communities of color along the Mississippi River Chemical Corridor and the broader Gulf Coast Region that are disproportionately harmed by pollution and vulnerable to climate change.” The Center offers workshops about how to monitor neighborhood environmental hazards, understand the risks of toxic exposures, know the duties of governmental agencies, develop strategic advocacy for policies and decisions that prevent and remedy unsafe environmental conditions, and more.

Furthermore, Greenaction for Health and Environmental Justice is a grassroots health and environmental justice organization that partners with low-income and working-class, urban, rural, and indigenous communities. They provide trainings for youth and communities at large on how to understand environmental review processes, best practices in community organizing, how to reduce health risks, and more. They also help communities document the health and environmental impacts of harmful projects as well as document the living stories of communities “to ensure that community voices are at the forefront of their struggle and to ensure communities remain in control of their narratives.”

Organizations such as the Deep South Center for Environmental Justice and Greenaction for Health and Environmental Justice are helping complete a vital part of the participatory justice puzzle by empowering citizens to become experts and advocates about the environmental injustices in their communities. However, if these community leaders and representatives do not hold any political power, they cannot participate in the policy making that impacts their communities. To achieve participatory justice, policy-making power must be redistributed from current policy makers to these local leaders from communities most affected by environmental injustice.

Within current power structures, this means electing environmental justice leaders who can accurately represent and act on input from their constituents. Organizations such as WE ACT for Environmental Justice, the League of Conservation Voters, and the Sunrise Movement provide leadership development opportunities for individuals as well as build support for political candidates that uphold environmental justice values at the local, state, and federal level. In a political system such as that of the US—in which financial support and endorsements from large, nationally known organizations are nearly essential for electoral victory—organizations such as these are a vital steppingstone on the path to redistributing decision-making power to environmental justice leaders.

Distributive Justice

Distributive justice is about more than fair participation in decision making—it is about the outcome of those decisions. Distributive justice concerns how burdens and benefits should be distributed. According to the 2007 text Environmental Justice and Environmentalism, while “many aspects of the environment cannot physically be transferred from one community to another,” distributive justice in terms of environmental justice is about “the distribution of benefits and costs of environmental resources.”

Distributive justice is reflected in several of the Principles of Environmental Justice and is integral to the environmental justice movement:

• Environmental Justice mandates the right to ethical, balanced, and responsible uses of land and renewable resources in the interest of a sustainable planet for humans and other living things.
• Environmental Justice affirms the need for urban and rural ecological policies to clean up and rebuild our cities and rural areas in balance with nature, honoring the cultural integrity of all our communities, and [provide] fair access for all to the full range of resources.
• Environmental Justice calls for universal protection from nuclear testing, extraction, production and disposal of toxic/hazardous wastes and poisons, and nuclear testing that threaten the fundamental right to clean air, land, water, and food.

When it comes to environmental resources, both burdens and benefits are at play. Environmental injustice is often caused by the inequitable distribution of a burden that makes an environment less healthy without any extra benefits or resources to compensate for it. One example of this is the unequal distribution of polluted air. A 2013 study in North Carolina found lower socioeconomic status, higher deprivation, and higher share of minority population were consistently associated with higher levels of annual average air pollution. Air pollution has been associated with increases in mortality and hospital admissions due to respiratory and cardiovascular disease. 

Rooting environmental burdens and benefit allocation in distributive justice would ensure communities with disproportionally unhealthy environments do not face continuous risks, while those communities that have been exempted or shielded themselves from environmental harm, as well as done harm unto other communities, receive their proportionate share of environmental burdens. Anchoring environmental policy in distributive justice would equitably allocate resources to help communities invest in building and sustaining healthy environments.

In practice, this might look like measuring the distribution of environmental benefits and burdens, as well as their impacts on health, and making decisions that allocate these positive and negative outcomes justly. In other words, all branches of the tree are deserving of resources, and in some instances, certain branches should receive more than others to compensate for generations of inequitable distribution. This redistribution is not easy for many reasons, including that Whiter, wealthier communities are historically resistant to hosting environmental burdens and have the power and resources to protect themselves, shunting these burdens—such as the placement of hazardous waste facilities—to the communities without the economic and political power to resist them.

Using environmental impact statements and health impact assessments is a great place to start measuring the distribution of environmental benefits and burdens, but making sure to track outcomes against the initial estimates is vital—and is part of the participatory justice work outlined in the previous section. Also, enforcing regulations around who drafts environmental impact statements is important for their integrity; this was a central problem in the determination of the placement of the Dakota Access Pipeline.

Prioritizing those facing the greatest disadvantage when distributing environmental costs and benefits supports communities facing poor health outcomes connected to their environments. As outlined in the Principles, balance of environmental resources and thus balance of their subsequent health effects is a central part of the environmental justice movement.

There are efforts around the US to integrate environmental justice priorities into new projects and policies through acts of distributive justice. For example, St. Paul, Minnesota’s Climate Action and Resilience Plan includes explicit equity components to ensure disadvantaged neighborhoods are not left behind in the city’s adaptations and preparedness for the effects of climate change. For instance, to reduce emissions from the transportation sector, the plan describes transportation equity efforts to specifically support communities of color and low-income communities.

Furthermore, policy makers can ensure that parks in communities of color and low-income communities are preserved through green space protection laws. Parks are associated with several positive health outcomes and protection against the effects of climate change. In 2017, US Representative Nanette Barragán (D-CA) introduced to the House the Outdoor Recreation Legacy Partnership Grant Program Act, which would, in Barragán’s words, “protect a National Park Service program that promotes the development of greenspaces and recreation facilities in underserved parts of cities.” Passing laws such as this one aid in equitably distributing greenspace, a beneficial environmental resource.

Moving Forward

Now, targeting interventions at the trunk and branches does not address the roots of the tree—racism and income inequality. This target level instead focuses on the effects of racism and income inequality, rather than addressing the underlying causes themselves.

Many critique this approach on the grounds that equity cannot be reached by operating within systems built on an inequitable foundation. That can hold true, while at the same time we can desire to improve lives and advance equity within current systems, while they unfortunately still exist, to prevent sickness and death from occurring today. Interventions are needed at all levels of the tree—we must uproot structural inequities while still treating those living with the health outcomes caused by them.

Looking back at the Principles of Environmental Justice can inform future interventions aimed at the intersection between environment and health, where changes to environmental policies, and those who get to make them, could improve health outcomes. Using the Principles to frame these reforms would improve environments and subsequently advance health equity and justice.

Public health professionals ensure we have our daily necessities. If they didn’t have our backs, there simply wouldn’t be healthy food to eat, clean water to drink or non-hazardous air to inhale. These experts might excel at ensuring the provision of necessities, but they are just as excellent at taking on curveballs as well — think auto safety, vaccine development and distribution, the prevention of new infectious diseases, maternal and child health, obesity, and health care reform. Their insights are crucial to managing and providing solutions to such challenges.

Many of today’s key figures in this dynamic field got their start at the George Washington University (GW) Milken Institute School of Public Health. At this institution ranked 12th nationally (US News and World Report’s List Of Best Public Health Graduate Programmes), students explore the field’s history and carve its future — a fact evident through the cutting-edge research conducted in the institution’s state-of-the-art facilities.

From Washington D.C., the school studies AIDS, antibiotic resistance, the health of women and girls, natural disasters, health inequities, malaria vaccines, global nutrition, air pollution, climate change, and obesity. To encourage more to join the fight, it recruits top investigators, researchers, policy experts and educators.

Together and individually, they deliver comprehensive lessons in specialized areas. The Milken Institute School of Public Health has room for every world-bettering aspiration, offering Master of Public Health (MPH) degrees in Biostatistics; Community Oriented Primary Care; Environmental Health Science Policy, Epidemiology; Global Environmental Health; Global Health Epidemiology and Disease Control; Global Health Policy; Global Health Programme Design Monitoring and Evaluation; Health Policy; Health Promotion; Humanitarian Health; Maternal and Child Health; Physical Activity in Public Health; Public Health Communication and Marketing; as well as Public Health Nutrition.

It also offers Master of Science programmes (in Epidemiology, Health and Biomedical Data Science, Public Health Microbiology and Emerging Infectious Diseases, and Strength and Conditioning), alongside a Master of Health Administration programme, and a suite of joint or dual degree programmes.

Each 45-credit programme requires two years of study and is topical in its own unique way. For example, the MPH Biostatistics teaches students to apply statistical methods to the biological, biomedical, and health services sciences. Its curriculum is constantly revamped in line with global developments (25 courses have been added in the past two years).

“The curriculum is modern and pertinent to our world,” says Professor of Biostatistics, Heather Hoffman. “While students learn the foundation, cutting edge researchers serve as their mentors — each leverages their research and passion to educate.”

The MPH Global Environmental Health is just as dynamic, preparing students to work in resource-poor settings and apply analytic skills to prevent or reduce health problems associated with environmental hazards.

“Environmental risk factors should not be a fringe issue, rather environmental health needs to be central to the global public health agenda,” adds Susan Anenberg, director of the GW Climate and Health Institute.

“The GW Climate and Health Institute is a differentiating factor of this programme. It allows students to network with leaders in Environmental Health and helps them gain exposure to programming, events, and discussions. Most importantly, it teaches them to seek new solutions to global health and equity challenges associated with climate change.”

Despite each programme’s varying goals, they are all filled with experiential learning opportunities. For instance, all students at the Milken Institute School of Public Health take on a Practicum (internship or applied practice experience) during their programme to apply newfound knowledge.

Just before graduating and joining an illustrious list of 290,000 living alumni, students close their GW chapter with a Culminating Experience, which entails conducting research with a professor, writing a paper or strategizing a presentation. This requirement was set in place to ensure every budding public health professional leaves with something stellar to show for themselves. “It can even lead to job opportunities,” says Professor Hoffman.

Thankfully, there are plenty of those in Washington D.C. — where the Milken Institute School of Public Health is one of a kind. In fact, students have completed practicum and internships in various settings, federal agencies (like the US Agency for International Development, the US Environmental Protection Agency, the National Institutes of Health, not for profits (like MITRE Corporation, Helping Children Worldwide), and healthcare or public health groups (like Mercy Medical Center Cambodia, the Council of State and Territorial Epidemiologists).  The opportunities are endless and GW’s Career Service team works with students to find the best match.

Opportunities aside, Ka Sin Cassie Ng, a second year Environmental Health Science and Policy student, loves living in DC!  It is a city of culture, museums, home to the capital of the United States, and great public transportation.  “I also enjoy D.C. because there are plenty of green parks and designated paths for me to ride my bike on,” she says. “Furthermore, D.C. is a smaller city, but it’s fun to navigate and gives students a nice balance of city life and nature.”

Little wonder why most of the Milken Institute School of Public Health classes are scheduled in the late afternoon and evening.  This allows its 800 residential graduate students to take advantage of all that DC has to offer! With museums, historical landmarks, parks, cuisines, and shop-a-holic havens galore, there’s no better place to find the sweet spot between the rigours of a quality Master of Public Health and the dynamism of a vibrant student experience. Click here to learn more about the Milken Institute School of Public Health.

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19 February 2022 – The COVID-19 pandemic has accentuated the importance of health research in finding solutions to health challenges. To address the most urgent health priorities using evidence-based solutions, the Ministry of Health and Human Services (FMOH) of Federal Government of Somalia and National Institute of Health (NIH), with support from the World Health Organization (WHO) and other partners, convened the first ever health research conference in Garowe, Puntland, from 30 January to 1 February 2022.

Some of the brightest Somali minds came together at the event ─ 200 national and international researchers ─ to present 51 unpublished research abstracts, showcasing new evidence and best practices around public health actions in Somalia which were neither researched before in the country by anyone nor had any evidence been generated before on these priority public health issues. Overall, Somali authors submitted 91 abstracts; the rest were either published already or did not meet the expected criteria.

Dignitaries who participated in the conference included HE Dr Fawziya Abikar Nur, Federal Minister of Health and Human Services; HE Dr Jama Farah Hassan, Minister of Health, Puntland; HE Per Lindgarde, Ambassador of Sweden to Somalia; Dr Mamunur Rahman Malik, WHO Representative to Somalia and Head of Mission. Representatives from the Swedish International Development Cooperation Agency (SIDA), the Public Health Agency of Sweden (PHAS) and African Field Epidemiology Network (AFENET), and colleagues from the University of Umea and the Gothenburg University in Sweden also participated.

Professor Khalif Bile, Chair of the NIH Board of Directors and the Scientific Committee for the NIH Research Conference, spearheaded the event, taking it from an idea to reality. Under the leadership of Dr Abdifatah Diriye Ahmed, NIH Executive Director, the NIH Public Health Specialist and research focal person, Dr Mukhtar Bulale, organized the conference, bringing together all relevant stakeholders.

Institutions supporting the NIH

WHO extended financial support to the conference, through the Alliance for Health Policy and System Research (AHPSR), which aims to build health systems research capacity for low and middle-income countries and use new knowledge and evidence from public health research to set policies that support system building. The AHPSR promotes the generation and use of health policy and systems research to improve health systems in low- and middle-income countries, such as Somalia, while developing the research capacity of institutions, systems and individuals.

Other partners of WHO supporting this first ever research conference include the PHAS, which provided financial support to the conference, and collaborates with the NIH, in addition to AFENET and SIDA, which offer regular technical support to the NIH’s activities.

Members of academia from 32 public, private and international universities attended the conference, and supported the NIH team at various stages of planning and implementation.

Young, budding Somali researchers light glimmer of hope

Participants at the conference included scientific and technical committees, organizers, presenters, stakeholders, panellists and partners. The scientific committee for the event assessed abstracts, mentored some of the authors whose abstracts needed further refining, and developed guidelines and checklists for peer reviewing the studies.

Of the 51 researchers, seven were female. Additionally, 10 trainees from the first ever Frontline-Field Epidemiology Training Program (FETP-Frontline) conducted in Somalia in 2021, with support from WHO, the PHAS, AFENET and the United States Centers for Disease Control and Prevention (US CDC), offered support to conduct the research conference.

Sadia Hussein, one of the two trainees from the first FETP cohort who presented an abstract, and a WHO Public Health Specialist, explained that she got the idea for her study while she was working in Deynile, Banadir, as part of the FETP field work. She added she enjoyed participating in the conference as it was a forum where researchers and experts came together with policy-makers to display their research skills, while highlighting gaps in the health system, and linking research to the bigger picture in health.

Researchers presented on an extensive range of topics

Researchers presented their findings on six themes that had been selected after taking into consideration the Essential Package of Health Services (Somalia EPHS 2020), Universal Health Coverage (UHC) and Sustainable Development Goals (SDGs). Researchers presented 10 abstracts under the theme of health systems; 15 as part of reproductive, maternal, newborn, child and adolescent health; 18 under communicable diseases; 8 as part of noncommunicable diseases. Panelists delivered 12 informative presentations related to the themes of health research production and dissemination; and research training and capacity building, linking research to action.

Presenters stimulated thought-provoking discussions between the sessions, including around strengthening pharmacovigilance and drug regulation; increasing and motivating human resources for health; occupational safety of health workers with the introduction of new diagnostics, improving access to health care for women; and providing compassionate care while maintaining dignity and the privacy of female patients. They discussed how to reduce and eliminate the harmful practice of female genital mutilation (FGM); and recruit assistant community-based midwives to improve maternal health care in rural areas. The only experimental study that was presented focused on ‘Effects of the Coenzyme Q10 on the Peripheral Nerve Injury: An Electrophysiological Study’, presented by a university professor.

Furthermore, participants debated over how to address the high burden of multi-drug resistant tuberculosis in Somalia, and the need to deploy community health workers to enhance early detection of the disease, in order to reach the SDGs’ target of ending tuberculosis epidemics by 2030. These rich discussions aim to spur changes in policies and programming eventually.

Introduction of the first Somali Health Action Journal

As another significant milestone, the NIH Board of Directors launched the Somali Health Action Journal (SHAJ) at the conference. This is the first Somali health journal that will receive articles, facilitate their review by peers, motivate Somalis to conduct further research, write and publish new articles, and take up opportunities to disseminate and use research for policy-making and the design of useful programmes.

The editors of the journal committed to supporting young Somali researchers by mentoring them where possible. The journal aims to inspire the young and future generations of Somali health professionals to study different topics that will lead to innovations in health in the country.

Research must address country’s problems

HE Dr Fawziya Abikar Nur, Minister of Health and Human Services for Somalia, praised the NIH, its board of directors, and scientific committees for motivating several young Somalis to present their findings on crucial health topics.

“Iencourage you to document these national efforts ─ both what works and what does not work and why ─ but, above all, provide us solutions that can address the challenges we face,” she said, while thanking the partners who made the event a resounding success.

While lauding the Government of Somalia for its exemplary role in organizing a milestone event of this kind, and commending international researchers for visiting Puntland for the historical gathering and partners such as the PHAS for their support, Dr Mamunur Rahman Malik inspired young and experienced Somali researchers by announcing that WHO will work with the NIH to introduce state-of-the-art libraries in all ministry of health buildings of Somalia. He also added the WHO would award the young researchers nominated by the NIH for the best research presented in future conferences.

Dr Malik reminded the audience that in 1990, it was noted that only 10% of global health research was allocated for addressing 90% of global health problems. A commission set up to address this problem warned that if this disparity was not changed, the world would experience a large burden of infectious diseases, increasing rates of tuberculosis, malaria, and epidemics of noncommunicable diseases including heart diseases. As predicted, Dr Malik explained, the world is now seeing a high burden of these diseases, including infectious and noncommunicable diseases.

“I encourage you to come up with a national health research agenda and improve collaboration between the public and private sector, especially universities,” said Dr Mamunur Malik. “Also, research needs to contribute to improving national health. For example, diarrhoea and malaria contribute to a high burden of diseases but people do not have access to health services. Research should help address issues like this, and how to improve access in fragile settings like in Somalia, address health inequities, and increase access to drugs so people lead healthier lives.”

Putting Somalia on the global research map

On behalf of the NIH team, Dr Mukhtar Bulale explained that the sessions were successful and led to rich discussions with questions being answered, which was a flagship symbol illustrating useful nationally owned health research.

“Even though we started small, this conference has put Somalia on the global research map. Seeing young researchers put their best foot forward has given us immense hope that Somalia’s health research development is undergoing a recovery phase. We saw at the conference a unity of purpose, solidarity and eagerness for research partnerships and solutions to challenges. I urge stakeholders to ensure we do not miss the opportunity to support these young, dynamic researchers,” Dr Bulale said.

At the end of the conference, the Federal Ministry of Health, NIH, and stakeholders advocated for sustained investment in health research to further promote the Essential Package of Health Services 2020, which would benefit the Somali population. They also resolved to promote health system research, linking it to public policy formulation, while ensuring it focuses on addressing existing barriers to health service delivery. This implies the development of a national research agenda to invest — attention, resources and skills — in research that will result in improved health outcomes for the populations, and thematic areas where more evidence is required to inform policies and strategies. Together, they also committed to foster cooperation between the public and private sector in health system research, and to promote the development of innovative technologies and approaches. The partners resolved to strengthen the links between evidence generation and health care provision, while calling on all national and international stakeholders to develop the capacity of learning institutions and to facilitate high-quality research in the country.

Note to editors

The World Health Organization (WHO) country office for Somalia, the Government of Sweden and the Public Health Agency of Sweden (PHAS) are providing support to Somalia’s Federal Ministry of Health and Human Services (FMOH) to support the establishment and strengthening the capacity of the National Institute of Health (NIH) of Somalia. Please below articles for additional information on this exemplary collaboration.