The Alliance’s Work in Action: From Hypertension in Ghana to Cleaner Air in Peru

As announced in September, the Alliance has advanced its efforts to boost global health equity with the awarding of four $250,000 grants this fall to JHU initiatives that address critical areas of global health equity. The $1 million investment supports cross-divisional teams at Johns Hopkins University representing biomedical, engineering, education, arts and sciences, and business divisions across the campus to advance their proposed transformative contributions.

The JHU teams are partnering with local community-based organizations and public sector entities to ensure community involvement and to expand the long-term benefits of research projects in low-and middle-income countries and in First Nations communities.

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“These important projects highlight what can be accomplished when a multidisciplinary strategy focused on health equity is appropriately resourced and put into action,” said AHW Executive Manager Benjamin Link.

“Additionally, this work emphasizes the three approaches we employ across sectors: Global to Local Learning Opportunities & Action; Female Led Innovation & Enterprise; and Open Science.”

Here is a closer look at each of the four projects:

Thermal Cooker for Healthier Air

Globally, approximately 3 billion people rely on biomass fuel (wood, agricultural crop waste, charcoal, and dung) for cooking, and the resulting toxic air pollution contributes to more than 4 million premature deaths annually. Girls and women are disproportionally affected by this type of air pollution because they are traditionally tasked with spending many hours per day cooking family meals. Additionally, the time-consuming process of gathering the biomass fuel puts girls and women at risk for sexual assault, animal attacks, and physical ailments. Shifting to liquefied petroleum gas (LPG), a mix of propane and butane, can reduce this destructive pollution but is financially out of reach for many. Our team is working with communities in highland Puno, Peru to test whether a thermal cooker can make LPG affordable for low-income rural households by dramatically reducing the quantity of fuel needed for cooking. A thermal cooker is a heavily insulated container that does not require fuel: Food is first heated to a high temperature on an LPG stove, then enclosed in the thermal cooker, which continues to cook the food for several hours without the use of additional gas. This could greatly reduce the amount of LPG required and dramatically improve health, especially for low-income women and girls.

Safe Passage for American Indian Adolescent Girls

Participants in adolescent health program, White River AZ/Fort Apache, 2016. Photo credit: Ed Cunicelli

Participants in adolescent health program, White River AZ/Fort Apache, 2016. Photo credit: Ed Cunicelli

Native American adolescent girls are frequent victims of gender-based sexual, physical, and emotional violence, and they contract sexually transmitted infections, get pregnant, and suffer from substance abuse at a rate that is two to four times higher than that of other racial and ethnic groups in the United States. At the same time, residents of rural communities have less access to support services and resources. Technology is one way to bridge that gap, and studies indicate that these adolescents are open to receiving information and interventions through smartphones platforms. Our research team is creating a new app, incorporating some components of two existing successful applications, to provide adolescent girls on reservations in Arizona and Montana with information about sexual and reproductive health. It will include functions such as a rescue-call button and a link to local case managers. The Alliance foresees enormous potential for the Safe Passage app to be customized for and tailored to local settings around the world.

Addressing Hypertension Care in Africa

The rates of cardiovascular diseases and stroke in Sub-Saharan Africa have surged dramatically in recent decades because of poor diagnosis and inadequate treatment and control of key risk factors such as high blood pressure (hypertension). Population growth, urbanization, poor diet, physical inactivity, and obesity are exacerbating the problem, and the World Health Organization estimates that hypertension will be the cause of 75 percent of all deaths in the Sub-Saharan region by the year 2020. This Alliance project addresses the gaps in management and treatment of hypertension in residents of Ghana, located on the western coast of the sub-Saharan region. Our researchers will enhance the ability of local healthcare providers and public health workers to apply interventions specifically targeted to this region’s communities, and well as build both infrastructure and the capacity of the local healthcare system to deal with the issue of hypertension. This project also aims to create a model that is scalable for use across the region for exponential results.

Zero TB in Tibetan Kids

Girls living in a nunnery near Dharamsala in Northern India after receiving a skin test for latent TB, 2018. Photo credit: Delek Hospital

Girls living in a nunnery near Dharamsala in Northern India after receiving a skin test for latent TB, 2018. Photo credit: Delek Hospital

Tibetan refugee children in India suffer from tuberculosis at an astounding rate 12 times higher than that of Indian children. Our researchers will employ innovative approaches to create the most effective strategies for eliminating TB among refugee children in Dharamsala, India. Using a Global-to-Local approach, our team will leverage Johns Hopkins University faculty expertise in the areas of TB control, treatment and preventive therapy, coupled with health communications, health economics, and psycho-educational counseling in partnership with local stakeholders to conduct school-based screenings and implement novel drug regimens. This initiative is potentially scalable and sustainable for the Tibetan population not just in Dharamsala but across India. Results from this project will inform policy and action at the national and global level, which is significant because current screening and treatment related to latent TB are largely insufficient despite the proven benefit of TB preventive therapy.

Future editions of the Health Equity Connector will feature in-depth articles about each of the four projects and the progress they are making in boosting global health.