This has also been a year of discovery and creativity. The breadth, scale and speed of global collaborations were unheard of.  And we figured out new ways to do many things – like providing medical care via telemedicine, having small meetings and large conferences via Zoom and other platforms, and teaching courses remotely.  Many of these changes are long overdue and have co-benefits like improving access and reducing carbon emissions.  Most – including teaching and learning remotely – require major time commitments to learn new approaches and support to facilitate the transition to these formats.

I am very hopeful about the coming months. There is a long road ahead to full recovery, but with vaccines available and more on the way, as well as advances in prevention and treatment, it is likely that we will turn the corner on this pandemic soon if we continue to accelerate vaccination rates here and globally, and simultaneously continue to follow public health guidance about things like mask use, physical distancing, and avoiding high risk activities and venues.

My thanks to each of you for all you have done over the past year and all you are continuing to do to help each other, our community and our global partners emerge and recover from the pandemic.

Equipping Community Health Volunteers
The WHO Ensuring Quality in Psychological Support (EQUIP) project trained 18 community health volunteers in brief psychosocial therapy. The study looked at how to deliver competency based training, and UW’s Global Mental Health program was one of seven sites selected by WHO for the project. 2020 posed massive challenges but the project was successfully completed through virtual training and care delivery. A large part of the project involved capacity development for Nairobi psychologists and collaboration with Nairobi County and citiesRISE.

M-healer
Together with Professor Angela Ofori-Atta and colleagues at the University of Ghana, Professor Dror Ben-Zeev (Psychiatry), Professor Pamela Collins (DGH and Psychiatry) and Professor Jaime Snyder (I-School) worked to develop a digital toolkit, M-healer, designed to support dissemination of evidence-based psychosocial interventions and strengthening of human rights awareness and knowledge among faith healers in West Africa. Members of the US and Ghana-based research team conducted interviews and focus groups with healers in Ghana in 2019, and the Ghana-based research team conducted user testing of the M-Healer toolkit with faith healers in 2020. The M-Healer toolkit content is organized into modules including an introduction to the system, brief mental health interventions, verbal de-escalation strategies, guided relaxation techniques, and human rights training. Each module contains several individually scripted digital animation videos that are approximately one minute long with narration.

Optimizing Implementation in Cancer Control: OPTICC
The mission of the OPTICC (Optimizing Implementation in Cancer Control) Center is to improve cancer outcomes by supporting optimized implementation of evidence-based interventions in cancer control. The OPTICC P50 Center at UW completed its first year, and a protocol paper is set to be published in Implementation Science Communications.

Mentored Research Scientist Career Development Awards
Implementation Science Program faculty members Melissa Mugambi received a K01 Career Development award for the design and evaluation of strategies to implement HIV prevention interventions for pregnant women in community pharmacy settings, and Anjuli Wagner received a K01 for Testing implementation strategies to improve delivery of PrEP for pregnant and postpartum women in Kenya.

To close the gap, the World Health Organization (WHO) released a new policy brief recommending countries offer a single RDT that screens pregnant women for HIV and syphilis simultaneously. The dual-purpose test will save costs for countries, especially those with limited resources, introducing this strategy into antenatal care settings. By testing a larger proportion of women with a single accurate test that is simple to use, rather than a smaller proportion with separate HIV and syphilis tests, pregnant women who test positive for either infection can rapidly start treatment and prevent infections among infants.

The evidence emerged from a Global Center for Integrated Health of Women, Adolescents, and Children (Global WACh) cost-effectiveness analysis, led by Alison Drake, DGH Assistant Professor, of incorporating dual HIV and syphilis RDTs into antenatal care visits in four countries with varying HIV and syphilis prevalence: South Africa, Kenya, Colombia, and Ukraine. In addition, the analysis evaluated the impact of using the dual HIV/syphilis RDT as a strategy to retest for HIV and syphilis later in pregnancy.

Defining relationships between diarrhea, growth, and child survival and interventions to improve survival and growth
A Global WACh study found that enteric pathogens—or bugs associated with diarrhea—become a much greater issue when they infect malnourished children. An initial study found that acute malnutrition was associated with more severe diarrhea, but new work shows the association with substantial mortality too. Researchers used data from the Global Enteric Multicenter Study, a seminal study of diarrhea among children ages 0-59 months in Bangladesh, India, Kenya, Mali, Mozambique, Pakistan, and Gambia.

DeWorm3
1.5 billion people worldwide are affected by internal parasitic worms known as soil-transmitted helminths (STH). The DeWorm3 study (PI: Judd Walson, DGH Professor) is a global project consisting of partners around the world aiming to interrupt STH transmission.DeWorm3 study teams in Benin, India, and Malawi conducted community censuses to describe the demographics of local populations, followed by a series of field surveys to assess the prevalence and intensity of STH infections within each community. During the assessment phases, site teams collected and analyzed more than 77,000 stool samples for intestinal worms. As sites prepared to administer early rounds of mass deworming treatment to community members, teams collaborated with local health workers to educate communities about the importance, benefits, and safety of deworming. To date, DeWorm3 teams have distributed over 396,000 doses of deworming treatment to participants.
The project is also collecting data on additional factors, such as costs and organizational readiness of existing educational and health system infrastructures, as part of DeWorm3’s implementation science scope of work, led by Arianna Means (DGH Acting Assistant Professor), that contextualizes clinical research findings and provides guidance on opportunities to optimize the delivery of STH interventions. DeWorm3’s evidence is informing national and global policies and practices regarding opportunities to deliver community-wide mass drug administration within routine health programs.

New Investigator Awards
The UW/Fred Hutch Center for AIDS Research announced eight 2020 New Investigator Award recipients. The award encourages junior investigators (at a senior stage of training or recently independent) to conduct independent research, acquire preliminary data to use for exogenous grant submissions, publish, receive mentorship, and write one or more grants to obtain funding to continue their HIV/AIDS research careers. Recipients are awarded $45,000/year (direct costs) for non-interdisciplinary projects or up to $55,000/year (direct costs) for interdisciplinary projects. UW CFAR found that the return on investment on the New Investigator Awards over the past 10 years was 996%.