I-TECH works in collaboration with key stakeholders, including communities, government entities, and the Centers for Disease Control and Prevention (CDC), to strengthen and implement surveillance programs focused on emerging disease threats, HIV recent infection, birth defects surveillance, and hospital acquired infections in sub-Saharan Africa. Eastern Europe, Asia, and South America.
In Malawi, I-TECH has supported the implementation of an active hospital-based birth surveillance system at four high-volume facilities in Malawi since 2016, and beginning in 2019, I-TECH began implementing recent HIV infection surveillance in April 2019.
In 2022, as part of the Integrated Next-generation Surveillance in Global Health: Translation to Action (INSIGHT to Action) project, I-TECH, the Peruvian Ministry of Health, the Universidad Peruana Cayetano Heredia, and CDC collaborated on a situational analysis to assess areas for potential strengthening of the Peruvian disease surveillance systems. In 2023, the INSIGHT for Action project launched the Triple Border Disease Surveillance Strengthening Program.
In Kenya, the I-TECH Kenya office is working with CDC on implementing surveillance for hospital acquired infections (HAI) in low resource settings, with a focus on surgical site infection surveillance.
Migrating waterfowl from Asia, Africa, and Europe intersect in Georgia, which increases the potential for novel avian-origin influenzas to emerge ... Read More
The Integrated Next-generation Surveillance in Global Health: Translation to Action (INSIGHT to Action) project is a five-year cooperative agreement with the ... Read More
Despite establishing COVID-19 monitoring measures within the existing routine national surveillance system and significant efforts to conduct testing, contact tracing, ... Read More
Population movement, limited public health infrastructure, different country reporting systems, and poor environmental conditions increase incidence of certain infectious diseases ... Read More
The World Health Organization recommends countries routinely implement nationally representative HIV drug resistance (HIVDR) surveys among people infected with HIV ... Read More
I-TECH Kenya’s Global Health Security Agenda (GHSA)-funded programs aim to advance the GHSA goals of preventing , detecting, and responding ... Read More
The Frontline Field Epidemiology Training Program (Frontline FETP) enhances the capacity of HIV and AIDS surveillance and strengthens health systems ... Read More
In collaboration with the Malawi Ministry of Health (MOH) and Centers for the Disease Control and Prevention (CDC), I-TECH has ... Read More
One Health
Human disruptions to natural systems are causing climate change and other major environmental upheavals including biodiversity loss, zoonotic disease emergence, toxic pollution, heat emergencies, and flooding that will have major impacts on the health of human and animal populations. To reflect the intersectionality and interconnectedness of the health of humans, animals, and the shared (and rapidly changing) environment, I-TECH partners with the Center for One Health Research in designing and implementing programs that use the One Health approach to prevent, detect, and respond to emerging disease threats. I-TECH’s One Health approach focuses on strengthening disease surveillance systems and laboratories to detect and assess new infectious disease threats, as well as detecting “sentinel” cases of disease in humans and animals that are indicators of health impacts of environmental change.
In 2022, I-TECH formed the Global One Health Group to support the prevention, detection, and response to emerging disease threats throughout the world. By leveraging the strength and expertise of the University of Washington Center for One Health Research and other UW partners, I-TECH is providing effective training, technical assistance, and laboratory services to support capacity and systems strengthening in affected communities. The Global One Health Group includes experts in zoonotic and other infectious diseases, antimicrobial resistance, public health, animal health, environmental health, and implementation science.
The Integrated Next-generation Surveillance in Global Health: Translation to Action (INSIGHT to Action) project is a five-year cooperative agreement with the ... Read More
On May 26, the International Training and Education Center for Health (I-TECH) bids a fond farewell to its Executive Director, Pamela Collins, MD, MPH. Dr. Collins joined I-TECH in July 2020, seeing the center through the height of the COVID-19 pandemic; a new brand; continued localization of I-TECH offices to independent organizations; and a strategic shift toward an increased focus on mental health, digital health, and One Health programming.
“I am privileged to have worked with this talented and compassionate group of colleagues from around the world for the past 3 years,” said Dr. Collins. “As I entered I-TECH, I discovered a network ready manage the demands of health care delivery during the COVID-19 pandemic and one whose capabilities are aligned with contemporary public health priorities—from workforce development, emerging infectious diseases, digital health, to mental health. While I am sad to leave this community, I am extremely excited for I-TECH’s future.”
While Friday was Dr. Collins’ last day leading I-TECH, she will remain through June as a faculty member in the University of Washington (UW) Departments of Global Health and Psychiatry & Behavioral Sciences. Dr. Collins will then transition to her new role as the Bloomberg Centennial Chair of the Department of Mental Health at Johns Hopkins University’s Bloomberg School of Public Health—the only school of public health in the country with a department dedicated to mental health.
Dr. Collins will be succeeded in leadership at I-TECH by Ivonne Ximena “Chichi” Butler, MPH, and Pam Kohler, PhD, MPH, BSN. Ms. Butler and Dr. Kohler will serve as interim co-directors of the center, with Ms. Butler overseeing business and administration and Dr. Kohler leading science and assuming a technical advisor role for faculty and staff. The co-directors will work together to represent and pursue collaborations and partnerships within and outside the UW; engage stakeholders to invest in I-TECH; and liaise with country leadership, principal investigators, and staff on program implementation.
Dr. Kohler brings experience as co-director of the UW Center for Global Health Nursing and has been a faculty member with I-TECH for 11 years. In that time, she has led a field epidemiology training program in Tanzania and evaluated STD/HIV treatment and prevention programs and policies in Eastern and Southern Africa. Her research is focused on de-stigmatizing adolescent HIV prevention and treatment service delivery.
“I’m excited about this new leadership structure, which emphasizes and acknowledges both the role of nurses in global health and the profound administrative efforts it takes to lead an organization of this size,” said Dr. Kohler. “I look forward to getting to know our many teams and projects on a deeper level over the coming year.”
Ms. Butler’s 17 years at I-TECH have seen her in various leadership, program management, and technical roles, supporting multiple countries and a diverse project portfolio from health systems strengthening to prevention and clinical treatment programs. She was most recently Associate Center Director.
“I will miss Pamela’s insightful, thoughtful, and inclusive leadership,” said Ms. Butler. “She was the right person to lead us through a uniquely challenging time. Moving forward, I am motivated to broaden our reach beyond HIV and AIDS care and delivery and intentionally put individuals and communities at the center of the care they receive. There is much to learn, and the I-TECH network is well-positioned to do this with the expertise and care that our global teams and partners bring.”
Thanks to new generators, the Rehabilitation Shelter had electricity, heat, and Internet connection during massive shelling in Ukraine in fall and winter 2022-2023.
In February 2022, at the advent of the war in Ukraine, the International Training and Education Center for Health (I-TECH) launched the I-TECH Humanitarian Fund to support the work of our team in Ukraine. Many team members remain displaced, away from their homes, and isolated from their families and friends. However, their tireless work continues provide uninterrupted access and services to Ukrainians living with HIV, who are more in need of care and refuge than ever.
Supported by generous donations to the I-TECH Humanitarian Fund, I-TECH Ukraine has been able to advance the work of Eleos-Ukraine, a network of like-minded people and organizations that develop social services through 13 regional offices throughout Ukraine. The common goal of Eleos-Ukraine partners is to feed, clothe, and protect 1 million people in need.
“The compassion and solidarity of our American colleagues and friends with Ukraine and Ukrainians, including those expressed through generous donations to the I-TECH’s Humanitarian Fund just in the first few weeks of the full-scale war, are overwhelmingly moving,” said Anna Shapoval, I-TECH’s Country Representative in Ukraine. “We are eternally grateful.”
To date, the I-TECH Humanitarian Fund has been directed to Eleos’ critical work on behalf of Ukrainian women and girls subjected to sexual violence and other trauma (e.g., incarceration and torture) by the Russian army, notably the development and establishment of the Rehabilitation Shelter in August 2022.
Money from the fund has gone directly to outfitting the shelter with video surveillance, fire alarms, and powerful generators. Thanks to the generators, the shelter had electricity, heat, and internet connection during massive shelling by the Russian Federation in fall and winter 2022-2023.
“We appreciate your cooperation and thank you for helping the citizens of Ukraine during the war,” wrote Eleos-Ukraine Board Chair Serhii Dmytriyev, in a thank you letter to I-TECH Humanitarian Fund donors. “Our joint humanitarian project will help women not just today, at this time of crisis; it will also be important in reducing the consequences of war – which makes it an important contribution to the future of Ukraine!”
Since the shelter opened, more than 150 women from Kyiv, Donetsk, Kherson, Mykolaiv, and Luhansk Oblasts have received help remotely and within the shelter. The duration of a stay in the shelter for one client varies from one to six months and can be extended. The shelter houses 15-20 women and girls as well as their families, with accommodation for up to 30 people.
“Eleos-Ukraine is a truly passionate and efficient organization. They have been at the forefront of response to this war since 2014, the actual start of the Russian invasion,” said Ms. Shapoval. “Eleos put their minds and souls into supporting Ukrainian women and girls, and other civilians, who have suffered from horrifying violence and deprivation daily. They will continue helping people of Ukraine, no matter what – and so, I hope, we as I-TECH will continue supporting groups like Eleos on the ground.”
I-TECH Executive Director Pamela Collins lauded both the Ukraine team’s work with Eleos and those who have contributed generously to the I-TECH Humanitarian Fund. “I am very proud of I-TECH Ukraine’s activities with Eleos to respond to the humanitarian emergency in Ukraine,” said Dr. Collins. “Thanks to our donors, we had the resources to do what I-TECH does well: identify and collaborate with strong partners in the countries where we work to meet urgent needs in a times of crisis.”
To mark two decades of work, the International Training and Education Center for Health (I-TECH) has updated its mission, vision, and branding. This move also reflects I-TECH’s new three-year strategy, with includes the continued growth of I-TECH’s portfolio into technical areas that expand the boundaries of “global public health.”
“While supporting access to health care for communities and individuals continues to be a critical part of our mission, our new mission recognizes that individual and community health is not just about seeking care at a health facility,” says Ivonne Ximena “Chichi” Butler, MPH, Associate Center Director of I-TECH. “It is about recognizing the whole individual, their family and community, their environment, addressing obstacles to health care and wellbeing—these are all part of the broader definition of what it is to be healthy.”
Mission: I-TECH fosters healthier communities around the world through equitable partnerships in research, training and public health practice.
A key to this holistic approach is meaningful partnership, said Ms. Butler. “Our new mission puts special emphasis on equitable partnerships with the end users as well as ministries of health and local leadership priorities coming first,” she continues. “Needs and gaps are being defined by the communities, and interventions must center those communities to inform locally led development efforts for long-lasting change. That means not just local institutions, but also those seeking care.”
I-TECH’s new color scheme also aligns the organization more closely with the University of Washington. “Our move to a purple-driven colorway is an amplification of our identity as a UW center,” says Anne Fox, I-TECH’s Assistant Director of Communications. “I-TECH has always sought cross-disciplinary partnerships, and that is only increasing as we expand our scope.”
Vision: I-TECH envisions a healthy world in which all people and communities flourish.
With I-TECH’s strategic focus on advancing health equity, efforts to end the HIV epidemic, greater integration of mental health, expanding digital solutions to meet health system needs, and addressing emerging public health threats, a vision that acknowledges influences beyond the health care system is warranted, says Pamela Collins, MD, MPH, Executive Director of I-TECH and Director of the UW Consortium for Global Mental Health.
“As our community reconsidered our vision, we wanted to capture a more holistic vision of health, and ‘flourishing’ conveys this,” says Dr. Collins. “Flourishing is about not just physical health, but also emotional health and wellbeing—being engaged with life. Importantly, it requires having the right social, physical, and built environment in which to feel good and grow.”
Data from the International Training and Education Center for Health (I-TECH) program in Malawi were presented during the 2023 Conference on Retroviruses and Opportunistic Infections (CROI). The annual conference took place in Seattle, WA, from 19-22 February 2023, and brought together researchers, academics, and experts to discuss and present on their scientific achievements and new research.
During the “Insights into Prevention and Treatment of HIV in Women and Children” oral abstract session that was held on 20 February 2023, representatives from I-TECH Malawi presented on recent HIV infection surveillance data in breastfeeding women in Malawi:
The Centers for Disease Control and Prevention also presented a poster during the poster session that used data from the I-TECH Malawi HIV Recency Surveillance project:
The Alto Maé Reference Center (CRAM). Photo courtesy of I-TECH Mozambique.
Four decades into the HIV epidemic, more than 50,000 people per year in Mozambique continue to die from HIV-related conditions.
The Alto Maé Reference Center (CRAM) provides a specialized package of care and treatment services for patients with advanced HIV disease from the urban health network of Maputo, Mozambique. Since January 1, 2021, the International Training and Education Center for Health (I-TECH) has served as the Ministry of Health’s primary partner for managing CRAM, a role handed over by Médecins Sans Frontières (MSF), which established the clinic in 2010.
Since I-TECH started its activities at CRAM, the center has had 1,599 active patients in follow-up care.
“More than 80% of patients admitted to CRAM for specialized care are referred by other health centers,” explains Dr. Florindo Mudender, Country Director for I-TECH Mozambique. “Critically ill patients are treated at CRAM until they are stable, then sent back to their facilities of origin to continue treatment. In addition to acute care, CRAM also provides individualized supportive services to patients who often present with dire psychological, social, and economic conditions.”
These supportive services proved crucial to Aisha,* a 43-year-old mother of five who had difficulty accepting her HIV status, believing that her church’s pastor had cured her disease through prayer.
Referred to CRAM five years ago with a diagnosis of Kaposi’s sarcoma, Aisha was prescribed second-line antiretroviral therapy (ART). However, after losing her job due to COVID-19, Aisha was subject to food insecurity, discrimination, social stigma, and physical, psychological, and financial abuse by her partner.
After routinely presenting a high viral load and suffering severe weight loss, Aisha’s care team at CRAM assumed she had not been taking her medication – possibly because of her religious beliefs and a lack of food. She was severely depressed, to the point of attempting suicide.
Worried about her condition, the team at CRAM enrolled Aisha in wraparound services, including behavioral psychotherapy, education in self-care and self-esteem, treatment adherence support, positive prevention, couple’s therapy and socio-family integration, group therapy with other patients with depression, and antidepressant medication.
After several months, Aisha’s last viral load test showed a result of “undetectable,” and her depressive symptoms abated. Thanks in part to the support from CRAM, Aisha is now adhering to her ART, has regained her self-esteem, is working again, and eats regular meals. Her partner tested HIV-negative and has learned to support her so that she feels valued and loved. Aisha attends psychotherapeutic sessions quarterly at the CRAM to monitor her psychological and social well-being.
“[My husband] helps me a lot, so I don’t forget to take my pills, and I am very happy about that and with the improvement I made with my health,” says Aisha. “Before, we were hungry, and now, I am back to work. With the little I earn I can help with the household expenses.”
CRAM is considered a center of excellence and the main training site for AHD for Mozambique Ministry of Health clinicians and PEPFAR-funded implementing partners.
“I-TECH is currently refining a referral and counter-referral system between CRAM and Maputo City’s health centers, to ensure patient care continues after discharge,” says Dr. Mudender “The system will include a free mobile line to assist clinicians with advice from senior specialists.”
I-TECH, in close partnership with voluntary medical male circumcision (VMMC) implementing partner, the Aurum Institute and technology partner, Medic, is conducting a five-year study funded by the National Institutes of Health to further evidence on the efficiency, safety, and scalability of two-way text-based (2wT) follow-up for VMMC services.
2wT is SMS-based telehealth, providing direct patient to provider communication that improves the quality of post-operative VMMC care. A daily educational message is sent to each participant, requesting a response to report potential complications. 2wT allows the nurse to triage men to care when needed or desired while supporting most men to heal independently at home. 2wT-based follow-up dramatically reduces unnecessary post-operative visits, saving patient and provider costs, while improving patient care quality through swift identification and referral for potential adverse events. In South Africa, the 2wT intervention benefits were similar across routine VMMC programs in both rural and urban settings.
For nearly a decade I-TECH has worked in Côte d’Ivoire in collaboration with the US Centers for Disease Control and Prevention to develop and implement an electronic laboratory information system (LIS) in key laboratories. In order to respond to evolving data needs and ensure timely access to quality laboratory data, an electronic LIS requires ongoing development and continuous user training and technical support.
Previously, from 2015-2017 I-TECH worked closely with the Ivorian Ministry of Health and Public Hygiene (MSHP)’s Directorate of Informatics and Sanitary Information (DIIS) to identify, develop and reinforce the capacity of local professionals to lead and conduct LIS training, deployment, and maintenance activities in anticipation of national roll-out of the LIS at 96 general hospital laboratories. As part of this effort, and in collaboration with the DIIS, I-TECH trained users and deployed LIS at 13 national and regional level laboratories. Between 2013 and 2015, the total number of local professionals competent in LIS deployment increased to 24 local LIS support providers, while the number of in-country LIS trainers increased to 27. Within ten months, local IT providers and trainers trained over 75 health care workers to use an LIS and implemented an LIS at 36 laboratories. During supervision visits to 26 laboratories, within 4 to 6 months post-installation, 25 out of 26 (96%) of laboratories were actively using the LIS.
More recently, Côte d’Ivoire International Training and Education for Health (I-TECH CIV), I-TECH’s local partner in Côte d’Ivoire, has started working directly with CDC and DIIS and continued to engage I-TECH computer developers and deployment strategists to continue the progress with LIS.
I-TECH continues to make considerable progress with code base development for OpenELIS. For more information, visit the OpenELIS Global website.
“I-TECH prides itself on working collaboratively with our international partners. We held the principle from day one that the most successful programs happen when the locus of control sits in-country,” said Marrianne Holec, Senior Program Manager at I-TECH. “We had the foundation in place with our local staff, what was missing was the organizational structure to allow the team in-country to truly lead the project. With the formation of Zim-TTECH, I’m happy to say we are there.”
Among USG funders, it’s recognized that future models for sustainable healthcare rely on local country ownership and leadership.[1] But making the transition from US-based ownership to country ownership isn’t a one-time event, added Holec, “It’s a process that takes time. We wanted to document our process so that other international organizations who are looking to pursue decolonizing global health programming can learn from our experience.”
Through 16 key informant interviews, the team gathered views on transition planning, implementation, and technical support, ethics, and success. Five themes emerged from the data collected:
Develop a vision and empower leadership for change by delegating clear roles and supporting local ownership;
Plan and strategize for transition in a manner that accounts for historical context;
Communicate with and inform stakeholders to understand transition perceptions, understand barriers to transition, and enable open communications related to risks and benefits;
Engage and mobilize staff by constructing necessary infrastructure and providing technical assistance as needed; and
Define short-term and long-term success.
“Sustainability of successful donor funded public health programs is critical if we want to maintain the important gains that have been made over the years,” says Dr. Batsi Makunike, Executive Director of Zim-TTECH. “Strong local organizations with good governance, management, and technical capacities are an important cornerstone of sustainability.
“The process of transitioning from an international to a local organization is daunting,” she continues. “We hope that this study is helpful to other organizations in their efforts to transition.”
[1] Goosby E, Von Zinkernagel D, Holmes C, Haroz D, Walsh T. Raising the Bar: PEPFAR and New Paradigms for Global Health. JAIDS Journal of Acquired Immune Deficiency Syndromes. 2012;60.
Data from the International Training and Education Center for Health (I-TECH) program in Malawi were presented during the 
