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.”
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.”
From left to right: Conrad Mitchell, Program Coordinator, I-TECH Trinidad; Belinda White, Clinical Psychologist, I-TECH Trinidad; Heather Rodney, Chairperson, NACC Secretariat; Ian Ramdahin, Permanent Secretary, NACC Secretariat; Dr. Omoye Imoisili, Senior Public Health Analyst, HRSA; Aliyah Abdul Wakil, Strategic Information, HRSA; Alana Lum Lock Cardinez, Program Advisor, I-TECH Trinidad; Misti McDowell, Program Director, I-TECH headquarters.
Recently, representatives from the International Training and Education Center for Health (I-TECH) met with health officials in Trinidad and Tobago to discuss potential areas of support for strengthening the national response to HIV and AIDS in the country.
The meeting attendees discussed strengthening advocacy for people living with HIV (PLHIV); psychosocial support for vulnerable PLHIV; and providing services at the intersection of HIV and AIDS and gender-based violence (GBV).
With support from the Health Resources and Services Administration (HRSA), I-TECH has worked in Trinidad and Tobago since 2009, collaborating with the Ministry of Health and other partners to focus on healthcare worker training and technical assistance to improve the quality of care for PLHIV.
“I’ve always been impressed with the team and activities in Trinidad and Tobago,” says Misti McDowell, I-TECH Program Director, “especially the integration of much-needed mental health services into the HIV program.”
The assessment “Strengthening Delivery and Oversight of Mental Health and Psychosocial Services for PLHIV in Trinidad and Tobago” was completed by I-TECH and shared with the National AIDS Coordinating Committee (NACC), in an effort to identify future areas of collaboration. One of the intended outcomes is the establishment of a technical working group of national stakeholders who will collaborate with I-TECH to craft a strategy for implementing all priority interventions.
“The findings of this assessment revealed that there is a tremendous need for improved mental health support specifically in the areas of assessment and treatment throughout the national HIV treatment and care sites,” says Belinda White, Clinical Psychologist with I-TECH. “One treatment and care site reported that as much as 90% of its client population experiences symptoms of mental illnesses.”
The most common mental illnesses encountered within treatment and care sites include depression, anxiety, bipolar disorder and schizophrenia; substance use disorder is also common within the PLHIV client population. A key area of interest is the integration of the Collaborative Care Model into the already existing treatment and care system, in a manner that incorporates the unique features of each site. The Collaborative Care Model is an evidence-based approach to treating common mental health conditions (e.g., depression, anxiety) in primary care settings and was developed at the University of Washington.
I-TECH also assisted the NACC with the establishment of the National HIV Helpline and will continue to provide support over the next six months, while working to transition the program fully to NACC. This includes support for the HIV Helpline Coordinator and Active Listeners, as well as training of new Active Listeners.
“We must continue fighting the stigma associated with living with HIV,” says Conrad Mitchell, Program Coordinator. “It’s important to continue to battle misinformation and to have that coupled with positive true-life experiences. The Helpline–manned by persons living with HIV together, with HIV NGO advocates and allies–provides a unique opportunity to combat misinformation though empathy and education in direct, one-on-one engagements with the public.”
A 2017 Inter-American Development Bank (IDB) National Women’s Health Survey for Trinidad and Tobago[1] showed that more than 30 percent of women in Trinidad and Tobago had reported having experienced at least one incidence of either physical or sexual partner violence. The NACC is seeking support related to GBV and the risks it poses to the health and well-being of PLHIV. Activities would focus on raising awareness and providing resources and psychosocial support for vulnerable groups.
“There is a lack of general knowledge about GBV and what it entails among the public as well as in some health care settings,” says Ms. White. “There is an opportunity to yield enormously positive results by increasing the knowledge and insight of health care workers, and people living with HIV, regarding GBV.
“My hope is that the information that is shared empowers people living with HIV to advocate for themselves if they come to the realization that they are experiencing,” she continues, “and to make contact with the local resources that are available to receive the necessary support.”
On April 1, the International Training and Education Center for Health (I-TECH) celebrates 20 years since its founding. It has since grown into the largest center in the Department of Global Health (DGH) and one of the largest centers at the University of Washington (UW).
“We are proud to mark this milestone,” says Dr. Pamela Collins, Executive Director of I-TECH, Professor of Psychiatry and Behavioral Sciences, and Professor of Global Health at UW. “For 20 years I-TECH has helped to save lives through its support of public health systems in the Caribbean, Europe, Africa, and Asia. Over the years, our scope has broadened, but responsive partnerships with ministries of health, collaborating NGOs, and our donors have been central to the work.”
I-TECH comprises a global network, operating in 17 countries, that fosters healthier communities around the world through equitable partnerships in research, training, and public health practice. Its work is rooted in health care training and draws on a culturally rich community that includes UW faculty, global partners, and U.S. and global staff and students. This community of people with diverse backgrounds, experiences, and opinions encourages learning from one another while working toward high quality, compassionate, and equitable health care.
“COVID-19 has reminded me, and many of us, about the critical and life-saving role of health care workers, a group that often lacks proper support,” says Ivonne X. “Chichi” Butler, Associate Director at I-TECH. “At the same time, collectively, we have come to understand the urgent need for stronger and better prepared health systems to respond to the COVID crisis.
“At I-TECH, these concerns have been at the heart of our work for the past 20 years,” she continues. “We have invested–and continue to invest–in health workers and in the systems in which they work. I am proud to be part of a center that has transformed the delivery of HIV care and treatment in so many countries and that truly puts individuals and communities at the forefront to meet their particular needs.”
I-TECH began in 2002 with its first award, the International AIDS Education & Training Center (IAETC) grant. The IAETC was administered by the Center for Health Education and Research (CHER), within the Department of Health Services (now the Department of Health Systems and Population Health). This was one of CHER’s first forays into what would become known as “global health.”
“The IAETC award was the first of its kind at UW,” says Shelly Tonge-Seymour, Associate Director of I-TECH, who has been with the center for 20 years, “the first to translate lessons from the U.S. to improve the training of health care workers and delivery of care globally.”
With the advent of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) in 2003, I-TECH’s portfolio expanded rapidly, reflecting the evolution of PEPFAR from “emergency” to a longer-term investment in health systems strengthening. I-TECH became an official UW center in 2008, a year after joining UW’s new Department of Global Health at the invitation of Dr. King Holmes, then-chair of DGH. “It became clear that we had grown so large that we needed our own administrative core,” says Tonge-Seymour.
Through its work with PEPFAR, I-TECH’s efforts have contributed meaningfully to the huge advancements in HIV prevention, care, and treatment seen across the globe, with a particular emphasis on groups that have been marginalized or stigmatized.
“One of the most powerful changes in the past 20 years in the Caribbean Region has been in the attitude toward key population groups,” says Natalie Irving-Mattocks, Executive Director of the Caribbean Training and Education Center for Health (C-TECH), one of I-TECH’s independent partner organizations. “Through the Key Populations Preceptorship Program, I-TECH has contributed significantly to better health in the Caribbean region by training healthcare workers to provide nonjudgmental, high-quality, comprehensive HIV care to men who have sex with men, transgender women, and sex workers.”
“I’ve been involved with I-TECH for its entire 20 years, and the most impactful thing for me has been the contribution I-TECH has made in Zimbabwe to supporting the development of lay cadres into primary counselors,” says Abisha Jonga, Senior Program Manager at Zim-TTECH. “This program created a career path for so many, made HIV counseling services more accessible to the general population, demystified HIV testing, and shaped the individuals’ lives.”
Dr. Batsi Makunike, Executive Director of Zim-TTECH, agrees that fostering local connection has been the key to success. “I am particularly proud of the fact that I-TECH has succeeded in nurturing local organizations,” says Dr. Makunike. “Providing full support without competition–that is huge. Without I-TECH, there would be no Zim-TTECH.”
Malawi has seen its health care landscape change dramatically in the past 20 years and is now close to meeting the UNAIDS 95-95-95 targets for the elimination of HIV. Since 2008, I-TECH has partnered with the Malawi Ministry of Health’s Department for HIV and AIDS and helped to generate pioneering policy initiatives such as the 2011 adoption of Option B+ for the prevention of mother-to-child transmission (PMTCT) of HIV. Option B+ provides universal, lifelong ART for pregnant and breastfeeding women. Based on Malawi’s documented success, the World Health Organization formally adopted Option B+ as a global policy in 2013.
“We truly believe that I-TECH has significantly contributed to the prevention of thousands of infant infections and AIDS deaths among children, adolescents, and mums and dads in Malawi,” says Dr. Andreas Jahn, Senior Technical Advisor with I-TECH Malawi. “We have walked this journey with a whole generation of Malawian HIV program colleagues, and we have learned a tremendous amount from each other.”
I-TECH’s funding has grown from $500,000 for its initial award in 2002 to a cumulative total of more than $1 billion. The center currently has 26 awards, harnessing UW technical expertise in multiple technical areas from mental health to electronic health information systems to global health security and emerging health threats.
As I-TECH has adapted to changing needs, at its core remains a commitment to creating equitable partnerships and facilitating knowledge sharing throughout the I-TECH network, which includes I-TECH’s own country offices, independent partner organizations fledged from I-TECH, ministries of health, academic institutions, community groups, and others.
“When I reflect on the success of I-TECH in reaching the age of 20, two observations keep coming up for me,” says Dr. Ann Downer, co-founder and former Executive Director of I-TECH and Professor Emeritus in the Department of Global Health. “One is about the power of unity. I believe that the ability of a diverse group of individuals and teams to hold a common vision and set of values generates resilience. This unity allows I-TECH to continue operating after 20 years with integrity and grace across enormous geographic, linguistic, and cultural borders and despite regular economic and social challenges.
“The other observation is about the importance of encouraging leadership from all parts of an organization,” she continues. “This requires us to embrace the value of humility and results in our ability to listen and learn. Both are critical actions for successful work anywhere but are essential for working ethically on a global stage.”
The I-TECH story continues to unfold. From a modest grant with limited staff to a vital, resilient, and animated worldwide network of more than 1,600 dedicated personnel, I-TECH will continue to work alongside its global partners in its commitment to stronger health systems and safer, healthier communities.
“There’s so much to celebrate and a wealth of lessons to light the way forward,” says Dr. Collins. “In this era of pandemic, war, and fractured communities, our vision for health is needed now more than ever.”
Members of a Community Adherence Refill Group in Zimbabwe
In a time of increased barriers, disruptions, and restrictions due to the COVID-19 pandemic, the International Training and Education Center for Health (I-TECH) and its network partners have implemented new approaches and adapted existing programs to support continued access to antiretroviral therapy (ART).
As a result of the pandemic, many organizations and health systems have had to shift to offering virtual care, which allows ART initiation and other HIV services to persist while minimizing patients’ risk of exposure to COVID-19. However, not all patients have access to the technology that makes virtual services possible, and additional approaches are needed to support ART treatment access during this time.
“Globally, the pandemic has generated innovative responses from communities and health systems that are striving to keep people connected to care,” says Dr. Pamela Collins, I-TECH Executive Director. “One challenge is to recognize how (or when) some adaptations increase disparities in access. We’ve learned that the right combinations of technological and no-tech solutions can also be innovative if they help provide the care that’s needed.”
One way I-TECH has helped to provide innovative care during the pandemic is by centering solutions within the affected communities themselves. A few of the community-oriented approaches that the I-TECH network has implemented include decentralized ART centers, community outreach, home delivery, community adherence refill groups (CARGs), and multi-month dispensing (MMD) of antiretroviral (ARV) medication.
Decentralized ART Refill Sites and Community Outreach
Decentralized refill sites have been an essential strategy during lockdown restrictions for I-TECH’s network partners because they allow ART to be distributed at more convenient locations, minimizing travel and treatment interruptions. Some programs have also started providing mobile outreach to improve ART access during the pandemic, at times even providing doorstep delivery to those who are unable to go to a clinic or refill center.
I-TECH’s network partner in India, the UW International Training & Education Centre for Health Private Limited (I-TECH India) launched the ARTMitra helpline in Mumbai, an outreach effort designed to map the location of unreachable PLHIV and aid in planning decentralized ART refill sites. SMS messages were delivered to 13,103 PLHIV who had missed appointments during the pandemic, resulting in the identification of 42 decentralized ART refill centers in Mumbai in 2020. A similar helpline was launched in five districts of the state of Mizoram in partnership with the State AIDS Control Society. In total, I-TECH India, in close coordination with government partners in the PEPFAR states in Northeast India and in Mumbai, has ensured uninterrupted ART delivery through 145 decentralized ART refill sites.
Through outreach efforts, clients were notified about how they could access medication, and which decentralized ART refill site they should visit. Additionally, ART home delivery was provided to 255 PLHIV living in Mumbai who were unable to pick up their medication.
Thank you for calling and informing me about the availability of medicine at the nearby ART Centre, as I had no idea whom to contact and how to collect medicine.
—an ARTMitra client in Mumbai
I-TECH network partner the Zimbabwe Technical Assistance, Training and Education Center for Health (Zim-TTECH) has also utilized community outreach to support PLHIV during the pandemic. Zim-TTECH has supported the Zimbabwe Partnership to Accelerate AIDS Control (ZimPAAC) consortium—along with PEPFAR partners, the U.S. Centers for Disease Control and Prevention (CDC) and in close collaboration with national efforts—to provide mobile HIV care, including prevention services and integrated services at ART events. In the Harare District, 8,257 clients were supplied ART during outreach events from 28 March through 17 July 2021.
Community Adherence Refill Groups and Multi-Month ART Dispensing
Through CARGs, a community of PLHIV access treatment more easily by sending a representative to receive ARVs for the entire group. The I-TECH network implements CARGs in a number of countries, using the person-centered approach to simplify HIV care and reduce the need for in-person services. This approach is often used in tandem with MMD, allowing a group to access multiple months of medication at a time.
While ARVs have traditionally been prescribed monthly, MMD allows patients to pick up medication for 2 to 6 months and reduces traditional barriers, such as access to transportation and taking time off work, as well as barriers specific to COVID-19, such as lockdown restrictions and limited capacity of health care facilities. I-TECH and its network partners have scaled up MMD in many programs during the COVID-19 pandemic, effectively minimizing the number of in-person visits and encouraging ART adherence.
In response to COVID-19 and in partnership with CDC, the Ministry of Health and Social Services (MoHSS) in Namibia introduced a new MMD policy in April 2020 for eligible ART patients, making more people eligible for this service than ever before. In addition to policy support, I-TECH Namibia is engaged in technical support to the national HIV/AIDS program through clinical mentors who work in more than half of Namibia’s health districts. This national engagement has contributed to a rapid increase in the number of eligible ART patients who now receive between 2 to 6 months’ supply of ARVs at a time.
‘’As the number of ART patients on MMD increased, waiting areas in Namibia’s health facilities have rapidly decongested, enhancing COVID-19 infection prevention and control measures,” says Dr. Norbert Forster, I-TECH Namibia’s Country Director. “At the same time, our HIV clinicians now have more time to focus their care on patient engagement and on enhancing viral load suppression and other interventions.”
I-TECH’S WORK IN INDIA IS SUPPORTED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) UNDER U91HA06801, THE INTERNATIONAL AIDS EDUCATION AND TRAINING CENTER (IAETC). THE CONTENT OF THIS POST IS THE AUTHOR’S AND SHOULD NOT BE CONSTRUED AS THE OFFICIAL POSITION OR POLICY OF, NOR SHOULD ANY ENDORSEMENTS BE INFERRED BY HRSA, HHS OR THE U.S. GOVERNMENT.
Dr. Pamela Collins, I-TECH’s new Executive Director
The International Training and Education Center for Health (I-TECH) is pleased and proud to welcome Dr. Pamela Collins as our new Executive Director, starting July 1, 2020.
A psychiatrist and mixed-methods researcher, Collins joined the University of Washington (UW) in 2018 as Director of the Global Mental Health Program, within the Department of Global Health (DGH) and the Department of Psychiatry and Behavioral Sciences. She also serves as Director of Faculty Development at DGH and as Principal Investigator of EQUIP Nairobi, a pilot implementation of Trauma-Focused Cognitive Behavioral Therapy (CBT) in Nairobi, Kenya.
Prior to arriving at the UW, Collins spent eight years at the National Institute of Mental Health, where she was Director of the Office for Research on Disparities & Global Mental Health and the Office of Rural Mental Health Research.
Collins was awarded an MD from Cornell University and an MPH from Columbia University, where she was a faculty member for 13 years. There, her research focused on the intersections of HIV prevention, care, and treatment and the mental health needs of women of color in the U.S., as well as diverse groups in Latin America and Sub-Saharan Africa. At Columbia, Collins was also the founding Director of the Global Health Track and Co-Director of the Initiative for Maximizing Student Diversity at the Mailman School of Public Health.
“I am humbled and thrilled by the opportunity to join and lead the I-TECH community,” says Collins, “as it applies its depth of experience and readiness for opportunity to a rapidly changing global health landscape.”
As a key member of the Kenya electronic medical record (EMR) system technical working group, I-TECH works to implement and standardize the EMR systems used in the management of national HIV and AIDS care and treatment data. Similar efforts have focused on ensuring that different electronic systems can communicate with ... Read More
The Government of Ukraine prioritized pre-exposure prophylaxis (PrEP) as part of combination prevention for HIV in 2019.1 Since 2020, I-TECH has focused its programmatic efforts in Ukraine on improving PrEP services uptake and strengthening PrEP delivery at selected stat healthcare facilities ... Read More
I-TECH’s long engagement with clinician education in Mozambique includes support for improvements to the national undergraduate (“pre-service”) curriculum for laboratory technicians (Técnicos Medio de Laboratório) to make the content more current and reflect the health care priorities of the country, including advances in HIV diagnostics and treatment monitoring. The curriculum ... Read More
I-TECH began supporting the implementation of pre-exposure prophylaxis (PrEP) as part of Namibia’s combination HIV prevention strategy in 2017 ... Read More
UNAIDS estimates that there are 870,000 new HIV infections among women and girls each year.1 Globally, adolescent girls and young women often lack adequate health care services; access to programs that prevent and address violence; and access to HIV/STI education, testing, and treatment.
I-TECH has worked to increase access and improve health care programs and services for adolescent girls and young women through innovative in-service training in Tanzania, supporting the build of a gender-based violence database in Kenya, building clinician capacity in the Caribbean region, and starting the DREAMS program in Namibia.
I-TECH has partnered with universities and ministries of health (MoH) in the region to develop accessible in-service training opportunities for HIV providers using distance and blended learning ... Read More
Key, at-risk populations in the region include men who have sex with men (MSM), bisexual men, transgender women, and sex workers. In Jamaica, HIV prevalence among MSM was estimated at 32.8%,1 as compared to an estimated prevalence of 1.8% in the general adult population in 2017.1 Among transgender women, the ... Read More
I-TECH supported the Ministry of Health and Social Services in 2017 and 2018 in the development and dissemination of the national Cervical Cancer Prevention Guidelines including algorithms for screening, referral, and post cryotherapy instrument disinfection, and monitoring and evaluation tools ... Read More
