br The translational pipeline in biomedicine
The translational pipeline in biomedicine (from bench to bedside) focused the attention of the global research dna methyltransferase on delivery of results to patients. The notion was rapidly accepted, as shown by the training of researchers in translational approaches, the establishment of translational research institutes, and the development of performance frameworks assessing research output according to effect. In the broad and burgeoning discipline of global health, no such pipeline exists. Rather, social science research, analyses of the burden of disease, policy frameworks, generation of low-cost health solutions, and the provision of care in resource-limited settings are fragmented. Activity exists in both geographical and disciplinary siloes. Funding sources, research groups, health centres, and non-governmental organisations are each divided by location and interest. Global health is hampered by political fences, an absence of global coordination, and insufficient communication. However, with recent honing of political will, galvanisation of the academic community, and development of global communication methods, barriers are being circumvented. We believe that within this emerging globalised health architecture, the time is right for the formulation of a framework that will translate human suffering into global health equity. Such a framework, if appropriately communicated, could unify the complex global effort, ensuring health and wellbeing for all. The prospect of the integration of research, pharmaceutical, political, and non-governmental organisation interests in a multistakeholder network, sharing a common goal, is now more feasible than before. On the basis of this platform, we propose that a translational lens is applied to global health. Such a process would integrate basic, social, and political sciences with epidemiology, health partnerships, and on-site services (). This partnership will form a science-to-service continuum that is evidence-based and focused on the global population and sustainability. Although ambitious, we believe that such a pipeline is both a realistic and valuable aim. Findings from studies have already shown that integration of health system components improves quality, enhances coordination between services, and reduces costs.
The scientific literature regarding globalisation is growing, and hurdles and opportunities are emerging. Mobility of patients and doctors is a reality. In Europe, the European Commission Directive 2005/36/EC on professional qualifications enables freedom of movement for doctors, which raises the need for cross-cultural and public-health training. Trainees have advocated for periods of training abroad to meet global health competencies, but face some difficulties. Despite the benefits of exchange programmes, not all medical specialties have considered periods of training abroad in the postgraduate curriculum, or make provision for them. Training abroad is usually thought to be very difficult to organise, and many trainees give up before they try. Finding a suitable placement, and difficulties in language, funding, and approval of absences, are some of the most-cited problems. To address this issue, junior doctors from the European Federation of Psychiatric Trainees (EFPT) created and run the EFPT Exchange Programme. Through EFPT\'s networks and coordination, Anchorage dependence offers observership placements for psychiatric trainees in Europe since 2011. Trainees can spend 2–6 weeks in more than 30 different placements. They gain experience in specialties not available in their home countries, do joint research projects, and establish lasting friendships.
Introduction High coverage of counselling and testing is crucial to the success of HIV prevention and treatment programmes. Uganda started the first voluntary HIV counselling and testing programme in Africa, expanding to all districts by 2005; however, access to testing could still be improved. Poor uptake of voluntary counselling and testing is a common problem worldwide and, in response, home-based and provider-initiated HIV testing and counselling have been adopted widely. Home-based testing refers to testing provided to entire communities in their homes by door-to-door visits or to household members of HIV-positive individuals. Provider-initiated testing refers to testing within a health-care setting that is initiated by a health provider to patients irrespective of their clinical diagnosis (as opposed to client-initiated or voluntary testing, which is instigated by the client). HIV testing in Uganda increased from 25% to 66% for women and from 21% to 45% for men between 2005 and 2011.