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Research at Mass General
The Division of Global Health at MassGeneral Hospital for Children was founded in 2010 and includes faculty, research fellows and staff with diverse experience and interests but a shared objective. Our goal is to build and foster strong partnerships for interdisciplinary research, education and clinical care aimed at improving the health of the most vulnerable children in our global community. Our work builds not only upon MassGeneral Hospital for Children’s long-standing commitment to scientific and clinical innovation, but also on our strong desire to see every child reach their full potential.
Our teams work on the most important challenges in pediatric global health. We focus on:
Our faculty and staff work on innovative solutions to prematurity, birth asphyxia, neonatal sepsis, childhood pneumonia, cholera transmission, and HIV at several sites across the globe. Each day, we strive to apply the strengths of the Mass General community to help the most vulnerable children in our global community.
Jason B. Harris, MD, MPHDivision Chief, Pediatric Global HealthAssociate Professor of PediatricsHarvard Medical SchoolPediatric Infectious Diseases, Microbiology
Jason Harris, MD, MPHDivision Chief, Pediatric Global Heath
Dr. Harris is chief of the Division of Pediatric Global Health at MassGeneral Hospital for Children, and an associate professor of pediatrics at Harvard Medical School. He is a pediatric infectious disease specialist with an interest in host-pathogen interactions in bacterial enteric infections. He received his MD from Duke University and MPH from the Harvard School of Public Health. He was a pediatric resident and chief resident at Massachusetts General Hospital and a pediatric infectious disease fellow at Boston Children's Hospital. His NIH and Bill and Melinda Gates Foundation funded laboratory research is focused on the human immune responses to cholera and cholera vaccines. His clinical interests include general pediatric infectious diseases, vaccines and immunizations, and travel medicine. With the knowledge that not everyone has access to safe and clean water, Dr. Harris has been working with an international team of cholera researchers and experts, from the International Centre for Diarrhoeal Disease Research in Dhaka, Bangladesh, (since 2003) and Partners In Health in Haiti (since 2010) in order to further the understanding of cholera prevention by vaccine.
Pediatric Global Health Focus
Assessing measures to eliminate cholera transmission in Haiti – This study is designed to assess the effectiveness and impact of integrated programs to control cholera combining community level oral cholera vaccination with the promotion of household water treatment strategies. The study not only evaluates the impact of these measures on the incidence of Vibrio cholerae infection, but also assesses the potential impact of these programs on other important health measures during early childhood. The project involves an ongoing close collaboration between Mass General and Partners In Health/ Zanmi Lasante in Central Haiti.
B cell responses to V. cholerae and protection against cholera – This study is designed to unravel the key mechanisms of protective antibody responses (following both vaccination and infection) against Vibrio cholerae infection in humans. The research involves a longstanding collaboration between Mass General and the icddr,b (the International Centre for Diarrhoeal Disease Research, Bangladesh).
Harris lab website
News: Harris Leads Pediatric Global Health Efforts as New Chief
Anne Neilan, MD, MPH
Dr. Neilan is a medicine and pediatrics-trained adult infectious disease physician at Massachusetts General Hospital and an Instructor at Harvard Medical School. She earned her MD and MPH from The Mount Sinai School of Medicine in New York. She was a Fulbright scholar in Italy and a Fogarty Scholar in Peru. Her clinical and research interests focus on adolescents and young adults. She is currently a research fellow in the Medical Practice Evaluation Center at Massachusetts General Hospital where she uses computer simulation modeling to inform optimal care strategies for adolescents with HIV and at risk of HIV. She has worked on analyses with the US Centers for Disease Control as well as national and international HIV networks. She is also assistant director of the modeling core for the Adolescent Medicine Trials Network for HIV/AIDS Interventions.
Pediatric Global Health focuses
Diagnosing and Preventing HIV Infection in Adolescents and Young Adults in the US: Clinical Impact and Cost-Effectiveness- Dr. Anne Neilan
Dr. Neilan is supported by an NICHD K08 Award to use computer simulation modeling methods and cost-effectiveness analysis to evaluate current questions in HIV prevention and screening in US adolescents and young adults at risk of HIV.
Investing in the HIV care continuum: Model-based methods to translate ATN findings into policy recommendations- Dr. Anne Neilan
Dr. Neilan is the assistant director of the Modeling Core for the Adolescent Medicine Trials Network for HIV AIDS Intervention (ATN 161). The ATN Modeling Core uses data already collected through completed studies and ongoing ATN protocols to inform critical health policy recommendations for youth living with HIV. More information can be found here.
Read about Dr. Neilan’s work with HIV-infected adolescents
Brett D. Nelson, MD, MPH, DTM&H
Dr. Nelson is an attending pediatrician and global health faculty at MassGeneral Hospital for Children and an associate professor at Harvard Medical School. Dr. Nelson received his MD and MPH degrees at Johns Hopkins and completed his residency at Boston Children's Hospital and his fellowship at Massachusetts General Hospital. In addition to helping establish the nation’s first Pediatric Global Health Fellowship at Massachusetts General Hospital, he was the program’s first fellow. Dr. Nelson’s interests are health care provision, development, research, and advocacy for vulnerable populations, particularly newborns and children in settings affected by poverty, conflict, or disaster. In order to help prevent perinatal deaths, the vast majority of which occur in low- and middle-income countries, Dr. Nelson has sought to use existing, simple, and cost-effective interventions and has led large-scale, country-level training programs, such as the ‘Helping Babies Breathe (HBB)’ newborn resuscitation program and ‘Essential Care for Every Baby (ECEB)’ in Tanzania and Ghana. He and his in-country teams are using an integrated multi-method approach to evaluate the effectiveness and impact of these training programs in order to improve the adoption, retention, and practice of life-saving skills and significantly improve newborn outcomes in resource-limited settings. Dr. Nelson directs the Harvard Medical School course “Clinical Topics in Global Health” and is the editor of the textbook Essential Clinical Global Health.
'Bubble CPAP’: an ultra-low-cost device for reducing newborn and child mortality from respiratory diseases
Respiratory illnesses are a leading cause of newborn and child mortality. The vast majority of these deaths globally occur in low-resource settings. To prevent a large number of these respiratory-related newborn deaths, we have developed an innovative, low-cost, best-evidence bundle that includes an innovative 'bubble CPAP' device — which assists the child in breathing — along with clinical checklists, training, training materials, and wallcharts. Our early results in multiple hospitals in Kenya and India suggest our bundle can greatly reduce child morbidity and mortality from respiratory diseases worldwide. We hope to now build upon this pilot work, expand to additional health facilities, and gather reliable evidence of our device's lifesaving potential.
Fiona Danaher MD, MPH
Dr. Fiona Danaher is a primary care pediatrician at MGH Chelsea HealthCare Center and a member of the MGH Child Protection Team. She received her M.D. and M.P.H. from Mount Sinai School of Medicine and completed pediatric residency at MassGeneral Hospital for Children. She serves as co-chair of the MGH Immigrant Health Coalition and conducts evaluations for the MGH Asylum Clinic. Her interests include adverse childhood experiences and social determinants of health, with particular focus on immigrant populations.
Pediatric global health focus
Howard J. Weinstein, MD
Dr. Weinstein is a pediatric oncologist, currently serving as chief of the Hematology/Oncology Unit at MassGeneral Hospital for Children. Dr. Weinstein graduated from Cornell University and the University of Maryland School of Medicine after which he completed an internship and residency in pediatrics at Massachusetts General Hospital. Following residency, Dr. Weinstein completed a fellowship in pediatric hematology and oncology at the Boston Children’s Hospital and Dana-Farber Cancer Institute. From 1980 to 1994 he was the director of the Pediatric Oncology and Bone Marrow Transplant Service at Children’s Hospital and in 1996, he returned to the Massachusetts General Hospital as chief of the Pediatric Hematology-Oncology program. In 2006, Dr. Weinstein was selected as the first R. Alan Ezekowitz Professor of Pediatrics at Harvard Medical School. Over the past thirty years, he has mentored pediatric hematology and oncology fellows, cared for children with cancer, and acted as the principal investigator for many novel clinical trials for children with acute myeloid leukemia and lymphoma. Dr. Weinstein has published over 150 articles and chapters in the area of childhood cancer and recently has joined the MGH Global Health effort in Mbarara, Uganda. There he leads an effort to develop a training program in pediatric hematology and oncology, taking his expertise and knowledge to a setting where children previously did not get the chance to survive their cancer.
News: Interview with Dr. Howard Weinstein
Jennifer Kasper, MD, MPHChair, Faculty Advisory Committee Global Health, Harvard Medical School
Dr. Kasper is an associate pediatrician at MassGeneral Hospital for Children, assistant professor of pediatrics and global health and social medicine at Harvard Medical School, President’s Council member of Doctors for Global Health, and chair of the HMS Scholars in Medicine Faculty Advisory Committee on Global Health. She received a combined BA/MD with honors from Boston University/Boston University School of Medicine and an MPH from Boston University School of Public Health. She practices “liberation medicine, the conscious and conscientious use of health to promote human dignity and social justice.” Her global health expertise and publications include health service delivery, rural community development, complex humanitarian emergencies, field-based operations research, health system strengthening, capacity building, and UME in global health and the ethics of global health work. She was the recipient of the HMS/HSDM Deans’ Community Service Lifetime Achievement Award for her work with Doctors for Global Health; a nominee for the HMS Donald O’Hara Faculty Prize for Excellence in Teaching; and a recipient of the Inaugural Scholars in Medicine Excellence in Student Mentoring Award. She is a co-editor of the MassGeneral Hospital for Children Handbook of Pediatric Global Health.
Kate Powis, MD, MPH, MBADirector of Resident Education, Pediatric Global Health
Dr. Powis is a physician-scientist with expertise in HIV in pregnancy and health outcomes in children born to women living with HIV. After a successful career in banking and finance, Dr. Powis followed her true passion, pursuing a career in medicine and global health. She graduated from the Medical College of Virginia and completed a combined Internal Medicine/Pediatrics Residency Program at Massachusetts General Hospital and Boston Children’s Hospital. Since 2008, Dr. Powis has worked with the Botswana-Harvard AIDS Institute Partnership on projects involving women living with HIV and their children. Her research focuses on pregnancy outcomes, novel treatment options for infants diagnosed with HIV at birth, and understanding why infants in resource-constrained settings with in utero exposure to HIV and antiretrovirals who remain uninfected are experiencing up to 4-fold increased risk of morbidity and mortality compared with infants born to HIV-uninfected women. Dr. Powis has NIH funding for ongoing research in Botswana, Kenya, South Africa and Zambia. She collaborates with WHO, UNICEF and the Collaboration Initiative for Pediatric HIV Education and Research (CIPHER) to conduct an annual international workshop focused on HIV-exposed uninfected infants. When in Boston, she attends on the Inpatient Medicine Service and at MGH Chelsea Urgent Care.
News: Read about Kate Powis’ unconventional path to medicine
Kevin Schwartz, MD
Dr. Schwartz is a pediatric hospitalist and pediatric emergency medicine faculty member at MassGeneral Hospital for Children. He attended the University of Massachusetts Medical School and completed his pediatric residency at MassGeneral Hospital for Children, followed by a pediatric emergency medicine fellowship at Boston Medical Center and a year of clinical training in pediatric hematology/oncology at Hasbro Children's Hospital. Dr. Schwartz is co-founder and US executive director of The Child is Innocent, an NGO founded in 2004 that provides educational opportunities and leadership development training to children from Northern Uganda. He has experience in pediatric residency curriculum development in Liberia, West Africa, and has served as a faculty member for the Harvard College Innovating for Health Transformation in Africa course in Kenya. His research interests include pediatric emergency medicine training curricula and pediatric oncology in low-income countries. Dr. Schwartz serves as co-chair of the International Society of Pediatric Oncology’s working group on Pediatric Oncology in Developing Countries Hospital Twinning.
Nupur Gupta, MD, MPH
Dr. Nupur Gupta practices at Massachusetts General Hospital and specializes in adolescent medicine, genetics, and primary care. She obtained her Bachelor of Medicine, Bachelor of Surgery at the University of Rajasthan in India and underwent her residency training in several different hospitals including Grimsby District General Hospital, Lady Hardinge Medical College, RNT Medical College & Hospital, Tufts Medical Center and Westmead Hospital until finally completing her fellowship in adolescent medicine at Tufts Medical Center. Dr. Gupta obtained her board certification in pediatrics and adolescent medicine from the American Board of Pediatrics and has professional interests in eating disorders including anorexia nervosa, adolescent gynecology, contraception, adolescent menstrual disorders, obesity and weight management, attention deficit hyperactivity disorder in adolescents and adolescent medicine. In 2013, Dr. Gupta received the Center for Global Health Travel Award from Mass General, allowing her to travel to the Indian states of Rajasthan and Maharasthra in order to assess possible research collaborations on projects involving non-invasive technology used to screen for anemia in adolescent and young adult populations. Collaborating with Seva Mandir, the largest NGO in Rajasthan, Dr. Gupta has worked with Indian medical providers on curriculum development and training opportunities for healthcare workers relating to adolescent health.
Pediatric Global Health focus
Peter Moschovis, MD, MPH
Dr. Moschovis is a pulmonologist with an interest in pediatric respiratory disease diagnosis and intervention in low-resource settings. He graduated from the University of Chicago Pritzker School of Medicine and trained in internal medicine/pediatrics at Massachusetts General Hospital. He completed clinical training in pulmonary and critical care medicine in the Harvard Combined Pulmonary/Critical Care Fellowship and a global health research fellowship in the Division of Global Health. Dr. Moschovis’s global health research focuses on treatable risk factors for childhood pneumonia and adult chronic respiratory disease. Working alongside collaborators in Uganda, Dr. Moschovis is the principal investigator on a study of risk factors for poor outcomes in childhood pneumonia. He is also the principal investigator of a study of a novel smartphone-based diagnostic device for pediatric respiratory diseases, making early diagnoses and subsequent treatment more attainable in limited-resource settings.
News: Meet the researcher who wants to diagnose respiratory disease with a smartphone
Rebecca Cook, MD, MSc, DTM&H
Dr. Cook received her medical degree from Vanderbilt University School of Medicine in 2011 and completed her residency in Internal Medicine/Pediatrics at Massachusetts General Hospital. Thereafter she obtained board certification in internal medicine, pediatrics, with several rotations at Mbarara University of Science and Technology (MUST) in Uganda. After serving as MGHfC chief resident she completed a global health fellowship at the University of Massachusetts Medical School where she worked in Liberia and earned her diploma in tropical medicine and hygiene in Peru. She now works with Partners In Health as the director of medical education and child health in Liberia, West Africa.
Ryan Carroll, MD, MPH
Dr. Carroll is on faculty with the divisions of Pediatric Critical Care and Pediatric Global Health. After completing his MD as a member of the charter class of the Medical School for International Health in Israel, his training in pediatrics and pediatric critical care at Dartmouth and Northwestern, respectively, led him to translational research in the pathophysiology of cerebral malaria -- enhancing the murine model while working with clinical research teams in Malawi and Uganda. From 2014 to 2017 he focused on capacity building, serving as the program director for the Global Health Collaborative in Uganda, overseeing 20 research projects and 15 departmental partnerships between Mass General and the Mbarara University of Science and Technology. He now serves as a clinical advisor for pediatric critical care-focused projects with Medicins Sans Frontiers and Epicentre, including establishing a PICU in Lebanon, delivering CPAP in Liberia, and developing TB diagnostic processing technologies in Uganda.
Read about Dr. Carroll’s work with low-cost CPAP prototypes
Assessing Measures to Eliminate Cholera Transmission in Haiti – Dr. Jason Harris
This study is designed to assess the effectiveness and impact of integrated programs to control cholera combining community level oral cholera vaccination with the promotion of household water treatment strategies. The study not only evaluates the impact of these measures on the incidence of Vibrio cholerae infection, but also assesses the potential impact of these programs on other important health measures during early childhood. The project involves an ongoing close collaboration between Mass General and Partners In Health/ Zanmi Lasante in Central Haiti.
B Cell Responses to V. cholerae and Protection Against Cholera – Dr. Jason Harris
This study is designed to unravel the key mechanisms of protective antibody responses (following both vaccination and infection) against Vibrio cholerae infection in humans. The research involves a longstanding collaboration between Mass General and the icddr,b (the International Centre for Diarrhoeal Disease Research, Bangladesh).
'Bubble CPAP’: an Ultra-Low-Cost Device for Reducing Newborn and Child Mortality from Respiratory Diseases- Dr. Brett Nelson
Dr. Anne Neilan is supported by an NICHD K08 Award to use computer simulation modeling methods and cost-effectiveness analysis to evaluate current questions in HIV prevention and screening in US adolescents and young adults at risk of HIV.
Investing in the HIV Care Continuum: Model-Based Methods to Translate ATN Findings into Policy Recommendations- Dr. Anne Neilan
Dr. Neilan is the assistant director of the Modeling Core for the Adolescent Medicine Trials Network for HIV AIDS Intervention (ATN 161). The ATN Modeling Core uses data already collected through completed studies and ongoing ATN protocols to inform critical health policy recommendations for youth living with HIV.
Early and Novel Treatment of HIV-infected Infants and Children
Neonatal HIV-1 infection and concurrent immune system development may offer unique opportunities for understanding HIV viral reservoir establishment and identify HIV eradication strategies. Dr. Kate Powis is a co-Investigator on two NIH funded studies in Botswana (U01AI114235, U01AI135940; Principal Investigator: Shapiro) exploring the efficacy and safety of early initiation of antiretroviral treatment (ART) among infants found to be HIV-infected at birth, and trialing exclusive use of broadly neutralizing antibodies as a treatment strategy for HIV-infected children on virally suppressive ART regimens from birth. Quantifying HIV viral reservoirs and change in the reservoirs over time among infants and children participating in these studies will inform the HIV cure agenda.
Addressing the Health of HIV-Exposed Uninfected Children Globally
Ensuring that pregnant and breastfeeding women living with HIV have access to antiretroviral treatment (ART) has resulted in over 60% reduction in HIV-acquisition among infants from 490,000 in 2000 to 180,000 in 2017. Yet, the number of women living with HIV who experience pregnancy annually has remained constant, at over 1.4 million per year. This has resulted in more than 1 million infants born annually with in utero exposure to HIV, and an increasing number also exposed to antiretrovirals (ARVs) in utero. While the vast majority of HIV- and ARV-exposed infants remain HIV-uninfected, they are HIV-affected. HIV/ARV-exposed uninfected (HAEU) infants are more likely to be born preterm and small-for-gestational age compared to infants born to HIV-uninfected women. Additionally, HAEU children experience 2-fold higher morbidity and mortality compared to HIV-unexposed uninfected (HUU) children, poorer growth and neurocognitive delays. In the maturing HIV epidemic, focus has shifted to finding the safest ARVs for using in pregnancy and breastfeeding to ensure that HIV-exposed infants remain uninfected and thrive.
Dr. Powis is the Principal Investigator of an NIH funded project (R21 HD093531) to harmonize HAEU exposure and outcome data collected by researchers and within health care systems globally. This project will provide flexible data collection tools for researchers and governments and uptake will achieve data harmonization. Ultimately, the project will enable comparison of HAEU child exposures and outcomes in key domains, such as birth outcomes, morbidity/mortality, and neurodevelopment, between research cohorts and national health systems data. Additionally, the project is structured to accommodate data pooling by participating researchers and governments. Pooling of data will permit identification of subtle disparities that may not have a individual clinical consequences, but impact population level human capital. Dr. Powis has secured the support of the World health Organization, UNICEF and other experts in child health to carry-out this project.
The Division has established a rigorous pediatric global health curriculum that provides residents an essential understanding of how to deliver effective clinical care in resource-poor settings and unique clinical needs of immigrant families for whom residents provide care in their continuity outpatient clinics. Energetic faculty members collaborate to provide expert resident training in global health through engaging presentations interspersed in the resident longitudinal curriculum and mentoring residents in global health clinical elective experiences. Topics include global burden of disease, child nutrition, newborn and maternal-child health, and infectious diseases, global health professionalism, and practical skills that you “must know before you go” on an international elective.
Residents have the opportunity to work globally during Global Health Clinical Electives in safe, mentored, and educational environments. Our residents have worked at well-developed sites in Botswana, Uganda and Mexico. Some residents have opted to coordinate their own elective sites, with vetting and approval from the Division of Pediatric Global Health. These have included Tanzania, Guatemala, Haiti and Geneva. Our residents benefit from the expertise of a diverse faculty working in a multitude of international settings who are eager to serve as mentors to the next generation of leaders in pediatric global health.
This global health course, co-directed by Brett D. Nelson, MD, MPH, DTM&H, and Peter Moschovis, MD, is a novel clinical skills-based curriculum established for Harvard medical students and residents with the primary objective of providing participants with essential clinical knowledge and skills to work effectively in resource-limited settings. The course consists of 10 evening sessions taught by a multidisciplinary faculty, with curriculum focused on the practical management of the leading causes of mortality and morbidity in low- and middle-income countries.
Botswana is a land-locked middle-income country located in southern Africa, and bounded by South Africa to the south, Zambia to the north, Zimbabwe to the east and Namibia to the west. The population is slightly greater than 2 million people. Formerly a British Protectorate, in 1966 Botswana gained its independence and has had a democratic and stable political system. In 1967, large quantities of diamonds were discovered. The gross domestic product of the country relies on the diamond and tourism sectors predominantly.
Botswana has the second highest prevalence of HIV among adults aged 15 to 49. The HIV epidemic in Botswana led to support from the United States government in the form of the President’s Emergency Plan for AIDS Relief (PEPFAR) initiated by President Bush. PEPFAR funding continues to support activities to control Botswana’s HIV epidemic. In late 1990s, Professor Max Essex of the Harvard T.H. Chan School of Public Health met with President Fetus Mogae and formed the Botswana-Harvard AID Institute Partnership (BHP), a collaboration between the Botswana government and Harvard School of Public Health to build laboratory capacity within the country to manage the HIV epidemic. This organization is one of the country’s national lab sites for HIV viral load testing. Activities have expanded to research, public health policy, and clinical education. In 2009, a partnership between BHP and Scottish Livingstone Hospital (SLH) was created to improve the overall quality of hospital care and provide a training site for Boston area residents. Scottish Livingstone is a district hospital with 350 beds and substantial outpatient services.
This clinical site accepts pediatric and med-peds residents to work on inpatient pediatrics and adult medicine wards, the outpatient pediatric HIV clinic, and outpatient adult medicine, accident and emergency centers. There are opportunities to engage in a quality improvement project selected from a list of initiatives deemed to be important to the hospital’s management team. The contact person for this site is Dr. Kate Powis.
Please contact Kate Powis with questions regarding this site.
Sub-Saharan Africa faces a most daunting challenge: it bears 25 percent of the global burden of disease but has only 3 percent of the world’s health workers. With a population of 37 million, Uganda is one of Africa's largest and fastest-growing countries. Despite rapid economic growth realized in the past decade, many Ugandans still live in poverty and confront several social and economic inequities: 65 percent of its population lives on less than US$2 per day. Training and retention of professional health staff is a serious problem, and Uganda is no exception. Under the auspices of the Mass General Center for Global Health, Mass General has developed a multidisciplinary collaborative relationship with Mbarara University of Science and Technology (MUST) and Mbarara Regional Referral Hospital (MRRH), as well as with the health center at Bugoye, a level III rural health center serving 35,000 people located approximately three hours by car northwest of Mbarara. Residents from the Mass General departments of Pediatrics, Medicine, Surgery, OB-GYN, Anesthesia, and others regularly visit MUST to collaborate on research and education. Additionally, the Bugoye Health Center is a primary training site for residents in the Mass General Global Primary Care Program.
Faculty in the Department of Pediatrics at MRRH, in the Mass General Center for Global Health, and in the Division of Pediatric Global Health at MassGeneral Hospital for Children are engaged in a diverse focus of research, including malaria, TB, pneumonia, HIV, and neonatal resuscitation. A collaborative initiative is presently underway to develop a regional oncology center at MRRH, with support from the Mass General Cancer Center and the Uganda National Cancer Institute.
At the Mbarara Regional Referral Hospital (MRRH), Mass General pediatric residents have the opportunity to work alongside Ugandan pediatricians and trainees from the Mbarara University of Science and Technology (MUST) to provide inpatient and outpatient care and to develop educational initiatives in a resource-constrained setting. Mass General pediatric faculty are currently active in research projects and medical education at MUST, and provide close mentorship and support for pediatric resident who chose to train at this site. The contact person for this site is Dr. Kate Powis.
Division of Global Health
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