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Re-inventing adherence:Patient-centered care fordrug-resistant TB/HIVMARCH 19 & 20, 2015EPIDEMIOLOGYSTONY WOLDHERBERT FUND
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AGENDADAY 1: MARCH 19, 2015Session 1: Epidemiologic and behavioralresearch on adherence in DR-TB/HIV9:30 – 10:45PREF EREN TIAL ADHEREN CE TO ARTOVER DR-TB TREATMEN TMax O’Donnell, MD, MPHColumbia UniversityDISCUSSANT8:00 - 8:30B RE A K FAST8:30 - 8:35W E LCO M E ADDR E SSCARIN G F OR THE COIN F ECTED: SOCIAL AN D ETHICALCON SIDERATION S IN DR-TB / HIVAmrita Daftary, PhD, MPHUniversity of TorontoWafaa El-Sadr, MD, MPH, MPAICAP, Columbia UniversityDISCUSSANT8:35 - 8:458:45 - 9:30David Bangsberg, MD, MPHHarvard Medical SchoolSY M P O S IU M INTR O DUCTIO NRivet Amico, PhDUniversity of MichiganMax O’Donnell, MD, MPHColumbia UniversityDECEN TRALIZATION OFTREATMEN T: A N EW DEF IN ITIONF OR DOT?F RA M I N G THE P R O BL E M:A DH E RE NCE AND PATIE NTC E N T E RE D CAR E IN DR -TB/HIVGerald Friedland, MDYale University School of MedicineSalmaan Keshavjee, MD, PhD, ScMPartners in Health, Harvard Medical SchoolDISCUSSANTErnesto Jaramillo, MD, PhDWorld Health Organization10:45 – 11:00COF F EE3
AGENDASession 2: Challenging adherence11:00 - 12:00PA N E L DISC U SSIO N: DR -TB/HIVA S A S OCIO ME DICAL DISE ASE :CO N ST RUCTING THE CASCADE O FCA RECO-CHAIRAmrita Daftary, PhD, MPHUniversity of TorontoCO-CHAIRNesri Padayatchi, MD, MSCenter for AIDS Programme of Research inSouth Africa (CAPRISA)PANELISTSCO-CHAIRGerald Friedland, MDYale University School of MedicineCO-CHAIRMike Frick, MScTreatment Action GroupPANELISTSUvistra Naidoo, MBChBUniversity of Cape TownMeera Senthilingham, MS, MSUniversity of Cape TownPetros Isaakidis, MD, PhDMédecins Sans FrontièresAnnika Sweetland, DrPH, MSWColumbia UniversityJames Brust, MDMontefiore, Albert Einstein College ofMedicineYael Hirsch-Moverman, PhD, MS, MPHICAP, Columbia UniversityErica Lessem, MPHTreatment Action Group3:00 - 3:15Session 3: Enhancing adherence3:15 - 5:00Jennifer Zelnick, ScD, MSWTouro College12:00 – 1:00LU N C H1:00 – 2:00W H O P E R SP E CTIVE O N PATIE NTC E N T E RE D CAR E IN DR -TBCOF F EEIN N OVATIVE TECHN OLOG IES TOMEASURE ADHEREN CEDavid Bangsberg, MD, MPHHarvard Medical SchoolJohn Metcalfe, MD, MPH, PhDUniversity of California, San FranciscoLESSON S LEARN T F ROM HIVErnesto Jaramillo, MD, PhDWorld Health OrganizationDISCUSSANT2:00 – 3:00Wafaa El-Sadr, MD, MPH, MPAICAP, Columbia UniversitySalmaan Keshavjee, MD, PhD, ScMPartners in Health, Harvard Medical SchoolGerald Friedland, MDYale University School of MedicinePA N E L D ISCUSSIO N: WHAT WO U L DI T TA K E TO HAVE AN ACTIVIST-L E DM OV E ME NT FO R DR -TB/HIV?IMPLEMEN TATION SCIEN CEAndrea Howard, MD, MSICAP, Columbia UniversityPetros Isaakidis, MD, PhDMédecins Sans Frontières5:004CON CLUSIONNesri Padayatchi, MD, MSCenter for AIDS Programme of Research inSouth Africa (CAPRISA)
AGENDADAY 2: MARCH 20, 20158:00 - 8:30B RE A K FASTSession 4: Synthesis of Day 1 and stepsforward8:30 – 9:30SY N T H E SIS O F ADHE R E NC ERE S E A RCH P R E SE NTATIO NSMax O’Donnell, MD, MPHColumbia UniversitySY N T H E SIS O F CASCADE O F CAR EPA N E LNesri Padayatchi, MD, MSCenter for AIDS PRogramme of Research inSouth Africa (CAPRISA)Amrita Daftary, PhD, MPHUniversity of TorontoSY N T H E SIS O F ACTIVIST PANE LMike Frick, MScTreatment Action Group9:30 – 12:00RO U N DTABL E DISC U SSIO N: THEWAY F OR WAR D FO R PATIE NTS12:00 - 1:00LU N C H1:00 - 2:00P RE S E NTATIO N O F R E SE AR CH ANDI M P L E M E NTATIO N AGE NDA5
PARTICIPANTSK RIVET AMICO, PHDDAVID BANGSBERG, MD, MPHResearch Associate Professor,University of Michigan, School ofPublic Health, Department of HealthBehavior and Health EducationDirector of Global Health,Massachusetts General HospitalDr. Amico is a research associate professor in the school ofpublic health at the University of Michigan. Her program ofresearch for the last 15 years has focused on social behavioral factors influencing HIV prevention and treatment. Shehas over 80 publications in these areas. She has contributedto practice guidelines and recommendations and to theevidence-base for assessment methodologies and design oftrials targeting adherence and retention in care. As a counseling psychologist, Dr. Amico’s work focuses on the interfacebetween biomedical advances and the social, structural, andindividual factors that influence uptake, adherence and bestoutcomes.6Professor, Harvard Medical School,Harvard School of Public Health, andMbarara University of Science andTechnologyDr. Bangsberg completed medical school at JohnsHopkins, internal medicine and chief residency at ColumbiaPresbyterian Hospital, and Fellowships in Infectious Diseaseand AIDS Prevention at the University of California, SanFrancisco. He also holds Master’s Degrees in Public Healthfrom the University of California, Berkeley and the Historyand Philosophy of Science from Kings College. Dr. Bangsberghas published over 320 manuscripts related to the study ofsocial, behavioral, and structural determinants of HIV treatment in vulnerable populations.
JAMES C.M. BRUST, MDAMRITA DAFTARY, PhD, MPHAssistant Professor of Medicine,Divisions of General InternalMedicine and Infectious Diseases,Montefiore Medical Center and AlbertEinstein College of MedicineLecturer, Dalla Lana School of PublicHealth, University of TorontoDr. Brust is an Assistant Professor of Medicine at MontefioreMedical Center and Albert Einstein College of Medicine wherehe holds joint appointments in the Divisions of GeneralInternal Medicine and Infectious Diseases. His researchhas been focused on the province of KwaZulu-Natal, SouthAfrica—an area with some of the highest rates of TB and HIVanywhere in the world. With a particular interest in TB drugresistance, he has spent the past 11 years studying TB/HIVco-infection, examining the epidemiology, transmission, andoperational responses to the drug-resistant TB epidemic inthe province.Research Associate, Centre for theAIDS Programme of Research inSouth Africa (CAPRISA), University ofKwaZulu NatalDr. Amrita Daftary is a Lecturer at the University of Torontowith expertise in socio-behavioural research and qualitativemethods. Amrita is committed to highlighting the patient’svoice to develop socially informed and socially responsiveapproaches to HIV and TB care. She has studied the socialchallenges of drug-resistant TB in sub-Saharan Africa since2005. She shares close affiliations with the CIHR SocialResearch Centre in HIV Prevention in Toronto, CAPRISA inSouth Africa, and ICAP at Columbia University. Amrita hasan MPH in health promotion, PhD in social and behaviouralsciences, and works as a community pharmacist in Toronto.7
WAFAA EL-SADR, MD, MPH, MPAMIKE WATSON FRICK, MScDirector, ICAPTB/HIV Project Officer, TreatmentAction GroupProfessor of Epidemiology andMedicine, Columbia University’sMailman School of Public Health andCollege of Physicians and SurgeonsDr. El-Sadr leads the Global Health Initiative at the MailmanSchool of Public Health. Dr. El-Sadr’s interests include: HIV/AIDS, tuberculosis maternal/child health, capacity buildingand health systems strengthening. Her work bridges interestand commitment to local and global public health challenges and an appreciation of the breadth of issues neededto transform the health of populations. She has extensiveresearch experience and leads the NIH-funded HIV PreventionTrials Network.Through ICAP, the center she established more than a decadeago, she has led the efforts that enabled the establishmentof large-scale programs in 20 countries in Africa and Asiathat link research, education, training and practice with afocus on HIV, other public health threats and health systemstrengthening.She received her medical degree from Cairo University inEgypt, a masters in public health from Columbia Schoolof Public Health (in Epidemiology) and a masters in publicadministration from Harvard University’s Kennedy Schoolof Government. Her scholarly work has appeared in leadingscientific journals. She was named a MacArthur Fellow in2008 and a member of the Institute of Medicine in 2009.8Mike Frick is the TB/HIV project officer at Treatment ActionGroup, an independent AIDS research and policy think tankfighting for better treatment, a vaccine and a cure for AIDSand its two major co-infections, tuberculosis and hepatitis C.Mike holds a bachelor’s degree in international studies andChinese from Kenyon College and a master of science degreein global health and population from the Harvard School ofPublic Health.
GERALD FRIEDLAND, MDProfessor of Medicine andEpidemiology and Public Health, YaleUniversity School of MedicineYAEL HIRSCH-MOVERMAN, PhD,MS, MPHAssociate Research Scientist, ICAPAdjunct Professor, Mailman School ofPublic Health, Columbia UniversityDr. Friedland has worked in clinical and clinical and epidemiologic research and care of people living with HIV, AIDSand TB since 1981. During the past decade this has includedwork in KwaZuluNatal, South Africa addressing issues in HIV/TB integration and MDR and XDR TB epidemiology, care andtreatment. He is Professor of Medicine and Epidemiologyand Public Health at the Yale School of Medicine andAdjunct Professor at the Mailman School of Public Health atColumbia.Dr. Hirsch-Moverman has an MS in Operations Researchfrom Columbia University’s School of Engineering andApplied Science and an MPH and PhD in epidemiology fromColumbia’s MSPH. She has vast experience in conductingepidemiologic and implementation science research, specifically in designing, conducting, and analyzing interventionsto improve adherence and retention in TB/HIV programs.She is co-investigator of two implementation science clusterrandomized trials that evaluate interventions to improve TB/HIV adherence in Ethiopia and Lesotho. She was recentlyawarded an NIH Mentored Research Scientist DevelopmentAward to evaluate a community-based intervention for theprevention of childhood TB in Lesotho.9
ANDREA A. HOWARD, MD, MSPETROS ISAAKIDIS MD, PhDClinical and Training Unit Director,ICAPSenior Operational Research Fellow,Médecins Sans Frontières (MSF) /Doctors Without Borders, IndiaAssociate Professor of Epidemiology,Columbia University Medical CenterDr. Howard is director of the Clinical and Training Unit atICAP, where she oversees the design and implementation ofclinical, laboratory, and training programs for the prevention, care, and treatment of HIV, tuberculosis, and relatedconditions in resource-limited settings in sub-Saharan Africaand Asia. She is currently leading two cluster-randomizedimplementation science trials aimed at defining best practices for integrating TB and HIV service delivery programs insub-Saharan Africa. Dr. Howard is an associate professor ofepidemiology at Columbia University and director of the NIHfunded Global HIV Implementation Science Research TrainingFellowship at Mailman School of Public Health.10Dr. Isaakidis is a medical epidemiologist and operationalresearcher. He has worked in Europe, sub-Saharan Africa,Middle East, South and South-East Asia, mostly withMédecins Sans Frontières(MSF)/Doctors Without Borders.Over the last 10 years he supported large-scale HIV andTuberculosis and Drug-resistant Tuberculosis projects as coordinator and epidemiologist . Since 2012 he has been facilitating Operational Research courses as part of the UNION/MSF/WHO SORT-IT initiative. His research interests include HIV,DR-TB, co-infections and humanitarian and global health
ERNESTO JARAMILLO, MD, PhDDrug-Resistance Policy Task Manager,World Health OrganizationSALMAAN KESHAVJEE, MD, PhD,ScMDirector, Harvard Medical School’sCenter for Global Health Delivery— DubaiAssociate Professor of Global Healthand Social Medicine, Department ofGlobal HealthAssociate Professor of Medicine,Division of Global Health Equity,Brigham and Women’s HospitalThe drug-resistance policy task manager at the Global TBProgramme of the World Health Organization is a Colombianmedical doctor (1990, Universidad del Valle, Colombia), PhDin Health Education (1998, University of London, London,UK). His professional career in TB began delivering clinicalcare and programmatic management of TB and MDR-TB atdispensary level in the slums of his country, and continuedwith operational and social science research in TB care andcontrol. Global policy on MDR-TB prevention, care andcontrol has been at the centre of his work in the last sixteenyears; twelve of them at the WHO Global TB Programme.While in WHO he has been the chief editor of the last two editions of the the WHO Guidelines for the treatment of MDR-TB,and has published in the field.Dr. Keshavjee completed his medical training (MD) atStanford University in 2001, after which he completed aclinician-scientist residency in Internal Medicine at Brighamand Women’s Hospital. Since then his clinical researchhas focused on drug-resistant tuberculosis treatment. Hehas worked extensively with the Boston-based non-profitPartners In Health (PIH) on the treatment of drug-resistanttuberculosis. Over the last 14 years has conducted clinicaland implementation research in Russia (2000-present). Hewas also the Deputy-Director for the PIH Lesotho Initiative(2006-2008), launching one of the first community-basedtreatment programs for multi-drug resistant tuberculosis/HIVco-infection in sub-Saharan Africa. His research has resultedin a number of manuscripts of global clinical and policysignificance.Dr. Keshavjee has been very involved in global policy discussions around the treatment of drug-resistant tuberculosis. In2005, he became a member of the World Health Organization/Stop TB Partnership’s Green Light Committee for MDR-TBTreatment. From 2007 to 2010, he was the committee’s chair.He has spent considerable time working on alternate mechanisms for drug procurement, technical assistance delivery,and program implementation. In addition to acting as aconsultant to a number of projects globally, Dr. Keshavjeewas the co-author of an Institute of Medicine white paper onovercoming barriers to expanding treatment for MDR-TB. Dr.Keshavjee is leading an initiative at Harvard Medical Schoolon how to achieve zero deaths from tuberculosis.11
ERICA LESSEM, MPHJOHN METCALFE, MD, MPH, PhDDirector, TB/HIV Project, TreatmentAction GroupAssistant Professor, Divisionof Pulmonary and Critical CareMedicine, University of California,San FranciscoAs director of Treatment Action Group’s TB/HIV Project, Ericaworks with activists, developers, donors and policymakers toaccelerate research and ensure it reflects input from affectedcommunities, and to expand access to evidence-based strategies to fight TB and TB/HIV.Erica has worked at the TB Alliance, with the CDC’s NationalHIV Behavior Surveillance System in Baltimore, and wasan Urban Fellow at the NYC Department of Health. Shesupported efforts to combat sex trafficking in South Asia,and started the Republic of Georgia’s first breast cancer peersupport program.Erica received her MPH as a Sommer Scholar at the JohnsHopkins Bloomberg School of Public Health. She has a BA inSpanish and Psychology from Georgetown.12Dr. Metcalfe completed his medical residency and fellowship training at the University of California, San Francisco(UCSF). He then completed a PhD in epidemiology from theUniversity of California, Berkeley. He is an Assistant Professorin the Division of Pulmonary and Critical Care Medicine atUCSF. His research interests focus on the diagnosis, management, and transmission of drug-resistant tuberculosis,domestically and in high HIV-burden settings. He holds anhonorary lectureship position at the University of ZimbabweCollege of Health Sciences.
UVISTRA NAIDOO, MBChBMAX O’DONNELL, MD, MPHPaediatric Registrar, University ofCape TownAssistant Professor of Medicine andEpidemiology, Columbia UniversityMedical CenterUvistra is a paediatric registrar at the University of CapeTown’s Red Cross War Memorial Children’s Hospital andGeorge Hospital in South Africa. He is a medical graduate ofthe University of KwaZulu Natal. He began his medical careerin Cape Town before having a substantial leave of absencedue to ill health. Though still at a young age, his first handexperience with tuberculosis prompted him to devote hiscareer toward fighting this dreaded disease. He is a FogartyGlobal Infectious Diseases scholar and his main researchinterests include Mtb diagnostics and biomarker detection aswell as understanding the mechanisms between malnutritionand TB, with emphasis in the child.Dr. O’Donnell is an academic pulmonologist and assistantprofessor of medicine and epidemiology at ColumbiaUniversity Medical Center. His research interests rangefrom laboratory-based biomarker discovery to clinical andqualitative research focused on the field of drug-resistanttuberculosis. His South African collaborators K-RITH andCAPRISA where he is a Research Associate. His clinical workincludes working as a volunteer physician at a busy New YorkCity tuberculosis clinic.13
NESRI PADAYATCHI, MD, MSMEERA SENTHILINGAM, MS, MSDeputy Director, Centre for the AIDSProgramme of Research in SouthAfrica (CAPRISA), University ofKwaZulu-Natal Nelson R. MandelaSchool of MedicineHonorary Research Fellow, Universityof Cape TownDr. Padayatchi is the Deputy Director of CAPRISA at theUniversity of KwaZulu-Natal in Durban. She is a lecturerin the Department of Community Medicine at the NelsonMandela School of Medicine. She has more than 30 yearsclinical and research experience in the management of TB andrelated problems. She served as the South African PrincipalInvestigator for the Columbia University-Southern AfricanFogarty AIDS International Training and Research Programme.She serves on the South African National and ProvincialAdvisory Board for MDR –TB. She is a member of ASSAf. Shewas the eThekwini Clinical Research Site leader from 2006 to2013 as well as the CAPRISA Principal Investigator for ACTG.14Meera Senthilingam is a global health journalist, researcherand communications specialist. Through her Mastersdegree in Science Communication from Imperial Collegeshe reported on global health issues across the world forthe BBC, Nature, New Scientist and now writes for CNNInternational and broadcasts on the BBC World Service. Hersecond Masters in the Control of Infectious Diseases from theLSHTM resulted in specializing in qualitative research withtuberculosis patients in South Africa with the Lung Infectionand Immunity Unit at UCT. She has researched perspectivesof XDR-TB patients who failed treatment and patient experiences of DOT in the Western Cape.
ANNIKA SWEETLAND, DrPH, MSWJENNIFER ZELNICK, ScD, MSWResearch Fellow in Global MentalHealth, Columbia UniversityAssociate Professor, Touro CollegeGraduate School of Social WorkAnnika Sweetland, DrPH, MSW is Research Fellow in GlobalMental Health at Columbia University and Co-Founder andCo-Chair of the TB and Mental Health Working Group at theInternational Union Against Tuberculosis and Lung Disease.Her research has focused on the integration of depressiontreatment in primary care in low resource settings, with afocus on TB and depression in Peru, Brazil, and Mozambique.Jennifer Zelnick is an Associate Professor and Social WelfarePolicy Chair at the Touro College Graduate School of SocialWork. Her research focuses on the impact of drug-resistant TBand HIV on lives of health care workers in South Africa. She isthe author of “Who is Nursing Them? It Is Us”: Neoliberalism,HIV/AIDS and the Occupational Health and Safety of SouthAfrican Public Sector Nurses, and has conducted qualitativeresearch on workplace safety and infection control in thecontext of drug-resistant TB. She collaborates with socialwork faculty in Durban, South Africa around social welfarepolicy and workforce issues.15
EPIDEMIOLOGYSTONY WOLDHERBERT FUND
Annika Sweetland, DrPH, MSW Columbia University James Brust, MD Montefiore, Albert Einstein College of Medicine Yael Hirsch-Moverman, PhD, MS, MPH ICAP, Columbia University Jennifer Zelnick, ScD, MSW Touro College 12:00 – 1:00 LUNCH 1:00 – 2:00 WHO PERSPECTIVE ON PATIENT-CENTERED CARE
