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PARTNERSHIP WITH JOHNS HOPKINS

Memorandum of Understanding

The overall objective of this collaboration is to improve child health by focusing on key interventions such as vaccine-preventable diseases and building public health capacity in India.

The Johns Hopkins Bloomberg School of Public Health (JHSPH) through its Department of International Health and the International Vaccine Access Center (IVAC) will collaborate with the Dr. Pradip and Kumkum Ghosh Foundation, and the International Institute of Innovation and Technology (I3T) to establish a Johns Hopkins India Maternal and Child Health Center. The mandate of this Center is to support efforts to achieve the child health-related United Nations Sustainable Development Goals (SDGs) in India. To help achieve this ambitious goal, the Center will focus on accelerating the introduction and effective implementation of existing child health interventions in India, with a particular focus on vaccine-preventable diseases and difficult-to-reach populations. Building public health capacity in India, and in West Bengal in particular, is a key outcome of this partnership. Model programs developed and established in West Bengal can be scaled up to other states and the entire country. The proposed approach is based on knowledge translation principles, which harnesses the strength of scientific evidence to inform health policy and practice. In order to sustain these goals, it is critical to build public health and technical capacity in India.

Incorporating Knowledge from Immunization Programs & Public Health Successes

Immunization systems are among the strongest and most successful health programs around the world. Vaccines were central to the global eradication of smallpox. Vaccines have also contributed substantially to the reduction in child mortality in India, and the country has made encouraging progress toward introducing new vaccines, eliminating polio and increasing routine immunization coverage. This progress has not occurred within a vacuum. Investments in research and advocacy activities have helped to overcome many of the “know-do gap” challenges in India. The proposed Center will draw upon the unique experience of immunization programs in India and around the world. There are several renowned immunization and nutrition researchers at JHSPH, as well as social scientists and health systems policy faculty, with expertise in vaccines and child health issues who will be facilitators and mentors for the Center.

I. Illustrative Research Activities

Below are illustrative activities that could be undertaken by the proposed Center, along with overall projected budgets and timelines:

  • Cost-of-Illness Study: The Center proposes to lead a study aimed at understanding the cost-of- illness (COI) associated with childhood diseases both in West Bengal and other states. Such evidence can be used by policy makers when considering new public health programs and interventions, including the introduction of new vaccines. Based on the findings of such a study, the Center would support the development of relevant policies and advocate for their adoption.
  • National Cash Transfer Benefit Scheme Implementation Research: A recent example of a national cash transfer program launched by the Government of India and focused on improving maternal and child health is the Pradhan Mantri Matritva Vandana Yogana (PMMVY). The Center will work to assess the barriers and facilitators to implementation of the program, and its effects on women and children in order to strengthen and potentially adapt the program to include additional interventions.
  • Vaccine Implementation Research for the ‘Zero-dose’ Child: While it is well known that vaccination is a public health measure that has saved the most lives, a substantial proportion of children are missed by the health system and remain un-identified and unvaccinated. Such ‘zero-dose’ children may exist in health-related blind spots where preventative and curative services are not robust, and where health literacy needs are not met adequately. The Center will help strengthen national efforts to identify vulnerable children and bring them into mainstream care. The lessons learned from West Bengal could be transferred to other states and help implement programs to reduce the proportion of zero-dose children in India.
  • This collaboration with I3T will build research capabilities in all areas of public health; for example, research on the prevention and treatment of malaria, dengue, hepatitis and other infectious diseases that affect children the most.
  • I3T will bring funding from different governmental and private agencies to supplement costs toward the Center’s programs.

Timeline for Research Activities

  • The Center will devote Q1 and Q2 of 2020 working with the Ministry of Health and other partners in West Bengal to identify research priorities in child health. The Center plans to begin implementation of the first project in Q3 and Q4 of 2020 and to implement two to three additional research projects in child health in 2021.
  • Based on research results from the above projects, and in consultation with the Ministry of Health and local partners, the Center will further refine its approach in Q1 and Q2 of 2022 and look to expand those projects in Q3 and Q4 of 2022 through 2023. Knowing that the Center has funding in place for these projects is essential to the long-term success of our work.

II. Capacity Building: Learning Through Structured Courses

JHSPH has a rich tradition of offering and supporting academic training in areas of public health, with topics ranging from human rights to infectious diseases modeling, from vaccine science to public health economics. This Center will conduct assessments of public health competencies to support and implement competency-based public health training model in West Bengal and provide assistance and support to local instructors to conduct academic training sessions in-person or via online courses modeled after courses taught at the JHSPH. The school will further strengthen academic and research expertise in public health through capacity building by recruiting qualified candidates to pursue doctoral degrees at the JHSPH. The Center would specifically focus on recruiting those who would return to India to teach at public health institutions related to I3T. Two illustrative examples of didactic courses are:

  • Short Courses in Epidemiology and Biostatistics: Epidemiology is an integral component of public health practice and aims to provide the basis for disease prevention and health promotion. Courses will focus on training participants to design and interpret measures of health burden of vaccine preventable illnesses in India, association of risk factors, and effectiveness of suitable vaccine and non-vaccine interventions. Fundamental and advanced concepts in biostatistics tailored to the needs of vaccine research and child health can be integrated into the courses.
  • Vaccine Science and Policy Courses: Blended and online short courses may be offered to enhance knowledge on vaccine science and policy, from clinical research to manufacturing strategies, global finance policies and implementation programs in India.
  • Offering academic and research programs jointly with I3T in all program areas of public health. Approximately twenty percent of the financial support will be used for capacity building and
    training.

Timeline for Capacity Building and Training

  • First short course in epidemiology, public health and biostatistics to be conducted in Q2 2020, with 2-3 additional short courses conducted in Q3 to Q4 2020. During 2021, more extensive courses on vaccine science and policy will be offered. These course, and additional courses based on need and demand, will be offered in 2022-2024.
  • Recruit two doctoral candidates in 2021 and 2022 (total of four students), providing full tuition, stipend, health care and travel funds to support four years of training, per student.

Stewardship

The International Vaccine Access Center (IVAC), in collaboration with the Bloomberg School of Public Health’s Office of External Affairs, will prepare annual reports, outlining progress on each of the activities listed above. These reports will include updated timelines, as well as updates on budget allocations for each area.