Taking down 'the Ivory Tower': leveraging academia for better health outcomes in Uganda.

ivory tower, noun (1) an impractical often escapist attitude marked by aloof lack of concern with or interest in practical matters or urgent problems; (2) a secluded place that affords the means of treating practical issues with an impractical often escapist attitude; especially a place of learning [1]. Sub-Saharan Africa (SSA) is home to less than ten percent of the world’s population but bears nearly a quarter of the world’s disease burden. At the same time, the region has limited financial resources to invest in solutions [2]. The international community has commonly responded with narrowly focused, short term, technical approaches or relatively simplistic aid programs. The absence of a comprehensive strategy or “systems approach” has resulted in a patchwork of well-intended but often poorly coordinated initiatives. While academic institutions in the North (i.e. North America and Europe) have sought opportunities to be helpful, concerns have been raised regarding the focus of their initiatives and misalignments with the priorities of host countries. Funding for such initiatives typically originate outside of the region and while academic institutions in the North have clearly benefited from these opportunities, the value to the host institutions or to health systems in SSA is often much more difficult to determine. Another concern pertains to the relevance of academic institutions in the face of dire global health challenges. What role can academic institutions play in creating practical solutions to tackle pressing societal problems? By their nature, institutions of higher learning are concerned with the creation of new knowledge, while often leaving the application of their findings to others. They rarely evaluate the relevancy of their training programs to the current needs of the health care system. Implementation has not traditionally been considered as part of the academic agenda. In addition, stakeholders who are most familiar with the problems that hamper improvements in health are usually not members of academic communities. As a result, civil society and government agencies, such as the Ministries of Education and Health, often view academicians as intellectuals who are cloistered in their Ivory Towers, seemingly uninterested or unwilling to deal with the pressing problems of the day. In the case of global health, an ever growing number of non-governmental organizations have stepped forward to work on solutions, with academic institutions watching from the sidelines. This collection of papers, focused on work conducted at Makerere University College of Health Sciences (MakCHS) in Uganda, challenges the Ivory Tower notion with a set of approaches and findings that are a testimony to the relevance of a leading academic institution to the health problems of SSA. The papers range from assessments of the educational approaches and ability to provide health services, to policy and strategic analysis needed for sustainability of the institution, to research projects that demonstrate the practical role of the University in the health sector. Furthermore they demonstrate a new model of collaboration between universities in lowand high-income countries; a model that emphasizes local leadership and ownership. Most of the papers in this supplement are based on work that was funded by the Bill and Melinda Gates Foundation (BMGF). With the belief that health science schools have a critical role in improving health care in SSA, the BMGF initiated their Collaborative Learning Initiative in 2008 with two-year learning grants designed to demonstrate and incentivize the accountability of health professions schools to the problems of society [3]. These grants brought together leading health science schools in SSA with partner schools in the U.S. to explore the value proposition that academia could bring to the pressing health problems in the region. To be sure, these relationships have existed for many years, long preceding the initiation of these learning grants. Correspondence: jckolars@umich.edu Professor of Medicine, Senior Associate Dean of Education and Global Initiatives, University of Michigan Medical School, Ann Arbor, MI 48109-5624, USA Kolars BMC International Health and Human Rights 2011, 11(Suppl 1):S1 http://www.biomedcentral.com/1472-698X/11/S1/S1