Global Health Security

Preparing for Global Health Threats to Children  

The Global Health Security Agenda (GHSA) is a partnership of over 64 nations, international organizations, and non-governmental stakeholders to elevate global health security as a national and global priority. Members of the GHSA work together to strengthen both the global capacity and nations’ capacity to prevent, detect, and respond to human and animal infectious diseases threats, whether naturally occurring or accidentally or deliberately spread. Children’s hospitals and hospitals with pediatric wards are key stakeholders in meeting the goals of the GHSA as they pertain to children, and Columbia's Program for Global Health Security and the Child aims to identify areas within the GHSA that are specific to the needs of children. The program's lead project is to create a survey tool and joint external evaluation process to assess the readiness of hospitals serving children’s needs to respond to health catastrophes and meet public health goals during emergencies. Drs. Philip LaRussa, Lawrence Stanberry, and Wilmot James direct the program at Columbia. 

CHAMP: Children's Hospitals in Africa Mapping Project 

The needs of children are often not considered when planning for emergencies, epidemics, and disasters. In 2018 Philip LaRussa, MD, Lawrence Stanberry, MD, PhD, Wilmot James, PhD and African colleagues, in partnership with the Columbia Global Center Nairobi, launched a study to explore how prepared hospitals in sub-Saharan Africa are to care for children in the event of emergencies and pandemics. Pediatricians from Ethiopia, Malawi, Rwanda, South Africa, Lesotho, Uganda, Tanzania, Zambia, Mozambique, Ghana, Liberia, and Kenya came together with the Columbia team at the outset of the study to share their views on children’s healthcare, and to develop a standardized model to evaluate existing services and identify needs. The survey, modeled on the Global Health Security Agenda’s Joint External Evaluation (JEE) tool, is designed to gather data about the size, infrastructure, surge capacity, resources, services, staffing, programs, and policies of children’s hospitals (major medical facilities with dedicated space allocated for inpatient and outpatient care of large numbers of children). With funding from the ELMA Foundation, the Charles Hamilton Fund, and Columbia University, the Columbia team embarked on the Children's Hospitals in Africa Mapping Project (CHAMP), with on-site assessments, using the CHAMP survey, of 24 hospitals throughout sub-Saharan Africa. The results will identify strengths, weaknesses, and needs, and allow institutions to prioritize investments that improve their capability to care for children in general as well as during emergencies, epidemics, and disasters.

Early during the CHAMP project it was recognized that some hospitals had high rates of hospital acquired infections in their newborn/neonatal units. Neonatal death due to hospital acquired infections in low-and middle-income countries has been recognized as a problem by the Bill & Melinda Gates Foundation. To explore factors that might contribute to the risk of hospital acquired infections in newborn/neonatal units, the CHAMP research team (with the addition of Lisa Saiman, MD, MPH), received a grant from The Bill & Melinda Gates Foundation to build on the earlier work. The new phase research will involve 60 hospitals across continental Africa. With input from Gates Foundation leadership and African Pediatric colleagues, the researchers are developing a neonatal care and infection prevention and control survey and site assessment tool (the Pan-African Neonatal Care Assessment Survey (PANCAS)). The group will conduct site visits and use the PANCAS instrument to gain information regarding the facilities, staffing, resources, and practices including Kangaroo Mother care, with the goal of identifying realistic strategies that can reduce the risk of neonatal sepsis and death in low- and middle-income countries.