Ann Marie Nelson, MD AIDS and Infectious Disease Pathology Joint Pathology Center, USA

Defining the Problems  High income country (HIC) research projects and programs in low income countries (LIC) ◦ Do not improve the basic health infrastructure of the hospital/countries where they are located  Pathology and Radiology Services  Physicians in training do not learn how to use these servics ◦ Nested or silo services do not train where training occurs  Medical schools  Teaching hospitals

 Who are they? ◦ Pathologists, Laboratory Scientists and Technical Staff, Clinicians, Educators, Researchers, Administrators, Politicians, Donors, Vendors ◦ Patients?  Where are they? ◦ Local, National, Regional, International (global) ◦ Medical Schools, Universities, Ministries, Foreign Institutions and Governments  What is their stake? ◦ Patient Care, Teaching, Research, Public Health, $$

Building Bridges  Set up meetings between pathologists/trainees and collaborators to determine potential projects  Help to design pathology component of projects  Identify potential training/mentoring required for implementation of projects ◦ Visiting professors in pathology to rotate on monthly basis over several years  Subspecialty training  Medical school and staff teaching  Research development and mentoring

Matching Pathologists with Clinical/Research Partners Matching Pathologists with Clinical/Research Partners Hepatic Pathology Expertise Hopkins/Fogarty Training Grant

Space Improvement Equipment Upgrades Reach Tibotec OSU NIH HIV Malignancy

Immunohistochemistry “Lab in a Box”  Hand methods  Antibodies ◦ Relevant to pt care ◦ Robust/reproducible  Regional resource ◦ Diagnosis ◦ Research ◦ Training UCSF NCI D43

Technical Training Standardization Reach Tibotec

Specimen Quality Diagnostic Accuracy

Do Anatomic and Clinical Pathology have value in improving the quality of information derived from the Verbal “Autopsy”? If so, where is our place at the table?

 In order to engage stakeholders, pathology services must be:  Available  Accurate  Affordable  Rapid  Relevant  Reliable