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Vital Signs

Tanzanian agreement targets the global impact of AIDS

By Laura Stephenson Carter

In Tanzania, when you hire someone for a new position, you often have to hire two people because one will [soon] be dead from AIDS": Dr. Stephen Spielberg, the dean of Dartmouth Medical School, was sharing something he'd been told by Dr. Kisali Pallangyo, his counterpart at a Tanzanian medical school. Tanzania has some of the highest HIV infection rates in the world, Spielberg went on, and its social fabric is unraveling as many young, potentially productive members of society are lost to AIDS. And those who've died have left behind more than a million orphans.

"Is international AIDS important?" Spielberg asked. Then he answered his own question: "Yes."

Mark: DMS's dean was speaking at a ceremony in November to mark the signing of an agreement between Dartmouth and Tanzania's Muhimbili University College of Health Sciences (MUCHS).

On the Dartmouth side, the joint effort— called the Global Health Initiative—is being led by DMS and Dartmouth College's John Sloan Dickey Center for International Understanding. It also involves Dartmouth's Tuck School of Business and Thayer School of Engineering. Projects under way include the creation of a global health program in Tanzania; public programs at Dartmouth to raise awareness of global health issues; a new course in global health for undergraduates; and even a course in Kiswahili, one of the languages spoken in Tanzania. DMS and MUCHS students and faculty will also study and do research at each other's institutions. And Tuck students have been invited to determine the feasibility of developing a pharmaceutical industry in Tanzania.

Tanzanian medical student Isaac Maro—foreground, visiting with friends at his Dar es Salaam campus—has also visited DMS as part of a program linking the schools.

The initiative builds on the DARDAR project, a collaboration between Dartmouth and MUCHS that began in 2000. Led by Dr. C. Fordham von Reyn of DMS and Dr. Pallangyo, DARDAR includes a clinic for children with HIV/AIDS, a trial for a tuberculosis vaccine, and a five-year Fogarty Foundation grant for training researchers in Tanzania. The word DARDAR was drawn from the first three letters of "Dartmouth" and of "Dar es Salaam," the city where MUCHS is located. In addition, the acronym is similar to the Kiswahili word "dada," which means "sister," emphasizing the relationship between the two institutions.

Contacts: "When we go overseas, we look to . . . where there are already good contacts made with a strong academic institution we can partner with," said Dickey Center Director Kenneth Yalowitz at the November event. Yalowitz, who is a former ambassador to Belarus and Georgia, retired from the U.S. Department of State in 2001 and so has considerable experience with global initiatives.

"We're trying to approach these kinds of problems not just as isolated medical issues, and not just as isolated social issues," Spielberg said, "but as a continuum of society. Is [AIDS] important to all of us in the world?" Yes—that's the clear answer from Dartmouth.

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