In collaboration with the Aga khan University, Pakistan & University of Pittsburgh, USA

1. Building aTelepreventive Medicine Program For The Aga Khan Development Network (AKDN)President Shams Kassim Lakha, Dr Sunita Dodani & Professor Ronald E LaPorte In collaboration with the Aga khan University, Pakistan & University of Pittsburgh, USA

2. AKDN & Supercourse Presentation Outline • Concept of telepreventive medicine • Current supercourse network • AKDN spread globally • Current linkages of AKDN with supercourse • Objectives of telepreventive medicine • Preventive cardiology program as a model

3. “The ability to project programmes and activities over great distances can bring educational opportunities and resources into settings where they are poorly developed at present, because of financial constraints, or sheer isolation. Where individuals have access to computers in their homes or, as will be the case in rural areas in developing countries for some time to come, in community centers, technology can provide the first real opportunity for lifelong education on a broad scale” His Highness the Aga Khan, Washington, 2001

4. Concept Of Telepreventive Medicine Definition of Prevention “Actions aimed at eradicating, eliminating, or minimizing the impact of disease and disability. The concept of prevention is best defined in the context of levels, traditionally called primary, secondary, and tertiary prevention” A Dictionary of Epidemiology, Fourth Edition Edited by John M. Last

5. Rising Life Expectancy (WHO Report, 1997)

6. Global Burden Of Disease Project1996 report

7. Global Burden Of Disease Project1996 report

8. Focus On Prevention WHO focuses on prevention, not clinical care. Prevention has brought global improvement of health this century and will continue into the next. The most powerful means to improve health in your country and the world is through prevention approaches. WHO report 1997

9. Concept of Telepreventive Medicine Telepreventive medicine Inexpensive Low to High bandwidth systems designed to reach large numbers of healthy people to prevent disease. Telemedicine Expensive High bandwidth systems designed to reach small numbers of sick people to cure disease.

10. Focus On Prevention • Increased life expectancy in the past century was achieved through the improvement of sanitation and prevention • Successful prevention in the past and in the future needs to be rooted in the networking of health professionals around the world to share their knowledge • Much of the prevention is information transfer • The internet is the prevention superhighway

11. Supercourse - Model Of Global Health Network The Global Health Network represents a group of leading public health and telecommunications officials who are bringing state of the art Internet technology into global health. Mission To connect people involved in prevention worldwide

12. Global Health Network Global health network components • Connecting health professionals of developed and developing countries together through internet • Sharing best knowledge of prevention and health in a very cost effective manner • Distributing prevention knowledge both in the rural and urban parts of the world with primary focus in developing countries • Networking NGOs

13. Global Health Network • Currently more than 151 countries are connected through supercourse • More than 1,500 lectures available on the website http://www.pitt.edu/~super1 • More than 40% members are from developing countries. • In Pakistan, there are 510 members and 45 from AKU • We share knowledge, all countries contribute the knowledge • Islamic supercourse

14. Supercourse in Pakistan • Supercourse in Pakistan was established and developed from the grass roots in September 2002. • Currently this network consist of over 510 leading scientists who share teleprevention information in all part of Pakistan, both in urban and rural parts http://www.pitt.edu/~super1/pakistan/pakistan.htm

15. Aga Khan Development networkAKDN • A group of private, international, nondenominational agencies working to improve living conditions and opportunities for people regions of the developing world. • The focuses on health, education, culture, rural development, institution-building and the promotion of economic development. It is dedicated to improving living conditions and opportunities for the poor, without regard to their faith, origin or gender

16. AKDN • AKDN seek to reach people without access to services, complementing but not substituting the efforts of government and other providers. • Network agencies function through the participation of local people at all levels – in defining services needed, providing them and evaluating their effectiveness.

17. AKDN Supporting 22 countries world wide

18. AKDN Areas of development • Education (primarily medical and primary) • Health (primary, secondary & tertiary • Culture • Architecture • Economic development • NGO enhancement • Rural development

19. AKDN Health • Improve the health and well-being of remote rural communities. • Special attention to women and children. • Examples are seen in rural support programs in Pakistan, India, Kenya etc Educational services • Community based schools (e.g. in Pakistan rural northern areas) • Center of excellence offering international curricula ( India, Bangladesh etc)

20. AKDN Aga Khan University • Chartered as Pakistan’s first private international university in 1983, • Promote human welfare by disseminating knowledge and providing instruction, training, research and services in health sciences, education and other disciplines.

21. “Where individuals have access to computers in their homes or, as will be the case in rural areas in developing countries for some time to come, in community centers, technology can provide the first real opportunity for lifelong education on a broad scale. One lesson is clear. The mastery of the use of the essential elements of communication and information technologies will have to be part of the experience of every university student sooner rather than later. The use of the technology should have a place in the educational process itself, and its mastery should be on the list of competencies that every graduate should possess”.His Highness, Washington, 2001

22. Proposed Telepreventive Medicine program for AKDN Objectives • Develop a network of researchers, scientists and health care professionals of AKDN and global health countries, who are experts in prevention and connect them through Supercourse to the global scientists. • Establish WHO collaborating centers in AKDN countries with the collaboration of University of Pittsburgh • Establish first Public health School in AKDN countries in collaboration with WHO collaborating center of University of Pittsburgh and global health network. • Develop Telepreventive Cardiology nationwide program as an offshoot of global health network in AKDN countries

23. Proposed Telepreventive Cardiology Program For AKDN Countries Objectives • Develop a network of cardiologists, scientists and specialist around the world to share their expertise on preventive cardiology themes with AKDN countries. • Formulate guidelines and protocols on the major risk factors and behaviors of Cardiovascular diseases by linking developed and developing world through telepreventive medicine network • Establish WHO collaborating centers in the Aga khan university of preventive cardiology with the collaboration with WHO collaborating center of University of Pittsburgh and global health network.

24. Current AKDN Countries And Spread Of Supercourse Network AKDN Countries Supercourse Members In AKDN Countries AKDN Countries Supercourse Members In AKDN Countries 1 Bangladesh 3 2 Burkina Faso 0 3 Canada 787 4 Congo 1 5 Cote D’lvoire 0 6 India 400 7 Kenya 18 (also from AKHS, Kenya) 8 Madagascar 1 9 Mauritius 3 10 Niger 2 11 Nepal 3 (Cont’d)

25. Current AKDN Countries And Spread Of Supercourse Network (Cont’d) AKDN Countries Supercourse Members In AKDN Countries AKDN Countries Supercourse Members In AKDN Countries 12 Nigeria 17 13 Pakistan 510 (45 in AKU) 14 Senegal 5 15 Switzerland 24 16 Tajikistan 2 17 Tanzania 12 18 UK 208 19 Uganda 5 20 USA 3689 Total 7344

26. Telepreventive Medicine program In AKDN countries Networking • Head quarters at the Aga khan university • A group of scientists will be developed by linking with developed countries scientists through internet • This network will than serve to provide and share prevention knowledge to al AKDN countries • Members from AKDN countries will be identified who will further spread knowledge in health care professionals, health workers, communities and rural areas. • Students trained will carry prevention knowledge to rural areas.

27. AKDN Web of Prevention AKU Central Asia Global Health Network Kenya FSU Northern Areas of Pakistan Harvard Bangladesh University of Pittsburgh

28. Proposed Telepreventive Medicine program for AKDN Partners • AKDN Aga Khan university, Aga Khan foundation, Aga khan health services, Aga Khan educational services, Aga khan foundation, Aga Khan planning and building services & University of Central Asia • University of Pittsburgh WHO Collaborating Center • Global Health Network

29. “Development is sustainable only if the beneficiaries become, in a gradual manner, the masters of the process. This means that initiatives cannot be contemplatedexclusively in terms of economics, but rather as an integrated programme that encompasses social and cultural dimensions as well. Education and skills training, health and public services, conservation of cultural heritage, infrastructure development, urban planning and rehabilitation, rural development, water and energy management, environmental control, and even policy and legislative development are among the various aspects that must be takeninto account.”His HighnessAMSTERDAM, 7 SEPTEMBER 2002