Dr Anselm Hennis is Director of the Department of Noncommunicable Diseases and Mental Health at Pan American Health Organization/World Health Organization. He studied for a PhD Epidemiology at LSHTM, graduating in 1996. In this blog he discusses his career since graduating from LSHTM, what innovation means to him and how his work is finding solutions for global health issues.
How did your career develop after leaving LSHTM?
I returned to Barbados at the end of 1996 and took up an academic position at the University of the West Indies, with joint clinical and research responsibilities. In addition to being a clinical consultant and lecturer, I joined the Barbados Eye Studies research project. This study included over 4,700 persons aged 40 to 84 at baseline, and remains the largest and most significant study of the major causes of visual loss in an African-descent population conducted worldwide. It significantly increased our understanding of the causes of visual impairment and blindness in this population, findings that are highly relevant to African Americans.
During my career in Barbados, the competencies and skills that I acquired during my training at LSHTM, allowed me to conduct collaborative research with UK-based groups and several major US universities in areas such as diabetes; hypertension and cardiovascular disease; overweight and obesity; systemic lupus erythematosus (SLE); breast cancer; prostate cancer; factors linked to healthy ageing; health disparities in African-descent populations; and genome-wide association studies across a wide range of human traits and diseases. This body of research was funded by multiple grants from the National Institutes of Health and led to more than 150 peer-reviewed papers. I have received several academic accolades, including being promoted to Professor of Medicine and Epidemiology at the University of the West Indies, and Research Associate Professor of Preventive Medicine at Stony Brook University.
I joined PAHO/WHO in 2013, and my current role allows me to contribute to national policies in the Region of the Americas; to prevent and control NCDs and mental health disorders through tackling risk factors; to assist the scale up health promoting factors; and strengthen health systems and service delivery, while making the case for domestic investments in health. It is also important that all stakeholders play a role in building multisectoral partnerships.
What does innovation mean to you?
Innovation means finding new solutions to what appear to be almost insurmountable challenges. This is particularly relevant to non-communicable diseases (NCDs). Globally, although NCDs are the principal cause of ill health and premature death, they receive only a tiny fraction of development assistance for health, which are still directed to infectious diseases such as HIV. Secondly, in the Americas as in many parts of the world, primary care services are structured to deliver maternal and child health services, as well as treatment of acute infections, and not chronic conditions. So how can the case be made for increasing health investments for NCDs, and where should such investments come from? Investing in the WHO Best Buys for NCDs as well as in mental health conditions can lead to significant returns on such investments, providing justification for making the case to governments. The basis of these funds are increased domestic funding and potential sources including excise taxes on commodities such as tobacco, alcohol and sugar sweetened beverages that are harmful to health. My colleagues are hard at work on estimating the tax share for sugar sweetened beverages which will be relevant to the development of simulation models, similar to those in use for measuring the impact of tobacco taxes on consumption levels.
How can innovation solve challenges in global health?
Optimising taxes on products that are harmful to health and directing the funds raised to health interventions in line with the Addis Ababa Agenda potentially has significant health and economic benefits. Strengthening the delivery of care for NCDs at the primary care level is also an important challenge. We are working with the WHO, CDC and Resolve to Save Lives, to improve the quality, cost-efficiencies and effectiveness of cardiovascular care through improved blood pressure control, through the HEARTS in the Americas initiative. Improved hypertension control at the population level will significantly reduce premature cardiovascular mortality.
What advice do you have for current students?
There are new and emerging public health threats; one current challenge being the novel Coronavirus outbreak which recently originated in Wuhan, China. There are huge challenges regarding NCDs, largely driven by modern environments, lifestyles, market forces, global trade etc. There are evolving crises linked to climate change and air pollution, and in the Americas, natural disasters adversely impact health. Mental health conditions affect large numbers of young people, while we have seen the growth and outcomes related to the opioid epidemic. Access to optimal health services remain a global challenge for many. LSHTM provides unique training opportunities for present and future health challenges grounded in its past achievements. Even though I didn’t know it at the time, studying at LSHTM was easily one of my most prescient decisions and the training I received allowed me to contribute to population health and well being at the national, regional and global levels in ways that I never imagined.