27. Mar 2015

Abdallah Daar: ‘Let’s create a pandemic of health’

Gwendolyn Carleton
A new global health thinker and innovator has joined the World Diabetes Foundation Board.
Dr. Abdallah Daar in Copenhagen, Denmark.
Abdallah Daar, Professor of Clinical Public Health, Global Health, and of Surgery at the University of Toronto, joined the WDF Board on 1 January. His academic career has spanned biomedical sciences, organ transplantation, surgery, global health, and bioethics. 
His personal history is equally wide-ranging. Born in Tanzania, he initially went to medical school at Makerere University in Uganda before leaving to complete his medical education at the University of London and then post-graduate studies at Oxford University, where he taught for several years before moving to the Middle East. 
There he was involved in establishing two medical schools, clinical transplant programs, and building research capacity. In Oman, he was the founding chairman of the department of surgery at Sultan Qaboos University before moving to Canada in 2001. 
His research at the University of Toronto and affiliated research institutions has focused on how genomics and biotechnology can reduce global health inequities. He has worked in various advisory/consulting capacities with the UN, the World Health Organization and UNESCO, and was the founding chair of the Advisory Board of the UN University Institute of Global Health. 
Gwen Carleton sat down with Prof. Daar to learn more about his interests, passions, and plans for the future.
Where did your interest in science and global health inequities originate? 
About 15 years ago, I was asked by the World Health Organisation to write a report on Medical genetics and biotechnology: Implications for public health. As a result of going very deeply into this subject, I realised that biotechnology and life sciences in general were really going to be important for global health, and that no one at that time was paying much attention to this. 
At that time, the Human Genome Project was at the forefront of big science. Working with my friend and colleague Peter Singer, we developed in Toronto the Canadian Program on Genomics and Global Health (CPGGH). We began by looking at the potential for biotechnology to improve global health, not in the sense of personalised boutique medicine but in the sense of diagnostics, vaccines, therapeutics, mosquito control, and other applications that were very relevant to improving health in low- and middle income countries (LMICs). Because of the central position of genomics, we coined a term ‘avoiding a genomics divide’. Then we set out to study what different countries were doing with biotechnology in terms of improving global health and reducing poverty. 
What did you find?
One of our first major research projects was a Delphi study to identify biotechnology applications that would help to improve health in LMICs in the following decade or so.  We found that molecular diagnostics, recombinant vaccines, drug and vaccine delivery systems, environmental remediation, and increased food production were among the top 10. 
This study and others that looked at how LMICs and emerging economies were internalising biotechnology into their research, education, industries, health care systems etc were published in Science, Nature, Nature Genetics, Nature Biotechnology et al. The findings found wide resonance globally and our work attracted major research funding in Canada, but also internationally.
Then, our work and research methodologies were noticed by the Bill and Melinda Gates Foundation (BMGF), when they were looking to identify the grand challenges in global health. We worked with them to identify 14 major ‘Grand Challenges’ that became the basis for their global health research funding. We continued to work with BMGF as research grantees but also as advisors on the many ethical, social and cultural issues that arose and continue to arise on cutting edge research. 
At some point with another set of colleagues from Oxford and the World Health Organization we began to focus on the world’s major killers i.e. chronic non-communicable diseases. The Oxford Health Alliance was established with funding from Novo Nordisk, and at its launch I met Novo Nordisk’s remarkable CEO, Lars Rebien Sørensen. We undertook a major international study that identified the 20 or so Grand Challenges- priorities- for research funding and this led to the creation of the Global Alliance for Chronic Diseases, which I had the privilege of chairing at its creation. Later we did the same for global mental health. These studies were both published in Nature.
The world community in time began to focus on the social determinants of health and how investments in health can give us huge dividends in terms of economic development. Reducing global health inequities really does require thinking of all these things together.  
What is your focus now?
‘Grand Challenges’ has become a movement, particularly among research/innovation funding organisations like BMGF and Grand Challenges Canada. Later other countries joined, and now we have Grand Challenges India, Brazil, Israel etc. The platform encourages identification of priorities, rapid and transparent evaluation of proposals, shared governance and collaborative partnerships, etc., in order to address real-world, practical health needs rapidly. There is a real focus not on inputs or outputs but on ultimate impact in terms of improving and saving lives. I continue to be involved as chair of the Scientific Advisory Board of GCC. I am also currently on the governing board of Genome Canada, and I am on the UN Secretary-General’s Scientific Advisory Board, where we are currently engaged in many areas of the development of the Sustainable Developments Goals. 
I have always had an interest in medical education and pedagogy. For example, I spent some time working with the Aga Khan University in developing their Faculty of Arts and Science and their medical education programmes in East Africa. I am currently heavily engaged at the University of Toronto in developing innovative techniques to teach global public health, with the aim of inspiring young minds to make them sensitive to the fact that we need seriously to reduce global health inequities. At the University of Toronto I am also involved in advising on our newly re-energised Institute for Global Health Equity and Innovation. 
We are moving from thinking of diseases to thinking about health and wellness. This change in mindset may have major implications in the future. It’s based on the idea that, when talking about public health, don’t focus on diseases, focus on wellness. Let’s create a pandemic of health.
Why did you accept the invitation to join the WDF’s Board?
I feel very privileged now to have joined the Board of the World Diabetes Foundation. I felt that my experience with research/innovation funding organisations, non-communicable diseases, LMICs etc would bring some value to WDF.
I look forward very much to working with this Board; I have a lot to learn from its members. I am learning of the many excellent projects funded by WDF in LMICs. I like the focus on concomitant TB, on gestational diabetes, on the WDF’s poverty lens, and I am delighted that my suggestion at my first Board meeting to include a gender-equity lens was supported. 
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