The early success of PEPFAR in delivering antiretroviral medications to some of the world’s poorest countries unmasked a new problem - many countries lacked the health workers needed to efficiently use the medications. PEPFAR’s 2008 reauthorization embraced this challenge, committing to training thousands of new health workers, particularly doctors and nurses. In 2010, PEPFAR launched the Medical Education Partnership Initiative, funding 13 medical schools ($130 million over 5 years) in 12 African countries to improve the quantity, quality, and retention of their graduates in an effort to begin strengthening health systems in those countries. MEPI is funded by PEPFAR through the Office of the US Global AIDS Coordinator in the State Department and by the National Institutes of Health (NIH). The initiative is administered by both the NIH Fogarty International Center and the HIV/AIDS Bureau of the Health Resources and Services Administration in the Department of Health and Human Services.
In 2010, 13 African universities were funded under this initiative through a competitive peer review process and The George Washington University and the Uganda based NGO, the African Center for Global Health and Social Transformation (ACHEST) were tasked to serve as the coordinating center. These universities have a diverse range of research and education activities ongoing under the MEPI umbrella, ranging from research infrastructure improvement to e-learning to curriculum review and beyond. These activities all broadly fit under MEPI’s three core overarching themes:
- Increasing Capacity: Enhancing the quality and quantity of medical education in funded schools and in their respective countries.
- Retention: Addressing the need to retain graduates and faculty in country to build the capacity of the health workforce as well as the capacities of medical schools.
- Regionally Relevant Research: Important for the generation of research capacity as well as a tool for faculty development and retention.
- Sustainability:To promote sustainability beyond the grant period, MEPI is facilitating engagement with ministries of health and education and methods to capture the indirect benefits of the MEPI investment. If MEPI universities can document how their efforts have strengthened the health system, future funding to sustain MEPI-efforts will becomes more promising.
- Building Communities of Practice: MEPI has the unique opportunity to serve as a catalyst for the formation of communities of practice, networks that share best practices and innovations.
The MEPI Coordinating Center is tasked with tracking and evaluating school activities, offering technical assistance, and providing platforms for communication, both virtually and via the MEPI website.
MEPI is a major venture in international educational innovation, and it has generated new thinking, energy, and optimism in the field of medical education in Africa. The presence of MEPI has also enabled partnership between African medical educators.
The Coordinating Center sponsored Annual Symposium is the largest meeting of African medical educators, attended by nearly 250 health professionals. The Principal Investigators council, which meets twice a year, has promoted increased collaboration between MEPI schools and created a platform for networking and the sharing of best practices. MEPI is unique in that it empowers African leaders to define local needs and develop the most appropriate solutions. This is especially evident in the partnership with ACHEST, which will gradually assume all coordinating center tasks over the five years of the award.
Sustainability is perhaps the ultimate challenge for MEPI. The five year PEPFAR investment in MEPI represents a serious commitment, but medical education scale up and health system strengthening require considerable amounts of time. Also, MEPI is funding a small minority of the more than 170 medical schools in Africa. Extending medical education innovations beyond the immediate MEPI schools will be a challenge moving forward. However, as an educational collaborative it has enormous potential, and will garner considerable attention in the years to come.