THE TIME IS NOW BECAUSE ACTION SPEAKS LOUDER TO INITIATE PANAFRICAN CME
By Ahmed A. Moen, DrPH, MPH, MHA
When I read the articles on People to People [P2P] as well as my role of frequent discussant of health care policies on higher education and health care delivery services, it is time to support the Pan African Continuing Medical Education [PAN-CME] offered by my colleague Dr. Enawagaw Mehari, President of People to People [P2P] bridge. Org. It is a viable window of opportunity to fulfill our dream of excellence by active sharing medical and interdisciplinary knowledge as true validation of our lifelong gratification. The gratification is also unique for those of us who believed in building bridges to achievable center for excellence as a goal among many other alternatives of integrative academia and best practice setting worldwide.
It is axiomatic to know that our professional oath is a serious commitment to validate our productive exercise to learn from knowledge offered from resource-rich to resource-poor areas nationally and internationally. Distance learning has contributed to employ dynamic state of the arts of virtual capability to close the disparities in quality and quantity of health care. For many decades, the connection to center of excellence was associated with the privilege of access allowed to few of graduates of departments of international health and medical centers located in higher learning comprehensive research institutions. The faculty who are successful using well-funded projects to sustain learning education are in need for private forum to purse excellence beyond the limited scope of graduation of selective number of home-grown African professionals who cannot afford admissions costs for enrolling in CME outside resource poor African health care settings.
Now that CME has become universal requirements for licensure and quality assurance, an innovative standard to institutionalize CME in health disparities area such as Africa will be mandatory. When implemented fully It sets extraordinary precedent for promotion, retention and tenure of the best practitioners to manage quality assurance of high rate of success. The African continent has been the recipient of a wide range of technical assistance for human resources development. However, there will be some time-consuming outstanding challenges to achieve the long run plan to manage affordable and sustainable knowledge driven by dependence on indispensable expatriate short term consultants to maintain frequent time-consuming travel plans from and to Africa. Continuing education becomes the least rewarding certification if not associated with mandated recognition to promote centers of excellence to penetrate the health educational disparities between the rural and urban areas. The other concern is the opportunity of implementing cost effective exchange programs to complement effective delivery of equivalent knowledge adaptable to resource poor countries. In other words, only those countries that have access to bilateral and multilateral funds offered by Private Organizations such as Bill Gates can sustain long-term support of virtual learning facilities to deliver effective maintenance of its products such as spare parts, repairs and replacements of the fast turnover of technological facilities.
It is frequently underestimated to advocate the added value of offering continuing medical education as mandated integrative experience shard between the practice settings and academia. The lack of policy of policy makes a difference to achieve sustainable quality care and cost-effective affordable care capacity building in many African. In this respect, it is time to consider the added value of Pan African CME to provide cost effective network of affordable and adaptable interdisciplinary home-based rich integrative experience.
Nonetheless, lack of facilities to learn and improve evidence-based time saving virtual network services adapted to live conference equipped for cost-effective use of global positioning satellite visual aid and transmission are one of the reasons that impede instant live continuing education. The other concern for implementation of Pan African Continuing Education [Pan-CME] deals with institute standard operations procedures that employ English language and if needed instant translation to Amharic as lingua franca of People to People in Ethiopia. The language disparities in other parts of Africa can be complimented by adaptation of P2P paradigm to override the artificial porous borders and language barriers by direct reach out to people and health providers where they work and live.
The time is now for sharing scarce resources because of the feasible use of integrative opportunity to access state of the arts knowledge and case studies adapted to both virtual technology and face-to-face conference such as Skype, Viber, IMO and What’s, Facebooks, etc. It a foregone conclusion that mobile cell phones are already status symbol for common use for commercial banking and transactions on demand in the absence of PC. Africa has already been part of the old adage of real-life “global village” but seem to lag behind reduction of health disparities and access for all in the 2th century.
People to People’s [P2P] initiative drives us to compete and excel in providing comprehensive service including and not limited to quality assurance policy such as validation of credentials, regulation for licensure to practice our professions in private, group, hospitals and health stations and prevention of death because of medical errors and drug expiration misreading or color change. Overall, medical and public health professions have vested interest to assure the people they serve and the institutions that employ them that continuing education is a life-time investment associated with access to quality health for their clients from the cradle to the grave.
On the one hand, no other professions have earned special honor, status and trust to live by their oath to swear “Doing no harm and people come first” like medicine and health care. It impresses me as my pre-public health oath that I took as a boy scout. Three fingers representing love of God and country, service before self and play by the rule. The WHO health definition as a comprehensive state of well being of physical, mental, social well being and spiritual well being to add to the original definition are also complemented by other ethical standards for human rights. To this effect, the dynamic nature of continuing education can easily integrate evidence-based adaptation and modification of policies in the real world.
Licensure and accreditation of voluntary national health services requirements for medical medical professionals will assist instituting universal Pan-African CME to reach out the isolated silos in the remote health disparities areas. This approach will be added value to expedite fast track adaptation as an alternative to time consuming required review process for internship provided in academic settings. In both cases peer review process are mandatory to provide equivalent competency-based education whether in academia or real-world best practice settings.
On the other hand, the medical and public health professions must integrate innovation of variable differences such as terminologies and insrvice training necessitated by delegation of tasks to allied health professions and other social and health care disciplines common to “doctors without borders” across porous international borders in the real world. In this time and age, modern technology puts us in untenable situation to alternative access to continuing education such as P2P paradigm. Different strokes for different folks means flexibility and cost-effective use media of communications including and not limited to instant gratification associated with online education to replace the anachronistic time-consuming Physician Desk Reference [PDR].
During the HIV epidemics expansion of drugs and laboratory facilities employed continuing education and competence-based certification programs proved to be affordable alternative free market lower costs negotiated by Pan-African pooling of orders and logistics connected to south of the equator partnership. The issue of adverse effects of porous boundaries can easily be overcome by retention of knowledge as an asset embraced by universal human rights and equity to share life-saving technologies in spite of the so-called north of the equator countries domination by trickling down its assistance to selective countries located south of the equator. By the same token, Africa and some Asian newly founded partnership open free marked for affordable books and online flow of knowledge between and among countries such as those covered by the proposed Pan-African policies and freedom of exchange regardless of the artificial boundaries that impede sharing the little knowledge they have.
The P2P Pan African Continuing Education initiative offers new broad horizon to access triangular collaboration between African to African countries and between north and south countries as exemplified by technical assistance initiated by Obama Administration to promote trade in Africa. The forum provided P2P forum and its participants to share affordable knowledge transfer from the rich resource countries to the less poor resources countries such as CME initiative to close the disparities in health, science and virtual technologies. However, the knowledge about access to good ideas and audiovisual technologies has the risk of being abused in the absence of regulation to validate the authenticity of the participant’s knowledge base and peer reviews processes available to P2P.
The proposal will allow transparent negotiated implementation of Pan African regulatory mechanism such as standardized requirements for universal licensure, accreditation of continuing education, patient privacy rights where the practitioners and users of the technology are aware about the credentials and competence of the providers of health and consultations, especially those solicited on line or radio shows unless the provider is retrained to keep abreast with the dynamic competency-based practices in the real world.
People to People [P2] has already provided Ethiopian professionals as an open access to integrative virtual forum for exchange opportunity. This include overring traditional annual face-to-face conference not only for the medical and public health professions but also for interdisciplinary allied health, social sciences and management. The founders of P2P have opted for English language-based resources and archives to offer consultations and participation in its forum . The forum was designed to reach out to the lowest common denominators of affordable health information and assistance by qualified and trained people. Once again this was a calculated risk to overcome language barrier across porous international sovereignty which has conflict associated with their colonial or ethnic-based written and spoken languages. Some of the partners may prefer an alternative instant translation of medical terminologies and concepts benefit from Pan African CME. The proposed core value attempts to focus on maintenance of center for excellence through its network of operations to connect each participant with the real-world communities suffering from health disparities from primary to specialized tertiary education.
The fact that P2P network continues to exist since the first decade of the 21st century, offers its leadership track record to sustain participation of multidisciplinary faculty in charge of CME especially those who are covered by solicited memorandum of understanding with colleges and universities locally and internationally. The Pan African CME offers an opportunity to avail Africa to an overdue window of opportunity to penetrate the porous international and local borders to pursue contact with health professionals where people live and work. By all measures of access for all, it has validated the value of effective collaboration of nongovernmental entity’s role initiated by the Alma Ata Declaration of Health for All in 1970s of the 20th century and its subsequent reform as Access for All by the 21st century.
Based on the above track record, P2P need to reconstitute and adapt its agenda to meet the everchanging interdisciplinary approach regularly used to complement its Annual Conferences in the United States and Ethiopia whether by professionals in Diaspora or the African continent was a landmark of excellence for shared knowledge. It has gained recognition by the consistent presence of officials from the ministry of health in Ethiopia together with the regular participation of international consultants with affiliation to higher learning institution and private practitioners in both USA and Ethiopian health care delivery systems.
The Pan African CME will be an added value to the promotion of interdisciplinary and integrative experiences that are rare among the public and nongovernmental organizations nationally and internationally. The academic institution have already embraced the ideas that their faculty and resources can be shared with medical and allied health schools through bilateral memorandum of understanding. For example, this includes and not limited to the international collaboration such as Mayo Clinic.
As for the future progress to consummate the P2P initiative it can be measured for its track record as an organization of vested interest in African collaboration with higher learning institutions such as the tenured faculty of Mayo Clinic and other colleges and universities chairs and private practitioners with a larger scale interactive connection nationally and internationally. Retention of bridging home-grown capacities to provide CME in Africa is an important precondition for sustainability in order to maintain continuity as exemplified by the Ethiopian P2P based operations. The CME enjoys the support of its board’s statement of capability written by its president Dr. Enawgaw Mehari citing among other thing constructive engagement built around worldwide network of virtual training complemented by live rotation of conference sites between USA and Ethiopia.
In the final analysis, It is important to consider comparative advantage of the active precedents set by affiliation of P2P’s transcontinental consultation style to offer a plan of action. For example, P2P was one of the few African projects recognized by the Obama’s Administration of the Triangular Trade Initiative . P2P has already occupied a seat on the table to advocate its vision of center of excellence of P2P’s driven projects. Its involvement are already posted to follow-up on website forum and online network. Acquiring the vision of knowledge is a shared an obligation of men and women in order to accomplish productive lifetime window of opportunity. It is the corner-stone to effective sustainable socio-economic, health and management when offered by nongovernmental international organizations fully-engaged in involving policies of ministries of health . P2P’s has the opportunity to benefit from signed memorandum of understanding as one of the partners to be a sub-contractor of multilateral and bilateral agencies that have proven track record such as institutions of higher learning in the resource countries.
Ahmed A. Moen , DrPH, MPH, MHA
Associated Professor of Interdisciplinary International Health, Epidemiology and Health Management Policy, Department of Family Medicine and Community Health, Howard University
Associate Faculty, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University
Lifetime Alumni Member of the School of Public Health, University of Michigan, Ann Arbor Michigan