Lifetime Achievement Award

Lifetime Achievement Award

Left to right: CSIH Board Co-Chair Shawna O'Hearn, Dr. Noni MacDonald, Dr. Robert Bartolucci

Every year, CSIH presents a Lifetime Achievement Award to one of its exceptional members. A full list of Past Lifetime Achievement Award winners is published here

2019 Lifetime Achievement Award

The 2019 award was presented to Dr. Noni MacDonald at the 25th Canadian Conference on Global Health in October 2019.

Dr. Noni MacDonald has demonstrated incredible leadership and a deep commitment to improving health for children in Canada and internationally, over the span of 37 years. Dr. MacDonald’s major areas of interest provide abundant evidence of her impact on Global Health, leadership internationally in vaccine research and use, and, through MicroResearch, building research capacity  in Africa.

Dr. MacDonald’s other leadership accomplishments are evident from the many awards and recognition. She was the first female Dean of Medicine in Canada (Dalhousie 1999), the driving force behind the founding of the first Canadian paediatric journal in 1996 (Paediatrics & Child Health), and the journal’s first editor. With over 500 scholarly publications, and numerous research grants, she’s broadened our understanding on vaccines, and public health and been a passionate advocate for women and children everywhere.

Vaccines:

As a result of her research in infectious diseases and vaccines, Health Canada selected Dr. MacDonald as a founding member of the Advisory Committee on Causality Assessment for Serious Adverse Events in 1994.

Dr. MacDonald’s expertise in vaccinology is also recognized internationally. In 1999 she became a founding member of the Global Advisory Committee on Vaccine Safety (GACVS) of the World Health Organization (WHO).  She also developed the first WHO advanced course for Adverse Events Causality Assessment, which has been taught in over 40 countries since 2005. Dr. MacDonald’s expertise in vaccinology lead to her being appointed to the WHO 15-member Strategic Advisory Group of Experts (SAGE) on Immunization, which provides the world with advice on issues related to vaccines.  From 2012-14 she was a member of the SAGE Working Group on Vaccine Hesitancy and helped draft the 2014 final report. She subsequently co-authored a technical report for mitigation of pain on immunization that would be relevant globally. She also chairs the SAGE working group on the “Decade of Vaccine”  -Global Vaccine Action Plan Assessment. A core task of this committee will be working with WHO, UNICEF, GAVI and others to develop the next decade 2021-2030 Global Vaccine Action Plan for presentation to the World Health Assembly in 2020. The impact of her vaccine work is vitally important globally since vaccine safety concerns are now recognized as an important factor in vaccine hesitancy.

Other research work in vaccinology has enhanced recognition of importance of influenza vaccine in children and in pregnant women, improved clinical management in meningococcal outbreaks and contributed to the development of the conjugated meningococcal C vaccine. HPV vaccine uptake in school-based programs, development of better vaccine product monograph language, surveillance of adverse events in pregnant women and evidence based guidance on how to address vocal vaccine deniers in public. Current projects include exploring school-based immunizations pain mitigation programs.

Global Health (MicroResearch):

Africa has daunting health problems, and meager resources. Western solutions to local African health problems often fail because they don’t fit the culture, and context or require resources beyond those available. Research capacity to identify solutions for local problems is also lacking. To counter these deficiencies, Dr. MacDonald, together with Drs. Robert Bortolussi from Dalhousie University and Jerome Kabakeyenga, from Mabarara University of Science and Technology in Uganda developed a program they’ve called “MicroResearch” (www.microresearch.ca ). Modelled on Microfinance principles, it trains local health professionals to identify and solve local community health problems and funds their research. The solutions they develop fit the context, culture and local resources available in Africa.

Since its founding in 2008, MicroResearch has conducted over 40 two-week workshops in seven African countries, trained over 1,000 health professionals and community members and launched over 100 local research projects to tackle important local African health problems. This success was only possible with help from others, who were inspired by her presentations on the MicroResearch program and her work in Africa. Over 300 volunteers from Canada, United States, Europe and Africa have become teachers in Africa, reviewed grant proposals or coached African research teams to accomplish their research goals. 

Successful African MicroResearch teams develop their own project ideas and conduct them with a small grant (~ $1,500-$2,000) and help from local and international volunteer coaches. Once the project has been completed, coaches also help the team to publish their discovery in a recognized PubMed journal so that others in Africa can benefit from the new knowledge. But the most important impact of MicroResearch has been from local implementation and changes to national policies. For example a study of traditional rural village birthing practices in Uganda revealed cultural practices for newborn cord care that were potentially dangerous. A second MicroResearch team investigating causes of deaths in infants under a month of age in rural Ugandan villages, discovered that 42% resulted from severe infection originating from the umbilical cord and likely due to the dangerous cord care practices. The two teams presented their findings to the Ministry of Health of Uganda. Because of these two studies, changes have been implemented that will likely save 1000’s of babies in Uganda. Applying a disinfectant, chlorhexidine gel, is now a standard of practice. Neither of these projects could have succeeded without the local MicroResearch teams, who recognized the problem, understood the culture, spoke the local language and gained the trust of the local villagers. 

The cost of the MicroResearch program is kept low with help of volunteers and a partnership with Academics Without Borders, which supports some of the travel costs. MicroResearch has relied on government and non-governmental organizations, and donations from the public to fund the peer-reviewed research projects. But more recently, local African institutions and NGOs are funders for such projects. This is strong evidence that local organizations recognize the important role MicroResearch can play to develop their capacity to solve local problems. 

As a result of the program that Dr. MacDonald cofounded, local African research capacity is growing, its faculty are teaching the workshops and administrative staff are managing it.  One African site has become “Hub” sites, assuming most of the teaching and administrative roles and providing strong evidence MicroResearch will be sustainable for the long term. MicroResearch has also allowed women to gain leadership roles and skills in research, thus helping to address the research capacity and gender gaps of Africa. MicroResearch has been such a success in Africa that the Nova Scotia Health Authority and the IWK Health Authority decided to introduce a Canadian MicroResearch version in Nova Scotia in 2016 (www.microresearch-international.ca ). The training provided in Africa is now growing in Nova Scotia with over 100 health and community professionals trained to undertake community based research to improve the lives of those in need. As of June 2019, six workshops have been held, 100 health and community professionals trained and two community based projects launched. The MicroResearch concept was recently featured in CIHR Canada 150.

Written by Dr. Robert Bartolucci