Global Health

A Jefferson Science Fellow in global health

Dr. Robert Balster discusses his fellowship at the USAID Global Health Bureau, providing the scientific expertise needed to impact international policy decisions.

By Robert L. Balster, PhD

Dr. Robert BalsterRobert Balster is a professor of pharmacology and toxicology at Virginia Commonwealth University (VCU) and founding director of the Institute for Drug and Alcohol Studies. He was awarded a 2011-2012 Jefferson Science Fellowship, which selects tenured American academics from the fields of science, technology and engineering to provide the scientific expertise needed to impact international policy decisions.

In early December 2010 I had a message on my university office phone from my Vice President for Research asking me to call him back, emphasizing that I wasn‘t in any trouble. It turns out that VCU wanted to nominate me for a U.S. State Department Jefferson Science Fellowship, with application material due in mid-January. This Fellowship program is directed at senior faculty with strong science backgrounds who are willing to spend a year in Washington assigned to one of the State Department‘s bureaus or agencies and advise on science policy. The program is administered by the National Academy of Sciences (sites.nationalacademies.org/PGA/Jefferson/index.htm) and has been favorably reviewed by the Carnegie Corporation (2010). The program was begun in 2004 and is organized under the Office of the Science Advisor for the Secretary of State.

Jefferson Science FellowshipNearly all previous Fellows had come from fields such as chemistry, physics, engineering, environmental sciences, nuclear energy and the like. Almost no psychologists. Nonetheless, I was encouraged by my university to apply, and I received strong support from the Science Directorate at APA, which provided one of the required supporting letters for me. This fellowship opportunity came at a propitious time in my career as I was already getting more involved in international science and training. I had just finished a 12-year term as editor of an international journal; I was the principal investigator on a State Department supported Humphrey Fellowship Program which brought cohorts of mid-career professionals to VCU for a year of training and scientific/cultural exchange; and I had co-founded an international online graduate program in addiction studies jointly offered by King‘s College London, the University of Adelaide, and VCU. Plus, I had participated in several NIH-supported research and training grants for international scientists to work in my laboratories.

Current activities

It is now February 2012, and I have been in Washington since last August along with 12 other Fellows. After arrival and orientation I was given a very wide range of options at the State Department where I could do my fellowship. During the interviews I discovered that most of these units had little experience with scientific psychology. Also, I learned quickly that they were interested in me because I had general science skills that could be applied to a wide range of policy topics, not because of my research experience in the area of substance abuse or because I am a behavioral scientist. It made me appreciate once again the solid training that psychologists have in scientific ways of thinking and appreciation for evidence-based practices and policies.

USAIDI was placed in the Administrator‘s office at the U.S. Agency for International Development (USAID) Global Health Bureau. USAID is a component of the State Department and focuses on the provision of foreign assistance in several areas, including health. I am attached to what is known as the Global Health Initiative Launch Team. This team reports to Amie Batson, the Deputy Assistant Administrator for Global Health, and I was quickly taken under the wing of Elizabeth Higgs, an infectious disease expert on loan to USAID from the NIH. A driving philosophy behind the work of the Global Health Bureau is President Obama‘s Global Health Initiative (GHI, www.ghi.gov). There are several principles articulated in the GHI, including goals such as increasing country involvement and ownership in its health problems, strengthening country systems for health delivery and research, and discovering and implementing solutions that work.

The major focus of my work has been to assist USAID in helping developing countries implement more of the solutions that work. As scientists, we know that ― doing more of what works is a call for evidence-based practice and policy, but infusing a culture of research and evaluation has significant challenges. One of the ways I have been helping has been to work with a small team to facilitate interactions between USAID and the National Institutes of Health (NIH), given NIH‘s investment in health research and evidence-based practices. More can be done to link NIH research to the health needs of other countries. Synergizing USAID and NIH makes sense because USAID has extensive on-the-ground experience with helping countries address their health problems. My extensive experience in the NIH grant world has helped me make a contribution to this initiative here at USAID.

Another important issue is defining what constitutes evidence for evidence-based practice and policy in developing countries. Since most research knowledge comes from work that has been done in higher resource countries, we need to ask how the knowledge generated by this work can be applied globally. There can be many challenges in advancing evidence-based practices inside the U.S., let alone in settings where the evidence base is leaner. One strategy USAID has employed to facilitate the use of research and evaluation has been through the use of Global Health Evidence Summits. I have been working as a technical advisor for four of these. The first one was on "Children Living Outside of Family Care" (www.hvcassistance.org/summit.cfm) where leaders in research and practice were convened to review evidence and make recommendations. It was great to see psychologists well represented among this group of scientists. Three more Evidence summits are being planned, including one on "Sustainable Population Behavior Change for Health Improvement in Lower and Middle Income Countries" that is just in the early stages of planning.

So far, it has been a challenging and rewarding year as a Jefferson Science Fellow. I have learned a lot about areas in global health that I had not worked on before. I have learned that my training and experience as a psychologist have value in addressing a myriad of global health problems. I am learning a lot about the functioning of a large governmental agency and have developed deep respect for the difficult but critically important work that is being done by USAID staff. I am proud to be a small part of it.