Meeting on the Global Health Service Partnership
November 18, 2011
Room 2307
Meeting Participants and roles in the Global Health Service Partnership:
Vanessa Kerry- Associate Director of Partnerships and Global Initiatives, MGH
Center for Global Health, Executive director GHPF Foundation
Pamela Richmond – MGH Center for global health, possible admin at GHSP
Pat Daoust- Nursing Director, representing nursing in this initiative
Tom Lasalvia – Chief Admin for the Center for global health at MGH, helping
with the admin and fiscal end of GHPF
Buck Buckingham-Director of PC Office of Global Health and HIV, key
coordinator of PC involvement in the GHSP (will soon be recruiting someone
to manage the GHSP from a senior level, currently filling that role)
Sarah Morgenthau – Director of PC Response and key coordinator of PC
involvement in the GHSP
Lien Galloway- GC coordinator, bringing together PC’s legal
Jan Miller- GC coordinator
Adam Poswolsky-Coordinating from PC’s end
Travis Johnson-Coordinating PC’s end/supporting Buck

Other instrumental coordinators in the GHSP:
Carrie Hessler-Radelet - PC Deputy Director
Robert Glass - Fogarty Center also (helped to approach Ambassador Goosby)

 Meeting Minutes:
1. OGAC does 4-5 CNs each year. Mark Dybul has worked with the hill to
increase notification on the use of PEPFAR funds
a. 4th CN will go to the hill just before, or immediately after, the
thanksgiving recess. The GHSP will be included in the CN (after DP
approval). We don’t anticipate any delays after that stage. There will
be a strict timeline and unless questions are asked (which they are not
expected to be), the funding will quickly be processed.
b. The process of how to bring in funding from the foundation will not be
delayed, we don’t have to go through forward open competition.
2. VK- Fogarty is 100% committed to funding three additional people (PC hires)
to work on the GHSP. The three spots will come from current Fogarty fellows
(PC doesn’t have to fill all three spots though if PC doesn’t approve of the
individuals). 47k is being put aside for this each hire.

Matrix:

1) Looking at the left column, we’re keeping this at a fairly high level, and our
determinations on this will result in what goes into the MOU, and then there
will be a separate financial instrument.
2) Are there critical aspects of the column that are not identified in the left
column?
a. Possibly include: Strategy/growth of the program (i.e. when do we
expand and include pharmacist, expand out of Africa, etc…)
3) Is there a board to oversee the entire program with PC?
a. There will be an individual tasked from the PC side to oversee the
partnership and they will be partnered with a counterpart on the
foundation’s/external organizations’ side. The MOU is an additional
layer between the two organizations. Also, the foundation will have a
board representing their interests on their side. PC will also have a
similar set of relationships that they will have to manage internally as
PC is a governmental agency and will have to manage relationships
with other federal agencies.
4) Drafting an MOU for PC is not a new process as PC currently has several
MOU’s with various universities and private institutions (i.e. TFA, City year,
AARP, Special Olympics, etc…)
5) VK-before the matrix, what we need to lay out:
a. As we transition, before we are done we need to work out how to
handle: publicity, process of recruitment and when we are going
to make an announcement. A timeline also needs to be hammered

 out today. We are competing against the academic cycle in regards to
new recruits.
6) BB- The public funding to start the GHSP is secured, it will come from OGAC
through PC to support core HQ and field based activities, and to develop a
sub-agreement to provide support to the foundation for contributions for their
work in this partnership
a. Private-PC would like to stay as far away from this as possible, in
particular to benefits not granted to standard PCVs.
b. In-kind contributions: On PCs side: the commitment by Fogarty to
commit three fully funded fellows to the program
i. On foundation’s side: this is still on the table
7) Both the foundation and PC want to push for mid-career professionals to
make the program as diversified as possible.
8) VK-the foundation will need input on site development in terms of how
contributions to the program and selection of volunteers will be developed.
a. There is a host-site contribution column missing in the matrix…..it
would be helpful to include a “green” column of details that would not
be relevant to the MOU but still helpful in understanding the greater
agreement between the partners.
b. BB - housing is expected to be provided by the institutions accepting
volunteers, host country contributions are generally a negotiated
option and we also have a standard site MOU.
9) Country selection
a. PC will need the final word here because it is a PC program, we need to
know PC posts can handle this responsibility.
i. PC will reach out to OGAC to get NEPI and MEPI perspectives,
and we have that as a separate agenda item. Today we are
hoping to come out with an initial 5 countries to start this
program and then follow up with our individual networks.
10)
Receiving institutions/sites:
a. For PC there is always a safety and security overlay to choosing sites
over what academically might seem to be a best fit (access to sites can
come into focus here too).
i. This will likely not be an issue in the first years of the program as
most of the early institutions (aside from problems associated
with some urban settings)
11)
Development and support to sites
a. PC would be responsible for ongoing programs at site, looking into
whether there is a good ongoing relationship with the counterpart at
site, etc… But what will be the Foundation’s role in the academic side
is still unclear and we would like to have a conversation on this.
b. The foundation would like to change the “O” to a “Y” as the foundation
would also need to sign off on any site. The foundation would manage
relationships with NEPI and MEPI to make sure that approval and
support network is in place. It is important to ensure that that
academic support is actually in place. Under the broad program

 12)
a.

b.

c.
d.
13)
a.

element of site development and ongoing support, the Foundation
needs to be able to take responsibility for how site’s change (be it in
leadership at the site, who the mentor is, etc…)
i. PC needs to ensure that there is constant and clear
communication with the PC Office and Post so that the Volunteer
is not receiving conflicting messages from the foundation and
from site.
ii. The situation can become complex when you talk about support
from NEPI and MEPI programs in regard to the fact that some
countries have a singular MEPI institution while others have a
network. To be at MEPI institutions may be a lost cause because
they aren’t located in the central cities, and then we would lose
the focus on putting volunteers where they could have the most
impact.
iii. The Foundation could give ongoing consultation and advice,
while the PC would have the final authority.
iv. In year 2-3 we could look beyond NEPI and MEPI programs, but it
will probably be simpler to stick to programs already receiving
PEPFAR funds.
Marketing of GHSP opportunity
Linked to our site selection, we need to hear from them what is most
needed. As a result we would post specific jobs rather than an open
invitation for all nurses and doctors.
i. We might want to be careful here not to impose our values on
what they need. That said, sites may ask for specialists to build
up their in-country programs rather than asking for the basic
training health specialists that they need first.
We will make sure with funding that we are focusing on internists and
others with general skills. We will give sites a limited list of types of
health specialists they could ask for rather than leaving it an open item
(Chinese menu example)
i. Because this is a pilot we cannot cover the universe and we
need to jointly determine what the countries are, where it is
viable to partner, and what skills we can support. We will
communicate with posts and then posts will communicate with
partners in the field in their countries, ministers of health, etc…
When potential applicants look at the listings it will follow a PCR format
where options are broken down to location, skills, etc…
For recruitment we expect to have recruitment in coordination with the
Foundation.
Screening
PC has a standard approach to deterring eligibility and suitability, but
in this instance because of the high level of skills required we would
like to task to the Foundation the role of ascertaining the host country
requirements of practicing medicine and the background of applicants.

 14)

i. Foundation would be charged with determining technical,
teaching and academic credentials.
ii. VK-Will there be interviews for these individuals?
1. Would traveling for interviews have to be done on
applicants own dimes?
iii. It would be best if the Foundation could give PC a “short list” of
applicants and then after that there will be the standard PC
screening.
iv. What is the timeline after the “short list” is given over?
1. 2-3 months on PC side
a. That is long period of time for applicants. MarchApril is the deadline for the academic timeline.
2. How long will medical and background checks take?
a. This will be longer than for the standard Response
applicants.
v. PC will be engaging countries in the beginning of December.
vi. BB-What is the academic year in most African countries?
1. It’s country by country, but generally begins
August/September
a. That said, faculty can start at any point, but this
will be more of a problem for recruitment.
vii. We don’t want to stagger starting them too early b/c of the predeparture training courses.
Pre-departure
a. We need to discuss what type of shortened in-country orientation
occurs before volunteers are sent to their sites.
i. We have developed this through PC Response, but the additional
technical training will be new and dependent on what stateside training will be.
1. Language training will also be crucial.
a. We’ve also agreed that the first set of countries will
be Anglophone countries.
b. How to deal with doctors and nurses deploying to the same and
different sites?
i. VK-fan of deploying them in pairs so that they can effect change
throughout the health care system.
1. This could potentially marginalize NEPI to a certain
degree.
2. If we are talking about increasing capacity it really could
be helpful to partner them because it shows how they
work together as a team.
3. VK – thinking of being more doctors heavy at launch
because there are more documented shortages in
teaching facilities on the doctor side than on the nursing
side.

 15)
a.

16)
a.

b.

17)
a.
18)
a.
b.

c.
d.

e.
f.

g.

4. NEPI really believes in this program and wants to support
us and see emphasis on nursing. HVO emphasized the
importance of nurses.
In-country ongoing
Will there be translators available?
i. Teaching in Anglophone countries is already mostly English
based, but for interacting with patients we need to be cognizant
of this.
ii. Changing “O” to “Y”, as in site development.
Loan deferral
Foundation is prepared to offer this to anyone who applies
i. Will this work? …will it present problems with volunteers being
essentially paid, while regular volunteers are not?
ii. We have to be aware if this is loan forgiveness or a stipend
1. Should we call it “loan forgiveness or a family support
stipend”?
Will families be able to go with volunteers if the foundation covers their
expenses?
i. PC might need to discuss this more internally?
1. PC has only ever referenced support regarding
educational debt
a. VK-If a family stipend is taken off we might likely
lose a strong contingent of specialists.
From Director’s office:
Dick would like Malawi on the list; the Director would not like Rwanda.
Country selection
We are sticking with Anglophone countries for the first phase
Dick - Uganda, Tanzania, Malawi, Namibia
i. Ethiopia is a difficult operating environment for us right now and
we’ve recently had a turnover in leadership. The same is true in
Malawi, but that is actually likely to be more helpful going
forward.
Malawi has a teaching hospital we have had a volunteer at, NEPU just
launched there.
VK-Would be interested in keeping Ethiopia there from a health
standpoint because it is an academic consortium with double the
enrollment of medical students, a very committed minister of health.
i. Within next three months the management of Ethiopia is going
to change entirely, so the timing unfortunately is poor.
ii. The PEPFAR environment is challenging.
Zambia is not interested right now. They have been a starting point for
several countries.
Kenya – Right now we have a pretty significant security concern
throughout the entire country, both with terrorism and with the
upcoming presidential elections.
Botswana – compared to other countries we are needed less there.
From a NEPI perspective they are also a bit “wobbly” right now.

 19)

h. Fitz – Uganda MEPI projects are very well managed and have latched
onto the idea of innovative transformation, all 5 medical schools are in
league with one another.
i. Tanzania- country has 5 schools, it is a stable environment with
good leadership
ii. Malawi – 1 medical college, it has one a “link” network award
(although that is very particular), Malawi is the only NEPI country
being mentioned
iii. Zambia-has 3 universities, their NEPI project is aimed to
populate the teaching faculty at two of the schools from the
oldest.
i. VK- interested in MEPI programs but not institutions, it is also important
to find NEPI countries with an academic support network to be
integrated into the mission of the ministry of health.
i. We must also keep in mind that some of this is going to come
down to what the countries say and what they state their needs
as in terms of doctors and nurses.
j. Dick-Puts Botswana as one of the first alternatives in terms of PC
leadership and programmatic focus.
k. Fritz – the link should be more to the school than the country
i. BB- from DPs meeting there is interest in having programs
alongside NEPI and MEPI rather than directly tied to them.
1. Fitz- the only issue there is that we have the ties with the
institution and not the country.
l. BB-for the second year hopefully we can start this conversation far in
advance and include our PC Country Directors, in the mean time we
will want to move further on this by early December
i. VK- the countries and ministries of health need to have a say in
where these volunteers go.
1. Fitz-We want to be careful not to minimize the competition
of ideas as we focus more microscopically on individual
programs and schools.
2. Dick- There is no way we’re going to avoid going through
the ministry of health. That said we can go through more
lightly in particular countries.
m. If we go through these three countries, then the PC CD goes and gets
the sign off from the in-country support institutions.
n. VK – Will the ministry of health be the first point of contact for choosing
what is needed?
i. BB- We need to lay it out soon how we are going to approach
this and approaches might need to vary from country to country.
o. NEPI might be easier to go into because NEPI is done through the
ministry of health in every country; MEPI however really isn’t tied to
the ministries of health.
Announcement Dates
a. Coordinating with the Director and Goosby for a date in January

 20)

21)

22)

b. Location
i. National Press club?
MOU
a. Areas of cooperation
i. There are a few points where the PC has to have final word for
various reasons (i.e. site selection, clearance, etc…)
ii. At a future date we should all schedule a conference call to
figure out what to plug into the MOU.
iii. Jan- what is new to us is that up to date we have not been
service providers. That said, the Foundation and PC
complement one another in what they have and have not done
before.
iv. The MOU stays as the foundation of understanding between two
organizations, which the scope of activities is what is used to
really hash out all of the fine details.
v. BB- what the MOU serves as is really just an agreement of what
the Foundation is going to do and what PC is going to do.
b. Ownership of data and monitoring and evaluating data is important to
bring up as well because the foundation is going to want to publish on
this.
c. We also need to be clear and work together on a logo as we will both
be working on this in conjunction.
i. “Program identity”
Monitoring and Evaluation
a. OGAC has an interest in this
i. We need a separate group to help us look at M&E
1. There also might be a component from the host country
here.
ii. There will be several levels of monitoring and evaluation (the
volunteer’s, the institutions, the Post’s, HQ’s, etc…)
Early next week PC will send out the updated version of the Matrix.