University of Washington School of Public Health
Global Health Week: 'Innovation Happens When You See What’s Not Working'
Despite overall great public health progress globally, there are huge challenges ahead. Joseph Babigumira knows the magnitude of the tasks from hard experience. As a Ugandan physician doing HIV work in Uganda for his Master's degree, Babigumira learned that his driver's sister had gone into septic shock. An unsafe, illegal abortion was to blame. Four days later, the driver's sister was dead.
Babigumira attended the funeral services and began to ponder the health and economic impacts of unsafe and usually unsanitary abortions. "I was thinking, 'Why did this happen?'" he said. Uganda has one of the world's highest rates of maternal mortality.
The subject later became the basis for his dissertation at the University of Washington, where he is now an assistant professor in the Department of Global Health.
Babigumira focused on the economics of unsafe abortions and found they have a substantial negative impact on the country's economy. Women who have unsafe abortions often become infected and some die. Others have to incur high health-care costs from ongoing infections and injuries, and many miss work or school.
"One solution is to make it safe, mainstream, like in the West," Babigumira said of abortion. "But that really isn't a policy option. Uganda is a religious country and predominantly Catholic. Abortion is illegal and subject to substantial stigma. On the legislative horizon, no one is going to legalize it soon. The mass public sentiment is against it."
Babigumira knows he's got a better shot at getting policy makers to improve access to modern contraception. At the moment, access in general is about 30 percent, he said.
"The next best policy option is increasing access to modern contraception," said Babigumira, who also is adjunct assistant professor in pharmacy. "That's a great buy, not only for reducing abortion but also improving other maternal and child health outcomes."
His study, co-authored by Andy Stergachis, Professor of Epidemiology and Global Health, and Adjunct Professor of Health Services, and by Louis Garrison, Professor, School of Pharmacy, and Adjunct Professor, Global Health and Health Services, was recently published, along with a separate study on the potential cost-effectiveness of a hypothetical program to provide universal access to contraception in Uganda. Babigumira's other ongoing work includes a health technology assessment in poor countries, the economics of drug safety and looking at incentives for getting more people tested for HIV.
"It's not going as well as everyone had hoped," he said. "We are probably losing the HIV/AIDS fight. One reason is that most people don't know that they have the disease. If more people know their HIV status, there is a better chance for success of prevention and care programs."
Babigumira says Seattle is a great place to be based for global health work because of the Gates Foundation, PATH and other organizations. However, he spends about one-third of his time overseas. "Global health is really about being in the field. Innovation happens when you can see what's going on and what's working and what's not working. When you come back to Seattle, all these lights go off and you have new ideas."