CORRESPONDENCE: LETTERS TO THE EDITOR
International Outreach Programs Are Laudable and Timely
William O. Ntim, MB, ChB, FACC, FACP*,
Tiyoko Johnson, RN, BSN, RDCS,
David L. Mount, PsyD, MA, HSP-P and
B. Waine Kong, PhD, JD
* Section on Cardiology, Maya Angelou Research Center on Minority Health, Wake Forest University School of Medicine, Bowman Gray Campus, Medical Center Boulevard, Winston-Salem, North Carolina 27157-1045 (Email: wntim{at}wfubmc.edu).
We read with interest the commentary by Weaver (1) on the planned international outreach programs by the American College of Cardiology (ACC). This laudable initiative is timely given the epidemiologic transition from infectious to cardiovascular diseases in developing countries, especially sub-Saharan Africa (2).
The proposed partnership did not include grassroots organizations with established collaborations in these medically underserved international communities. In December 2007, the U.S.-based Association of Black Cardiologists, partnering with the government of Ghana and Ghana medical schools, organized a successful international conference in Ghana (3). This forum provided a healthy exchange of ideas among cardiovascular specialists in the Americas and Ghana. It also demonstrated the political will among emerging economies in sub-Saharan Africa to tackle the rising tide of cardiovascular diseases.
Although several strategic points were highlighted in the article by Weaver (1), partnership formation is not simple, as mission planning is frequently hampered by low buy-in from the international community precipitated by historical challenges displaced on developing countries by the more resourced Western society. Without multicultural competency training, acts of good faith from resourced partnership brokers are likely to be oppressed. That could sabotage the social efforts wisely authored by Weaver (1). At this point, we offer additional recommendations to support the ACC's planning process.
First, our experiences on health care disparity have confirmed the need for critical dialogues on global possibilities in cardiovascular medicine given the multilevel determinants of cardiovascular disparities and health inequities (4). Second, the participation in social change in global cardiovascular outreach will benefit from the involvement of complementary social science disciplines (4) to mobilize the heavy lifting in front of this noble effort. Third, by employing a multidisciplinary advocacy model, mutually beneficial enterprises can be appropriately vetted.
Taken together, participation in this movement to facilitate international awareness in cardiovascular medicine will require access mapping and talent engagement supporting transnational cultural competency training, which is a first-tier priority. That said, there exist the critical needs for transparent agendas and policy accountability that collectively excite opportunities for capacity building well into the 21st century.
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Footnotes
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Please note: Dr. Ntim is a member of the Novartis Speakers' Bureau.
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References
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1. Weaver DW. President's page: the continuing importance of international engagement J Am Coll Cardiol 2008;51:2193-2194.[Free Full Text]2. Opie LH, Mayosi BM. Cardiovascular disease in sub-Saharan Africa Circulation 2005;112:3536-3540.[Free Full Text] 3. Kong BW, Ntim W. Preventive cardiology in special patient populations—twelve days in Ghana Cardiol Rev 2008;25:47-48. 4. Leon DA, Walt G, Gilson L. Recent advances: international perspectives on health inequalities and policy BMJ 2001;322:591-594.[Free Full Text]
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