Building Global Health at Michigan Public Health

Center member Sioban Harlow has spent her academic career focused on improving how and how much research is conducted abroad by US academics and how research and healthcare capacities can effectively and equitably be shared.

Harlow is professor emerita at the University of Michigan School of Public, having joined the department of Epidemiology in 1992. At that time, global health—then known as international health—focused resources and training narrowly on family planning and teenage pregnancy, child health and nutrition, and infectious diseases.

Harlow arrived at Michigan Public Health with a new vision for global health. Having participated in a seminal workshop in Mexico, the first ever meeting addressing occupational risks to human reproduction within Mexico (organized by alum Rosa Maria Nunez,’84), and coming to U-M from Mexico’s Institute of Public Health, she was acutely aware of the need to expand the field of international health, increase focus on the etiology of chronic disease and build capacity in epidemiology.

When the school reorganized itself into disciplinary departments in 1995, dissolving the department of Population Planning and International Health, she saw an opportunity. Together with Arnold Monto and the late Steven Meshnick, she brought the international health program into Epidemiology, creating an international health track within the MPH in Epidemiology, the first of its kind in the country.

Monto and Meshnick—and subsequently Mark Wilson—formed the core of the international infectious disease group. Harlow subsequently recruited Amr Soliman, who built a global cancer epidemiology program developing capacity of cancer registries throughout the Middle East and North Africa while providing numerous training opportunities for MPH students funded by the National Cancer Institute.

For several years, Harlow provided leadership both within the department and across the university, spearheading development of training opportunities and promoting research in reproductive, women’s health, and chronic disease epidemiology.

At U-M, Harlow served as associate director of the International Institute (2000-2005), led the Fogarty International Center-funded Institutional Frameworks for Global Health program (2005-2008), and chaired the President’s Advisory Committee on Labor Standards and Human Rights (2003-2005, 2008-2012). In each of these roles she worked to develop on-going institutional support for international internships for undergraduate, master’s, and doctoral students as well as pilot funding programs for new faculty initiatives in global health research. The funding structures she developed not only continued but served as models for expanding such programs throughout the university.

Numerous epidemiology MPH student internships were funded through these programs and have led to impactful careers in global reproductive health. Internationally, Harlow was a member of the Scientific and Technical Advisory Group, Division of Reproductive Health Research, World Health Organization 2003-2009) and of the Scientific Steering Group, Choices and Challenges in Childbirth Research, School of Public Health, American University of Beirut.

Harlow's global research focused on the impact of global trade and export production on women’s and children’s health. In 1999, she was awarded a National Institutes of Health/Fogarty International Center research training grant. Over seven years, in collaboration with Dr. Catalina Denman of El Colegio de Sonora, Harlow co-founded the Programa de Formación de Investigadores en Salud Reproductiva to foster the development of human resources in reproductive health research in northern Mexico, providing local research training, support for the first two PhDs in epidemiology awarded to residents of Sonora, Mexico, and numerous opportunities for MPH and PhD students at the University of Michigan.

Since the early 1990s, building national health research competency and infrastructure in low- and middle-income countries (LMICs) capable of generating national health data and promoting research on local health issues has been recognized as critical to developing evidence-based national health programs and ensuring global health equity. This goal represented a challenge for research institutions such as the University of Michigan as it required adapting a more inclusive vision and a major shift toward partnership in—rather than leadership of—health research in LMICs.

Faculty at the School of Public Health and the Medical School made an early commitment to health research capacity development, securing Fogarty International Center Research Training Grants in infectious disease (Meshnick/Wilson, Malawi), maternal child health (Harlow, Mexico), environmental and occupational health (Robbins, South Africa), and substance abuse (Zucker, Poland) in the 1990s. These early engagements focused on building sustained research partnerships, providing doctoral and postdoctoral training opportunities for in-country collaborators, and developing research programs that met local needs—approaches that are central to Harlow's vision and continue to characterize the university's global health engagements.

Profoundly aware of the central role women’s labor played in economic development, she has long pushed for greater attention to the impact of work in export production on women’s health. Another area in which she was an early champion is gender-based violence (GBV). Harlow now works in GBV and research capacity building in the Democratic Republic of the Congo, where she was a Fulbright Scholar in 2017-2018 at the International Center for Advanced Research and Training in Bukavu.

When Denis Mukwege was awarded the Wallenberg Medal in 2010, the University of Michigan was well positioned to assist Panzi Hospital and his colleagues at the Evangelical University in Africa to build local health research capacity. In a collaboration led at U-M by Janis Miller from the School of Nursing, the International Center for Advanced Research and Training (ICART) was established in Bukavu in 2013 with funding from U-M’s Global Challenges for a Third Century Program.

In 2019, the UEA established the Denis Mukwege Center of Excellence (CEDM) to institutionalize and further the work begun at ICART.

Now professor emerita, Harlow continues to mentor former ICART trainees and Congolese researchers.