On Nov. 18, UM alumni, partners, faculty members, students and friends of the college will celebrate the 140th anniversary at a gala at the RBC Convention Centre. The event will raise funds for MD and grad student bursaries.

While the medical college has educated generations of physicians and served the community, it has also been a thriving centre for the advancement of medical science.

“We’re known for punching above our weight in terms of our research achievements,” says Peter Nickerson [B.Sc.(Med.)/86, MD/86], vice-provost (health sciences) and dean of the Max Rady College of Medicine and the Rady Faculty of Health Sciences.

“Each year, the college brings in more than $100 million in external research funding. Our investigators, including master’s and PhD students, conduct multidisciplinary research that influences health policy, improves patient care and saves lives.”

From innovative disease research carried out in labs and at hospital bedsides, to studies that give a voice to under-represented patient groups, to findings gleaned from one of the world’s richest storehouses of health data – the Manitoba Population Research Data Repository – the Max Rady College of Medicine is constantly generating new knowledge.

“Our strengths include being exceptionally collaborative, forging effective external partnerships and reaping the benefits of intergenerational chains of research mentors and mentees,” says Nickerson, a kidney specialist who is himself a distinguished research scientist.

In addition to the acclaimed faculty members and alumni who are laureates of the Canadian Medical Hall of Fame – we’re spotlighting them in a list on Nov. 16 – here are 10 Max Rady College of Medicine research highlights that have made an indelible impact.

Dr. Lorrie Kirshenbaum

• In 1948, a cardiologist convinced nearly 4,000 air force veterans to enrol in a study of their cardiovascular health. The extraordinary project, based at UM and known as the Manitoba Follow-up Study, is one of the world’s longest-running health studies of a specific cohort. One of its findings in the 1990s was that shorter men are at greater risk of dying of heart disease than taller men. The study, now led by Robert Tate [M.Sc./75, PhD/00] and marking 75 years, is still tracking a handful of surviving participants. Meanwhile, UM scientists like Lorrie Kirshenbaum [B.Sc./86, M.Sc./88, PhD/92], Canada Research Chair in molecular cardiology, are engaged in leading-edge cardiovascular research. Kirshenbaum has earned international recognition for his work on cardiac cell death and its impact on the development of heart failure.

Dr. Edward (Ted) Lyons

• In the mid-1960s, UM radiologist Edward (Ted) Lyons [B.Sc./63, B.Sc.(Med.)/68, MD/68] became one of the earliest pioneers of ultrasound. His groundbreaking research helped to establish ultrasound as safe for fetuses and mothers, and his findings influenced hospitals across the globe to adopt the technology. Lyons led the first lab in Canada to perform general ultrasound. For years, he worked with manufacturers to evolve the technology from a machine the size of a refrigerator to a portable device no larger than a cellphone. He has called himself “a traveller on a stream of new imaging technology.”

Dr. Stephen Moses

• Frank Plummer [MD/76], who passed away in 2020, was a key member of a multigenerational chain of researchers who have worked for more than 40 years in partnership with the University of Nairobi, making high-impact discoveries in the area of sexually transmitted infections. In the late 1980s, Plummer led a UM team in discovering that some Kenyan women sex workers who had been exposed to HIV infection were naturally immune to it. This breakthrough provided vital new information for HIV vaccine and drug development. In 2007, UM’s Dr. Stephen Moses co-led a study showing that circumcision reduced the risk of HIV infection by 50 to 60 per cent in men who had heterosexual sex. This insight was named one of the biggest medical breakthroughs of the year by Time magazine.

Dr. Heather Dean

• In the late 1980s, when Type 2 diabetes was considered an adult-only disease, UM pediatric endocrinologist Dr. Heather Dean and her colleagues made the startling discovery that some First Nations children in Manitoba and northwestern Ontario had the disease. They published the first paper about these children in 1992. Dean went on to work closely with First Nations communities to better understand the disease. Today, UM researchers continue to study many aspects of youth-onset Type 2 diabetes, including following a cohort of offspring of First Nations individuals who were first diagnosed as children.

Dr. Ryan Zarychanski (Photo: Doctors Manitoba)

• In 2012, a breakthrough by UM and CancerCare Manitoba scientists made the cover of Blood, the world’s top medical journal on blood disorders. The study, led by Dr. Ryan Zarychanski [B.Sc./95, B.Sc.(Med.)/00], identified the genetic mutation responsible for the hereditary blood disorder xerocytosis. Groundwork for this discovery had been laid 40 years earlier by UM hematologist Lyonel Israels [MD/49, M.Sc./50], founding father of CancerCare Manitoba. Zarychanski now holds the Lyonel G. Israels Research Chair in Hematology. This year, he was named Physician of the Year by Doctors Manitoba for leading international clinical research to rapidly assess potential treatments for COVID-19.

Dr. Gary Kobinger

Dr. Jason Kindrachuk

• During the Ebola outbreak in West Africa, UM’s Dr. Gary Kobinger was chief of special pathogens at the Public Health Agency of Canada (PHAC) National Microbiology Laboratory in Winnipeg. His team of UM and PHAC researchers co-developed an experimental antibody cocktail called ZMapp. In 2014, it was used in saving the life of an American doctor with Ebola – a dramatic event that made international headlines. Today, Dr. Jason Kindrachuk, Canada Research Chair in the molecular pathogenesis of emerging viruses, is keeping UM on the map as a virus centre through his work on viruses such as Ebola, mpox and coronaviruses.

Dr. Marcia Anderson

• UM is a national leader in partnering with Indigenous communities in health research. In 2019, for example, a landmark joint study by the First Nations Health and Social Secretariat of Manitoba and the Manitoba Centre for Health Policy in the Max Rady College of Medicine illuminated the worsening health gap between First Nation people and all other Manitobans. This year, UM’s Marcia Anderson [MD/02] took a leadership role in making Manitoba the first province to systematically ask hospital patients to voluntarily declare their race, ethnicity or Indigenous identity. The purpose of collecting this data is to address racial inequities in health care.

Dr. James Blanchard

• In 2022, health research and programming in India led by James Blanchard [B.Sc.(Med.)/86, MD/86], executive director of the UM Institute for Global Public Health, received a major injection of support from the Bill & Melinda Gates Foundation. The funding of US$87 million will support reproductive, maternal, newborn and child health in the state of Uttar Pradesh. In total, the Bill & Melinda Gates Foundation has invested US$280 million in international UM projects. The Institute for Global Public Health has been a world leader in forming partnerships to strengthen health systems and influence health policy, particularly in countries in Asia and Africa, says Blanchard, who holds a Canada Research Chair in epidemiology and global public health.

Dr. Ruth Ann Marrie

• An internationally renowned multiple sclerosis (MS) researcher at UM, neurologist Dr. Ruth Ann Marrie, directs the MS Clinic at Health Sciences Centre. This year, Marrie received a prestigious U.S. prize for her trailblazing body of work. She and her team were the first to explore the implications of comorbidities such as high blood pressure and heart disease in people with MS. She has also shown that the disease may have a “prodromal phase” that precedes the onset of specific MS symptoms. Her ongoing research is laying important groundwork for both prevention and improved treatment of MS.

Dr. Meghan Azad

• Meghan Azad [PhD/10] is a worldwide expert on the science of breast milk. She holds a Canada Research Chair in developmental origins of chronic disease at UM and is also a researcher with the Children’s Hospital Research Institute of Manitoba. This year, she and her team landed a grant of US$2.5 million from a prestigious U.S. funder, the National Institutes of Health. The project will include in-depth lab analyses of milk samples from 1,600 mother-child pairs, looking at breast milk in a way that is unique in the world. The data will then go to machine-learning experts at Stanford University, who will use artificial intelligence to explore it. The study is expected to generate the world’s largest and most detailed dataset of mothers, infants and breast milk.

And the University of Manitoba is there.

Dr. Marissa Becker [MD/99] is an associate professor in the department of community health sciences and the department of medical microbiology and infectious diseases within the Rady Faculty of Health Sciences. She is also director of technical collaboration for the Institute for Global Public Health (IGPH).

In Delhi, her role with IGPH supports UM projects in India.

Dr. Marissa Becker

UM has been working in India since the early 2000s, beginning with work on HIV prevention and care led by Drs. James Blanchard and Stephen Moses. Since then, the work has expanded to maternal and child health, nutrition, family planning, and health systems strengthening, as well as work on infectious disease surveillance and tuberculosis.

Becker notes: “We currently work in Delhi, Madhya Pradesh, Karnataka, and Uttar Pradesh. Our biggest program is in Uttar Pradesh in partnership with India Health Action Trust, where we work with the local government to run a Technical Support Unit (TSU) on maternal and child health. We support the government in achieving its health goals in the areas of maternal, newborn and child health, nutrition, family planning and health system strengthening.”

The UM TSU team, funded by the Bill and Melinda Gates Foundation, is large, with about 1,200 people, mostly local residents, providing technical support for programs at the state level and local community level. They work with frontline workers, health care providers, health systems, data, and they design and implement surveys.

Becker explains: “The TSU team is headed by Dr. Vasanth Kumar who has an appointment with UM community health sciences, as do many of our senior core team members from India.

In addition to the team in India, we have a number of UM faculty who support the work, including Drs. Stephen Moses, Maryanne Crockett, Rob Lorway, Shiva Halli, Lisa Avery, Ties Boerma, and BM Ramesh. Dr. James Blanchard is lead of the TSU team in Uttar Pradesh. A number of our postdoctoral students and other graduate students are also engaged.”

When the pandemic hit India a year ago, UM researchers were asked by the government of Uttar Pradesh to help provide support in dealing with the pandemic. They created and implemented a multi-pronged strategy using data for decision making and helped establish a very comprehensive COVID-19 surveillance system for the state. In addition, they provided training and support to front line workers in the community around prevention measures and community surveillance. Further, they supported forecasting for strategic planning of equipment and supplies and helped in conducting COVID seroprevalence studies.

With the tidal wave of COVID cases today, the UM team is working with the government to help address the very serious and very dire oxygen shortages.

Becker says: “The situation here is very difficult- and the health system in many areas across the country is overwhelmed- the impact is immense. The health care facilities are full and many have insufficient equipment and supplies. Families are really struggling. On top of their trying to cope with loved ones that are sick, many are incurring significant financial costs — catastrophic out of pocket expenses.”

She explains that the vaccination program in India started out strong but unfortunately the total proportion of the population immunized was still very low when this latest wave hit.

“I fear that the country will have a difficult time in catching up quickly enough to address this current wave,” she says. “In the meantime, other prevention measures have been put back in place with lockdowns in many states across the country. We are also now seeing many countries step up with support now, but I’m worried about the shift to more cases in the rural areas and also to neighbouring countries in the region in which we are seeing increases in cases — and these countries are also facing shortages of vaccines.”

Becker admits that the pandemic is affecting her personally to some extent.

“Many of our team members and their families have been affected,” she says sadly. “Many friends and colleagues are trying desperately to help their loved ones find a bed, find medicines, to provide care to them. You can hear people’s frustrations, grief and exhaustion when you speak with them.”

Becker believes that the UM community should be proud of the UM response in India. “Not only has our team played an active role in addressing the pandemic, but it has also tried to help the state of Uttar Pradesh ensure that many of the consequences of the pandemic, such as interrupted health care services, have been mitigated. We have worked very hard to ensure the quick and safe return of full services for ensuring maternal and child health.”

Finally, Becker appeals to all of us in taking the situation seriously.

“Sitting here in Delhi now, I want to convey that this is a global emergency and we need to treat it as such — with upmost speed in rolling out vaccination programs, and ensure access to all- within our own country, but also globally,” she explains. “We must learn from this pandemic in effort to prevent and better address future epidemics, and mitigate their very significant consequences, including the tremendous health,  social and financial impacts.”

She adds: “As academics, we need to keep making sure we are using science and appropriate data to inform our response to the pandemic. It’s so critical right now. I think our projects here demonstrate the use of data for decision making.”

“India has been trying hard to address the pandemic, but the public health system is not as well equipped as it needs to be,” says Dr. Marissa Becker, an infectious disease specialist and associate professor of community health sciences, internal medicine and medical microbiology.

Becker, a UM alumna in medicine, works for the UM Centre for Global Public Health (CGPH), which is part of the Rady Faculty of Health Sciences. She, her husband and their two sons have lived in India for the past two years.

On March 23, with just five hours’ notice to pack up and catch a departing flight, they followed the Canadian government’s advice to return to Manitoba. India is now under a nationwide lockdown to limit the spread of the coronavirus.

Becker is now in post-travel self-isolation at a family member’s house in Winnipeg. She is determined to do as much as she can to keep supporting India’s pandemic fight via email, phone and videoconference.

“I had very mixed emotions about leaving,” she says. “I hope to get back as soon as I can. We’re all in this together.”

The state of Uttar Pradesh in northern India has a population of roughly 223 million. The University of Manitoba leads the Uttar Pradesh Technical Support Unit, funded by the Bill & Melinda Gates Foundation.

The unit, established in 2013, employs about 1,200 people. It works in partnership with the India Health Action Trust to support the Uttar Pradesh government in strengthening maternal and child health, nutrition and family planning.

A number of faculty members from the CGPH, including Dr. James Blanchard, director of the CGPH, and Dr. Stephen Moses, associate director, travel regularly to Uttar Pradesh. All have left India for the time being.

In light of the pandemic crisis, Becker says, the Technical Support Unit has responded to the Uttar Pradesh government’s request for help with urgent priorities such as assessing medical supplies and health facility preparedness, creating a state-wide command centre and setting up a call centre. 

“We’re applying our health-system expertise to analyzing data on things like the supply of hospital beds, ventilators and personal protective equipment for health-care providers,” Becker says.

“We’re developing a phone line similar to the Health Links line in Manitoba, where people can call with questions related to COVID. A key concern is making sure people in the rural and remote areas can access the call centre and get information in a timely manner.”    

The unit is also producing guidelines for health-care facilities on procedures such as infection control and managing patients with COVID-19.    

The professor has high praise for the Technical Support Unit team and health workers on the ground in Uttar Pradesh. She herself is based in Delhi, a city of more than 20 million people.

She works in a six-person office that supports all the health projects in India in which UM is involved, including HIV units in Delhi and the state of Karnataka, and a new unit to support public health in the state of Madhya Pradesh.

Becker hopes to play a part in Manitoba’s pandemic-fighting effort as soon as she’s out of isolation. Meanwhile, her thoughts are with her friends and colleagues in locked-down India. The country’s dense population, widespread poverty and inequitable access to health care pose daunting challenges during the pandemic and lockdown, she says.       

“I think of all the people who are daily wage labourers, not being able to go to work and buy food,” she says. “Crises like this always hit the most vulnerable the hardest.

“Ever since the U of M started to partner in improving public health programs in India nearly 20 years ago, reaching those who are most vulnerable has been one of our core principles.”

Living in this impoverished resettlement colony are groups of people who come from other cities, a large number hailing from Bangladesh or its surrounding borders. They earn a living by gathering bits of cloth; some gather plastic bottles and bags to repurpose into other items — a bit like an up-cycling system, explains Blanchard, director of the Centre for Global Public Health (CGPH) in the Faculty of Health Sciences.

James Blanchard, director of the Centre for Global Public Health (CGPH) in the Faculty of Health Sciences.

“In these villages you have women who are trying to have healthy lives and healthy babies, but quite often are facing various barriers in terms of accessing care, [barriers that] can vary from knowledge to finances or gender roles and lack of power in making decisions related to their own health,” says Blanchard, who is also a professor in the departments of community health sciences and medical microbiology and a Canada Research Chair in Epidemiology and Global Public Health.

In June, the CGPH announced it had received funding from the Bill & Melinda Gates Foundation to establish a Technical Support Unit (TSU) led by a team of global public health experts from the university’s College of Medicine. Blanchard is principal investigator on the project, which includes co-principal investigators: Lisa Avery, an assistant professor in the departments of community health sciences, obstetrics, gynecology & reproductive sciences, and medical microbiology; Maryanne Crockett, an associate professor, in the departments of pediatrics & child health and medical microbiology; and Stephen Moses, a professor in the departments of medical microbiology and community health sciences, where he also serves as head of the department.

Local women, children and goats in Gudur, India

Through the five-year $21.1-million project called “Technical assistance to the Government of Uttar Pradesh to improve health, nutrition and development coverage and outcomes,” the TSU’s goal is to support the government and to increase the efficiency, effectiveness and equity of the delivery of key reproductive, maternal, new born and child health services and outcomes.

At 210 million, Uttar Pradesh is the country’s most populous state: close to 78 per cent live in rural areas across nearly 100,000 villages. According to the Census of India’s 2012-13 Annual Health Survey, it also continues to report the highest maternal mortality ratio, of 258 per 100,000 live births, and an infant mortality rate of 72 deaths per 1,000 live births.

“The reason we were selected, we believe, and we’ve been told by the Gates Foundation, is because we have the capacity, capability and track-record of incorporating learning and data into the development and design of programs,” explains Blanchard. “The ‘program science’ approach [a newly evolving approach to prevention science] is really a unique thing for the U of M.”

One facet of program science is incorporating research into the development and implementation of evidence-based interventions. This approach also provides information on how interventions can be adapted to specific situations or communities.

Avery focuses her research on inequities in health care access and outcomes, particularly the determinants of health and their impact on sexual and reproductive health (including maternal, neonatal and child health) of low and middle income societies.

Lisa Avery and Maryanne Crockett. Photo by Daniel Gwozdz

“The old way of doing things were you would get funding, you would do a program and you would try to get the government to be involved, or like what you’ve done, and roll it into something,” she says. “We’ve found through experience, especially our previous India projects, by directly linking to and partnering with the government from the start, they became involved with all decision-making steps from the beginning and it was much easier to take something to scale and make it sustainable.”

Avery adds that in order to enable sustainable change, experts are embedded in the government system to provide technical support. “Our innovation is working at the community, health facility, and policy-making level, with data, monitoring and evaluation at each tier.”

At the outset of the project, the TSU completed a rapid assessment of the potential critical needs or gaps. With this particular project, this involved mapping health care facilities and services and qualitative research within the community in order to fully understand the issues and impact on utilization or behaviors at the community level, Avery explains.

One approach is to utilize frontline health workers, such as India’s accredited social health activists (ASHAs). Instituted by the Government of India’s Ministry of Health and Family Welfare as part of the National Rural Health Mission, these women are trained to act as health educators and promoters within their communities.

“They have learned to track women and their children across the continuum of care in a continuous manner. We use that information to micro-plan,” says Avery. “They are then able to actually identify who potentially isn’t accessing care or … not getting appropriate nutritional services. The ASHA then puts that all together to try and problem solve with the woman and the community.”

The ASHAs relay back issues related to social, cultural, gender and resource constraints. Once the TSU establishes the constraints within a specific village, they work with the frontline workers towards finding solutions.

Mother and child in a village of India.

“That’s our mandate. We want to be able to give them the tools on how to problem-solve around the issues that are facing them as individuals or as a community,” Avery explains. “We know that communities often have their own solutions, but having them come together and brainstorm informs our programs. We incorporate the issues they are problem-solving around and the solutions they come up with into broad program content.”

Avery says she sees similarities to her clinical and program work in Winnipeg. “It isn’t just women overseas who potentially lack power or who have limited education. Sometimes some of the work we’re actually doing overseas is based on learning from here.”

She thinks people often forget that in Canada, especially in Manitoba, there are a large number of vulnerable, marginalized populations living in remote communities, similar to the ones in Uttar Pradesh.

“We’ve developed innovation models to try and better serve the health-care needs of Manitoba,” says Avery, pointing to the College of Medicine’s J.A. Hildes Northern Medical Unit, which provides medical services for northern and remote residents who are temporarily in Winnipeg, and helps to train medical residents to become family physicians who will work in northern and remote locations.

“I think that’s actually influenced a lot of the type of thinking we do with our global health programs and vice-versa. Many of these issues are far reaching and impact all of us in some way or another. The world is a small place; what happens locally also impacts things globally and the other way around.”

Avery hopes that by the end of the five-year funding, the TSU has worked itself out of a job and that the women and children in Utter Pradesh will be doing much better than they are today.

Blanchard visited the ragpickers colony just days before he got on a plane back to Winnipeg to speak at the formal Gates Foundation funding announcement. Looking back, he remembers thinking, as he stood in the impoverished community: “It was really something, the fact that this project, which at one level is an academic institution in Winnipeg, Canada, is able to actually project its skills. Our experts in obstetrics, gynecology, and our trainees — we’re able to basically take the resources, experience and expertise that we have and develop programs.

“It really struck me that a project like this really does have an impact within the village, within these homes.”

Story originally appeared in the Winter 2015 issue of Research Life.

Dear Colleagues:

As part of the University of Manitoba’s Academic Structure Initiative (ASI), Senate approved in principle and recommended to the Board of Governors the merger of the Department of Family Social Sciences (FSS), Faculty of Human Ecology, and the Department of Community Health Sciences (CHS), Faculty of Health Sciences.  On June 24, 2014, the Board of Governors approved this recommendation.  As such I am writing to inform you that a FSS/CHS committee, co-chaired by Dr. Stephen Moses, Head, CHS, and Dr. Caroline Piotrowski, Head, FSS, has been struck to guide the implementation process to bring together these departments and the transfer of the associated undergraduate programs of the Faculty of Human Ecology to the Faculty of Health Sciences.  The committee will make reports and recommendations to the Faculty of Health Sciences Implementation Steering Committee.

By bringing together the Departments of FSS and CHS, the University of Manitoba strengthens its leadership role in teaching, research and outreach in family and population health research and education. The joining of these two departments will strengthen and enhance their respective missions, creating an innovative and unique emphasis on family and population health.

It is anticipated that undergraduate students in the Faculty of Human Ecology FSS programs will transition to the Faculty of Health Sciences for the Fall 2015 academic term.  There will be no changes to these academic programs at this time, and proposals for future changes to these or other academic programs in the Faculty of Human Ecology will follow the standard institutional processes already in place and will require the appropriate Senate and/or Board approvals.

It is proposed that the academic and support staff from the Department of FSS will transition to the Department of CHS in the Faculty of Health Sciences with full rights and responsibilities by July 1, 2015.  Processes to support interim appointments within both departments until July 1, 2015 are being reviewed by the committee.

For continued information, please monitor the Academic Structure Initiative webpage or UM Today.

Sincerely,
Joanne C. Keselman, PhD
Vice-President (Academic) and Provost