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Spring/Summer 2010

Big Step in the Middle East

Wilmer agreement could speed breakthroughs in blinding eye diseases.

By: Dean and CEO Edward D. Miller MD
Date: May 15, 2010

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Back when Colin Powell served as secretary of state under President George W. Bush, I wrote to him suggesting the United States might achieve more in the Middle East if the U.S. focused on showing what Americans can do for people instead of flexing its military might. Powell responded that this was a great idea. His encouragement was one reason Hopkins Medicine signed a 10-year contract in 2006 to manage hospitals in Abu Dhabi for the United Arab Emirates.

Now we’ve taken the next step—a five-year renewable agreement with Saudi Arabia’s King Khaled Eye Specialist Hospital (KKESH)—the region’s largest, best-equipped and best-financed ophthalmology facility. This is a terrific opportunity for Hopkins to elevate standards of science and health care in the Saudi kingdom and accelerate the Wilmer Eye Institute’s efforts to cure blinding eye diseases.

We’re honored the Saudi government approached us after observing our success in Abu Dhabi, where we’ve improved medical services, staff training, and patient safety at the three hospitals we manage.

In Riyadh, Wilmer will collaborate with 50 board-certified physicians on research, education, and patient care. Ashley Behrens, who has developed novel therapeutic approaches while at Wilmer, will serve as KKESH’s medical director. He’ll be working at a high-volume hospital—100,000 outpatient visits, 26,000 Emergency Department visits, and 10,600 surgical procedures a year. Wilmer faculty will share best practices, design clinical trials, and help train the next generation of Mideast leaders in eye care.

The goal is to combine Hopkins’ medical knowledge and KKESH’s huge volume of eye patients to fast-forward our research. As an example, over 26 percent of the Saudi population suffers from diabetes; diabetic retinopathy has reached epidemic proportions.

For Neal Bressler, chief of Wilmer’s Retina Division, the KKESH agreement opens exciting joint research possibilities. Neil currently chairs the government-sponsored Diabetic Retinopathy Clinical Research Network from Johns Hopkins University, overseeing 108 clinical sites to get meaningful patient numbers for research into diabetic retinopathy; the addition of KKESH instantly provides an opportunity to greatly increase the number of patients who can participate in these trials sponsored by the National Institutes of Health.

Since we created Johns Hopkins Medicine International (JHI) in 1999, we’ve made great strides in delivering “knowledge to the world.” Today, JHI is setting the standard of medical excellence in a variety of countries, with joint ownership and management of an oncology unit in Singapore; hospital management contracts in the UAE and Panama; clinical affiliations in Turkey, Chile, Lebanon, and Japan; and strategic academic and clinical collaborations in Italy, Mexico, Canada, and Trinidad and Tobago.

We’ve always welcomed international patients to our East Baltimore campus, and these visitors remain important. But in today’s increasingly interconnected world, Hopkins must build a bigger presence.

Benefits flowing from international ventures, such as the KKESH agreement, are substantial. Overseas income supports East Baltimore academic and research activities. Medical staff, house officers, and administrators gain exposure to medical practice through the filter of another culture and the international experience necessary to take their careers to the next level. The Hopkins community can use more of its enormous intellectual capital to help transform entire health care systems. International projects provide us with fresh perspectives and new learning experiences, which is good for all of us.

Johns Hopkins may be the best-known academic medical center in the international market but we’re selective in sorting through the offers we constantly receive. We want the right partners in developing nations who are serious about lifting their health care delivery standards. JHI will not take on these challenges unless we feel certain Hopkins can bring value to that nation’s peoples—and to our own institution.

Evaluation standards are rigorous. We will not stretch our resources or talent pool too thin. First, we send in a project team, which prepares a detailed analysis. We’ve discovered, though, that the team often gets too invested in gaining approval for the project. So we assemble a second group to evaluate everything anew. What are the risks? How might this affect Hopkins’ reputation? What are the legal implications?

Hard questions must be answered: Does the project fit our tripartite mission? Do we have the right people to run things? Is the payoff—financially and medically—big enough? What pitfalls have we missed?

Only after two years of due diligence did we sign off on the KKESH agreement. The potential benefits more than outweighed the risks.

I’m proud of Johns Hopkins Medicine International’s progress in the past decade under the leadership of Steve Thompson and now Harris Benny. We have assembled a talented and culturally diverse staff. It is due to their efforts that JHI is growing our medical presence and making a difference globally.

—Dean/CEO Edward D. Miller, MD

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