At Sparkman Center for Global Health, Alonge is focusing on “what works and why”

Across the planet, public health has made remarkable progress over the past 100 years, eradicating smallpox and polio across continents, lowering blood lead levels, bringing safe water to billions, and much more.

But around the world, in both low- and middle-income countries, and in regions of the United States alike, stubborn gaps remain. “Globally, we have made a lot of progress in improving maternal health and the health of children; but making that improvement has been very difficult in a number of places,” said Olakunle Alonge, M.D., Ph.D., who joined UAB from Johns Hopkins University in 2023 as the new director of the Sparkman Center for Global Health.

Creating a hub for implementation science work

Alonge, an expert in the young field of implementation science, is principal investigator for two major Gates Foundation-funded projects and was recently appointed to the board of directors of the Consortium of Universities for Global Health. He has studied a number of issues, from child injuries and health care financing to an effort to learn lessons from the successful eradication of polio from all but a small pocket of the planet. “Implementation science is all about trying to understand why and how we can implement interventions more effectively,” Alonge said. “In public health, we are always thinking about solutions and interventions, but not about studying the implementation. Implementation science has remarkably effective tools for unpacking the complexity and how it shapes outcomes.”

At UAB, Alonge is building on the legacy of the Sparkman Center to create a hub for implementation science work that is resolutely focused on meeting the “last mile” problem in public health in global health settings — how to get solutions to the people who need them most.

“The Sparkman Center is one of a kind — established by an act of Congress in 1979 to collaborate with institutions abroad in implementing graduate-level educational and training programs in public health,” Alonge said. As such, it has a network of alumni around the world who are open to partnerships and collaboration. “We hope to use the center to be a place to convene faculty to work on specific implementation challenges and leverage our access to different partners to go beyond UAB and facilitate with different countries,” Alonge said. “It has been very successful in education, and over the years that morphed into more of a focus on research. Now is the time to focus on solutions. That does not mean we will stop doing research on defining the problems; but where solutions have already been identified, that is where we will expand our efforts.”

Sparkman Summer Institute

This summer, Alonge is launching the first major piece of that effort: the Sparkman Center for Global Health Summer Institute. The intensive, one-week course, which will run from July 18-24, 2024 (with a break on Saturday and Sunday), is focused on training practitioners in implementation research principles, with a particular focus on addressing health inequities in global health research and practice.

Although implementation science has coalesced since about 2010, Alonge says, only in the past two or three years has there been increased interest in using implementation science to address health inequity.

“We now have these tools to think about traditional issues in non-traditional ways,” Alonge said. “We have not been bold to confront these issues because we did not know how to study them; what implementation science is doing is giving us methods to unpack those areas and do it in a way that is reproducible and rigorous and valid so that it is like any other kind of research.”

In one ongoing project, funded by the Gates Foundation, Alonge is gathering lessons from the successful global campaign against polio. “How can we translate this knowledge to other lifesaving programs?” Alonge said. “There has been significant investment in research and innovation across the world, and some of these are fundamental public health assets. The polio assets in some countries essentially are the health system in that country. This project is asking, ‘What can we learn from polio eradication with respect to how to program things, strategize for engaging communication in communities for immunization campaigns, disease surveillance and more?’”

In another Gates Foundation-funded project, Alonge has built an interactive dashboard that lets users experiment with different methods of reorganizing health services at a national level in order to do the most good.

In keeping with his field’s focus on action, Alonge says the Sparkman Center for Global Health Summer Institute will include a problem-solving clinic in which participants will apply implementation research concepts and approaches to their own implementation challenges in their workplaces, their research and their academic work. “We will be applying the concepts in real time, and that will morph into research proposals and policy briefs that, at the end of the session, they will be able to take back what they have learned to support programming and implementation,” Alonge said.

The Summer Institute is “targeted to people who are already working in the field, because if you train them, you can get the shortest route possible into the population,” Alonge said. That includes faculty, researchers, program managers and even postdocs, from the Southeast United States and internationally. It will include training in the theories and concepts of implementation research, as well as case examples. Lessons from the Summer Institute can then be applied to the traditional students in the School of Public Health, Alonge adds.

“Irrespective of what you are working on, or how complex the intervention, implementation science offers you principles, approaches and strategies, theories, and frameworks for thinking about what you are doing,” Alonge said. For instance, consider a project to increase COVID-19 vaccinations in a rural area. “The problem is people don’t trust the vaccine, but that is not just one thing,” he said. “Why do people not trust the vaccine? What is the health system doing to engender trust? What is the role of gatekeepers? Implementation science has frameworks and theories to answer those questions.”