Different Modus Operandi in International Health
Dr. Vella's multifaceted experience in the field of medicine
Working with WHO, UNICEF and the World Bank provided me with different modus operandi in international health. My experience at Imperial College London gave me an academic perspective and the present job at GSK provides me with a business perspective.
GlaxoSmithKline’s Dr. Venanzio Vella is a management board member in COMBACTE-NET and an EFPIA lead in the COMBACTE-NET new study ARTHR-IS. Dr. Vella is a medical doctor specialized in Pediatrics (University of Rome, Italy), Epidemiology (MSc, PhD, London School of Hygiene, UK), and Health Economics (MSc, University of York, UK). We invited Dr. Vella to shed more light on his multifaceted experience.
“I was interested in applying research methods in evaluating health interventions and thus a career in medicine was the most appropriate choice.”
— Venanzio Vella, GSK
- "Medicine has a good mix of disciplines going from the micro (e.g. microbiology) to the macro level (e.g. public health) with a good opportunity to apply scientific knowledge to quantifying problems, identify their causes, propose and test solutions and see if they work and how."
From trial to operational
“It is not enough to know that an intervention has been efficacious in trials conditions if we do not know how to make it effective in operational conditions, where the environment is less than optimal and resources are much lower than in trial conditions. Applying epidemiological and health economics methods to field conditions helps to identify the minimal conditions of effectiveness to avoid potential failures of interventions. It is not so much “medicine” per se that is the driving force of my career but the above mentioned two subspecialties, which allow to apply scientific methods to identify problems and potential solutions and to select the best affordable options among several alternatives, while considering the limitations of available human and financial resources.”
The extent of healthcare influence
“The area that I like it most is the verification of the validity of the assumptions underlying the impact of health care. There is a tendency to assume that most of the burden of diseases can be reduced through the health care system which is far from true, as most causes of ill health remain unknown or are multifactorial and thus only partially influenced by health care. We need to estimate what fraction of specific health problems can be directly impacted through specific health interventions and validate this assumption through hard data.
For example, we assume that certain risk factors cause the Staphylococcus aureus infections in joint replacements and this study will try to verify which of these factors are more associated with health care practices so that the occurrence of these infections could be reduced. The results will help design better strategies to prevent and treat such infections which need to then be validated through proper monitor and evaluation. Reiterating the validation of assumptions is critical to the effectiveness of interventions and helps to understand what fraction of ill health can be directly influenced by health care.
Other types of assumptions requiring validation is related to the minimum conditions for the effectiveness of health interventions. It is frequently assumed that an intervention that was efficacious in trial conditions will be always effective in operational conditions. This assumption needs to be validated into a variety of operational settings where variability of resources and specific factors create the conditions from transferring the efficacy recorded in the ideal trial conditions into operational effectiveness.”
"Evaluating the mix of human and financial resources and local conditions associated with effectiveness in different settings will be critical to quantify the inputs, outputs and outcomes required to produce the impact of specific interventions in field conditions."
