Introduction
Solving
the world’s health challenges requires multidisciplinary collaborations
that bring together the talents, experiences, resources, and ideas from
multiple sectors in low and middle-income countries (LMIC) and high
-income countries (HIC).1 In addition, a commitment to
working together, can lead to the development of creative and
multidisciplinary solutions required to tackle system challenges such as
those in global health.1 To create an effective
collaboration between institutions from LMIC and HIC, stakeholders
should be willing to work together. Each stakeholder can bring varying
strengths and resources to the partnerships, but they also bring their
own organizational cultures, regulations, and
expectations.1 Ideas to overcome geographic, economic,
social, and political challenges should be addressed early in any
collaboration. It is extremely important to be sensitive to cultural and
religious differences in different LMIC countries. Understanding these
differences helps connect people in these countries. Overcoming the
cultural and language barriers in different countries/cultures can be
achieved through having medical and cultural interpreters.
Cystic Fibrosis (CF) was thought to be a disease of Caucasian
populations from European decent. However, it has been shown to affect
people from all ethnic backgrounds.2 CF care varies
significantly for people with CF (pw CF) from HIC with median survival
approaching 50 years of age,3 to LMIC with pw CF dying
in infancy or early childhood. LMIC face significant challenges to
promote CF diagnosis and improvements in CF care due to financial
constraints and significant burden of other diseases.4Health disparities for pw CF in LMIC can result from limited access to
clinical care owing to lack of its availability on a national or local
level, to limited diagnostic tools for the disease in some countries, to
restriction of access to specialized services or therapies (financial or
physical), and/or to lack of knowledge or education regarding how the
disease should be treated, resulting in poor
outcomes.5 Western European countries show
significantly different clinical outcomes compared to countries in
Eastern Europe including Turkey as shown from the European Cystic
Fibrosis Society Patient Registry (ECFSPR).6Disparities could be due to several factors including differences in
resources and available medications. A paucity of resources and
medication contributes to suboptimal treatment, lower lung function,
poor nutrition, poor quality of life and shortened lifespan.
To address the discrepancy in
quality of care and outcomes, we report on a collaboration between our
team at the University of Michigan cystic fibrosis center (UoM CFC),
through support from the Middle East CF Association (MECFA) and the CF
Foundation (CFF), and a CF center in Turkey (Marmara University CF
Center, Istanbul) to address deficiencies and improve quality of care in
that center.