![Smiling woman in yellow shirt](https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_200_21_9/public/media/images/teaser/2023-11/230316_gaspar_domingos_matias_lopes_lr-117.jpg?itok=pufh78m- 200w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_260_21_9/public/media/images/teaser/2023-11/230316_gaspar_domingos_matias_lopes_lr-117.jpg?itok=dyoUMLJg 260w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_320_21_9/public/media/images/teaser/2023-11/230316_gaspar_domingos_matias_lopes_lr-117.jpg?itok=j6CxlkEv 320w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_400_21_9/public/media/images/teaser/2023-11/230316_gaspar_domingos_matias_lopes_lr-117.jpg?itok=QrRBcqge 400w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_520_21_9/public/media/images/teaser/2023-11/230316_gaspar_domingos_matias_lopes_lr-117.jpg?itok=0nwBDEve 520w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_640_21_9/public/media/images/teaser/2023-11/230316_gaspar_domingos_matias_lopes_lr-117.jpg?itok=QHMuH8n6 640w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_800_21_9/public/media/images/teaser/2023-11/230316_gaspar_domingos_matias_lopes_lr-117.jpg?itok=52VaOtei 800w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1040_21_9/public/media/images/teaser/2023-11/230316_gaspar_domingos_matias_lopes_lr-117.jpg?itok=whZF2xvy 1040w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1280_21_9/public/media/images/teaser/2023-11/230316_gaspar_domingos_matias_lopes_lr-117.jpg?itok=th53fJ2p 1280w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1600_21_9/public/media/images/teaser/2023-11/230316_gaspar_domingos_matias_lopes_lr-117.jpg?itok=V_H7Blms 1600w)
This Is What Global Health Looks Like
Twenty years after it was founded, ICAP at Columbia University keeps reaching for more impact.
In 2003, the world was in despair over HIV/AIDS. At the time, the crisis in sub-Saharan Africa was devastating individuals, families, and communities—as it had been for years. Many were skeptical that anything could be done to save the millions of people living with HIV in some of the world’s poorest countries. But Wafaa El-Sadr, MD, MPH ’91, MPA, had cared for patients with HIV in New York City’s Harlem community, and she firmly believed that not only could a lot be done, but also that it must be done.
![images of and about ICAP](https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_200/public/media/general/2023-11/icap-mag-1-2-3.jpg?itok=YWGEsheu 200w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_260/public/media/general/2023-11/icap-mag-1-2-3.jpg?itok=9SrxAL8i 260w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_320/public/media/general/2023-11/icap-mag-1-2-3.jpg?itok=vMpIbnpu 320w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_400/public/media/general/2023-11/icap-mag-1-2-3.jpg?itok=G9yBCGkm 400w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_520/public/media/general/2023-11/icap-mag-1-2-3.jpg?itok=GZisnFal 520w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_640/public/media/general/2023-11/icap-mag-1-2-3.jpg?itok=BoNFmWpW 640w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_800/public/media/general/2023-11/icap-mag-1-2-3.jpg?itok=9G4Txbj6 800w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1040/public/media/general/2023-11/icap-mag-1-2-3.jpg?itok=p4Hf3bib 1040w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1280/public/media/general/2023-11/icap-mag-1-2-3.jpg?itok=ni5t6GHq 1280w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1600/public/media/general/2023-11/icap-mag-1-2-3.jpg?itok=NZCSsLF1 1600w)
At left, in Angola, a mother living with HIV and her child receive care. Above (1) ICAP's founder and director, Wafaa El-Sadr, visits a clinic in Kenya. (2) Outside a hospital in Ethiopia, a doctor tests people for COVID-19 to help control the spread of the virus. (3) The Population-Based HIV Impact Assessment (PHIA) Project, led by ICAP, is the gold standard in capturing the state of HIV epidemic response in 15 countries and counting.
This simple but world-changing conviction led to the birth of ICAP, a global health center—situated at Columbia Mailman School of Public Health—that would go on to help change the face of the HIV crisis across the globe. “When ICAP came into the country, we really needed to scale up treatment,” recalls Rejoice Nkambule, MPH, deputy director of health services at the Ministry of Health of Eswatini, one of the African countries most affected by HIV/AIDS. With funding from the U.S. President’s Emergency Plan for AIDS Relief (founded the same year as ICAP), ICAP worked shoulder-to-shoulder with ministries of health and partners from government, academia, and civil society to strengthen health systems and train nurses, midwives, doctors, laboratory workers, and data managers in countries across the region—including Eswatini.
![Nurse rides a horse](https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_200/public/media/general/2023-11/screen_shot_2023-11-08_at_12.07.52_pm.png?itok=ks3Bak1n 200w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_260/public/media/general/2023-11/screen_shot_2023-11-08_at_12.07.52_pm.png?itok=mBzkO-_h 260w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_320/public/media/general/2023-11/screen_shot_2023-11-08_at_12.07.52_pm.png?itok=TNviPMgU 320w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_400/public/media/general/2023-11/screen_shot_2023-11-08_at_12.07.52_pm.png?itok=jsjyMSwx 400w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_520/public/media/general/2023-11/screen_shot_2023-11-08_at_12.07.52_pm.png?itok=VVylP_Ei 520w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_640/public/media/general/2023-11/screen_shot_2023-11-08_at_12.07.52_pm.png?itok=3GFQt0xr 640w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_800/public/media/general/2023-11/screen_shot_2023-11-08_at_12.07.52_pm.png?itok=rfG3cCgL 800w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1040/public/media/general/2023-11/screen_shot_2023-11-08_at_12.07.52_pm.png?itok=QF5tDJsj 1040w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1600/public/media/general/2023-11/screen_shot_2023-11-08_at_12.07.52_pm.png?itok=wrZpjhi4 1249w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1280/public/media/general/2023-11/screen_shot_2023-11-08_at_12.07.52_pm.png?itok=jxGVanJH 1280w)
In Lesotho, nurses trained by ICAP bring care to isolated residents by riding horseback over rough terrain.
![Healthcare worker speaks with patient](https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_200/public/media/general/2023-11/screen_shot_2023-11-08_at_12.11.45_pm.png?itok=qUYcsJ8T 200w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_260/public/media/general/2023-11/screen_shot_2023-11-08_at_12.11.45_pm.png?itok=qPpfyvxs 260w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_320/public/media/general/2023-11/screen_shot_2023-11-08_at_12.11.45_pm.png?itok=2ISJm4SB 320w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_400/public/media/general/2023-11/screen_shot_2023-11-08_at_12.11.45_pm.png?itok=48-l6fRF 400w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_520/public/media/general/2023-11/screen_shot_2023-11-08_at_12.11.45_pm.png?itok=AVTxDk-P 520w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_640/public/media/general/2023-11/screen_shot_2023-11-08_at_12.11.45_pm.png?itok=4auMKkBz 640w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_800/public/media/general/2023-11/screen_shot_2023-11-08_at_12.11.45_pm.png?itok=tDSW7OUr 800w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1040/public/media/general/2023-11/screen_shot_2023-11-08_at_12.11.45_pm.png?itok=5ZEf1o3Z 1040w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1600/public/media/general/2023-11/screen_shot_2023-11-08_at_12.11.45_pm.png?itok=I0tFXBJs 1192w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1280/public/media/general/2023-11/screen_shot_2023-11-08_at_12.11.45_pm.png?itok=CAVpXiFj 1280w)
An ICAP-trained healthcare worker in Tajikistan talks with a person living with HIV about how to stay well.
“ICAP has been a very effective partner that has helped us grow our response to the epidemic,” says Nkambule, who has seen her country make dramatic strides toward ending its epidemic in the past 20 years.
![Student organizes with ICAP](https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_200/public/media/general/2023-11/screen_shot_2023-11-08_at_12.15.19_pm.png?itok=rHRk_tor 200w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_260/public/media/general/2023-11/screen_shot_2023-11-08_at_12.15.19_pm.png?itok=JUScNBun 260w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_320/public/media/general/2023-11/screen_shot_2023-11-08_at_12.15.19_pm.png?itok=YBeW5tKn 320w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_400/public/media/general/2023-11/screen_shot_2023-11-08_at_12.15.19_pm.png?itok=QJxt9-g9 400w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_520/public/media/general/2023-11/screen_shot_2023-11-08_at_12.15.19_pm.png?itok=5ESrri5K 520w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_640/public/media/general/2023-11/screen_shot_2023-11-08_at_12.15.19_pm.png?itok=zQde6u4n 640w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_800/public/media/general/2023-11/screen_shot_2023-11-08_at_12.15.19_pm.png?itok=KIqyYcAU 800w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1040/public/media/general/2023-11/screen_shot_2023-11-08_at_12.15.19_pm.png?itok=DY0qsvpw 1040w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1600/public/media/general/2023-11/screen_shot_2023-11-08_at_12.15.19_pm.png?itok=ynnWC2uf 1164w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1280/public/media/general/2023-11/screen_shot_2023-11-08_at_12.15.19_pm.png?itok=KWeoLX0r 1280w)
In New York City, ICAP conducts critical public health research, such as a study on the impact of the mpox virus.
![Woman smiles while holding a pamphlet](https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_200/public/media/general/2023-11/screen_shot_2023-11-08_at_12.21.20_pm.png?itok=L01wS4fa 200w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_260/public/media/general/2023-11/screen_shot_2023-11-08_at_12.21.20_pm.png?itok=pJyEabTg 260w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_320/public/media/general/2023-11/screen_shot_2023-11-08_at_12.21.20_pm.png?itok=W1KFj1j5 320w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_400/public/media/general/2023-11/screen_shot_2023-11-08_at_12.21.20_pm.png?itok=6WZuWhQh 400w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_520/public/media/general/2023-11/screen_shot_2023-11-08_at_12.21.20_pm.png?itok=MQPcLwCp 520w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_640/public/media/general/2023-11/screen_shot_2023-11-08_at_12.21.20_pm.png?itok=fXlPjr4V 640w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_800/public/media/general/2023-11/screen_shot_2023-11-08_at_12.21.20_pm.png?itok=LRGcyqgj 800w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1600/public/media/general/2023-11/screen_shot_2023-11-08_at_12.21.20_pm.png?itok=LpLwzELD 1033w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1040/public/media/general/2023-11/screen_shot_2023-11-08_at_12.21.20_pm.png?itok=M9Bx7aBQ 1040w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1280/public/media/general/2023-11/screen_shot_2023-11-08_at_12.21.20_pm.png?itok=IP3AuYl0 1280w)
A transgender sex worker in Panama gets information on PrEP (pre-exposure prophylaxis), an important HIV-prevention method.
Today, ICAP works in 40 countries, designing and implementing some 180 innovative projects designed to strengthen health systems, increase access to health services, and enhance the capacity to respond to a range of health threats. From its roots in global HIV response, ICAP has grown to focus on an expanding list of other health challenges—from tuberculosis and malaria to COVID-19 and mpox—while advancing maternal and child health and setting its sights on increasingly urgent new health challenges, such as antimicrobial resistance and the health effects of climate change and forced migration.
![Analyst reviews data](https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_200/public/media/general/2023-11/screen_shot_2023-11-08_at_12.32.09_pm.png?itok=mn3o9OWP 200w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_260/public/media/general/2023-11/screen_shot_2023-11-08_at_12.32.09_pm.png?itok=IAWrJ52a 260w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_320/public/media/general/2023-11/screen_shot_2023-11-08_at_12.32.09_pm.png?itok=nHexkhek 320w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_400/public/media/general/2023-11/screen_shot_2023-11-08_at_12.32.09_pm.png?itok=UAx92yB6 400w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_520/public/media/general/2023-11/screen_shot_2023-11-08_at_12.32.09_pm.png?itok=Cd18VG9V 520w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_640/public/media/general/2023-11/screen_shot_2023-11-08_at_12.32.09_pm.png?itok=WPJ-GCz7 640w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_800/public/media/general/2023-11/screen_shot_2023-11-08_at_12.32.09_pm.png?itok=Z3LxWuvo 800w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1040/public/media/general/2023-11/screen_shot_2023-11-08_at_12.32.09_pm.png?itok=iDEyI3vR 1040w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1600/public/media/general/2023-11/screen_shot_2023-11-08_at_12.32.09_pm.png?itok=rZDekrtZ 1209w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1280/public/media/general/2023-11/screen_shot_2023-11-08_at_12.32.09_pm.png?itok=x0_F_U6X 1280w)
An ICAP analyst in South Sudan reviews data to guide effective health interventions.
![Lab technician holds performs extraction](https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_200/public/media/general/2023-11/drc_lab_52920556131_38ccbc18b8_k.jpg?itok=Oji_BDPB 200w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_260/public/media/general/2023-11/drc_lab_52920556131_38ccbc18b8_k.jpg?itok=4z3B78L5 260w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_320/public/media/general/2023-11/drc_lab_52920556131_38ccbc18b8_k.jpg?itok=xzQqEBu9 320w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_400/public/media/general/2023-11/drc_lab_52920556131_38ccbc18b8_k.jpg?itok=V0YogFfZ 400w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_520/public/media/general/2023-11/drc_lab_52920556131_38ccbc18b8_k.jpg?itok=yMLTk0wT 520w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_640/public/media/general/2023-11/drc_lab_52920556131_38ccbc18b8_k.jpg?itok=7NvxNkXc 640w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_800/public/media/general/2023-11/drc_lab_52920556131_38ccbc18b8_k.jpg?itok=gnfI1qQV 800w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1040/public/media/general/2023-11/drc_lab_52920556131_38ccbc18b8_k.jpg?itok=wa8QLaCk 1040w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1280/public/media/general/2023-11/drc_lab_52920556131_38ccbc18b8_k.jpg?itok=NzVYO-3s 1280w, https://www.publichealth.columbia.edu/sites/default/files/styles/cola_media_1600/public/media/general/2023-11/drc_lab_52920556131_38ccbc18b8_k.jpg?itok=5x0fz3qo 1600w)
A technician in a molecular lab extracts blood samples for testing in the Democratic Republic of the Congo.
“Two decades after we first got off the ground, ICAP finds itself more needed than ever,” says El-Sadr.“While much has been accomplished, so much more is yet to be done.”
51,000,000
People tested for HIV
9,200,000
HIV patients screened for tuberculosis
2,400,000
People treated for HIV
12,000,000
Pregnant women tested for HIV
790,000
Women given antiretrovirals to prevent HIV transmission to their fetus
400,000
Health workers trained
218,000
People given PrEP (pre-exposure prophylaxis)
7,965
Health facilities supported
7,025
Laboratories provided with technical assistance
Photo credit: Header photo and photo of masked technician were taken by Artur Francisco. All other photos courtesy of ICAP.
This Is What Global Health Looks Like was first published in the 2023-2024 issue of Columbia Public Health Magazine.