Welcome from the Founders

Welcome to the Global Health Initiative of the University of Louisville Department of Medicine. For more than 20 years, the U of L Division of Infectious Diseases has been involved in international research activities in the field of pneumonia and influenza

Julio Ramirez

Julio A. Ramirez, M.D., FACP
Founding Director
Dept. of Medicine Global Health Initiative


Ruth Carrico

Ruth L. Carrico, Ph.D., RN
Founding Associate Director
Dept. of Medicine Global Health Initiative

Dr. Julio Ramirez created the Community-Acquired Pneumonia Organization (CAPO) in 1999. The Organization brought together researchers and clinicians from around the world. The CAPO international study, evaluating the management of hospitalized patients with pneumonia and influenza, has been operational since 2001.

Today, the CAPO database contains data on more than 10,000 patients from 127 centers representing 23 countries, and the CAPO data and statistical coordinating center is located at the University of Louisville’s Clinical and Translational Research Support Unit in the Division of Infectious Diseases.

Pneumonia and influenza are one of the most relevant global health issues. They are the No. 1 cause of death globally and they represent the most common clinical manifestations of several emerging pathogens including new strains of avian influenza, SARS, and the recent MERS-CoV. The serious nature of emerging pathogens has been recognized by both the Centers for Disease Control and Prevention as well as the Department of Homeland Security, and the Division of Infectious Diseases has been supported by both of these agencies to perform surveillance of pneumonia in Kentucky.

The Severe Influenza Pneumonia Surveillance (SIPS) program coordinated surveillance of pneumonia, influenza and patient outcomes in ten healthcare facilities geographically distributed across Kentucky.

Louisville has been the epicenter of the HIV/AIDS epidemic in Kentucky, and the Division of Infectious Diseases has led efforts in care of patients living with HIV/AIDS (PLWHA) since the beginning of the epidemic in the 1980s. These activities are currently supported by funding from the federal government through the Health Resources and Services Administration (HRSA) Ryan White grants. Addressing the challenges of this disease demonstrated the global nature of health as HIV/AIDS is recognized as a disease without borders.

The Kentucky Office for Refugees was established in 2006 in recognition of the increasing numbers of refugees entering the U.S. and seeking resettlement in Kentucky. The provision of healthcare for this population began immediately in order to address the needs of the resettling population as well as those refugees currently residing in the community.

The Division of Infectious Diseases, with the aid of funding provided by the Office of Refugee Resettlement (ORR) and administered by Catholic Charities, was able to structure a program to assess the health status of newly arriving refugees to Kentucky. Based upon these data, specific needs were identified, and a new Refugee Health Immunization (RHI) program was created in the Division of Infectious Diseases in 2012.

Today, that program has expanded and now includes:

  1. provision of the refugee health screening and assessment;
  2. provision of all age-appropriate vaccines for adults, adolescents and children;
  3. provision of school physicals for children; and
  4. health-promoting education tailored to the unique cultural and language needs of the refugees.

To further assist resettling refugees, a Civil Surgeon program was established in order to provide the examination and immunizations required for their journey toward citizenship. Our ultimate goal has been to facilitate the healthcare of refugees by enabling access to all needed health services under one umbrella.

Based upon experiences with infectious diseases and global health, in 2011 the Division of Infectious Diseases assumed responsibility for the management of the University’s International Travel Clinic. Initially, only the traditional pre-travel counseling and immunizations were provided.

Expansion of services was based upon recognition that:

  1. individuals traveling for leisure were becoming increasingly adventurous visiting regions of the world that have minimal or no healthcare support;
  2. global business opportunities were sending business travelers to new areas of the world where safety considerations are as relevant as health and immunization;
  3. mission workers interact with communities who are located in increasingly remote areas lacking the most basic needs; and
  4. the increased interest among students regarding global issues has led to an exponential growth of students from high schools, trade schools, and universities traveling to almost every destination across the globe.

In response to these challenges, the clinic determined that there was a need to enable connection between the traveler and local experts during the time the traveler is abroad. This is facilitated through electronic means such as email and Skype connection with a local expert. Post-travel evaluation and counseling services were added due to the number of returning travelers who experienced a health concern upon their return.

Pediatric immunization has long been recognized as critical for individual as well as community safety. More recently, there has been an increasing emphasis on immunization of adults beyond the traditional influenza and pneumococcal vaccines. In response to this challenge, the Division of Infectious Diseases developed the Vaccine and Interprofessional Practice (VIP) clinic.

This clinic focuses on the provision of age-appropriate vaccines for adults and adolescents within a practice environment that brings together  health professionals representing medicine, nursing, public health and pharmacy. Through this clinic, all FDA-approved vaccines are readily available.

With all of these activities as the foundation, in 2013 the Global Health Initiative (GHI) of the Department of Medicine was born. The GHI provides all of the services described above as well as global health training and global health research.  For more detailed information regarding any of these activities, we invite you to explore this website.

As we are all part of global health, we welcome your comments as to how we can improve these efforts.

Julio A. Ramirez M.D., FACP

Founding Director
Global Health Initiative

Ruth L. Carrico Ph.D., RN

Founding Associate Director
Global Health Initiative