DEVELOPING INTERDISCIPLINARY BIOMEDICAL ENGINEERING: THE UNILAG EXPERIENCE

1. DEVELOPING INTERDISCIPLINARY BIOMEDICAL ENGINEERING: THE UNILAG EXPERIENCE Akinniyi Osuntoki, Ph.D. Former Ag. Head Department of Biomedical Engineering Former Head Department of Biochemistry Faculty of Basic Medical Sciences College of Medicine University of Lagos Principal Investigator Unilag BME Frameworks program

2. UNIVERSITY OF LAGOS • The University was established in 1962 with two campuses; the main campus at Akoka and the Medical School at IdiAraba. • The University of Lagos presently has three campuses, Akoka, Idi-araba (College of Medicine) and Yabacampuses • 12 faculties. • Nine (9) of these are at the Akoka campus namely: Engineering, Law, Arts, Social Sciences, Education, Environmental Science, Science, Pharmacy and Management Science, • The College of Medicine at Idi-araba campus houses Basic Medical Sciences, Dental Sciences and Clinical Sciences. • Faculty of Pharmacy is physically located at the IdiAraba campus. • All faculties have both undergraduate and postgraduate degree programmes.

3. DEPARTMENT OF BIOMEDICAL ENGINEERING • The department evolved from the BME unit that was established at The College of Medicine in 1974. • The unit was responsible for the installation, maintenance, calibration and repair of engineering facilities medical and research equipment within the College of Medicine, the Lagos University Teaching hospital and the Science Departments of the University. as well as train Biomedical Technologists. • The University of Liverpool, United Kingdom assisted in the creation of the unit, donated equipment and was involved in the initial training. • There was also some support from the World Health Organization. (W.H.O.).

4. During the early period of the unit, it was equipped with state-of-the-art equipment for medical diagnosis and research, including a Transmission- electron microscope. • As far back as the 1970s it was putting plans in place for an undergraduate programme in Biomedical Engineering. • At that time, the Provost of the College of Medicine had responsibility over both the College and the teaching hospital.

5. The establishment of the Biomedical Engineering (BME) department at the University of Lagos was driven by needs identified by the medical and research community of the College of Medicine, University of Lagos.

6. DRIVERS OF THE ESTABLISHMENT OF THE BME UNIT • A major problem which led to the unit’s establishment was the observation that many equipment available at the institutions were not maintained, when they broke down they were discarded and replaced, and when the replacements broke down they were also replaced, leading to an unending cycle of waste. • It was apparent that it was more cost effective to train the manpower to maintain and repair equipment than continually replacing them. • There was an urgent need to develop the capacity to maintain and ensure the serviceability of equipments. This would elongate the equipment lifespan and ensure better utilization of resources.

7. DRIVERS…… • It was also recognised that clinical sciences and modern health care delivery are technology driven and the acquisition of relevant technologies needed to be backed up by a workforce able to maintain it. • The population of Nigeria is estimated to be approximately 20% of the African population and 60% of West Africa, it is also the largest economy in the sub region thus one of the aims was to train BME technicians to cater for the West African sub-region.

8. DELIVERABLES • The capacity to maintain equipment and ensure functionality is central to the successful provision of healthcare, medical education and biomedical research. The production of this capacity was a key deliverable of the Biomedical Engineering unit and nearly a hundred biomedical engineering technicians were trained until a government policy on tertiary education interrupted the program.

9. INTERDISCIPLINARY FOCUS • From its inception, the department had an interdisciplinary focus and not only served the research community but the healthcare delivery system. • The first head of department was Prof. H. A. Von der Mosel of the University of Liverpool who had degrees in Electrical Engineering and Pharmacology. • Other Heads of Department

10. evolution • The BME unit became a full- fledged academic department of the CMUL in the 2009/2010 session. • There was an identified critical need for BME programmes in Nigeria and based on its history and experience, it decided to pursue the establishment of these programmes. • It commenced inter-disciplinary postgraduate programmes in BME in the 2012/2013 session with a post-graduate diploma(PGD) in BME and Masters in BME in 2013/2014.

11. The department decided to establish postgraduate programmes to build critical human capacity required for BME in Nigeria and the sub region. • The programmes aim to develop human capacity in an area where Nigeria has a critical need and where there is a shortage of human resources. • The objective is to leverage on knowledge in engineering and the sciences to create a synergy that stimulates innovative, interdisciplinary cross fertilization of ideas leading to solutions, new technologies and therapies that solve medical and allied problems and improve health care delivery.

12. The objective is to leverage on knowledge in engineering and the sciences to create a synergy that stimulates innovative, interdisciplinary cross fertilization of ideas leading to solutions, new technologies and therapies that solve medical and allied problems and improve health care delivery.

13. Why Postgraduate programmes? • To develop and produce faculty for the planned undergraduate BME programme • To harness existing institutional skills and resources into BME. • To synergize learning and develop inter-professional education for needs-based health solutions.

14. Strategies Used In kick starting the programmes • Identification of potential resource persons and teaching faculty. This was done by identifying staff in various departments of the university conducting research in or with declared interest in areas of BME. • Meetings and consultations to harmonize ideas, develop goals and plan implementation strategies to achieve the goals of the programmes. • The Department of Biomedical Engineering also hosted a one day seminar on Biomedical Engineering at the College of Medicine. The seminar had a dual intention; to create awareness and to identify and develop clients for design projects.

15. CHALLENGES • An initial challenge was the fact that most of the identified faculty were trained under the traditional curriculum of clearly defined specializations and many had little experience working or collaborating outside the boundaries of their disciplines.

16. CHALLENGES • The programme structure in most of our conventional universities • Many senior academics had the traditional training with clearly defined specializations • Dissimilar methodologies and problem solving approaches in different specializations

17. KNOWLEDGE SILOS

18. CHALLENGES • There were very few engineers familiar with medical or clinical problems • Even fewer clinicians or medical scientists with a clue to possible engineering solutions to extant medical and allied issues. • The reward system (how points are awarded for multi author publications) for career elevation • Inter professional rivalries

19. The challenges encountered in this initiative are however not peculiar and have been reported by previous interdisciplinary initiatives (Domino et. al., 2007, Bindler et. al., 2012). • There have been a few positive fallouts from the various efforts, which include: the revival of some past collaborations, the start of new collaborations and the identification of potential projects on which to collaborate.

20. The NIH frameworks grant • A critical event during the initial stage of establishing the Unilag BME programme was the award of a D43 NIH grant to Northwestern University, Illinois (primary recipient institution), under the Frameworks Innovation programs. • The project is entitled “Developing Innovative Interdisciplinary Biomedical Engineering Programs in Africa”. • The University of Lagos is a member of the benefitting consortium. The inaugural Biomedical Engineering workshop which brought faculty from various disciplines together also acted as a catalyst to together also acted as a catalyst to stimulate interest and create awareness. • Other members of the consortium are; University of Ibadan and Cape Town University.

21. THE NEED FOR AN UNDERGRADUATE BME PROGRAMME • University of Lagos has offered a post-graduate diploma (PGD) since 2012/2013 and a master’s degree (MSc) in BME since the 2013/2014 academic session. • Applicants were admitted from a broad range of disciplines namely sciences, engineering and medicine. • Those with first degree in engineering, mathematics, physics and computer science are admitted directly to the MSc program while others are required to go through the PGD program.

22. Our experience is that while many of those without an engineering background lacked the basic numerical and computational skills required for BME • The engineering students lacked the basic knowledge in biological and medical sciences. • Lecturers had to go back to basics (the undergraduate curriculum in the relevant subject areas) in order to make up for the knowledge gap. • This made it difficult for most students to attain the desired learning goals within the stipulated time. • It also affected the quality of research output. • These challenges underscore the critical need to introduce an undergraduate BME program. • It is expected that these identifiable difficulties at the postgraduate level will be taken care of at the undergraduate level, so that students entering the master’s program will be adequately prepared. • Opportunities also abound locally and globally for biomedical engineers

23. UNDERGRADUATE BME PROGRAMME AT UNILAG • The Bachelor of Engineering programme started in the 2017/2018 session INITIAL CHALLENGES • Location • The process of starting an undergraduate degree programme in the Department of Biomedical Engineering since 1974 at the College of Medicine generated a debate on the domiciliation of the program and the Department. • The argument was along the lines of the definition implied by “biomedical” or “engineering”, • Other special interests e.g. ownership of programmes, and the nuances of individual preferences. In an attempt to objectively resolve the debate some questions were considered: • Likely effect of the location of the programme on the professional identity of the undergraduate students • Courses that require inter-campus commuting • UNILAG, all undergraduate engineering programmes are in the Faculty of Engineering.

24. Which is/are the appropriate body/bodies responsible for licensing, accrediting and regulating the practice of BME in the country? Engineering programs are regulated by COREN in Nigeria • Where are the majority of teaching resources for this programme (such as personnel, labs etc.) located? • How best will the domiciliation of the program enhance the interaction between students, their professional peers, and lecturers from the different faculties and departments in the medical school? • How can administrative bureaucratic bottlenecks be minimised or eliminated in managing multidisciplinary faculty members so as not to be counterproductive?

25. It was however resolved that the undergraduate biomedical engineering program be domiciled in the Faculty of Engineering but co-located in Akoka and Idi-araba campuses for student training.

26. The aim of the programme is to offer comprehensive interdisciplinary training in biomedical sciences and engineering that will position our graduates for innovation in the healthcare industry and research.

27. RESEARCH • There is a paradigm shift in UNILAG from the traditional silos to a more robust interdisciplinary collaborative research culture. • The Department of Biomedical Engineering has been a flagship platform that has popularised collaborative research within the University especially through the United States, National Institutes of Health (NIH) funded program “Developing Innovative Interdisciplinary Biomedical Engineering Programs in Africa”.

28. Collaborations and initiatives to strengthen BME capacity at UNILAG DEVELOPING INNOVATIVE INTERDISCIPLINARY BIOMEDICAL ENGINEERING PROGRAMS IN AFRICA • The frameworks funding support which lasted for 5 years afforded the faculty involved directly in the BME programmes and others the opportunity to undergo training visits to the Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University and other established BME programmes in the United States as well as inter-professional education training and projects visits to University of Cape Town. Trainees also attended various Biomedical Engineering Conferences and workshops in Nigeria and the United States of America.

29. Beneficiaries were from the following faculties: • Basic Medical Sciences • Engineering • Clinical Sciences • Dental sciences • Science • Management sciences • Social Sciences

30. THE AFRICAN BIOMEDICAL ENGINEERING CONSORTIUM(ABEC) • The Universityis also part of the African Biomedical Engineering Consortium ABEC (https://abec-africa.org/) ABEM PROJECT • Unilagis participating in the Education, Audiovisual and Culture Executive Agency (EACEA) of the European Commission sponsored African Biomedical Engineering Mobility (ABEM) project started in 2016 (https://www.africanbmemobility.org/). • ABEM grants scholarships to students to undergo postgraduate programmes and credit seeking visits to partner institutions. • It also facilitates staff exchanges between partner institutions. • These will strengthen intra-Africa BME cooperation with the inherent benefits of partnerships across institutions.

31. OTHER SUPPORT • The BME programme is also being enhanced by additional N.I.H. support under the Medical Education Partnerships Initiative (MEPI) 2 grant, Building Research and Innovation in Nigeria’s Science (BRAINS) awarded in 2015 which has BME as one of its core themes and is supporting training and mentored research projects and for junior faculty. • U 54 grants • Epigenetics of HIV associated cancers • C-THAN

32. reflections

33. GLOBAL HEALTH INNOVATION • Global Health Innovation is an electronic, peer-reviewed open access journal published bi-annually by the University of Cape Town Libraries. • The journal has the mission of advancing and disseminating interdisciplinary knowledge on all aspects of social and technological innovation for improved health and healthcare, with an emphasis on research addressing developing settings and with a developmental focus. • The journal is the product of a partnership between Northwestern University, the University of Lagos, the University of Ibadan, and the University of Cape Town, and its development has been supported by a grant from the NIH-Fogarty International Center (D43TW009374). • https://journals.uct.ac.za/index.php/GHI

34. FUNDING OPPORTUNITY FOR POINT-OF-CARE TECHNOLOGIES • The Center for Innovation in Point-of-Care Technologies for HIV/AIDS at Northwestern University (C-THAN) is funded by the National Institute of Biomedical Imaging and Bioengineering (NIBIB) at the NIH. C-THAN seeks to support collaborative research projects to develop novel point-of-care technologies aimed at improving diagnosis and treatment monitoring of HIV/AIDS and its co-morbidities in low- and middle-income countries. Projects should be viable candidates for commercial development. Awards will be up to $100,000. • See the full solicitation for more details: https://cimit.net/web/c-than/solicitations

35. acknowledgements Northwestern University • Rob Murphy • Matt Glucksberg • David Gatchell • Kara Palamountain • Rob Lisenmeier University of Cape Town • Tania Douglas University of Ibadan • Akinwale Coker University of Lagos FolasadeOgunsola All the mentees on our Frameworks and BRAINS grants