Azerbaijan proactively pursues a revitalization of its medical sector. To improve the Ministry of Health, Azerbaijan has worked alongside the United States and other Western partners to train its physicians. Azerbaijani physicians have been trained at the postdoctoral level by such as Harvard Medical School and the Boston Children’s Hospital. This is citing the U.S. National Library of Medicine in the publication “Medical Science, Research and Higher Education in Azerbaijan from Bioethical Developments Perspective” which was published in 2016.
This study reviews the steps that Azerbaijan has taken to pursue establishing bioethical research for the region. Establishing good bioethics is a priority of expanding upon the modern values of Azerbaijani healthcare. Azerbaijan pursues an increased standard of both medical and scientific research to increase post-conflict public health and preserve human rights among the Azerbaijani diaspora. This is an ongoing effort that proceeds from the 26 years since the freeze fire of the Nagorno-Karabakh conflict. A conflict which, while having ended on paper, has not ever fully ceased.
The Azerbaijani healthcare system moves to attain normalization and post conflict stability. These efforts have existed since at least 2003. Healthcare normalization and modernization efforts are marked here as making a conscious effort to progress beyond the conflict survivalism of the previous decade.
The U.S. National Library of Medicine documents motions by the Azerbaijani Ministry of Health to fasttrack the surgical referral process in the region impacted by the Nagorno-Karabakh conflict. This effort was originally published in the Journal of the Royal Society of Medicine in London, England. In the decade that immediately followed the freeze fire of the Nagorno-Karabakh conflict, which came to its documented pause in 1994, Azerbaijan partnered with European medical relief organizations. The publication in the Journal of the Royal Society of Medicine states that the Leonard Cheshire Centre of Conflict Recovery implemented the surgical fast track method. The LCCC had partnered with the Azerbaijani government as early as 1997, three years after the official stated end of the conflict. LCCC was brought on at the request of the Azerbaijani government, to conduct post-conflict research of the continued medical needs of the Azerbaijani diaspora.
Regional medical research and study fellowships at the postdoctoral level exist in the United States, but do not appear to prioritize medical research. Rather, they focus quite heavily on cultural interests of Azerbaijan, and in sending scholars to research Azerbaijani culture as distinct from the other states of the South Caucasus region.
A postdoctoral fellowship worth of note is the American Research Institute of the South Caucasus, abbreviated ARISC. The ARISC program awards grants and fellowships to U.S. and Canadian citizens or permanent residents to launch research projects in the South Caucasus. Their national outreach includes Azerbaijan. The ARISC Resident Director for Azerbaijan is Leyla Rustamli.
While Azerbaijan is a member of this fellowship association, it is not necessarily its priority. ARISC has not yet fully established in Azerbaijan. The organization offers free services for U.S. scholars to visit the nation for academic purposes. It has yet to be seen to what degree the U.S. will consider prioritizing the access of Azerbaijani scholars to postdoctoral programs in the United States. The degree of involvement remains undetermined in the wake of 2019’s National Institute of Health letters incidents, citing Science Magazine. Science Magazine reports that “unscrupulous” foreign powers submitted letters to the National Institute of Health, abbreviated NIH, circa late 2018. This prompted an increased vigilance among the academics receiving NIH submissions from these foreign entities. At least 55 American institutions were put on a higher alert system after the incidents with the suspicious NIH submissions.
The submissions were held under scrutiny of the American academics because the scholars who submitted them had underreported affiliations with Chinese institutions. These affiliations were meant to be reported to NIH before submissions were fully considered, but they were not. This was during the time that the U.S. had accused Chinese personnel of launching espionage campaigns at academic institutions across the United States.
For the above reasons, the growing participation of individual Azerbaijani scientists in US medical practice and research is a particularly exciting development. I had an opportunity to interview two practitioners, who are also engaged in research and to discuss prospects for growing Azerbaijani-US research and medical cooperation.
Dr. Agha Guliyev came to the United States as a student in 1994 and has his own private practice as a solo practitioner at a clinic called Town and Country Internal Medicine, PA where he treats multiple medical conditions such as diabetes, hypertension, heart disease and thyroid issues. In the past, Dr. Guliyev also participated as a research observer in HIV-related studies with another institution.
In addition, he is affiliated with Biopharma Informatic, LLC, a research company where he is a Board member and where the research team conducts studies in areas that include but are not limited to GERD, diabetes,, kidney disease, menopausal symptoms, gastrointestinal conditions and working on conducting studies on Covid-19 treatment and vaccines. One such trial could potentially be in conjunction with Merck due to the fact that Houston, where the clinic is based, is a hotspot for COVID-19 cases. Dr. Guliyev spent a great deal of time discussing the latest findings concerning the effects of COVID-19, including the HIV-like immunological response, and discussed the prospects for vaccinations, which, he emphasized, should not be politicized nor rushed to meet a political agenda.
Dr. Guliyev is also an active staff member at Memorial Hermann Memorial City Hospital, a member of the Medical Execute Committee and a Chairman of Credentials Committee. He is Board Certified in Internal Medicine and has been in practice for over 15 years in the US. Asked about prospects for collaboration with Azerbaijan, he was very excited. In Azerbaijan, too, COVID-19 has been a major issue, and Dr. Guliyev sees a potential for a joint study between a clinic such as his and a Baku hospital, another populous hotspot. He also sees room for various joint clinical studies related to the medical issues he is working on, and is optimistic about overcoming political inertia and furthering greater scientific engagement between the two countries.
Dr. Nigar Dargah-zada has had strong ties with both Azerbaijan and the United States since she spent a year abroad in the US as a high school student thanks to a State Department program (FLEX – future leaders exchange). Since then, she studied medicine in both countries, and had extensive research experience as well, with a special focus on conducting clinical trials related to multiple sclerosis and neuroimmunology disorders. She did her neurology residency at Mount Sinai Downtown. Interested in MS since medical school, she conducted a meta-analysis study during the residency. She also had a rich experience with fellowships, studies, and affiliations with assorted major institutions, including the National Institute of Health, the National Institute of Neurological Disorders and Stroke, an internship in Azerbaijan’s Central Clinical Hospital (Merkezi Klinik), work experience in the Neurology department of the University Clinic of Ulm in Germany, where she’s worked primarily with Movement and Motor neuro disorders, Azerbaijan Medical University, and did student rotations in George Washington University, and Ronald Reagan Institute of Emergency Medicine.
Her clinical trials included the study of pregnancy outcomes in MS patients with interferons or glatiramer acetate exposure, in which Dr. Dargah-zada and her team established that the most commonly used medications may not increase the risk of congenital anomalies. Dr. Dargah-zada also wrote a chapter for the book on Controversies in Caring for Women with Epilepsy, exploring the potential management options for women with Juvenile Myoclonic Epilepsy (JME), who are usually treated with teratogenic Valproic acid. She and her team also conducted a monocentric study looking at the depression rate in low income population with MS (“Depression Rate in Low Income Population with Multiple Sclerosis.”)
In her current, ongoing endeavor, Dr. Dargah-zada is conducting a study called,“Mapping vibratory sensory loss across MS disease course”, which involves collecting the quantified measures of neurological dysfunction in MS patients across their disease course. This will help the doctors to identify the pattern of disability accumulation in patients along the disease spectrum , and may aid in preventing the overt disease accumulation by early intervention (treatment). Her other ongoing study at NIH is” Anakinra for the treatment of chronically inflamed white matter lesions in multiple Sclerosis.”. The aim of the study is to establish the potential safety, tolerability and efficacy of IL-1 inhibitor- Anakinra, which is approved for treatment of certain rheumatological conditions, but has never been used in MS- based on radiological outcomes, in the subset of patients with multiple sclerosis, who have evidence of the chronic active lesions in the white matter.
When not occupied with professional projects, Dr. Dargah-zada enjoys mentoring young ambitious Azerbaijani medical students, and counseling them on professional paths and programs in the United States. She is also an active member of the Azerbaijani Medical Association, a group of Azerbaijani doctors and researchers in the diaspora, who lend their expertise and mentorship through professional channels, and as a member of the Azerbaijani diaspora, enjoys educational outreach with community organizations. She has had particular opportunities to do so with the outbreak of the pandemic; besides basic informational outreach, Dr. Dargah-zade had an opportunity to participate in a program dealing with COVID-19 and mental health issues, which involved Israeli doctors discussing their experiences with psychiatric patients in isolation, as well as discussing the growth of critical mental issues in the general population due to the effects of the pandemic. Moreover, she had an opportunity to produce a short video for the US Embassy, as part of the FLEX alumni network.
Dr. Dargah-zada recognized the current challenges for collaboration between Azerbaijan and the US, but as someone straddling the two cultures with ease due to the depth and diversity of her professional experiences, is excited about the potential for joint programming in various areas. She discussed encouraging Azerbaijani medical students and scientists to come to the US and to learn and understand the US medical system and programming, but also seeking out and building institutional partnerships between specific departments, clinics, and hospitals. There is limitless potential for clinical trials, and professional collaborations of all sorts, both on a people-to-people and intergovernmental level, and Dr. Dargah-zada is looking forward to the blossoming of these relationships.