22 April 2021
Name: Dr. Nadine Kronfli
Location: Montréal, Canada
Job title: Assistant Professor, Department of Medicine, Division of Infectious Diseases, McGill University; Clinician-Investigator, McGill University Health Centre; Scientist, Research Institute of the McGill University Health Centre; Vice Chair, INHSU Prisons
Specialisms: Prisons and correctional facilities
As a scientist, researcher, and clinician – with a background in public health – Dr. Nadine Kronfli offers a unique perspective on the challenges faced by people who use drugs when accessing treatment and care for infectious diseases.
Nadine focuses her work primarily in the correctional setting and is the vice chair of special interest group, INHSU Prisons.
In our latest Meet the Members article we speak to Nadine about the intersection of policy and research, discuss the under-representation of women in the field, and find out why involving the community in research is so incredibly important.
Tell us a little bit about your work
Since 2018, I have been working as a Clinician-Investigator at the McGill University Health Centre, based in Montréal, Quebec, Canada. I spend 60% of my time conducting research and 40% of my time doing clinical work, focused on HIV and hepatitis C care for marginalised populations.
I started my career in health policy – obtaining a Master’s in Public Health in 2007 and working in Panama with UNICEF and in Geneva with the World Health Organization.
However, I soon realised that a medical degree would greatly influence my ability to accelerate health care policies, so I pursued a career in medicine in Ottawa and completed my Internal Medicine and Infectious Diseases residencies at McMaster University.
You focus your research on the incarcerated community, why is this?
I chose to become a researcher because it allows me to generate the evidence necessary to drive changes in health policy. My research focuses on designing, deploying, and evaluating evidence-based models of care that aim to increase engagement along the HIV and hepatitis C virus care cascades for vulnerable populations, with a particular focus on incarcerated populations.
I chose this focus as those incarcerated in prison rarely have access to similar standards of health care as those in the community, lack advocacy, and are seldom included in research focused on the advancement of their health.
What are the biggest challenges facing the community of people who use drugs right now and how do we overcome them?
In correctional facilities, it is the deficient implementation of harm reduction measures. There are many reasons to explain this, but without a change in political will, which requires the engagement of key stakeholders, people in correctional settings worldwide will continue to be denied access to these fundamental evidence-based tools in hepatitis C prevention.
During your career how do you think that the health of people who use drugs has improved?
The advent of pan-genotypic direct acting antiviral (DAA) regimens and the decentralisation of care to nurses, pharmacists, and general practitioners have both significantly contributed to the improvement of the health of people who use drugs.
There has also been a paradigm shift in the way we care for patients, with a focus on “meeting patients where they are”, which has allowed us to get creative in the ways we provide care, as well as reach more people than we would have ever imagined.
What is the one thing you’ve come across in your research that you think everyone should know if they work with people who use drugs?
I have learned that involving people with lived/living experience of incarceration in the design and implementation of my research is key to success.
This proactive process ensures that the study design is person-centric, that ethical challenges are addressed a priori, and that the needs and concerns of key partners are met. Efforts should always be made to involve community members from study inception to ensure that the research design and outputs are culturally sensitive and ethically appropriate.
What advice would you give to someone considering a career in the field?
I’d recommend finding a mentor early on, particularly if you’re a woman. Women are under-represented in research, are less often funded in peer-reviewed competitions, and are thus less likely to be promoted to senior leadership roles. My recommendation is not only to find a mentor but to find a female mentor who will understand the challenges you will face in your career, guide you during trying times and create opportunities for you. Research is challenging on many levels, but patience and perseverance will make the journey worth travelling.
Why should someone join INHSU? What do you get from the network?
INHSU brings together a global network of people who are genuinely and enthusiastically committed to improving the health of people who use drugs.
In 2019, INSHU Prisons was established to bring together a similarly engaged network of people who seek to enhance hepatitis care in custodial settings. Both INSHU and INSHU Prisons networks bring together people from different backgrounds and walks of life, underscoring a diversity of representation.
While still in its infancy, INSHU Prisons has allowed me to expand my network, learn from others, and advance and advocate for hepatitis C prevention and care in the custodial sector worldwide through various partnerships. INSHU and INSHU Prisons also host several educational events, from ‘Speed Geeking’ sessions to the annual INHSU conference, which serve as excellent opportunities for information exchange.
Once you join, you’ll never look back; it’s a vibrant and forward-thinking network.
If you’d like to join our growing community of researchers, clinicians. advocates, policymakers and community members dedicated to the health of people who use drugs, you can find out more here.