Dr. MacDonald stood out early on for her keen interest in solving major health challenges.
“In medicine, it's not enough to identify problems,” she says. “You have to take the initiative to bring innovative solutions to those problems”.
She made history in 1999 as the first female dean of a Faculty of Medicine in Canada at Dalhousie University, breaking through the glass ceiling in the medical field. This achievement followed her advocacy for a "social responsibility" at medical faculties to train future doctors in the realities of Canadian diversity and needs, a forward-thinking vision at the time that is now an accreditation standard.
In the 1980s she was also the first woman to be certified by the Royal College of Physicians and Surgeons of Canada in pediatric infectious diseases, a brand-new field of expertise at the time. She founded the Division of Infectious Diseases at The Ottawa Hospital, CHEO and the University of Ottawa in 1981.
“It was at the beginning of the HIV epidemic,” recalls Dr. MacDonald, noting it was “a very difficult time when infectious disease specialists were scarce.” She says that the few available specialists and others had to step up to care for these patients as well as advocate on their behalf. Working with children with cystic fibrosis, her advances in understanding and managing these diseases quickly earned her recognition. Thanks to the continuous improvements made to treatments, when she left Ottawa in 1999 there had been no pediatric deaths related to cystic fibrosis for 10 previous years, a remarkable achievement at the time.
As a pediatric infectious disease specialist and editor-in-chief of the Paediatrics & Child Health journal for 20 years, Dr. MacDonald became passionate about vaccination in the 1980s and 1990s, a topic that would dominate the following decades of her work.
Her pioneering research on vaccine safety, reducing pain during vaccination, and factors that can help address vaccine hesitancy are now authoritative in the field.
“The greatest health challenges are often at the frontiers, where few dare to venture early on,” says Dr. MacDonald. “It's up to us to be the pioneers and explore these uncharted territories.”
Her role as a globally recognized expert recently earned her a seat on several World Health Organization committees and working groups including the Global Advisory Committee on Vaccine safety and the Strategic Advisory Group on Immunization. She helped define the WHO’s Global 2030 Vaccine Agenda. According to her, it is a never ending process to try to increase vaccine acceptance among the population, particularly in the wake of the COVID-19 pandemic where maintaining global confidence in vaccination is a crucial public health issue.
Dr. MacDonald has published over 500 peer reviewed papers and one scientific article has been cited more than 5,000 times, a major accomplishment reflecting her important contribution to research on vaccine hesitancy and strategies to overcome it. She has collaborated closely with numerous researchers, academics, and health organizations in Canada and around the world to advance this essential field. Vaccines have saved countless millions of lives thanks to the sustained awareness efforts of experts like her.
It is perhaps with MicroResearch, the organization she co-founded in 2008, that Dr. Noni MacDonald best expresses her pioneering spirit and transformative vision for health research. MicroResearch's mission is to decolonize and democratize community-focused research by training and funding often under-resourced local teams in Africa and Asia so that they can find sustainable solutions to public health issues within their communities.
“True innovation here does not come from laboratories or outside experts, but from those who work in the communities.”
Dr. Noni MacDonald
“True innovation here does not come from laboratories or outside experts, but from those who work in the communities,” says Dr. MacDonald. “It is by listening to and directly involving the concerned populations that sustainable, culturally adapted and realistic solutions to local health problems can emerge”.
This innovative approach, which breaks with traditional health development aid models, has already proven itself time and again, as with the discovery of the major source of neonatal sepsis in rural Ugandan villages and its solution.
“You don't have to be a superhero to do relevant research. Anyone with the Microresearch training can do it,” explains Dr. MacDonald, citing a core tenet of the MicroResearch philosophy. The initiative, which operates thanks to small community grants, is now having a significant impact in many countries. And to support this expansion, MicroResearch is on the lookout for volunteers keen to improve community health conditions one small project at a time by becoming MicroResearch coaches and reviewers.
In Canada itself, MicroResearch is rapidly gaining traction with organizations as diverse as the Durham Regional Police Services, the Fraser Valley Health Authority and Nova Scotia Health, all of whom are keen to find innovative, contextual and sustainable solutions to their local public health problems.
For example, in Newfoundland a team made up of ship captains, fishers, a coastguard officer and students chose to study the difficult question: How do fishermen want to receive mental health care? No one had looked into the mental health of this profession previously, one that carries a very high risk of work-related mortality—higher than firefighters or police. Thanks to MicroResearch, this crucial issue for the fishing community has been raised and is now the subject of a funded project.
“The team itself will have to find new and different solutions, corresponding to the culture, context and resources specific to the fishermen”, explains Dr. MacDonald. Avenues such as facilitating access to appointments during stopovers on land or setting up a confidential teleconsultation system for long sea crossings are being considered. However, in keeping with MicroResearch's philosophy, Dr. MacDonald has no idea what specific answers the team will come up with.
“It's up to the local communities themselves to define the problems and identify context and culturally appropriate solutions, with our support,” she emphasizes. It's a resolutely innovative approach to democratizing health research.
From the countless honours she has received, including the Order of Canada, to her impressive record as a practitioner and advocate, for over 40 years Dr. Noni MacDonald has inspired thousands of doctors with her avant-garde spirit, clinical, teaching and research excellence.
“Local populations whether in Sub-Saharan Africa or in Canada are best positioned to identify the cultural and contextual roots of health problems,” she says. “It is up to us to be the catalysts to unlock their research potential.”
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