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Disease Burden and Simulation

Other Transversal Programs:

Improving global understanding of the disease burden associated with catastrophic childhood illness and strengthening data for evidence-based decision-making.

 

The Global Disease Burden and Simulation (DBS) Unit is a multidisciplinary program that aims to provide and strengthen key data on pediatric cancer and catastrophic blood diseases for clinicians, health administrators and health policy stakeholders to enable the best possible decisions. The team includes faculty, staff and global collaborators external to St. Jude with expertise in statistics, decision sciences, cancer survivorship, health economics and epidemiology.

 

Program Initiatives

 

Functioning as the epidemiology and health economics program within St. Jude Global, the DBS Unit emphasizes building collaborative partnerships to synergize global efforts and leverage diverse expertise across relevant multidisciplinary fields.  

 

The program’s projects span various topics, including novel methods development, the innovative application of methods to answer new questions, and direct data collection and analyses to increase equity within existing or planned global health policies. Our research agenda is broad but includes the following:

  • Developing novel methods of enumerating and estimating multimorbidities across diverse cohorts. 
  • Designing microsimulation analyses to support pre-clinical and health policy decision-making. 
  • Constructing costing tools and cost-effectiveness models to guide budget allocation. 
  • Establishing standardized methodologies for assessing family economic burden to support benchmarking and evidence-based interventions. 
  • Integrating hospital-based cancer registry to inform quality improvement surveillance and design. 
  • Developing normative standards for cancer classification and outcome assessments. 

Many projects undertaken by the DBS team originate within the core program. However, the program also administers key strategic partnerships with global agencies and academic institutions to improve the estimation of childhood cancer burden. Examples include:

  • In 2017, St. Jude and the Institute for Health Metrics and Evaluation (IHME) at the University of Washington began a formal partnership to advance knowledge and understanding of the global childhood cancer burden. This collaboration combines institutional expertise in health metrics, global health, epidemiology and disease burden estimation to provide more accurate estimates of the global burden of childhood cancer. 
  • In 2020, St. Jude and the International Agency for Research on Cancer launched a bilateral initiative, Targeting Childhood Cancer through the Global Initiative for Cancer Registry Development (ChildGICR), with the primary aim of improving data quality and availability on cancer in children, particularly in countries with limited resources. This collaboration unifies expertise in cancer registration and data standards, disease classification, epidemiology, global implementation science, education and health economics. 
  • In 2023, the DBS program partnered with the CONCORD Programme at the London School of Hygiene and Tropical Medicine to provide technical expertise in childhood cancer to support world surveillance of trends in cancer survival, using population-based registry data. 

Projects encompass diverse subject matters and strategies across these collaborations and within the DBS program, with cross-specialty engagement. The ultimate goal of this work is to generate evidence that allows all stakeholders — including policymakers, health advocates and the public health and global health communities — to improve outcomes for childhood cancer patients worldwide.

 

Our Team

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    Nickhill Bhakta, MD, MPH

    Associate Member, St. Jude Faculty

    Director, Sub-Saharan Africa Region, St. Jude Global

    Director, Disease Burden and Simulation

    Co-Director, ARIA Program

    Nickhill Bhakta, MD, MPH

    Associate Member, St. Jude Faculty

    Director, Sub-Saharan Africa Region, St. Jude Global

    Director, Disease Burden and Simulation

    Co-Director, ARIA Program

    Research Interests

    • Disease burden estimation, decision analysis, global epidemiology of childhood cancer
    • Prioritization and the cost-effectiveness of childhood cancer treatment in low and middle income countries
    • Pediatric leukemia, cancer survivorship

    Contact Information

    Nickhill Bhakta, MD, MPH

    Global Pediatric Medicine

    MS 721, Room S2013

    St. Jude Children's Research Hospital

    262 Danny Thomas Place

    Memphis, TN 38105-3678

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    Nancy Sobhy Bolous, MD, MA, MSc

    Assistant Member, St. Jude Faculty

    Instructor, Graduate School of Biomedical Sciences

    Senior Research Scientist, Disease Burden and Simulation

    Nancy Sobhy Bolous, MD, MA, MSc

    Assistant Member, St. Jude Faculty

    Instructor, Graduate School of Biomedical Sciences

    Senior Research Scientist, Disease Burden and Simulation

    Affiliations

    Short Biography

    Nancy Sobhy Bolous holds a dual appointment as an Instructor in the Graduate School of Biomedical Sciences and a Senior Research Scientist, Disease Burden and Simulation in the Department of Global Pediatric Medicine. For her first role, Nancy teaches the Health Economics course in the Global Child Health Master’s Program and for her second role, she conducts research focused on costing and cost-effectiveness analysis of medical interventions in hematology and oncology. Nancy’s research projects span several geographic regions in which she collaborates with multiple stakeholders including the World Health Organization, local institutions and governmental bodies. She joined St. Jude from Cairo, Egypt, where she worked as a project manager on various health care projects on a national and international scale.

    After completing her training as a physician in Cairo, Nancy pursued a double degree master’s program called the European Healthcare Economics and Management Program (Eu-HEM) in which she studied in three different European universities, The University of Bologna in Italy, Erasmus University of Rotterdam in The Netherlands and Management Center Innsbruck in Austria, over two years, and earned an MA and an MSc by the end of the program.

    With the knowledge and experience gained from different countries, Nancy joined the health care management consulting department established by 57357 Children Cancer Hospital Egypt (57357 CCHE) as a Project Manager in which she managed multiple projects, most notably the viral hepatitis C national project with Tahya Masr Fund. Later, she joined IQVIA as a Public Health Project Manager during which she worked on several projects including a hospitals quality improvement initiative contracted by the Saudi Ministry of Health, and national health insurance scheme model for the Ghanian Ministry of Health.

    Over the years, Nancy has been involved with multiple organizations and has traveled to serve the communities in multiple countries around the world. The dream of having a global-scale impact motivated Nancy to join St. Jude, the institution that inspired the establishment of 57357 CCHE in the first place. She aspires to use her expertise as an economist to help guide developing countries, such as her home country, to invest their limited resources in a cost-effective manner.

    Contact Information

    Nancy Sobhy Bolous, MD, MA, MSc

    St. Jude Children's Research Hospital

    262 Danny Thomas Place

    Memphis, TN 38105-3678

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    Monica Key DNP, BSB-M, APRN, ANP-C, AOCNP

    Program Manager, ARIA Guide

    Monica Key DNP, BSB-M, APRN, ANP-C, AOCNP

    Program Manager, ARIA Guide

    Short Biography

    Monica Key is the program manager for the Adapted Resource and Implementation Application (ARIA) Guide for Global Pediatric Medicine. In September 2022, Monica started working with the Department of Global Pediatric Medicine as a medical content writer contractor. She is currently witnessing and supporting the expanded global reach and continued success of the ARIA Guide program.

    Her extensive professional nursing background includes direct patient care in oncology, hematology, breast health, palliative care, telemetry, medical-surgical, intensive care, critical care, emergency care, case management, program development, and as an oncology-hematology nurse practitioner. Monica earned specialized certification in critical care nursing and currently is an Advanced Oncology Certified Nurse Practitioner.

    While providing oncology/hematology patient care, Monica also was key in supporting, building, and growing new clinics and programs such as a new Oncology Nurse Practitioner Transition-to-Practice program, Survivorship program and clinic, Breast Health Center, Young Adult and Adolescent program, Sickle Cell clinic, Prompt Care clinic as well as an Evaluation and Diagnostic Center.

    Prior to joining Global Pediatric Medicine, Monica was pivotal in the launch of a new healthcare tech start-up leading a global oncology team and building a new data platform for both liquid and solid malignancies that experienced tremendous success in a very short time which resulted in a lucrative and exciting acquisition. She is a published author in various peer-reviewed healthcare journals, has served as an expert content writer and professional speaker for various organizations, and received many local and national awards for contributions to health care and community service.

    Monica also served as a graduate and undergraduate adjunct didactic and clinical nursing instructor for various local higher education institutions and continues to participate in councils, committees, and boards in various roles and capacities. Nursing is a second career for Monica with 20+ prior years of experience as an executive in business development and marketing research assisting national, regional and local health care and non-profit organizations.

    When she is not working, Monica enjoys her Mexican heritage, traveling, fitness endeavors, reading, writing, discovering new music, attending concerts and festivals, baking and spending time laughing with friends and family. 

    Contact Information

    Monica Key DNP, BSB-M, APRN, ANP-C, AOCNP

    Global Pediatric Medicine

    St. Jude Children's Research Hospital

    262 Danny Thomas Place

    Memphis, TN 38105-3678

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    Amirah Anderson, MPH

    Program Coordinator, Disease Burden and Simulation Transversal Program

    Amirah Anderson, MPH

    Program Coordinator, Disease Burden and Simulation Transversal Program

    Short Biography

    Amirah Anderson is a Program Coordinator, Disease Burden and Simulation Transversal Program for the department of Global Pediatric Medicine.

    Amirah joins St. Jude Global Pediatric Medicine with 5+ years of experience in clinical trial coordination, protocol development, and multi-team management. She is adept at procuring and allocating necessary resources for projects and delivering secure, efficient, and cost-effective security solutions with a client-centric focus.

    A native Memphian, Amirah graduated from the University of Tennessee-Knoxville with a Bachelor of Science degree in Microbiology. She received a Master of Public Health degree from the University of Memphis with a concentration in Epidemiology.

    Amirah has a passion for research development, community service, and civic engagement. She is thrilled to be working at St. Jude Children’s Research Hospital, supporting the efforts of such a renowned healthcare institution.

    Contact Information

    Amirah Anderson, MPH

    Global Pediatric Medicine

    St. Jude Children's Research Hospital

    262 Danny Thomas Place

    Memphis, TN 38105-3678

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    Kristina Iligan, MSN, MPH

    Program Specialist - ARIA Guide Program

    Kristina Iligan, MSN, MPH

    Program Specialist - ARIA Guide Program

    Short Biography

    Kristina Iligan completed her Bachelor of Science in Nursing from the University of Florida (UF) in 2017 and worked as a registered nurse on a bone marrow transplant unit at UF Health for two years. With a drive to work in the global health field, she moved to Baltimore, Maryland to pursue her Master of Science in Nursing and Master of Public Health degrees at Johns Hopkins University. Kristina completed this dual degree program in December 2020 along with a Global Health certificate. 

    After graduate school, she has been working as a research nurse for malignant hematology clinical trials at the University of Florida, coordinating research participants' care to hopefully advance cancer treatment and interventions for patients with blood cancers like leukemia and lymphoma. 

    As a child of Filipino immigrants, Kristina has always been passionate about global health equity. From listening to her parents' and grandmothers' stories to personally experiencing the stark contrast between the health system in the Philippines and the United States, she is dedicated to work for actionable and sustainable change that ensures health equity around the globe. 

    Kristina is incredibly honored and excited to be a part of St. Jude's Department of Global Pediatric Medicine team and feels like their goal closely aligns with her own. St. Jude is a world-renowned organization doing pivotal work for children with cancer everywhere, regardless of where they live, and the opportunity to work here is a wonderful blessing.

    Contact Information

    Kristina Iligan, MSN, MPH

    Global Pediatric Medicine

    St. Jude Children's Research Hospital

    262 Danny Thomas Place

    Memphis, TN 38105

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    Jessica Farmer

    Program Specialist, ARIA Program

    Jessica Farmer

    Program Specialist, ARIA Program

    Affiliations

    Short Biography

    Jessica Farmer, BA, is a program specialist for the ARIA Program in Global Pediatric Medicine. She started as an independent contractor with the program in 2022. Jessica is excited about the opportunity the ARIA Program has given her to expand her skills and abilities. She loves working with the ARIA Program and the GPM team.

    Aside from work, Jessica has a 7-year-old son who keeps her busy.

    Contact Information

    Jessica Farmer

    Global Pediatric Medicine

    St. Jude Children's Research Hospital

    262 Danny Thomas Place

    Memphis, TN 38105

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    Madison Smith, RN, CCRP

    Program Coordinator, ARIA Program

    Madison Smith, RN, CCRP

    Program Coordinator, ARIA Program

    Short Biography

    Madison’s interest in health care started while interning with ALSAC's donor relations team in 2008, leading her to obtain RN licensure before completing her bachelor's degree in liberal studies. This diverse educational background allowed her to succeed as a clinical research coordinator at West Cancer Center and Research Institute, helping to revive the gynecologic oncology research program through increased awareness, communication, and clinical knowledge.

    Additionally, she was instrumental in developing policies, procedures, and training for departmental quality improvement and workflow optimization throughout the life cycle of clinical research programs.

    For Madison, returning to St. Jude Children’s Research Hospital is a meaningful, full-circle career milestone. With a servant leader’s heart and a naturally curious spirit, she is thrilled for the opportunity to expand St. Jude’s mission globally alongside the Global Pediatric Medicine team.

    In her spare time, Madison enjoys spending quality time with her family, being outdoors, exploring all things Memphis, watching sports and reading. 

    Contact Information

    Madison Smith, RN, CCRP

    Global Pediatric Medicine

    St. Jude Children's Research Hospital

    262 Danny Thomas Place

    Memphis, TN 38105-3678

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    Lauren Wiest, BSN

    Program Coordinator – ARIA Guide

    Lauren Wiest, BSN

    Program Coordinator – ARIA Guide

    Affiliations

    Short Biography

    Lauren is a dedicated nurse and program coordinator with a strong background in oncology and a passion for improving patient care. With over a decade of experience in hospital settings, she transitioned to a fully remote role as a program coordinator for the ARIA guide at St. Jude, where she plays a key role in advancing evidence-based clinical practice guidelines for pediatric oncology in low-resource settings. Driven by a deep commitment to making a difference, Lauren is pursuing a master’s in nursing informatics to bridge the gap between clinical care and data-driven solutions. She thrives on continuous learning and is motivated by the opportunity to enhance patient outcomes through innovation, collaboration, and education. Her work at St. Jude aligns with her mission to improve symptom management and care quality for children with cancer worldwide.

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    Rocio Marilyn Caja Rivera, PhD

    Program Coordinator, Disease Burden and Simulations Program

    Rocio Marilyn Caja Rivera, PhD

    Program Coordinator, Disease Burden and Simulations Program

    Affiliations

    Short Biography

    Rocio Marilyn Caja Rivera, PhD, is a native of Peru, earning Bachelor and Licentiate degrees in Mathematical Sciences from Universidad Nacional Mayor de San Marcos in Lima. She received a fellowship from the Mexican Council of Science and Technology and the Organization of American States for her doctoral dissertation, 'Control Policies and Vector Behavioral Effects in Vector Host Interactions with Novel Applications for Cutaneous Leishmaniasis in Peru.' Her research involved building mathematical models, using descriptive and Bayesian-inference statistical methods, and implementing computational techniques to understand vector-host pathogen interactions in endemic settings.

    After completing her Doctorate at the Center for Research in Mathematics (CIMAT) in Mexico, Rocio worked as a postdoctoral researcher at the Department of Biological Sciences at the University of Notre Dame and the Center for Global Health and Interdisciplinary Research at the University of South Florida. She collaborated with the Neglected Tropical Disease Modelling Consortium, contributing to research on vector-borne diseases (microparasites and macroparasites) in Asia, Africa, and Latin America. Rocio has published her research in esteemed journals covering applied mathematics, medical sciences, and global health.

    Additionally, she enjoys participating in multidisciplinary workshops and international conferences as both organizer and lecturer. Rocio, a bilingual PhD Applied Mathematician, is eager to join the Disease Burden Simulation Program at St. Jude to apply her skills in mathematical modeling and data analysis, collaborate with global multidisciplinary teams, and contribute to impactful research benefiting children worldwide.

    Contact Information

    Rocio Marilyn Caja Rivera, PhD

    St. Jude Global

    St. Jude Children's Research Hospital

    262 Danny Thomas Place

    Memphis, TN 38105-3678

Contact

To learn more about the Disease Burden and Simulation Unit, email dbs.global@stjude.org