• Co-Founder, CEO & Director of the IHCAI (Institute International Health Central American Institute Foundation), since 1988 (affiliated to Harvard Medical School, Boston, MA and University of Connecticut School of Medicine, Farmington, Connecticut, USA)
• Director of the Iberoamerican Cochrane Centre (Central America and Spanish Caribbean)
• IDB-DIME Collaborative Network for decision-making of high financial impact medicines in Latin America since 2017
• Senior Consultant PAHO-WHO, Washington, D.C.
• Public Health Journal, Editorial committee member since 2017
• HL7 (Health Level Seven) – FHIR (Fast Healthcare Interoperability Resources)
• COKA (COVID Knowledge Accelerator), USA, since 2019
• Scientific Committee Member University of Connecticut School of Medicine, since 2002
• Adjunct associate professor, community health and research, Harvard Medical School
• Off-Campus Adjunct associate professor, Harvard Medical School. (ME 518 Rural Medicine and Nutrition in Latin America), since 1999