Call for Proposals: Health and Climate Solutions due 2/8

Posted on behalf of the Climate Change and Health Working Group
———————————
 Application Deadline: February 08, 2019, 3:00 p.m. ET
 
Purpose
 
Through this funding opportunity, Robert Wood Johnson Foundation (RWJF) seeks to develop and amplify the evidence around a set of approaches that improve community health and well-being and advance health equity, while also addressing climate change adaptation or mitigation. Eligible, local approaches can focus on one or more of a range of determinants of health—including, but not limited to: air quality; energy sources; transportation or mobility design; food and water systems; housing; and health systems. Proposals should specify the determinants of health that the given approach is addressing, and the expected impact on health and well-being. Grant funds will support research and evaluation activities to develop the best possible evidence highlighting what is working well with the select approach and why; where there have been opportunities and challenges; and how other communities may learn from this approach to tackle similar challenges. *All interventions eligible for this funding must have been implemented and active for at least one year as of the date of the application.
 
Eligibility and Selection Criteria
 
·      Proposals must discuss approaches focused in one or more geographically defined communities.
·      The community or organization implementing the approaches to address the health impacts of climate change, while improving health equity, must serve as the primary applicant (Project Director), and will be the prime recipient of funds. Individuals from collaborating organizations (e.g. research partner) can serve as the co-Project Director.
·      Eligible applicant organizations include public and private nonprofit organizations, federally or state-recognized Indian tribal governments, indigenous organizations, local government, and academic institutions.
·      Preference will be given to applicant organizations that are either public entities or nonprofit organizations that are tax-exempt under Section 501(c)(3) of the Internal Revenue Code and are not private foundations or Type III supporting organizations. The Foundation may require additional documentation.
·      Applicant organizations must be based in the United States or its territories.
·      Only one proposal may be submitted per applicant organization.
 
RWJF encourages applicant organizations representing diverse geographic areas, first time-applicants, and communities that are most vulnerable to the effects of climate change to apply.
 

Key Dates

Monday, January 7, 2019 (3:00 – 4:30 p.m. ET)
The first of two optional applicant webinars to provide an overview of the program and an opportunity to ask questions that are general in nature. The second webinar (see below) will be a repeat of the first. Registration is required; please register here for the January 7th webinar.
 
Tuesday, January 15, 2019 (8:00 – 9:30 p.m. ET)
A repeat of the first optional applicant webinar to provide an overview of the program and an opportunity to ask questions that are general in nature. Registration is required; please register here for the January 15th webinar.
 
February 8, 2019 (3 p.m. ET)
Deadline for receipt of brief proposals.
 
March 6, 2019
Selection of semi-finalists; notification of invitations to submit full proposals.
 
April 3, 2019 (3 p.m. ET)
Deadline for receipt of full proposals.
 
May 2, 2019
Selection of finalists; notification of invitation to participate in a site visit interview.
 
May 6, 2019 – May 20, 2019
Site visits conducted.
 
May 31, 2019
Selection of recommended grants; notification of decisions.
 
July 15, 2019
Approximate grant start date.
 
Total Awards
·      Up to eight awards will be made through this funding opportunity.
·      Proposals may request a budget of up to and including $350,000 each, for a project duration of up to and including 24 months.
·      Grant funds will support only research and evaluation activities and some communication and dissemination efforts; funds may not be used to develop or implement a new intervention, program, or approach.
 
For more information and to apply:
https://www.rwjf.org/en/library/funding-opportunities/2018/health-and-climate-solutions-hub.html
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Preparing for the Health Effects of Drought: California Climate Action Team Public Health Workgroup Meeting on 2/4

Event Date & Time:

Monday, February 4, 2019 – 10:00am to 4:00pm

Pacific Time

CalEPA Headquarters, Sacramento, CA

Please join the California Department of Public Health, the National Integrated Drought Information System (NIDIS), the Centers for Disease Control and Prevention (CDC), and the National Drought Mitigation Center (NDMC) for a workshop on Preparing for the Health Effects of Drought: A Workshop for Public Health Professionals and Partners. This workshop is hosted by the California Department of Public Health as part of the California Climate Action Team Public Health Workgroup meeting series and will take place at the CalEPA headquarters in Sacramento, CA with webinar participation available.

The morning session will be an informational and educational session for public health professionals on the health impacts of drought, and drought projections, with a focus on California. The afternoon will be a facilitated session by NDMC to help participants better understand and use a new CDC National Center for Environmental Health resource guide called Preparing for the Health Effects of Drought: A Resource Guide for Public Health Professionals.

Local health department staff and partners are particularly encouraged to attend, to hear tips and lessons learned from California health departments that have responded to severe drought.

The entire workshop will be shared via webinar, but we encourage in person participation, when possible, to get the most out of the facilitated learning.

Agenda (draft) available here: https://www.arb.ca.gov/cc/ab32publichealth/meetings/meetings.htm

Register to attend here: https://cpaess.ucar.edu/forms/preparing-health-effects-drought-california-2019

Webex webinar option – register by clicking herehttps://cdph-conf.webex.com/cdph-conf/onstage/g.php?MTID=ef6d7ecb278ccd899bf962522b9c8b926

For more details, please contact: Amanda Sheffield (amsheffield@ucsd.edu)or Dan Woo (daniel.woo@cdph.ca.gov).

Tick, tick, tick: Reflections from this year’s annual meeting

Tick, tick, tick.

The ticking of Dr. Victor Sidel’s metronome resonated throughout the large ballroom where a reception in his honor was held during the first days of the 2018 APHA Annual Meeting in San Diego. Dr. Sidel, a formative figure in the field of public health and a past president of APHA, died earlier this year after spending his career as a physician vigorously defending the rights of the world’s most vulnerable populations. The beats of the metronome, which he used to punctuate his presentations and speeches since the 1980s, were meant to represent the social disparities inherent in global public health. One tick meant that somewhere in the world, a child was dying due to preventable illness. One tick also represented tens of thousands of dollars spent in weapons sales. Among Dr. Sidel’s published works included seminal books such as War and Public Health and Social Injustice and Public Health, both edited by his longtime collaborator Dr. Barry Levy, who spoke at the APHA reception to honor his colleague. At a prior eulogy for Dr. Sidel, Dr. Levy summed up the body of work that had driven them for decades: “Vic taught us that health, peace and social justice were not isolated concepts, but tightly woven together. I can still hear him saying there cannot be health without peace and social justice, and there cannot be peace and social justice without health.” In many ways, the 2018 APHA conference showed just how deeply these intersections between health, peace, and social justice have been woven into the fabric of the organization, starting with honoring Dr. Sidel, continuing with the breadth and diversity of panels and posters, and concluding with a number of resolutions that were adopted.

Many panels examining various aspects of health and social justice were available throughout the conference. The International Health Section sponsored panels on topics like global health and human rights, equity in global women’s health and maternal, neonatal, and child health, health and war in countries like Yemen, Mexico, Syria, and Gaza, and refugee health. The Peace Caucus sponsored several complementary panels on topics of war and public health, militarization of the border, and violence on indigenous women, along with a presentation from the joint Lancet- American University of Beirut Commission on Syria. The Human Rights Caucus also presented panels on sexual and reproductive rights, as well as issues of health governance and advocacy. A search through the 2018 conference program found topics like environmental justice, worker’s rights, racial disparities, the rights of the incarcerated, and many other issues of social and health justice presented throughout hundreds of panels, roundtables, and posters.

More than many other health-related organizations and associations, APHA has long served as an advocacy platform for the pressing social issues of the time, recognizing the depth of issues that influence public health. While many APHA resolutions address topics traditionally associated with clinical outcomes, like smoking, diet, and reproductive health, combing through the decades of policy statements on the APHA Database shows positions on timely and controversial issues like opposing military action in Afghanistan and Central Asia in 2002, ensuring access to health services for undocumented immigrants in 1994, and raising concerns about the health impacts of fracking in 2012. This year was no different, with a total of 12 new policy statements adopted, many directly focusing on contemporary issues of social justice such as opposing family-child separations at the US border and addressing police violence as a public health issue.

The latter topic was first brought to APHA in 2016, where a collective of authors, motivated by grassroots organizing against state violence, recognized the significance of a national public health entity taking a strong position on the issue. While the resolution passed the APHA Governing Council vote overwhelmingly in San Diego (87% to 13%), just last year it was voted down by a 30-point margin (35% to 65%). A year of collaborative work on drafting and promoting the statement resulted in this year’s triumphant victory, which was crafted to specifically point to the public health implications of the “underlying conditions of the institutions, systems, and society we live in that determine our health outcomes,” according to the End Police Violence Collective. For them, APHA recognition of this resolution “is one more tool that organizers against law enforcement violence can use to pressure their elected officials.” This success, they state, is also portending a needed shift in public health from focusing primarily on behavioral interventions to considering structural ones as well. APHA’s role as a representative of the field of public health makes its willingness to frame public health inequities as social justice issues significant. Despite the two-year trajectory of this resolution within APHA, the Collective maintains that “this work has been ongoing for generations, in communities organizing to draw attention to, intervene on, and rebuild after experiences of law enforcement violence. This statement is a product of those generations of work. It is an important step. But there is more work to be done.”

A reminder of work to be done may be seen in another resolution that came before the governing council but was not met with the same cheers and jubilation. Members from the International Health Section, including Dr. Kevin Sykes, the Chair of the Advocacy and Policy Committee for the IH Section, and well-known scholars of war and public health Leonard Rubenstein and Dr. Amy Hagopian, put forward “A Call to end to attacks on health workers and health facilities in war and armed conflict settings.” Incidentally, the latter two authors have both been recipients of the APHA Victor Sidel and Barry Levy Award for Peace, in 2011 and 2018, respectively. The statement was introduced as a latebreaker due to the accelerated pace of attacks on health workers in 2017, as detailed by a report published by Safeguarding Health in Conflict, a coalition of which APHA is a member, and received several endorsements from multiple APHA components, including from the Peace Caucus, the Occupational Health and Safety Section, and the Forum on Human Rights. However, opposition to some of the specific details of the statement, especially those regarding Israel, led to a contentious process that culminated in little floor debate on the merits of the resolution and, ultimately, the governing council voted no (25% to 75%). Dr. Hagopian echoed the sentiments of the End Police Violence Collective when discussing the importance of APHA taking a stance on issues of social justice, despite what she sees as the sometimes conservative stance of the governing council when it comes to controversial issues. “People working to make the world a better place need all the support they can get- both this sort of written, academic association support as well as political support out in the world. When they can cite the APHA, as the largest and longest stand public health organization in the country, as being on board, that carries weight.” As a result, Dr. Hagopian plans to revise the statement and resubmit it for next year’s APHA conference in Philadelphia. Upon receiving the Award for Peace at the IH Section Awards Ceremony this year, she said “It’s important to be on the right side of history, early and often. So we’ll be back another day.”

Tick, tick, tick.  

Global News Round Up

Politics & Policies

Microsoft founder and philanthropist Bill Gates, who’s in D.C. this week to meet with administration officials and members of Congress, told Axios he hopes the U.S.’ souring relationships with Europe and China — sparked by the Trump administration’s tariffs — won’t hurt long-term global health or climate change goals.

Stereotypes that migrants are disease carriers who present a risk to public health and are a burden on services are some of the most prevalent and harmful myths about migration.

Pakistan’s expulsion of 18 international aid agencies will hurt 11 million aid recipients in a South Asian nation grappling with perilously low standards of education and healthcare.

Programs, Grants & Awards

Each year, in June and November, the Global Health Center at Children’s Hospital of Philadelphia facilitates educational exchanges in the Dominican Republic (DR) through the Global Health Allies Program.  The program is open to all benefits-eligible CHOP employees who have been employed at CHOP for at least 18 months at the time of the trip.  Approximately six people whose expertise fits with the particular needs of each exchange are chosen following a formal application and interview process.

Students from the Clinton, Janesville Craig, Janesville Parker, Marshall, Milton, Portage and Sun Prairie high schools spent the day at “Opening Doors to the World,” the sixth annual High School Global Public Health Day at UW-Madison.

Research

For most people who take statins to lower cholesterol, the risk of side effects is low compared to the benefits, according to a recent scientific statement.

Diseases & Disasters

U.S. Navy sends hospital ship to Colombia to treat Venezuelan migrants.

The UN appealed Tuesday for $4 billion to cover humanitarian needs in Yemen in 2019 – its largest country appeal ever – and announced its first appeal related to Venezuela, calling for $738 million to help those who have fled the country’s economic meltdown and health crisis.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) confirmed that in September of 2018, first ladies from both China and Africa have committed to advocate and prevent HIV/AIDS among adolescents, creating a joint initiative that emphasizes a three-year health promotion and HIV-prevention advocacy program.

Newly released data by the US President’s Emergency Plan for Aids Relief (Pepfar) shows it is this community-centered approach that has helped Namibia exceed some of the 90-90-90 targets set by UNAids in 2014.

Decades after polio was eradicated from Papua New Guinea, the crippling and sometimes deadly disease has returned, leaving doctors scrambling to revive long-lapsed vaccination programmes.

A drug that protects children in wealthy countries against painful and sometimes lethal bouts of sickle-cell disease has been proven safe for use in Africa, where the condition is far more common, scientists reported on Saturday.

The Ebola outbreak in the Democratic Republic of the Congo (DRC) is quickly becoming an international concern.  With 489 people diagnosed with the disease and 289 deaths, it is already the second largest Ebola outbreak in history (although still dwarfed by the 2014 West Africa outbreak). While the DRC has a good track record of responding to these outbreaks, the ongoing military conflict in the country is making the response much more difficult.

Technology

Tanzania is the first confirmed country in Africa to achieve a well-functioning, regulatory system for medical products according to the World Health Organization (WHO).

A chatbot is a computer program that automatically replies to user messages based on a decision tree or artificial intelligence algorithm. Increasingly, chatbots are being used to give technology a more human face and make data more accessible to people.

Researchers from the Loyola University Chicago Stritch School of Medicine have generated six antibodies that could be used to test for and potentially treat the Zika virus.  To date, the mosquito-borne disease has afflicted more than 1.5 million people worldwide, but there is no effective vaccine or drug available for treatment. It is most dangerous during pregnancy, which can result in miscarriages, stillbirths, or congenital disabilities.

An inexpensive, easy-to-use blood test could dramatically alter how sickle cell disease is diagnosed in Africa, where the often-undiagnosed disease is a leading cause of childhood mortality, according to a manufacturer-sponsored study presented here.

Environmental Health

Britain is bidding to host the UN climate change conference in 2020, the biggest since the Paris agreement was signed in 2015, as part of the government’s aim to be seen as a green leader.

Equity & Disparities

Uterine cancer is killing more women, and black women are disproportionately burdened by the disease, a new report from the Centers for Disease Control and Prevention shows.

Women, Maternal, Neonatal & Children’s Health

Malaria quickly kills toddlers.  But rapid diagnostic tests, a new suppository drug and  bicycle ambulances can buy enough time to get stricken children to hospitals.

The Developing World & Non-Communicable Diseases: A Pandemic of Drug Shortages & Inequitable Access

Throughout the developing world, health demographics are rapidly shifting from communicable diseases to non-communicable diseases (NCDs) due to urbanization, lifestyle changes, and introduction of processed food. Although still retaining a significant portion of their communicable disease burden like tuberculosis and malaria, the prevalence of hypertension, diabetes, and cancer in developing countries has increased dramatically and is expected to cause every 7 out of 10 deaths by 2020. With the rise of these health ailments, the global health community has highlighted the importance and severity of these diseases through UN High-level meetings, incorporating relevant indicators in the Sustainable Development Goals (SDG’s), and forming interagency coalitions within countries to address the barriers of NCD prevention and treatment. However, NCD medication supplies have remained an underappreciated barrier that humans affected by global health inequalities confront each day. The complications of drug supplies range from common medications being out of stock to not having a vital class of medications available at the health facility. The medication shortages that plague developing nation states often have a more pronounced effect on underserved populations – essentially causing an impossible barrier to treating their chronic condition and preventing morbidity/mortality.

Last month on November 20thThe Lancet Diabetes & Endocrinology revealed predictions in the year 2030 regarding the world’s insulin supply that stunned health care professionals around the globe. From data gathered recently, the number of individuals diagnosed with Type 2 diabetes is estimated at 405 million people. Although some patients can be treated with oral or injectable diabetic medications like metformin or GLP1 inhibitors, there are approximately 63 million people on earth today that require the use of insulin to manage their diabetes. However, only 30 million individuals use insulin due to availability, affordability, and inequitable access to this essential class of medications. Although these numbers provide a clear indication of the necessity for change in regards to access to insulin globally, the scientists at Stanford that conducted the aforementioned study in The Lancet predicted that the number of individuals diagnosed with Type 2 diabetes will increase to 510 million in 2030 – 79 million of those will need insulin to proper manage their health disorder with only 38 million having equitable access to insulin. These statistics exhibit that, in 13 years, less than half of the people on this planet will be able to access insulin, a medication developed 97 years ago. Though over half of the world’s diagnosed Type 2 diabetics will reside in China, India, or the United States, the study continued and stated that the insulin supply shortage will distress those inhabiting Africa and Asia most significantly. The reasons formulated to explain this health disparity include the fact that three pharmaceutical industries control almost 100% of insulin being manufactured in the world, the complexity of insulin which is a hormone produced by living cells, and generic companies’ lack of interest in producing a biosimilar at an equitable price.   

Cardiovascular diseases (CVDs) pose an implausible health burden on the global society with 30% of all deaths worldwide being attributed to these ailments. Of this mortality caused by CVDs, it is estimated that 80% occurs in the developing world with projections suggesting a steady increase in this percentage. However, with equitable access to cardiovascular medications, approximately 75% of recurrent CVDs can be prevented causing a decrease in both mortality and morbidity for humanity. To determine the access to common cardiovascular medications like atenolol, captopril, hydrochlorothiazide, losartan, and nifedipine, the BMC Cardiovascular Disorders journal published findings in 2010 of a survey within 36 countries. The findings revealed that the drug shortages transcended more complex medications like insulin and affected the access of medications that are considered ubiquitous in the developed world. The analyzed data revealed that of the abovementioned medications in the 36 countries, only 26.3% was available in the public sector and 57.3% in the private sector. The study also stated that in several nations, the wages earned within one working day was insufficient to meet the cost of one day of purchasing treatment. When considering situations where monotherapy is inappropriate, this finding would disclose that treatment would be particularly unaffordable.

When considering access to NCD medications generally, wealth has been a substantial determinant of inequitable access to treatment of hypertension, asthma, cancer, and others classified as NCDs. In many low-income to middle-income countries (LMICs), a wealth gradient has even been observed. In order to gather information to disprove or support this theory, the BMJ Global Health Journal published a study conducted in Kenya in August 2018. The study administered surveys to patients prescribed hypertension, diabetes, and asthma medications and collected data on those medications available at their home, including location and cost of the service. When analyzing the data, the results clearly indicated a wealth gradient for each of the three diseases included in the study in terms of access. As household income increases, so does the likelihood that a family has an opportunity to obtain proper medication. In addition, the results showed that poorer patients had to travel further to obtain treatment than those with a higher income. Finally, and most meaningfully, poorer patients paid more for their medications than their fellow humans inhabiting other parts of the country.  

These global health inequalities are unjustifiable in a global society where the quantity and quality of medications on the market is incredible. The drug shortages and inequitable access differ between the developed world and developing world, but also by socioeconomic stratifications within countries themselves. In order to provide compassionate care to every human suffering from any of these ailments, governments need to begin initiatives to make insulin, losartan, albuterol, and every vital NCD medication available to every citizen in their country. Heads of states, pharmaceutical industries, ministries of health, and health care professionals need to accompany their citizens and patients with a health mindset moving away from health as a commodity to health as a right. Most urgently, universal health care coverage needs to be at the forefront of every national health agenda to properly address this pandemic of drug shortages and inequitable access.