Separating parents and children at US border is inhumane and sets the stage for a public health crisis

Statement from the American Public Health Association and Trust for America’s Health

Washington, D.C., June 15, 2018

“The Trump administration’s policy of separating parents and children at the U.S.-Mexico border will have a dire impact on their health, both now and into the future.

“As public health professionals we know that children living without their parents face immediate and long-term health consequences. Risks include the acute mental trauma of separation, the loss of critical health information that only parents would know about their children’s health status, and in the case of breastfeeding children, the significant loss of maternal child bonding essential for normal development. Parents’ health would also be affected by this unjust separation.

“More alarming is the interruption of these children’s chance at achieving a stable childhood. Decades of public health research have shown that family structure, stability and environment are key social determinants of a child’s and a community’s health.

“Furthermore, this practice places children at heightened risk of experiencing adverse childhood events and trauma, which research has definitively linked to poorer long-term health. Negative outcomes associated with adverse childhood events include some of society’s most intractable health issues: alcoholism, substance misuse, depression, suicide, poor physical health and obesity.

“There is no law requiring the separation of parents and children at the border. This policy violates fundamental human rights. We urge the administration to immediately stop the practice of separating immigrant children and parents and ensure those who have been separated are rapidly reunited, to ensure the health and well-being of these children.”

###

APHA champions the health of all people and all communities. We strengthen the public health profession. We speak out for public health issues and policies backed by science. We are the only organization influence federal policy, has a nearly 150-year perspective and brings together members from all fields of public health. Visit us at www.apha.org.

Advertisements

Global News Round Up

Politics & Policies

Within the space of a few short weeks, the reputation of Peter Sands, incoming Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, has gone from respected to reckless according to some critics.

A report from the WHO’s Independent High-level Commission on Noncommunicable Diseases (NCDs) has called for urgent action, high-level political commitment and immediate scaling of actions to address NCDs.

“Winning the fight against tuberculosis (TB)  requires that ‘social drivers’ of the disease – especially poverty and inequality – are tackled head on, the United Nations Secretary General said [Monday], urging greater efforts to provide universal health coverage and combat the growing threat of anti-microbial resistance…”

Being active is critical for health. But in our modern world, this is becoming more and more of a challenge, largely because our cities and communities aren’t designed in the right ways,” said Tedros Adhanom Ghebreyesus, WHO Director-General on Monday, launching the WHO Global action plan on physical activity and health 2018-2030: More active people for a healthier world, alongside Portuguese Prime Minister, António Costa.

Programs, Grants & Awards

The World Health Organization has certified Paraguay a malaria-free country. An independent panel concluded earlier this year that Paraguay interrupted indigenous malaria transmission for the requisite 3-year period and that it can prevent re-establishment of transmission.

Research

In a new study, scientists suggest that your beloved furry companion could trigger a flu pandemic among people in the future. Why? Researchers found that flu strains can jump from pigs to dogs, and that flu is becoming increasingly diverse in dogs.

In a day long mock pandemic exercise organized by Johns Hopkins Center for Health Security, an unreal mystery virus, Clade X, brought the world to its knees before eventually burning out.

A large-scale clinical trial, called HOPE (HIV Organ Policy Equity Act) in Action, a multicenter kidney study, assessing the risks of transplanting kidneys from HIV- positive donors into patients living with the virus, is set to begin soon.

Travellers carrying standby antibiotics take them more often than those traveling without such drugs.  Having antibiotics packed in the bags allows their use – against recommendations – also for mild and moderate diarrhoea, i.e. cases not requiring medication.

Diseases, Disasters & Wars

Haider Hammoud often goes tent-to-tent at the refugee camps near the Syrian border asking families whether they’ve enjoyed their iftar meal.  It’s the Muslim holy month of Ramadan and the Syrian 32-year-old wants to ensure that when the sun goes down, displaced families break their fasts with a taste of home-cooked food.

First case of Polio (since 1989) has been reported in Venezuela as it falls deeper into crisis that has crippled its healthcare system.

In 2015, a dermatologist in Russia’s fourth largest city, Yekaterinburg, diagnosed Katia with herpes. “I had no idea what it was,” says Katia, who asked that her last name not be used. But because she had suffered repeated illnesses over the preceding 2 years and had an alcoholic ex-boyfriend who simultaneously had other girlfriends, she suspected that something more serious might be wrong.

Technology

Bausch + Lomb, a leading global eye health company and wholly owned subsidiary of Valeant Pharmaceuticals International (NYSE/TSX: VRX), today announced the introduction of Ocuvite® Blue Light eye vitamins, a nutritional supplement formulated with lutein and zeaxanthin, the two carotenoid pigments naturally found in the eye. This formulation of eye nutrients includes high levels of lutein and helps protect eyes from the blue light that reaches the macula, which is responsible for our central vision.

Mobile health technology has the potential to transform the way we prevent and manage heart disease, but there are unanswered questions about how to optimize this technology and maintain engagement with patients, according to a recent review.

A new study by Waldemar Gorski, professor and chair of the UTSA Department of Chemistry, and Stanton McHardy, associate professor of research in chemistry and director of the UTSA Center for Innovative Drug Discovery, describes a method that could show quickly and accurately whether a person has been infected with harmful bacteria or other pathogens.

Environmental Health

Plastic and chemical pollution has been detected in most samples of snow and seawater taken by researchers in Antarctica, said the non-governmental environmental group Greenpeace.

Equity & Disparities

An estimated 239,000 excess deaths occur among girls under 5 years of age each year in India. The study highlights the significant effects of gender bias on mortality.

For urban planners, data and technology are valuable tools in the drive to improve administration and services. But while these innovations are making urban environments more livable, they come with a hidden cost: the potential to deepen inequality among digitally marginalized groups.

Women, Maternal, Neonatal & Children’s Health

Childhood deaths from pneumonia and meningitis decreased significantly between 2000 and 2015. This sharp decline could be attributed to the introduction of vaccines against these bacteria in high-burden countries.

The unique composition of a mother’s breast milk may reduce food sensitization in her infant, report researchers at the University Of California San Diego School of Medicine with colleagues in Canada.  The findings, publishing in the June 15 issue of Allergy, further highlight the health role of human milk oligosaccharides (HMOs), which are not found in infant formula, and underscore their potential for therapeutic interventions.

Challenges Accessing PrEP for HIV Prevention in England

The successful integration of HIV prevention programs that increase testing and offer early treatment for infected individuals is contributing to reductions in new HIV infections. By 2016, the 5,164 HIV diagnoses in gay and bisexual men living in England represented an 18% decline compared to the 6,286 diagnosis in 2015.  Secure integration of pre-exposure prophylaxis (PrEP) will continue to reduce infections. HIV prevention programs need to address persistent barriers and doubts however, including limited access of PrEP in England. Continue reading “Challenges Accessing PrEP for HIV Prevention in England”

MS: An Unpredictable Disease That Needs More Attention

What would you do if you had symptoms of extreme fatigue, blurred vision, loss of balance, slurred speech, tremors, problems with memory and concentration, or paralysis that occurred sporadically throughout your life and potentially worsened over time? It is a crazy and debilitating thing to think of, but this is what people with multiple sclerosis deal with every day. Multiple sclerosis (MS) is a chronic neurological disease of the central disease system (brain, spinal cord and optic nerves) and is thought to be a disease in which the immune system incorrectly attacks its own healthy tissue. Over 2.3 million people are affected by MS across the globe, but because symptoms can be invisible or difficult to diagnose, the National Multiple Sclerosis Society predicts there are many more cases than accounted for.

This past month I volunteered at the MS150 – a two day, 150 mile bike ride from Houston to Austin that fundraises for the National MS Society. Anyone that races has a four hundred dollar minimum to raise towards MS. This year, they were able to raise over $10 million dollars total towards helping the National MS Society bring hope to those affected. I had heard of this race and organization in the past, but had never really pursued looking further into it. This year I decided to cheer on a fellow friend racing in it and learn a little more about MS while I was there. I was so glad I did. It was such an uplifting experience with everyone gathered and racing for a common cause. It really made me consider if there’s anything similar being done – information sharing, raising money, learning about the disease – in other countries. The U.S. is lucky to have resources to coordinate these kinds of events, but they are not the only people affected by the disease.

MS does not know country borders or only affect populations in certain nations. It is a disease that affects those across the globe. Global prevalence of MS showed greater numbers in higher income countries (>60 people per 100,000) than lower income countries (ranging from 0-20 people per 100,000) from a study done by the Global Atlas in 2013. However, these numbers could be skewed from showing the whole picture due to less lower income countries adequately diagnosing and reporting the disease. Another study, the global burden of disease study, or GBD, conducted in 1990 estimated the incidence, prevalence, duration and mortality for more than 500 different diseases and injuries. Neurological diseases, like MS, were measured in disability-adjusted life years, or DALYs. These measure the impact of a disease such as MS, on a person’s healthy lifespan. If the impact is one DALY, then it can be thought of as losing one year of healthy life free from disease and disability. This study revealed that noncommunicable diseases, including neuropsychiatric diseases like MS, had a notable impact on the health burden in all parts of the world. MS was predicted to have an increasing number of total DALYs from 2005 (1,510,000 DALYs) to 2030 (1,648,000 DALYs). This was measured out of a total of 92 million DALYs contributed by neurological disorders in 2005 and a predicted 103 million DALYs in 2030. Although the burden of MS seems small in the group of neurological disorders, it is predicted to increase and continue to make an impact.

Luckily, scientists today are researching and testing different theories to try and pinpoint the unknown cause of multiple sclerosis. A recent study published this past week points to gene expression of what’s called TOX. TOX contributes to the development of lymphocytes that attack foreign threats in the body. However, when this TOX is activated in CD8+ T lymphocytes, the lymphocytes can not hear signals from the brain telling them that the neurons they want to attack are actually healthy and not a threat. They instead attack the brain cells and eventually lead to the development of MS. This discovery is an exciting first step in understanding MS better and how to prevent it from impacting so many.

However, we are not all scientists. So what can we do to help those with MS or other noncommunicable diseases across the globe? We can start with learning, understanding and speaking out about the burden that noncommunicable diseases like MS have on our communities. In the 2013 Atlas of MS survey, it was found that there were 4.7 neurologists per 100,000 people in high income countries compared to 0.04 per 100,000 people in low income countries. The range of MS nurses was also similar and many low income countries reported having zero nurses with these specific skills and expertise. The number of MRI machines also closely matched this trend, with lower income countries having less machines available to them. Low and middle income countries unfortunately have the double burden of communicable and noncommunicable diseases. It is easy to spend so much time on infectious and communicable diseases because we see “easier fixes” to the problem such as providing vaccines, adequate hand hygiene education, and access to clean water initiatives. However, diseases like MS, while trickier to tackle, should be kept in the forefront of our minds.

The World Health Organization has an awesome chapter from a book called, “Neurological Disorders: Public Health Challenges” that hits home this point about resources (both financially and the public health workforce) being needed to help those with neurological disorders alongside communicable disease resources. It aims to provide a basis for decision making at global, regional and national levels so that resources are available for both realms of public health challenges. I believe if we’re acknowledging and advocating that noncommunicable diseases are also of public health importance – we can slowly chip away at the multitude of different global health challenges we are faced with everyday. I’ll end with a quick link to the World Health Organization’s page titled 10 facts on noncommunicable diseases. Check it out and see if there’s something new you can learn today!

Mid-Year Message from Our Chair

Dear International Health (IH) Section members,

At the half-year mark since our 2017 annual meeting in Atlanta, I hope this finds you well and starting plans to attend the 2018 annual meeting in San Diego.  Registration and Housing open on June 4!  Also – please vote for new IH Section leaders – online voting opens any day now!

First, a quick note to summarize global health news from Washington this year.  Despite the Administration request for a one-third reduction for foreign assistance in the federal FY2018 budget proposal (which was not taken to a vote until well into 2018), Congress decided to continue funding at nearly the same level as for FY2017.  For the FY2019 foreign assistance budget, we again face the same 30% reduction request from the Administration which would take effect on Oct. 1, 2018.  Please plan to call your congressional representatives to state your opinion when this comes up for a vote in Congress!

As for IH Section business, we have several new initiatives this year with the objective to improve involvement of global health professionals in our Section.   These initiatives have evolved through active discussions among IH Section leaders in our standing and ad-hoc committees since the last annual meeting.  These are:

(1)   A new program to provide Travel Scholarships to eligible IH members in the category of Early Career Professionals (ECPs).  Winners of the scholarships will be the top-ranked abstracts submitted to the IH Section, based on scoring by blinded reviewers.   Section Council members will coordinate special recognition for scholarship winners at the annual meeting.  The purpose of this program is to promote submission of high quality abstracts by ECP members and to help defray costs of their attendance at the annual meeting for presentation of their work.

(2)   A new Young Professional Award for an outstanding IH Section member who is under 30 years of age.  The awardee will be someone who has shown special initiative in global health.   Nominees must be IH Section members.   Our Awards Committee, in charge of nominations and voting, will recognize the 2018 winner of this new award at the IH Awards Ceremony and Reception in San Diego on Tuesday, November 13, 2018.      Other IH awards given annually are the Carl E. Taylor Lifetime Achievement Award, the Mid-Career Award, the Gordon-Wyon Award for Community-Oriented Public Health, Epidemiology and Practice, and the IH Section Distinguished Service Award.

(3)   A renewal from past years of regional Mid-year Meet-ups, organized for the benefit of Section members in various cities across the U.S.  The successful Washington DC meet-up in April, co-sponsored with the Global Health Council, was held at APHA headquarters.  A San Francisco gathering will be held in June for IH members in conjunction with the Public Health Institute.  Many thanks to event organizers Jessica Keralis (DC), Jean Armas (SF), Theresa Majeski (LA), and Brianne Riggins-Pathak (Albuquerque).

San Diego promises to provide us again with a great opportunity for learning, networking, and reconnecting with old friends. Our volunteer section members have been actively organizing the hundreds of details for the annual meeting. Just a few highlights on the upcoming meeting:

(1)   Our active IH Program Committee handled 473 scientific abstracts that were submitted to IH by February of this year and were evaluated online by 181 volunteer reviewers.  Abstract acceptances for presentation in San Diego have been announced.

(2)   Our IH Policy Committee fielded the review and editing of a good number of policy statement proposals developed by our Section members, some jointly with other sections.  Proposals that successfully transit the APHA Joint Policy Committee (JPC) review and are approved by vote of the Governing Council at the annual meeting will become official policy of APHA!

(3)   Our Community-Based Primary Health Care Working Group is preparing their annual pre-conference in San Diego with the theme this year, Community Health Workers, in a collaborative effort with the APHA Community Health Worker (CHW) Section.  You can soon register to attend this workshop (all day Saturday and half-day Sunday) on November 10-11, 2018.

(4)   A special presentation is planned to commemorate the 40th Anniversary of the Declaration of Alma Alta on Primary Health Care!

Please connect to us through www.aphaih.org (the [Unofficial] Home of APHA’s International Health Section) where you can sign up to receive IH Connect by email and link to our other social media via Facebook and Twitter for job postings and items of interest, as well as receive our excellent Global Health Connections Newsletter with features on IH members and section leaders.

As always, we hope that you are able to seek out and discover ways in which you can engage with your professional association, APHA, as an International Health Section (IH) member.  Your feedback is always welcomed.

Best regards,
Laura C. Altobelli, DrPH, MPH
Chair, International Health Section
American Public Health Association