Another ACA repeal bill may be gaining momentum

Posted on behalf of Paul Freeman, IH Section Action Board Representative

Colleagues, the battle continues. Please contact your Senate representatives for just 5 minutes as suggested below. It is crucial that you spend 5 minutes of your time for the ACA at this time.


In the coming days, the U.S. Senate may begin consideration of yet another proposal to repeal and weaken major portions of the Affordable Care Act. Like previous proposals defeated earlier this year in the Senate, this one, known as the Graham-Cassidy proposal, would cut health coverage and raise premiums and out-of-pocket costs for millions, eliminate the Prevention and Public Health Fund, slash federal Medicaid spending and end the ACA’s Medicaid expansion, and allow states to weaken protections for people with pre-existing conditions.

Your advocacy efforts were a key reason the Senate defeated the previous proposals to repeal or weaken the ACA. Take the time to contact your senators and urge them to oppose the disastrous Graham-Cassidy bill and any other proposal to repeal or weaken the Affordable Care Act either by using APHA’s action alert or by calling the Capitol switchboard and asking to be connected to the offices of your senators at 202-224-3121

Sample phone script:

Introduce yourself as a constituent and public health professional.

I urge Sen. XX to oppose the Graham-Cassidy Affordable Care Act repeal bill. This proposal would:

  • Cut health coverage and raise premiums and out-of-pocket costs for millions.
  • Eliminate the Prevention and Public Health Fund.
  • Slash federal Medicaid spending and end the ACA’s Medicaid expansion.
  • Allow states to weaken protections for people with pre-existing conditions.
  • Eliminate Medicaid reimbursements to Planned Parenthood for one year.
  • Instead, I’m asking my senators to support the bipartisan effort to strengthen and improve the Affordable Care Act.

Thank you for you continued advocacy to support and strengthen the Affordable Care Act!

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Don’t miss the Community-Based Primary Health Care Pre-Conference this year: Saturday, November 4th!

Community-Based Primary Health Care and Community Health Workers: Underfunded Afterthought or Key to Achieving Universal Health  Care? 

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In 1978 the WHO’s Declaration of Alma-Ata outlined CBPHC as the strategy for achieving universal healthcare, with health being defined as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Almost forty years later, we are far from achieving “health for all.” Despite accumulated evidence in the literature demonstrating the effectiveness of CBPHC and CHWs for increasing health equity, why is this strategy often either an underfunded afterthought, or left out to favor “sexier” vertical interventions like mosquito nets for all, or hospital care?

In this interactive workshop, participants will share their own expertise as well as develop new knowledge and understanding about issues with global experts in CBPHC and CHWs. Conference topics will include: 1) Review of the latest evidence on the effectiveness of CBPHC as a strategy to achieving health equity, 2) Debate on the pros and cons of vertical, horizontal and diagonal approaches to achieving universal health, 3) Sharing of resources for the implementation of CBPHC, 4) Case studies on effective global CBPHC programming 5)Community based participatory research (CBPR) and its relevance to CBPHC and 6) Global funding for CBPHC. This workshop is sponsored by the CBPHC working group of the international health section.

Speakers include: Stanley Foster, Henry Perry and Nina Wallerstein!

 Here is the link to the CBPHC website where you can register, share information, and put this pre-conference on your calendar for Saturday, November 4th!

Please share this Save the Date information for the CBPHC Pre-conference widely as well as the link to the CBPHC Pre-Conference titled:

Community Based Primary Health Care and Community Health Workers: Underfunded Afterthought or Key to Achieving Universal Health Care?

Here is the link to purchase the ticket for the pre-conference that you can share.

Facebook event has been created for the workshop and will be continually updated and used as a platform for advertisement. If you are active on Facebook, please mark that you are “Going”, share the event, and invite your Facebook friends.

Adaptation Community Meeting 9/21: Climate Change and Health in Mozambique – Impacts and Responses

Remarkable progress is being made across Sub-Saharan Africa on public health. Child mortality, rates of stunting and incidence of diseases such as malaria and meningitis are dropping. But these gains may be lost as changes in climate and weather promote disease outbreaks and greater food insecurity. Owing to its location, demographics and geography, Mozambique is particularly vulnerable to negative outcomes on health resulting from changes in climate. Malaria is already widespread and poor water supply and sanitation infrastructure lead to frequent contamination of water resources during floods.

Over the past few years, the USAID-funded Climate Change Adaptation, Thought Leadership and Assessments (ATLAS) project has been examining the relationship between temperature and rainfall trends and diarrheal disease and malaria rates in Mozambique.

At the September Adaptation Community Meeting, Climate Vulnerability and Adaptation Specialist Fernanda Zermoglio will provide the latest research and findings from this work, as well as what is being done to strengthen Mozambique’s health system preparedness and response.

Thursday, September 21, 2017
4:00 pm – 5:30 pm ET

Location:
Chemonics International, Inc.
1717 H St. NW, Washington, DC 20006

To join remotely:
Online webinar – https://meet93445775.adobeconnect.com/september2017/
*If it is your first time using Adobe Connect please allow for up to 15 minutes for the plug-in to download before you can join the webinar.

For more details and registration, click here.

Speaker:
Fernanda Zermoglio has been on the forefront of climate change adaptation science, assessment methodology, programming and policy for the past 15+ years. A geographer with a detailed knowledge of climate modeling and various adaptation methodologies, she has synthesized applied research, pragmatic tools and knowledge-sharing platforms to inform the design, implementation and integration of climate adaptation assessments across a number of countries, in support of various donors and local governments. Since 2014 she has been the Climate Vulnerability and Adaptation Specialist on the DC-based ATLAS project.

Check out the Adaptation Community Meetings page on Climatelinks to find: 1) information on upcoming meetings, 2) recordings of previous meetings organized by category and 3) post-event blogs.

Global News Round Up

Politics & Policies

In identical language, the House and Senate bills explicitly prohibit the Trump administration from changing the formula used for decades to calculate and pay indirect costs of research financed by health institutes.

House Minority Leader Nancy Pelosi (D-Calif.) in her remarks at the conference’s opening plenary on Thursday noted President Trump’s proposed budget for the 2018 fiscal year would cut … [funding for] the President’s Emergency Plan for AIDS Relief (PEPFAR) and … the Global Fund for AIDS, Tuberculosis and Malaria…”

Programs, Grants & Awards

Duke receives $12.5 million to study children with Autism and ADHD.  NIH funds will be used to improve early screening, develop biomarkers and test therapies.

The University is considering founding a new Global Health Institute, pending the approval of Yale Corporation, as part of a joint effort of the deans of the schools of Public Health, Nursing and Medicine.

The Medical University of South Carolina Center for Global Health has received a $3.1 million grant from the National Institutes of Health to study an integrated approach to screening and treatment for HIV, diabetes and hypertension in Tanzania.

Research

Tungiasis or jigger infestation is a parasitic disease caused by the female sand flea Tunga penetrans. Secondary infection of the lesions caused by this flea is common in endemic communities. This study sought to shed light on the bacterial pathogens causing secondary infections and their susceptibility profiles to commonly prescribed antibiotics.

Diseases & Disasters

The Conch Republic is still here, if dark, dirty, trashed, and weeks away from being what it was before Hurricane Irma blew in. It wasn’t devastated because, for some reason, this massive storm punched below its weight.

Hurricane Irma pounded the Bahamas before making landfall Friday night in the northern part of Cuba as it cycled toward Florida.

Hurricane Irma lashed the Caribbean today, causing at least 10 deaths, while in the U.S., Florida, Georgia and South Carolina are facing states of emergency as residents brace for the monster storm.

Hurricane Irma has landed in the Caribbean and left a path of destruction in its wake.  Images have emerged from Caribbean islands such as Puerto Rico, Antigua and Barbuda that show the powerful Category 5 storm bringing heavy winds, high water and devastation.

More than one million people have been displaced in the aftermath of Hurricane Harvey, according to estimates reported by Reuters. The storm is shaping up to be one of the costliest disasters in US history.

September has already been a rough month.  Over the past week, catastrophic flooding hit Texas, an unprecedented tide of refugees entered Bangladesh, a nuclear test sent tremors across Asia and a monster hurricane ravaged the Caribbean.

Women going through midlife aren’t getting enough sleep, according to a new government report.

Brazil, which has recently suffered serious outbreaks of Zika virus and yellow fever, now faces a new threat, according to reports from local scientists: Oropouche fever.

Chagas is a deeply misunderstood disease that affects about 8 million people around the world, primarily in Latin America, and is responsible for for 10,000 deaths a year, according to the World Health Organization. It is estimated that 300,000 people in the United States have it, per the U.S. Centers for Disease Control and Prevention.

This past year China had the largest outbreak of a deadly bird flu since the virus was first detected in March 2013.

Technology

Tuberculosis kills almost two million people a year. A perfect vaccine could save many of them, but the one now in use — invented in the 1920s and known as BCG, for Bacillus Calmette-Guérin — has so many flaws that some countries, including the United States, have never adopted it.

Environmental Health

A new report reveals the widespread microplastic contamination in tap water in countries around the world.

Equity & Disparities

The psychological problems and related influential factors of left-behind adolescents (LBA) in Hunan, China: a cross-sectional study.

When it comes to living a long life, Italy is the place to be.  The high-heeled boot surrounded by five seas is ranked the healthiest country on Earth in the Bloomberg Global Health Index of 163 countries. A baby born in Italy can expect to live to be an octogenarian. But 2,800 miles south in Sierra Leone, the average newborn will die by 52.

Maternal, Neonatal & Children’s Health

Having been awarded a $120 million grant from Bill and Melinda Gates Foundation, PATH has launched a new maternal immunization initiative aimed to provide pregnant mothers vaccines to protect their newborns from infectious diseases.

Researchers have identified six gene regions linked to preterm births, including a new gene area that suggests a role for selenium.

The Promise of Data for Transforming Global Health

I recently came back from a field visit and as my organization’s designated data person (among the many other hats I wear), I think constantly about the role of data in our work and more broadly, its role in global health.

We’ve always had a problem with data in our field, more specifically the dire lack thereof. Recent efforts to spotlight the lack of high quality data in global health has led to somewhat of a data renaissance. And you know it’s a big deal when Bill Gates throws his weight behind it. It seems like every global health innovation talk I go to nowadays portrays data (in all its forms, from big data, predictive analytics, and machine learning) as the ultimate game changer in global health. Data is so much easier to collect now with the various technologies and innovations available. Its potential is pretty obvious and I don’t disagree that data can and will create more positive changes in global health. But every time I attend one of these talks or I get an email alert about another new data innovation challenge, part of me gets really excited and the other part remains skeptical.

Anyone who has tried to implement a data collection initiative in the field, whether for research, monitoring and evaluation, or donor reporting, knows the many challenges faced when working in already resource-limited clinics and hospitals: the questionnaires are long and time consuming, we don’t have the resources to hire people to do just data collection (which is especially true in smaller facilities), data collection activities take away from clinical activities, data quality is poor, the staff spends a whole week every month doing reporting, every donor wants a report on different indicators, no one at the clinic knows how or has the time to analyze the data, the data is not in a format that is easy to use, etc. And the list goes on.

One huge barrier to accurate data collection involves the inordinate amount of burden placed on health care providers and/or clinic staff to collect and report data. Data collection is often a task that already busy doctors and nurses have to undertake in addition to their clinic duties. Hiring an extra data collection person is one solution, but may not always be sustainable outside of a research study setting. Reporting data to donors is not any less painful. It is too often a rote and uncoordinated endeavor. Donors ask for the same data, but sliced and diced in a slightly different way. Those asking for data haven’t exactly done a good job making data collection easy to do. Shorter questionnaires, standardizing indicators, simplifying and coordinating reporting are different approaches for addressing these issues. Getting providers and clinic staff to collect high quality data though is another beast. Some argue that doing regular data audits will fix the data quality problem. Others argue that mobile data collection has reduced data entry errors. Mobile data collection has certainly made it easier to collect data and scale-up data collection activities.

And while a lot of work is being undertaken by major development agencies and smaller NGOs alike to improve their data collection efforts in order to deliver on the promise that data has to offer, I’m not entirely convinced we’re there yet. A huge part of my skepticism in why data hasn’t yet reached its transformative power in global health is because even though I think we’ve spent lots of resources in building capacity to collect data, we haven’t spent equal amounts of efforts building capacity for local team members to use the data in a meaningful way.

If those who collect the data don’t understand why or how the indicators they collect impact patient care, then why do it? Although national level data is helpful in understanding what the different health needs are and how to allocate resources to address them, the interventions needed to dramatically move the needle when it comes to decreasing morbidity and mortality happen at the individual facility level, outside of the research setting. The frontline healthcare workers that help in the collection and reporting of data very rarely get the data back in a way that can help them understand how to improve care delivery and health outcomes for their patients.

I believe in the potential of data to transform global health but there are many obstacles to overcome before this happens. First things first, instead of thinking about data collection as an activity that providers and clinic staff have to do, it should be an activity they want to do. By having data available to providers that is easy to understand, timely, and meaningful, only then can the promise that data holds for transforming global health be fulfilled.