Global News Round Up

Politics & Policies

Regulations to fight climate change likely will be casualties of the incoming Trump administration, but environmental experts taking stock of the changing American political landscape said that work in the field will continue elsewhere and that a broad-based rollback of U.S. environmental protection will prove easier said than done.

2015 marks the fourth year that the Kaiser Family Foundation has been analyzing donor government funding for family planning, tracking progress against commitments made at the 2012 London Summit on Family Planning.

Last week, the world was shocked by the news that Donald Trump would become the next United States President. In this post, Emory University’s James Michiel takes a first look at how this surprising result might influence global health in the coming years.

Programs, Grants & Awards

UN World Toilet Day highlights the urgent need to address a global sanitation crisis by providing toilets and sewage management systems and to aggressively implement programs of WASH (Water, Sanitation, and Hygiene).

Research

Domestic violence during pregnancy needs to be addressed at different levels in Nepal, where women are often dependent on others for access to health care.

Global performance of epidemiologic surveillance of Zika virus.

Dengue fever, caused by the dengue virus (DENV), is now the most common arbovirus transmitted disease globally. One novel approach to control DENV is to use the endosymbiosis bacterium, Wolbachia pipientis, to limit DENV replication inside the primary mosquito vector, Aedes aegypti.

Diseases & Disasters

Scientists say they may have found a way to protect babies in the womb from the harmful effects of Zika.

In a Sierra Leone village considered an Ebola “hotspot” during the epidemic, researchers discovered 1 year later more than a dozen people with minor symptoms of infection that had gone undetected.

Since the beginning of 2016, the humanitarian partners working in cholera response identified a risky scenario created by the increase in the number of suspected cholera cases and the decrease of funding to fight the disease.

The World Health Organization (WHO) announced Friday that it no longer considers the Zika epidemic a public health emergency of international concern.

Technology

Funding for phase one of pilot deployments of the world’s first malaria vaccine in sub-Saharan Africa has been secured and immunization campaigns will begin in 2018, the World Health Organization (WHO) said on Thursday.

Environmental Health

The Flint water crisis hasn’t gone away. Thousands of the city’s residents are still at risk from the water supply. The city has switched back to Detroit water, but experts say the distribution system will never be the same.

The EU’s environment watchdog has said air pollution is “the single largest environmental health hazard in Europe.” Around 467,000 premature deaths in 41 European countries were linked to air pollution in 2013.

Back in late September, Polk County officials spilled five gallons of fuel while refueling a generator at the Babson Park Water Treatment Plant. How do we know this? We know this because Gov. Rick Scott wants us to know this.

The Trudeau government has taken important steps to assert Canadian leadership on environmental issues after years of neglect under the Harper government.  Now it plans to phase out almost all use of coal to generate electricity by 2030, a move that will cut greenhouse gas emissions while producing significant health benefits from cleaner air.

Equity & Disparities

Unsafe drinking water is a bigger problem for minority communities in the US than for white communities, suggests a new study from the University of North Carolina, Chapel Hill.

GSK has today been ranked first in the Access to Medicine Index for the fifth time, taking a leadership position in research & development; pricing, manufacturing and distribution; and product donations.

Disparities in health and health care remain a persistent challenge in the United States. Disparities not only result in inequities but also limit continued improvement in quality of care and population health and result in unnecessary health care costs.

Maternal, Neonatal & Children’s Health

Community health workers (CHWs) have the potential to reduce child mortality by improving access to care, especially in remote areas. Uganda has one of the highest child mortality rates globally. Moreover, rural areas bear the highest proportion of this burden. The optimal performance of CHWs is critical.

Sebastian Vollmer and colleagues (April, 2014) conclude that “the contribution of economic growth to the reduction in early childhood undernutrition in developing countries is very small, if it exists at all.”

Diarrheal disease is the second-leading cause of death for children under the age of five.  And it disproportionately affects kids in the developing world, where it’s tougher to access safe water and medical care.

The global news round up was prepared by SS.

Global News Round Up

Politics & Policies

Donald Trump has been elected as the 45th President of the United States of America. There is concern that climate change regulations and commitments would be watered down and would take a back seat under his presidency.

Margaret Chan isn’t backing down in her last few months in office. Early this week, she engaged member states in her fourth — and last — financing dialogue in hopes of convincing them to increase their contributions to the World Health Organization.

In this election season science and health have taken a backseat. Worse, presidential candidate Donald Trump dismissed climate change as a Chinese hoax. His opponent, Hillary Clinton, vowed to dig up what the government knows about UFOs. Science is hardly getting its due.

In an effort to prevent surgical infections, the WHO has released the “Global Guidelines for the Prevention of Surgical Site Infection” that includes a list of 29 recommendations to combat the growing burden of healthcare associated infections.

Nigeria calls for urgent action on sustainable urban development.

The World Medical Association has released a statement in support of the taxes on junk foods and sugary drinks and bans on advertising to children to prevent and curb the rising burden of obesity.

Children with disabilities in rural areas have been especially hit by cuts to Medicaid that the Texas Legislature approved last year.

Programs, Grants & Awards

The 2016 Food Governance Conference was held between Nov 1 and Nov 3 in the University of Sydney, Australia.

Research

Trends in racial and ethnic disparities in antiretroviral therapy prescription and viral Suppression in the United States, from 2009–2013.

Snakebite is a major public health problem in agricultural communities in the tropics leading to acute local and systemic impairments with resultant disabilities. Snakebite related long-term musculoskeletal disabilities have been a neglected area of research. We conducted a population-based, cross-sectional study in an agricultural community to describe the chronic musculoskeletal disabilities of snake envenoming.

Historically, implementing nutrition policy has confronted persistent obstacles, with many of these obstacles arising from political economy sources. While there has been increased global policy attention to improving nutrition in recent years, the difficulty of translating this policy momentum into results remains.

A new study by Pettifor et al in Lancet Global Health showed that while cash transfers have impact on HIV risk reduction, the conditionality of the cash transfers does not advance the cause considerably.

A study published in Science shows a direct link between number of cigarettes smoked in a lifetime and the number of DNA mutations in tumors. The authors find that smoking one pack a day can lead to up to 150 damaging alterations to a smoker’s lung.

Diseases & Disasters

The Ebola epidemic that tore through West Africa in 2014 claimed 11,310 lives, far more than any previous outbreak. A combination of factors contributed to its savagery, among them a mobile population, crumbling public health systems, official neglect and hazardous burial practices.

The U.S. Department of Health and Human Services said on Thursday it added seven new agents, including the HIV virus and an industrial solvent to its list of carcinogens.

Cholera can kill a person in a matter of hours. It’s a severe gastro-intestinal disease, and it can trigger so much diarrhea and vomiting that patients can rapidly become dehydrated. The water-borne disease has been around for centuries, and it remains a global health risk. According to the World Health Organization there are roughly 3 million cases a year and 90,000 deaths.

A boiling pot of global conditions, like ubiquitous travel and the growing populations of developing cities, have led to an outbreak of pandemics like Ebola, Zika, SARs, and even the flu over the past decade.

Providing increased access to contraception to women in Puerto Rico during the Zika outbreak would be a cost-saving measure, including avoiding $62.3 million in costs related to Zika-linked microcephaly, researchers from the US Centers for Disease Control and Prevention (CDC) and Puerto Rico reported today.

After confirmation of the first Zika Virus case in Myanmar’s largest city, the Ministry of Health is going to release a statement advising women in the Yangon region to avoid getting pregnant in the next six months.

Technology

Genetic testing could help identify breast cancer patients at high risk for venous thromboembolism (VTE), according to a study published online Nov. 1 in Clinical Cancer Research.

Environmental Health

For about 3 billion of the world’s poorest people, the simple act of cooking dinner is fraught with risk. They burn wood, charcoal, dung or crop waste, often on open fires, fouling the air they breathe. It’s no small matter: Household air pollution from cooking fire is thought to be the world’s leading environmental cause of death and disability.

A new UNICEF report estimates that nearly 300 million children breathe extremely toxic air. Overall 2 billion children are estimated to breathe air that has been deemed “long term hazard.”

According to the new Global Lead Paint Report, many paints sold in 46 low and middle income countries contain dangerous levels of lead, including nearly 70% of paints tested in Philippines.

Equity & Disparities

Investing in human resources via education is essential to improving access to surgical and anesthetic care across the globe.

Basic cancer-fighting measures—for as little as $1.72 per person—could save hundreds of thousands of lives in poor countries, according to research published yesterday in The Lancet.

A clinical trial for an injectable male contraceptives was halted due to side effects that included mood changes, depression, pain at injection site and decrease in libido.

Maternal, Neonatal & Children’s Health

Women should see a doctor, nurse or trained midwife at least eight times during each pregnancy, with five of those visits in the last trimester, the World Health Organization said Monday as it issued 49 recommendations to prevent deaths in childbirth.

Eight of nine children exhibiting symptoms of a mysterious illness have been confirmed to be suffering from acute flaccid myelitis, a highly infectious polio-like disease that primarily strikes children, the Washington State Department of Health announced Friday.

A therapy that successfully treats two-thirds of children with chronic fatigue syndrome is being trialled for NHS use.

Diarrheal diseases are a major causes of child mortality and one of the main causes of medical consultation for children in sub-Saharan countries. This paper attempts to determine the risk factors and neighborhood inequalities of diarrheal morbidity among under-5 children in selected countries in sub-Saharan Africa over the period 1990–2013.

Stunting affects one-third of children under 5 years old in developing countries, and 14% of childhood deaths are attributable to it. A large number of risk factors for stunting have been identified in epidemiological studies. However, the relative contribution of these risk factors to stunting has not been examined across countries.

The number of preterm births in the United States has risen for the first time in the last 8 years from 9.57 to 9.63 in 2015.

A new study has ranked poor fetal growth in the womb as among the greatest risk factors associated with stunting among children. This study emphasizes the need to improve women’s health before and during a pregnancy.

The global news round up was prepared by the communications team.

Global News Round Up

Politics & Policies

Election campaigns are light on science. But once a new president is in office, technical issues have a way of demanding attention.

Hillary Clinton affirmed women’s right to abortion while Donald said he would appoint judges to the Supreme Court who oppose it.

Global Health Council (GHC), announced today that it has named Loyce Pace, a leader who has worked on the ground in more than 10 countries delivering health programs and mobilizing advocates, as the organization’s new Executive Director.

Two weeks after congress allocated $1.1 billion in supplemental funding to fight Zika, the Department of Health and Human Services (HHS) announced today during a teleconference how the pie of Zika funding will be sliced among major players.

Who will be the World Health Organization’s next director-general? In September, the U.N. agency announced the six nominees, four men and two women.

The next WHO Director-General faces major challenges: operational responsibilities for epidemic response, universal health coverage (UHC), and the rise of non-communicable diseases.

Programs

Purdue’s chapter of Timmy Global Health and the Purdue Student Engineering Council are teaming up to host an event to contribute to Quito, Ecuador, where Timmy works with people in need of medical assistance.

Research

The Zika virus outbreak in the Americas has caused global concern. To help accelerate this fight against Zika, we launched the OpenZika project.

This is the first study to evaluate the efficacy and safety of switching to E/C/F/TAF in HIV/HBV-coinfected adults. One year after switching from predominantly TDF-based regimens to E/C/F/TAF, participants maintained high rates of HIV and HBV suppression, had improved renal function, and reduced biomarkers of bone turnover, consistent with other E/C/F/TAF studies.

Accumulating evidences have assigned a central role to parasite-derived proteins in immunomodulation.  Here, we report on the proteomic identification and characterization of immunomodulatory excretory-secretory (ES) products from the metacestode larva (tetrathyridium) of the tapeworm Mesocestoides corti (syn. M. vogae).

In this study, SIV-infected rhesus macaques were treated with an antiretroviral drug for 90 days and in addition they were treated with a specific antibody for 23 weeks. After finishing this therapy, all macaques showed sustained control of the infection as almost no SI viruses could be detected in the blood and gastro-intestinal tissues.

Diseases & Disasters

TV crew filmed as a 15th century church spectacularly collapsed in Italy yesterday as the country was rocked by a string of powerful earthquakes.

Across the globe, poor diets now pose a greater collective health risk than unsafe sex, alcohol, drugs and tobacco use combined.

Briefing the United Nations General Assembly on the humanitarian situation in Haiti following the devastation caused by Hurricane Matthew, Secretary-General Ban Ki-moon underlined the urgency of additional resources to help respond to the dire needs on the island.

Hurricane Matthew, which ripped through Haiti 13 days ago, has left more than 700,000 people in an “extremely difficult situation.” United Nations Special Adviser David Nabarro said today, and while steady progress is being made, led by Haitians themselves, the response must be accelerated as the needs are still great, frustrations are high, and access to hard-hit areas remains tough.

Using a recently developed technology for analyzing DNA, the scientists found dozens of genes and two major biological pathways that are likely involved in the development of the disorder but had not been uncovered in previous genetic studies of schizophrenia.

Household air pollution created by using wood, coal and other solid fuels for cooking and heating homes is a leading cause of respiratory and cardiovascular diseases worldwide.

Scientists in India will extract DNA from more than 20 skeletons of suspected victims of devastating floods in 2013 in the northern state of Uttarak.

Tuberculosis is killing more people than thought, yet governments are not doing enough to bring the debilitating infectious disease under control, the World Health Organisation has said.

Technology

The World Health Organization, drugmakers and humanitarian groups are hammering out details of new vaccine supply system aimed at getting vital shots to vulnerable people in crises such as wars or natural disasters.

A register of patients in England with breast and other cosmetic implants has been set up to allow them to be traced in the event of any safety concerns.

Environmental Health

The United Nations World Health Organization (WHO) in partnership with the Coalition for Climate and Clean Air (CCAC) and the Government of Norway has launched a global awareness campaign in the dangers of air pollution – especially ‘invisible killers’ such as black carbon, ground-level ozone and methane – for the health of individuals and the planet.

Up to 122 million more people worldwide could be living in extreme poverty by 2030 as a result of climate change and its impacts on small-scale farmers’ incomes, a major UN report warned on Monday.

Equity & Disparities

Girls in developing countries are less likely than boys to complete schooling because of forced marriage, child labour and female genital mutulation, risking the opportunities presented by their largely young populations, said the study, launched in London.

Maternal, Neonatal & Children’s Health

The humanitarian crisis in South Sudan is contributing to severe health service delivery challenges: It impedes access to already highly vulnerable populations, slows delivery of medical supplies and drugs, and exacerbates shortages of health workers.

The “Midwives voices, midwives realities report 2016″ documents the voices and realities of 2470 midwifery personnel in 93 countries and describes, from their perspective, the barriers they experience to providing quality, respectful care for women, newborns and their families.

Bangladesh has a reasonably good network of health care facilities – most recently expanding the network of community based clinics. But it still suffers from a shortage and distribution of qualified health workers.

It was amazing and very educative as a jam-packed Parliament listened to children, especially girls conducting parliamentary session right in the Well of the Parliament of Sierra Leone as ‘Honourable Members of Parliament’ in commemoration of the International Day of the Girl Child.

Women aged 25 to 35 are the most likely group in Northern Ireland and Republic of Ireland to access medication online to end a pregnancy, a study suggests.

One girl under the age 15 is married every seven seconds, according to a new report by Save the Children.

The global news round up was prepared by the communications team.

Global News Round Up

Politics & Policies

Until last week, Congress had appropriated exactly zero dollars in emergency funding to support Zika prevention, public education, and reproductive health services, leaving women to bear the burden.

Thai authorities have decided that pregnant women infected with Zika virus can undergo abortion without legal consequences.

Venezuela has become dangerous for the healthy, it is now deadly for those who fall ill.
One in three people admitted to public hospitals last year died, the government reports.

The Census Bureau released a report last week showing continued improvements in the uninsured rate between 2014 and 2015 following the implementation of the major coverage provisions of the Affordable Care Act (ACA).

Boosting developing nations’ access to medical advances is top of the agenda at Berlin’s World Health Summit, but will it improve healthcare for the poorest?

Valentin Fuster, MD, PhD, director of Mount Sinai Heart and physician-in-chief of The Mount Sinai Hospital, has been appointed co-chair of the consensus committee on global health that will advise the next presidential administration.

It’s gratifying when global health research affects policy. This was the case when Peru’s federal government declared a state of emergency after the publication of a report by DGHI researchers showing the distressing impact of gold mining on the health of people living downriver from mines in the Peruvian Amazon.

Programs, Grants and Awards

The Health Scholars Program  provides outstanding Princeton students with funding for travel and research to pursue global health-related internships and senior thesis research, both in the US and abroad. This competitive program, administered by the Center for Health and Wellbeing, is open to students from all departments.

World Mental Health Day is observed on 10 October every year, with the overall objective of raising awareness of mental health issues around the world and mobilizing efforts in support of mental health.

Research

Researchers have completed the most up-to-date analysis on the state of the world’s health to equip governments and donors with evidence to identify national health challenges and priorities for intervention.

In this pilot study, we found that a colorimetric system using AuNPs and MSP10 DNA detection in urine can provide fast, easy, and inexpensive identification of P. Vivax.

Cutaneous anthrax, a disease associated with biological terrorism in western countries, is common and underreported in the rural areas of Africa .It can be lethal in some cases, especially when the oropharyngeal area is affected after ingesting meat from contaminated sources.

The most up-to-date analysis of the world’s health shows that while life expectancy has increased, about 7 in 10 deaths are due to non-communicable diseases. You can access these articles here.

Researchers have sequenced the full-length genome of a Zika virus taken from a patient in Brazil and identified a virus-derived molecule that inhibits part of the infected person’s immune system.

We use national population-based survey data to quantify diabetes prevalence and met and unmet need for diabetes diagnosis and care in 12 countries in sub-Saharan Africa. We further estimate demographic and economic gradients of met need for diabetes diagnosis and care.

Diseases & Disasters

Zika infections are expected to continue rising in the Asia-Pacific region, where authorities are increasing surveillance, preparing responses to complications and collaborating on information about the disease, the World Health Organization said Monday.

Every few years, a group of federal agencies publishes a raft of data on every conceivable subject affecting older people.  At every age, the report shows, older men are far more likely to be married than older women.

It’s dangerous to be a doctor in Afghanistan.  This is what the staff deal with most days at a hospital in the country’s north-west: physical attacks by patients’ relatives; gun-wielding soldiers inside the wards; and verbal assaults and threats of bodily harm against doctors and nurses who are only trying to help.

Myanmar’s largest city, Yangon is capturing some of its tens of thousands of stray dogs, using blowpipes to sedate them for neutering and vaccinations to combat a rabies epidemic.

After Hurricane Matthew slashed through the impoverished nation of Haiti on Tuesday, leaving death and destruction its wake, the country may be facing another deadly crisis:  a surge in cholera.

Life expectancy has increased by 10 years across the globe in the past 35 years, thanks in part to efforts to treat infectious diseases such as AIDS and malaria, but diet, obesity and drug use are now major causes of death and disability while too many women still die in childbirth, data reveals.

In 2007, a World Health Organization committee said shift work “probably” had a link to breast cancer, based on studies of animals and people.  But this new work by leading UK cancer experts looked at data on 1.4 million women and found there was no association with night shift work.

The Region of the Americas is the first in the world to have eliminated measles, a viral disease that can cause severe health problems, including pneumonia, blindness, brain swelling and even death. This achievement culminates a 22-year effort involving mass vaccination against measles, mumps and rubella throughout the Americas.

A 10th of children have a “monkey-like” immune system that stops them developing AIDS, a study suggests.

Hypertension (high blood pressure) is the leading risk factor for heart disease and stroke and is responsible for 9.4 million largely preventable deaths worldwide – more than tobacco. Thirty three percent of adults in Barbados have high blood pressure, and they develop it for largely the same reasons as people in other developing countries: not getting enough exercise and eating an unhealthy diet.

Those who are malnourished are set to be, by far, the biggest casualties of Yemen’s war. More than 6,000 people have been killed in the bombing and fighting.

International aid agencies have called for millions of dollars of funding for an urgent relief effort in North Korea after floods in the country’s remote north-east in August left 70,000 people homeless and 600,000 others in need of humanitarian assistance, including tens of thousands of children.

With more than 65 million people displaced globally – the most there have been since World War II – the global refugee crisis has captured the attention of aid groups and political leaders worldwide.

Technology

As drones quickly pick up momentum around the world in everything from military strikes to pizza delivery, Africa, the continent with some of the most entrenched humanitarian crises, hopes the technology will bring progress.

Researchers at McMaster University and two American universities have taken another step closer to developing a much more effective, “one-punch” universal flu vaccine.

The Microsoft co-founder and philanthropic leader sets out an agenda of global issues that he thinks whoever wins the presidential election should address.

In 2014, the Senegal Ministry of Health and Social Action (MOHSA) began the development of a national eHealth strategy.

The U.S. Department of Health and Human Services (HHS) has announced progress on several fronts to develop vaccines that protect against Zika and yellow fever viruses.

Environmental Health

According a new interactive air quality map released by the WHO, nearly 92% of the world’s population lives in areas where outdoor air quality do not meet WHO standards.

While members from the least developed countries applauded the ratification of the Paris deal, they have urged that financial support be made available swiftly in order to start implementing their plans to curb emissions.

The Quest CCS (carbon capture and storage) project near Edmonton announced last week that it successfully stored one million tonnes of carbon dioxide deep underground in its first year of operation. That’s equal to the emissions from about 250,000 cars.

Equity & Disparities

A new measure of development from the Global Burden of Disease study, called the Socio-demographic Index (SDI) aims to use a finer yardstick of development to accurately reflect the reality among disenfranchised populations.

A quarter of a billion children across the globe may not achieve their full potential because of extreme poverty and stunting, says a series of papers published in The Lancet.

New research published in the journal Urology reveals that African-American and Hispanic men in the US were less likely to receive treatment for prostate cancer. The study was based on 327,641 men diagnosed with localized prostate cancers reported to the SEER program between 2004 and 2011.

In order to achieve the education goals put forth in the SDGs by 2030, the international community needs to recruit and train 69 million teachers. South Africa and South Asia are most affected by the shortage of well trained teachers.

When it comes to health, there are many factors that influence how long and how well people will live, from the quality of their education to the cleanliness of their environment. But of all social determinants of health, research shows there is one that is perhaps the most influential: income.

Dr. Jim Kim, the president of the World Bank and one of the founders of Partners in Health, recently gave a talk about changing the focus of the World Bank, and cited two leading principles: “A preferential option for the poor and evidence-based medicine.” I could not agree more, and I suspect many in global health are guided by a similar set of values.

The 2016 Lancet Advancing Early Childhood Development series updates the science on various aspects of early childhood including epigenetic effects of adverse childhood experiences on brain development and cognition. The series also focuses on strategies for implementation of early childhood programs at scale.

The global news round up was prepared by the communications team.

Social determinants of health

“When we try to pick out anything by itself, we find that it is hitched to everything else in the universe”, you can probably extrapolate this John Muir quote to health. For far too long, health has been a very specific, very individual-driven personal attribute. Although social inequalities and inequities are not new to any of us, we now have data that show how health is impacted by not just individual preferences/behaviors and biology but also by social, environmental and economic conditions that individuals live in. These are collectively known as social determinants of health (SDH or SDoH) and the WHO defines SDH as “the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems.”

Recognizing the impact of social determinants on health, Dr. Frieden introduced the Health Impact Pyramid in 2010.

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Source: Health Impact Pyramid

What exactly are social determinants of health? Below is an easy-to-read table from a Policy Brief from Kaiser Family Foundation.

Figure 2: Social Determinants of Health
Health equity can be achieved by addressing the upstream root causes a.k.a the social, environmental and economic factors that negatively impact health. Health Equity, as so aptly described in the image below, is defined by the WHO as “the absence of avoidable or remediable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically.”

IISC_EqualityVsEquityCartoon
Source: “Interaction Institute for Social Change | Artist: Angus Maguire.”

While there is plenty of evidence for how social determinants impact health, there have not been many solutions that have been tested and you can probably imagine why!

In the coming months, we will explore evidence for working upstream and programs and practices that are being tested to impact health by addressing social determinants of health. If you know of any implementation examples, please leave a comment.

Don’t forget to tune into and participate in APHA’s Social Determinants of Health Twitter chat #SDOHChat  on October 5th, 2016 between 1:00 PM – 2:00 PM (EST).