Category Archives: APHA IH Section

APHA 2017 Section Elections Start May 25th!

The polls for the American Public Health Association’s Section Elections will be open May 25 – June 15.

As an APHA member, selecting Section leadership is an integral part of your Association’s governance. We encourage you to take part in this year’s election.

On May 25, look for an email (subject line: “APHA Voting Information Enclosed”) that will include voting instructions and a direct link to your online ballot.

All you have to do is click on the link, review the candidate statements and VOTE!

Rest assured the site is secure and will prevent anyone from voting more than once.

What’s next for US global health funding?

On April 30th, a bipartisan budget deal was passed which will keep the US government funded through the end of September this year. Although funding for global health programs remains largely intact this year (in some cases, budgets have even increased), the future of US global health funding is looking pretty bleak.

Trump’s “skinny budget” proposal for fiscal year 2018 includes steep cuts of nearly 30% to foreign aid and diplomacy delivered through the Department of State. Additionally Trump’s budget proposes cuts to the United Nations and its affiliated agencies, multilateral development banks like the World Bank, and the complete elimination of funding for the Fogarty International Center. And while we can all breathe a collective sigh of relief knowing that malaria programs, PEPFAR, the Global Fund, and Gavi have been spared, the proposed 25% cut to global health programs is disconcerting to all of us within the international development and global health community.

Although such dramatic cuts in US foreign aid spending impacting global health are rightfully shocking, a recent study published in the Lancet shows that financing for global health programs by all development agencies (which includes bilateral (government to government) assistance, multilateral development banks, international NGOs, and others) has already been slowing significantly in recent years. Between 2010 and 2016, development assistance for health grew annually at only 1.8% compared to 11.3% in the first decade in the millennium and 4.6% in the 1990s.

The United States is currently the largest contributor (in absolute dollar amounts) of bilateral foreign assistance even though we spent only 0.18% of our gross national income (GNI) in 2016 on foreign assistance. As a comparison, the OECD country which spent the most of its GNI on foreign assistance, Norway, spent 1.11%. (Just in case you’re curious, most of our federal tax dollars are budgeted toward defense, social security, and major health programs.)

With Trump touting an “America First” agenda and Americans grossly bigly overestimating the amount the US spends on foreign assistance (on average, those polled guessed 26%), it is probably safe to guess that the general public knows little about how foreign assistance can help contribute to a safer America. Although a majority of US foreign aid goes toward funding critical global health programs (including being the largest funder of HIV/AIDS projects), foreign aid isn’t completely altruistic. Foreign aid also helps bring peace and stability to countries where we can benefit from open trade and less volatile economies. In addition, foreign aid helps keep Americans healthy by preventing the global spread of deadly diseases.

In a recent op-ed for Time magazine, Bill Gates provides the proof in the pudding:

According to one study, political instability and violent activity in African countries with PEPFAR programs dropped 40 percent between 2004 and 2015. Where there was no PEPFAR program, the decline was just 3 percent.

….. A more stable world is good for everyone. But there are other ways that aid benefits Americans in particular. It strengthens markets for U.S. goods: of our top 15 trade partners, 11 are former aid recipients. It is also visible proof of America’s global leadership. Popular support for the U.S. is high in Africa, where aid has such a dramatic impact. When you help a mother save her child’s life, she never forgets. Withdrawing now would not only cost lives, it would create a leadership vacuum that others would happily fill.

As global financing for international health programs is expected to continue to slow, it is critical that the United States continues to provide foreign assistance not only because it keeps Americans safe and our economy healthy, but also because it is the right thing to do. While it’s true that foreign aid is in desperate need of extensive reform and that at some point a few low-income countries will be able to start financing a majority of their own health programs, change doesn’t happen overnight. Another Lancet study found that global spending on health is expected to increase from $9.21 trillion USD in 2014 to $24.24 trillion USD in 2040 with low-income countries growing at 1.8% and per capita spending expected to remain low. Failing to support global funding for health at adequate levels has serious consequences not only for the health and well-being of the millions of vulnerable individuals around the world who depend on our support, but in a world where we are inextricably linked, it also endangers the health and well-being of the American people.

The bipartisan deal reached by Congress provides a small glimmer of hope that Trump’s proposed cuts may be dead on arrival, but in such an unpredictable political climate, our collective cynicism is teaching us to expect the unexpected. Trump’s full budget proposal is expected to be released the week of May 22nd. Until then, let’s make sure we are fully prepared to fight in this uphill battle.

Preventing Rickets Globally

This is a guest blog post by Dr. Mark Strand, IH Section Councilor and Professor in the Pharmacy Practice and Master of Public Health Departments at North Dakota State University.

For the last fifteen years, I have collaborated with a group of scholars to research and prevent nutritional rickets in children. Recently our newest paper was published, a look at the global burden of disease due to rickets, and prospects for reducing this preventable disease of poverty. Rickets is caused by insufficient circulating 25-OH-D (vitamin D levels), as a result of insufficient sun exposure, high amounts of melanin in the skin, or both; as well as inadequate intake of dietary calcium. Therefore, the condition begins at birth in children facing these conditions, and worsens up to age 2 or 3, when self-selection of food, and outdoor play, tend to slow or stop the progression. However, during that time these children have higher rates of pneumonia and other preventable conditions, and if severe, will maintain the skeletal deformities for life.

I am deeply committed to research which provides scientific evidence to explain causes of disease and burden among underserved and vulnerable populations. This has been one of my more satisfying contributions.

My colleagues and I published this paper on nutritional rickets nearly ten years ago: https://www.researchgate.net/publication/7282059_Nutritional_rickets_around_the_world_Causes_and_future_directions

Here is a link to our newest article:
http://www.tandfonline.com/eprint/p5idF3CXdvKph3tBMHhT/full

Global News Round Up

Politics & Policies

Taiwan is pushing for a last-minute invitation to an annual World Health Organization summit amid rising pressure from Beijing to isolate the island by blocking its participation in international events.

As the burden of such diseases shifts, and the threat of pandemics begins to hit home even in the world’s wealthiest countries, advocates are pushing for the health ministers of the G20 – gathering in Berlin later this month for the first meeting of its kind – to do their bit in supporting global health R&D in tackling neglected diseases, antimicrobial resistance and pandemic preparedness.

A federal court on Friday granted the Trump administration’s request to suspend lawsuits against the Clean Power Plan rule, signaling the likely end of President Barack Obama’s signature climate policy.

Mexico’s Lower House of Congress passed a bill on Friday to legalize the use of marijuana and cannabis for medical and scientific needs.

Liberia’s vice-president has backed US President Donald Trump’s plans to slash foreign aid, saying that the West African country “cannot continue living on handouts.”

On Tuesday night, the United States House of Representatives passed a near-unanimous resolution calling for continued US engagement on the famine in South Sudan.

While the president pooh-poohs foreign aid, health programs supported by organizations in Seattle are saving millions of lives in places like sub-Saharan Africa.

Programs, Grants & Awards

The third annual Seeds & Chips Global Food Innovation Summit started off with a panel titled “How Millennials Are Changing the Food System.”

The international conference on healthcare in a globalizing world ‘SymHealth 2017’, was held on May 4 to 6, 2017 at the Symbiosis International University (SIU), Pune.

The University of Wisconsin-Madison is celebrating a milestone with one of its new programs.  This is the end of the first year of UniverCity Year. The program paired UW students studying city planning with the city of Monona to work on projects within the community.  Next Fall, the program is partnering with Dane County to address issues like affordable housing and pollution in the Yahara waterways.

Research

In this study the prevalence of SP resistance mutations was determined among P. falciparum found in pregnant women and the general population (GP) from Nanoro, Burkina Faso and the association of IPTp-SP dosing and other variables with mutations was studied.

In lung cancer patients who were taking immunotherapy drugs targeting the PD-1 pathway, testing for CD8 T- cell activation in their blood partially predicted whether their tumors would shrink.  The results were published online by PNAS April 26.

Scientists have developed a highly sensitive, inexpensive diagnostic tool based on the CRISPR protein that targets RNA instead of DNA.

Diseases & Disasters

The largest Somali-American community in Minnesota is currently experiencing the state’s worst measles outbreak in nearly three decades.

Somalia is suffering from the largest outbreak in the past five years and the number of people killed is expected to double by the end of June, the United Nations health agency.

Liberia is sending blood samples from people suffering from an undiagnosed disease abroad. The disease had already claimed 11 lives in Sinoe County. Tests for Ebola were negative.

Owing to armed conflicts, natural disasters and increased food prices, international food insecurity rose in 2016.

Exercise addiction is not included in the Diagnostic and Statistical Manual of Mental Disorders, the authoritative guide to defining, classifying and diagnosing mental health disorders. The only behavior-associated addiction in the DSM is gambling. However, a paper that published last month in the British Medical Journal encourages health-care professionals to recognize and understand the risks of exercise addiction.

Technology

Sisu Global Health, a medical device company developing a low-cost auto-transfusion device called Hemafuse, has won the First Mile Innovation Challenge, a global call for innovative solutions that directly address clinical or community hardships in primary healthcare, conducted by The Consortium for Affordable Medical Technologies (CAMTech) at Massachusetts General Hospital’s (MGH) Global Health and GE Healthcare.

The fusion of biology and technology was used to control blood sugar levels in mice with diabetes. The idea, described in Science Translational Medicine, could be applied to a wide range of diseases and drug treatments.  The research team said the findings “could pave the way for a new era of personalised, digitalised and globalised precision medicine”.

WHO announced on Monday that the world’s first malaria vaccine will be field-tested in pilot programs in Ghana, Kenya and Malawi in 2018.

Environmental Health

According to the survey conducted by World Water Council, drinking water standards have improved considerably in India but much more needs to be done to achieve SDG WASH goals.

A new study conducted in Hyderabad, major production hub for the global drug market shows that improper waste water management has led to contamination of water resources with antimicrobial pharmaceuticals.

Equity & Disparities

A new study looks at the distribution of bed nets before and after the launch of an initiative in 2008 called Cover The Bed Net Gap to address the inequities in ITN ownership. They show that this initiative did reduce inequities but also note that some countries did better than others.

A new study reveals that 90% of development assistance goes to people below 60 years of age and that assistance to meet health targets largely ignores the older population.

Maternal, Neonatal & Children’s Health

Artemisinin combination therapies (ACTs), medications widely used against malaria, are safe to administer to women in their first trimester of pregnancy, according to research published today. ACTs had previously been recommended at that stage of pregnancy only in life-saving circumstances.

In a six year trial involving over 20,000 women in 21 countries, researchers have shown that a blood clotting drug tranexamic acid invented in the 1950s reduced maternal bleeding deaths by about a third if given within 3 hours.

A new national survey reveals that American toddlers are more likely to eat french fries than vegetables on any given day. According to the study, one in four 6-11 month old and one in five 1 year olds had no reported vegetable consumption on the days they were surveyed.

Human Rights

According to anti-trafficking NGO and Nepal’s National Human Rights Commission, human trafficking is still on the rise, a trend that seems to continue two years after the devastating earthquakes.  

According to a new report called “Impunity Must End”, nearly 106 Syrian hospitals were hit in 2016 and that aggression against health care facilities and workers continues even after the passing of UN resolution 2286.

Engaging our members: Results of the 2017 Member Engagement Survey

At the beginning of March, the International Health Section sent out a membership engagement survey put together by the Membership, Communications, and Global Health Connections Committees. The survey was sent out over the APHA Connect e-mail listserv and individually to all members who provided an e-mail address with their APHA member profiles. We collected responses for approximately three weeks and closed data collection after about three weeks, on March 25.

Thank you to all who responded! We have been working to analyze the data and discuss the feedback we received. We want our members to know that we are taking this feedback seriously and actively working on changes to our communications and approach to member engagement in response. We hear you loud and clear!

A summary report of the survey responses and the committees’ action plan are included below. You can access this report, as well as an Excel spreadsheet and a Tableau workbook summarizing the survey response data, in the Section’s library on APHA Connect. (You will need to log into Connect using your member ID, so be sure to have it handy.

2017 Member Engagement Survey Results: A Summary
April 21, 2017

Methods
On March 6, a 19-question member engagement survey was sent out over APHA Connect and individually to all members included on the March 1 roster provided by APHA. Of the 2,368 members, 43 did not list an e-mail address, and 61 e-mail addresses were invalid, meaning that the survey link was sent to 2,264 recipients. We received 230 responses between March 6 and March 25, a 10% response rate.

Overview
Of all survey respondents, nearly two-thirds (62%) listed the IH Section as their primary affiliation, compared to 38% with IH as their secondary Section. By membership category, 43% were regular members (full, discounted, or affiliate), 33% were students, 18% were Early Career Professionals (ECPs), and 6% were retired. Primary members (62% of respondents vs. 45% of all members) and ECPs (18% of respondents vs. 11% of all members) were over-represented among survey respondents. Most (86.5%) indicated that they intended to renew their APHA membership.

Consistent with overall membership data, nearly half (45.5%) of respondents had been members for less than a year, and an additional 28% had been a member for 1-3 years. The most common reason listed as the primary motivation for joining APHA was networking (48.7%), followed by professional collaboration (“to connect with other researchers/professionals to collaborate on studies/projects,” 21.3%). Nearly a quarter of respondents indicated that they joined to either attend (13.5%) or present (11.3%) at an Annual Meeting.

Committees and working groups
Members were given the opportunity to indicate if they were interested in learning more about the Section’s committees and working groups, and to provide their e-mail address for the chairs of their selected committees and working groups to reach out to them with information on how to get more involved. Committees that generated the most interest among respondents were Advocacy/Policy (36.5%), Mentorship (23%), and Program (21.3%). Working groups with the largest number of interested respondents included Global Health Connections (46.5%), Maternal and Child Health (27.4%), and Community-Based Primary Health Care (25.7%). Committee and working group selections were not mutually exclusive, as respondents could indicate multiple committees and working groups in their form response.

Communications
Survey respondents seemed to be largely unaware of the Section’s communications platforms. Among the four platforms in the survey, awareness of APHA Connect (https://connect.apha.org) was highest (38.6%), followed by the quarterly Section Connection newsletter (33.1%), the Section’s social media channels (30.2%), and the blog/website (https://aphaih.org, 28.8%). Respondents were most likely to actively read the newsletter (20%) and follow the Section’s social media channels (8.9%).

Discussion and follow-up
The general tone of most of the responses was that members want to get more involved but aren’t sure how, and that our communications channels are not advertised well enough. The Membership, Communications, and Global Health Connections Committees have developed a list of action items, found on the next page, to address the needs indicated by the survey responses.

Action Items

Completed items

  • Distribute e-mail addresses of respondents who were interested in committees/working groups to the respective committee/WG chairs (March 27)
  • Share initial survey results with the Section leadership (March 31 conference call)
  • Make survey data and results analysis available to members in the following formats (April 21):
    1. Written report
    2. Spreadsheet
    3. Dashboard
  • Publish the results of the engagement survey on the IH Blog and the APHA Connect listserv (May)

Ongoing items

  • Include links to APHA Connect, the blog, and all social media channels on all newsletters
  • Promptly send out welcome e-mails to new members when the Membership Committee receives new rosters

Items in development

  • Publish the results of the engagement survey for all members in the Section Connection newsletter (July)
  • Create a checklist for members and present it as a 6- to 12-month program to acquaint them with the IH Section and APHA (June)
  • Host a short webinar to “tour” our social media channels, APHA Connect, old issues of the newsletter, and leadership contact information (August)

Event Invitation: Community Meeting on the Implementation Guidance for the Mexico City Policy, May 10

Global Health Council invites you to a Community Meeting on the Implementation Guidance for the Mexico City Policy

May 10, 2017
9:00-11:00 am ET

PAI
1300 19th Street, NW
Washington, DC

RSVP: http://tinyurl.com/MCPmeeting 

In anticipation of the release of the implementation guidance for the Mexico City Policy (also known as the global gag rule), Global Health Council invites you to join us for a community discussion around updated analyses and available resources. We will be joined by speakers from Kaiser Family Foundation, CSIS, PAI, and others to discuss impact and next steps and to answer questions.

In person attendance of advocates, implementers, and grant/development staff is strongly encouraged. In the event that the release is delayed, we will postpone the meeting.

Member spotlight: Len Rubenstein featured on NPR’s Morning Edition

Longtime IH Section member Len Rubenstein was on NPR’s Morning Edition this week! On Monday morning, he was featured in a story on attacks on health workers in conflict:

Leonard Rubenstein, a lawyer who directs a program on human rights, health and conflict at the Bloomberg School of Public Health at Johns Hopkins. says there were a staggering number of assaults on health care facilities in 2016.

“The international community says it wants to stop this and then does nothing to implement its own recommendations,” he says. “These attacks go on.”
Rubenstein is the editor of a new report called “Impunity Must End” about aggression against health facilities and health workers globally last year.

Rubenstein found that health care facilities were under assault last year in many other parts of the world. The report was not able to compile data on the total number of attacks in each country.

“It’s quite remarkable how varied the forms of attack are,” Rubenstein says. “For example we found in 10 countries hospitals were bombed or shelled, in 11 countries health workers were killed, in about 20 countries there were various forms of intimidation — abductions, kidnapping of health workers.”

You to listen to the story here. A transcript is also available.