Category: APHA IH Section

Global Health News Last Week

by ihsection, posted in APHA IH Section, News

SECTION NEWS

The 2011 IH Section award winners have been announced!

  • Lifetime Achievement Award: Henry Mosley
  • Mid-Career Award: Neil Arya
  • Service to Section Award: Donna Barry
  • Gordon Wyon Award: John Bryant

Congratulations to this year’s awardees!  They will be honored at the section social on Monday night of this year’s Annual Meeting, so don’t miss it!

July 11 was World Population Day.  In honor of WPD this week, Secretary of State Hillary Clinton called for a greater focus on providing improved health to mothers and children.

POLITICS AND POLICY

  • Last week, a United States federal appeals court overturned  a George W. Bush-era “anti-prostitution pledge” that required all organizations that receive US funds to fight HIV and AIDS to adopt a formal position condemning prostitution and trafficking.
  • Uganda’s legislative body has passed a bill that will criminalize  the intentional spread of HIV/AIDS.
  • An in-depth report by Gregg  Carlstrom for Al Jazeera examines the state of the new Republic  of South Sudan’s health systems. Future plans appear to be in the right direction, but the present health situation is dire for the newly established
    country.
  • U.S. officials are defending  the CIA’s use of a vaccination program in the hunt for al-Qaida leader Osama bin Laden amid concerns from international aid groups that the operation  could compromise future public health efforts in Pakistan. The CIA orchestrated a hepatitis vaccination program in the city of Abbottabad in a bid to collect DNA evidence to help identify the location of bin Laden family members.
  • A growing reluctance from donor countries to provide funds to help ever-wealthier China battle HIV/AIDS will adversely affect efforts against the disease’s spread, says Michel Sidibe, head of UNAIDS.

PROGRAMS

  • The Medicines Patent Pool, established by UNITAID to share drug patents, has just received its first contribution from Gilead Sciences. This will allow Indian generics companies to make cheap copies of some of the best HIV/AIDS drugs.

RESEARCH

  • A new study has shown that ARVs taken by women with HIV/AIDS may have an effect on fertility.
  • The United Nations praised a study showing that the use of ARVs by people with HIV can reduce chance of infection between partners by 73%.
  • Mosquitoes are growing increasingly resistant to pyrethroids, the only insecticides approved by the WHO for use on bednets.
  • HIV/AIDS drugs can be used to provide additional protection against infection as well as for treatment of those already affect by the disease, according to results of two studies conducted in Africa.
  • Researchers in Tanzania are developing a device that uses the scent of malodorous human socks to attract mosquitoes in the wild, then poisons them. Donations of $775,000 announced today by the Bill & Melinda Gates Foundation and Grand Challenges Canada are intended to reduce the global infection rate of malaria by producing an affordable outdoor trap ranging in cost from between $4 and $27.
  • A new study says that an inexpensive de-worming pill can help people become deadly to malaria-carrying mosquitoes, but for the pill to work, nearly everyone in a community would have to take the pill at the same time — and repeat monthly. The drug reduces insect lifespan, helping against malaria because only the older mosquitoes can transmit it.

DISEASES AND DISASTERS

  • The World Health Organization says the world is better prepared for the next influenza pandemic. The centerpiece of the plan is to strengthen the capacity of manufacturers to provide enough vaccines to immunize the world’s population against influenza.
  • The WHO has certified that Uganda has successfully eliminated maternal and neonatal tetanus.
  • According to a report published in March 2011 by the United Nations Environment Programme, only two in every five people in the Southern Africa have access to safe water for drinking and household use. Three quarters of those lacking access, live in rural areas and the majority of these are women and children.
  • The CDC has expressed concern over the recently discovered strain of gonorrhea in Japan that is resistant to all present antibiotic treatments.
  • Drug manufacturers, government representatives and pharmacists from six countries in East Africa have estimated that as much as 30 percent of all drugs on the market are either of very poor quality or counterfeit medicines.
  • A lack of financial support and political will are contributing to the upsurge of measles in 33 countries. In an video interview, Andrea Gay at Measles Initiative, explains the different reasons for measles outbreaks in the developing and developed countries.
  • The number of children facing death by starvation in Somalia has almost doubled since March and the country’s child malnutrition rate is now the highest in the world, the International Committee of the Red Cross warns. Aid agencies have struggled to reach Somalis affected by drought due to security concerns across the conflict-ravaged country.

Systems Sciences for Health Systems Strengthening: Invitation to Join New IH Working Group

by ihsection, posted in APHA IH Section, Health Systems

Greetings, friends and colleagues.

The purpose of this message is to invite you to join a new working group within the international section of the American Public Health Association (APHA): ‘Systems Sciences for Health Systems Strengthening.’ Please forward this invite to any and all interested parties. We hope that you will advertise this group widely on the various listservs and newsletters that you manage.

As most of you know better than we do, the importance of health systems strengthening is increasingly recognized. However, health systems are incredibly complex, and there does not seem to be a consensus on the way forward. The so-called systems sciences provide unique approaches and methods to consider unintended consequences, delayed effects, and high-leverage points to strengthen health systems. You can learn more about the need for this working group, and our objectives and plans on this Google document.

We are very excited about the potential that this group will have in providing opportunities for collaboration, networking and advocacy at the interface of research, policy and practice of strengthening health systems in developed and developing countries. We hope that you will consider joining us; you don’t need to be a member of the APHA. If you are interested in the group, please join this Linkedin Group.

Best Regards,

Chad Swanson, DO, MPH
Brigham Young University
Working Group Chair

Kaja Abbas, PhD
University of Rochester
Working Group Co-Chair

Notes on IH Section Conference Call: Current Developments in MCNH (June 27, 2011)

by ihsection, posted in APHA IH Section, Maternal and Child Health, Section Announcements

The IH Section held its third topic-focused conference call on Current Developments in MCNH on Monday, June 27, 2011 from 1:00 to 2:00 EST. We had several members of the IH section offer their commentary and expertise on current issues concerning maternal and child health.

Speakers
Laura Altobelli (Future Generations)
Elvira Beracochea (Midego)
Carol Dabbs (U.S. Department of State)
Miriam Labbock (Carolina Global Breastfeeding Insititute)
Mary Anne Mercer (University of Washington)

Laura Altobelli: Brief presentation of the APHA policy resolution proposal submitted by the IH section entitled, “Call to Action to Reduce Global Maternal, Neonatal, and Child Morbidity and Mortality.”
Laura discussed the new APHA policy proposal on MCH. There was nothing previously on the APHA policy regarding global action on this issue per se – one previously existing resolution focuses on reducing maternal and child mortality in the US, and one focuses on breastfeeding and has both domestic and global aspects. This, then, is the first policy proposal on global MNCH. Justification for the policy proposal is lack of progress on the MDGs and lack of policy commitment to protect vulnerable populations. APHA will be joining important other organizations that are putting out strategies, including the Partnership for MNCH (WHO), and the UN, and attended global meetings in 2010 in observation of the Year of Maternal Health (some of these mentioned below). There is also an effort to increase attention to this in the Global Fund and GHI. Six other sections/forums are co-sponsoring the resolution.

Elvira Beracochea: Update on the Millennium Development Goals 4 and 5.
A factsheet has been sent out (available upon request – please contact jmkeralis [at] gmail [dot] com). These MDGs and their targets have served us well to measure our progress so far. There have been improvements, though progress has been uneven. MDGs 4 and 5 focus on reducing mortality but not necessarily on improving health, development and well-being, and we need to address this as well. We know where women and children die and how. We also have the knowledge to prevent these deaths. We need to coordinate work at global scale and have a concerted strategy to ensure the rights of all women and children are met. We need to take global health goals to a new level of effectiveness using efficient strategies and a human-rights-based approach. A rights-based approach does not focus on only survival, but also on development. We need new targets and indicators that measure not only deaths but also number of children whose right are fulfilled; the children that are breastfed, fully immunized, drink clean water, are protected from malaria, and that that attend school. We need targets and indicators that measure not only the number of women that died or delivered with assistance of a skilled attendant, but that also measure the number of pregnancy complications effectively treated. We need new MDGs and targets.

Miriam Labbok: An update on reproductive health continuum (birth, breastfeeding and birth spacing promotion, protection, support) as an essential MNCH intervention approach.
It is vital that we pay attention to the reproductive health continuum within the life-cycle approach: birth, breastfeeding and birth spacing. Programming must include not only promotion, but also skill- and capacity-building so that support can be provided. In addition, policy change is needed to: support treating women with dignity, provide NFP knowledge (at least for the times that family planning supplies run out), and create the capacity to support health-supportive birth, breastfeeding and spacing practices. All such programming and policy creation should be carried out with recognition of the rights of both women and children to the best possible health support and with attention to appropriate technologies, as one size does not necessarily fit all. In addition, programs that address cultural change and intimate family and social decisions demand the building of trust that comes with reliability and long-term relationships. Programming should be designed for the long term, with a strong base and phased in activities, and with excellence and sustainability as the focus.

Mary Anne Mercer: Partnership for Maternal, Neonatal and Child Health – what it does and how one can get involved.
The Partnership for Maternal, Neonatal and Child Health is a WHO-based coalition of organizations that support increased funding commitments to MDGs 4 and 5. Any organization that supports MCH can be a member simply by filling out an application from the PMNCH web site at http://www.who.int/pmnch/. Be sure your organization is a member (it’s free!) by checking the member list. Also check out the ‘Knowledge Portal’ that aims to maintain updated programmatic information on current approaches to improving MCH. I am on the Board of Directors of the Partnership as an NGO representative, and we will be electing a new member of the Board this year that will represent an Africa-based NGO or the Africa office of an international NGO — please let me know if you have any suggestions for good candidates for that position.

Carol Dabbs: Trends in US government funding levels for global MNCH.
Funding has increased and is overseen by the State Department. Global Health targets are to be achieved with funding from FY 09-14, generally for implementation in FY 10-15. The Global Health Initiative includes principles supporting country-led plans and to coordination with other partnerships and donors, as well as between USG agencies and health programs. Eight countries have been selected as “plus” countries (places to conduct learning laboratories): Ethiopia, Kenya, Mali, Malawi, Rwanda, Bangladesh, Nepal, and Guatemala. Almost all of the Global Health Initiative funding is from USAID and State (there is also some DHHS funding, but that was not included in this discussion). There are two stages in the fiscal year: requesting funds from Congress and appropriation of funds by Congress. Unfortunately, delays have been a reality this year. However, we should look at trends and context of the rest of foreign assistance and of overall health fundig. The budget now includes nutrition as a separate item, and it’s included in the MNCH numbers here. There has been a trend of increased funding; funding for MNCH has increased about by 22% over two years (FY 2008 to FY 2010), but the full year continuing resolution for FY 2011 allocation to MNCH is still pending. We do not know what the appropriations for FY 2012 and FY 2013 will be.

Discussion: Is this in addition to Dept of State HIV funds? Yes, there are additional funds in USAID for HIV/AIDS, as well as funds for MCH and the rest of the health programs.

Addendum: What does health reform have to do with IH?

by Disease Detective, posted in APHA IH Section

While I am sure that most of you have been riveted by my recaps of APHA’s Mid-Year Meeting on health reform, many readers are probably asking what the heck I, your friendly neighborhood Communications Chair, was doing there, and why the IH section was asked to send a representative to this meeting. The whole purpose of inviting section representatives and state affiliate leaders was to stimulate discussion about health care reform as it related to each section or affiliate’s work, and how the sections and affiliates could get more involved in the effort. Upon discovering this, my mind drew a blank.

How does health reform relate to the work of our members?

After some thought, I can see two major areas in which our membership would be interested in health reform. The first is in border health: despite the increased coverage that came with the new law, it does not cover undocumented immigrants and even some classes of migrant workers with temporary work visas (for example, those who come to work during the harvest season).

The other area is in sharing information. Our health reform battle has received much global attention, and the international health community is interested in the way the new health legislation will finally take shape and how individual communities will implement it. Also, a lot of the population health and wellness challenges that are being targeted by the Public Health and Prevention Fund grants (e.g. obesity, diabetes, tobacco use) are receiving increasing amounts of attention in developing nations as professionals are realizing that these countries share a disproportionate burden of chronic conditions. IH members who work in communities outside the U.S. may be interested in seeing how communities here address these issues, and they could apply some successful programs to their own communities facing similar issues.

The section representatives and affiliate leaders attended a luncheon that served as a breakout session to discuss these very issues. We were divided into geographic regions by table (which did not seem to make a lot of sense for section members, but it was productive nonetheless) and hashed out our impressions from the meeting and how the sessions related to the work of the sections and/or affiliates. APHA plans to use the notes from these discussions to compile a report for the sections and affiliates to use in their work as it relates to the mid-year meeting.

APHA Mid-Year Meeting, Day 3: Advocacy and Closing Remarks

by Disease Detective, posted in APHA IH Section

Day three of the mid-year meeting started off with one last break-out, then moved to the closing general session and a break-out luncheon for the section representatives and state public health affiliates. I attended the “Assuring Population Health: Advocating for Prevention and Wellness” session, which left me wondering how the presentations in this session related to the topic. While I appreciate learning about how different communities are using their Prevention and Public Health Fund grants, I found myself asking where the advocacy was in some of the slide presentations.

One presentation which I did find interesting was one on “The Employer’s Perspective on Health and Health Care Reform” by Larry Boress, President and CEO of the Midwest Business Group on Health. Mr. Boress brought some very good points on the role of businesses in providing and advocating for health coverage (“We pay for everything, so we are advocating for how our money is spent”), as well as the incentive for employers to provide coverage for their employees – “It’s not because we’re altruistic. We do it for business reasons.” I was disappointed, however, when my question about a graph on one of his slides was completely sidestepped. It looked at the breakdown for how businesses answered the question, “How likely is it that drop health insurance coverage and let employees buy individual insurance from the new health insurance exchanges?” Twenty-six percent answered “Unlikely” while 27 percent said “Not likely” – what is the difference between these two? Are they not the same response? Unfortunately, Mr. Boress responded by explaining to me why employers would choose to provide health coverage to their workers.

On a more positive note, I was very impressed with the closing speech given by Dr. Lawrence Wallack, Dean of the College of Urban and Public Affairs at Portland State University. Not only did he spare us from a script on slides, he drove home some very important points about why health care and health reform are important, how we need to be framing the debate, and how we should engage the opposition when advocating for it. He said that there are two prevailing mentalities among Americans: the “yo-yos” (You are On Your Own) and the “wits” (We are In this Together). While the yo-yos stress personal responsibility and the idea that a person will do whatever it takes to get what he or she wants, wits believe that communities have to stick together to improve the common good, and that one person’s well-being is intimately connected to that of his or her neighbor. Most of us strike a balance between these two, and we need to appeal to the wit philosophy when framing the need for reform.

“If they can get you asking the wrong questions, they don’t have to provide the answers.” Dr. Wallack reminded the audience that we need to stop being distracted by questions that cannot be adequately answered and focus on framing the debate in terms of values that all Americans hold in common. He cited Lakoff’s three levels of analysis:

  1. Big ideas and universal values like fairness, equality, justice, family, community
  2. Issue types such as housing, education, etc.
  3. Specific issues such as beer taxes, toxic waste sites, and health care coverage

During debates, progressives tend to argue from level three down, while conservatives argue at level one. Wallack argues that if we frame the health care issue at level one, we will have success at level three.