In this edition, you will hear more about the different Annual Meeting events our section hosts; learn more about our Student Committee; and get up close and personal with IH section member – Dr. Idong Essiet-Gibson. We will share updates from the Global Health Mentoring Committee, the Climate Change and Health Working Group, the Communications Committee and Social Media Subcommittee, the Systems Science for Health Systems Strengthening Working Group and the Community Based Primary Healthcare Working Group.
We hope you continue to stay connected and involved with our section. See you in November in Philadelphia!
The global health community knows that the world is unprepared for the next influenza pandemic. While public health practices have come a long way in terms of preparedness since the 1918 Spanish flu, which killed around 50 million people, we are still far from ready for an outbreak of that scale today.
According toPreventEpidemics.org, more than 100 outbreaks occur daily and can be spread worldwide in just 36 hours because of increased global travel. The cry for better pandemic preparedness is loud (Bill Gates,Margaret Chan, former director of the World Health Organization (WHO) andRobert Redfield, Center for Disease Control and Prevention (CDC) director) but is only being heard in certain circles; and the global health community needs the message to get out more broadly, especially in the private sector.
The bottom line
Disease outbreaks, even if they only occur within a country or region, affect everyone and negatively impact the global economy. A World Economic Forum/Boston Consulting Groupreport stated that epidemics have negative impact on the private sector by impacting their employees, customer bases and operations.
The World Bank projects that a large pandemic will cause an average annual economic loss of 0.7 percent of global gross domestic product (GDP) or $570 billion USD. The 2009 H1N1 pandemic resulted in an economic loss of 0.14 percent of GDP, or $1.09 billion USD, and the Ebola epidemic in 2014 resulted in aneconomic loss of $2.2 billion USD in GDP, threatening macroeconomic stability, food security, human capital development and private sector growth across West Africa.
The private sector is no stranger to making financial contributions for pandemic preparedness and response. In 2014 the private sector contributed $500 million USD to the Ebola outbreak response, and these days the private sector can financially assist in pandemic preparedness through the World Banks’Pandemic Emergency Financing Facility (PEF). However, while financial contributions are always needed there are other ways the global health community can engage the private sector to improve pandemic preparedness.
More than money
In 2018, the WHOsurveyed member states to assess global pandemic preparedness and found levels of preparedness to be “far from optimal” even among high and middle income countries. Based on these survey results the WHO identified several areas for improvement in regards to preparedness, four of which are particularly advantageous for private sector partnerships.
Conducting simulation exercises to test pandemic plans
TheInstitute for Disease Modeling (IDM) is one example of a private sector partnership to assist in pandemic preparedness. IDM’s Epidemiological MODeling software simulates the spread of disease to help determine the combination of health policies and intervention strategies that can lead to disease eradication. There are anumber of other modeling and simulation tools available for pandemic preparedness, however, some of these tools require financial and/or technical resources not available to a global health organization. Private sector companies that use, or produce modeling software could be favorable partners for testing preparedness plans, since these companies already have the modeling skills to use the software and interpret results.
2. Establishing mechanisms to secure access to vaccines during a pandemic
There are two notable private sector partnerships already working to secure access to vaccines,GAVI, the Vaccine Alliance, and theCoalition for Epidemic Preparedness Innovations (CEPI) are both working on improving vaccine supply chains and healthcare infrastructure in low-and middle income countries in order to increase access to routine vaccinations, as well as secure access to vaccines during a health emergency.
3. Preparing mechanisms to conduct risk communications and community engagement during a pandemic
There is also potential for collaboration with the private sector in regards to risk communications and community engagement. Social media companies already have platforms to engage large audiences, as well as lucrative business platforms to sell ideas, information and products. Engaging people in preparing for and acting appropriately during a pandemic will require persuading an audience – something social media companies have already mastered.
4. Establishing SOPs to conduct systematic influenza risk assessments using surveillance data
Several consulting companies offer pro bono services, such asDeloitte andPwC. Consulting firms have the business acumen to offer services that could help design effective pandemic SOPs for multilateral organizations, country governments and agencies, as well as non-governmental organizations working on pandemic preparedness.
Building these private sector relationships needs to happen now, and not in the midst of the next outbreak. Mutually beneficial partnerships will ultimately help the private sector, the global health community as well as the entire population when, not if, the next pandemic occurs.
A new study by WHO, published in Lancet Global Health, found that investing $6 billion per year in eliminating hepatitis in 67 low- and middle-income countries would avert 4.5 million premature deaths by 2030, and more than 26 million deaths beyond that target date.
The Bangladeshi government has confirmed another five deaths from dengue fever, bringing the total number of fatalities in the country since January to 23, the Directorate General of Health Services (DGHS) reported Tuesday.
Obesity is a growing problem in many countries around the world. Obesity is reaching further into Mexico and costing their citizens and healthcare system millions of dollars.
Technology
It is hard to get much of a reputation if nobody knows you’re around, and that has definitely been the case for mycoplasma genitalium, the tiny bacteria estimated to be more prevalent than the bug that causes gonorrhea but is almost completely off the public’s radar.
Ocean heat waves, which can push out fish, plankton and other aquatic life, are happening far more frequently than previously thought, according to a study published today in the Proceedings of the National Academy of Sciences.
The Bill & Melinda Gates Foundation has published a report, Examining Inequality, on how the world is doing. In short, it’s not great. It’s even worse if you are a girl.
UNICEF and the World Food Programme provide food and nutrition aid to North Korean children—but a lack of funds, fueled by political tension and the US-led strategy of pressure and isolation of North Korea, have limited their reach.
New Zealand’s government announced that it plans changes to the country’s abortion laws that would treat the procedure as a health issue rather than a crime.
Author’s Note: This article discusses suicide and may be triggering for individuals with lived experience. While resources will be presented later on, this website has a list of country specific resources for those who need them. If you or someone you know is struggling with passive or active suicidal ideation, please reach out for help.
The National Suicide Prevention Hotline in the USA is 1-800-273-8255.
Every 40 seconds someone, somewhere in the world, takes their own life. That amounts to over 800,000 deaths per year. On September 10th each year, World Suicide Prevention Day, the world comes together to reflect on the lives lost and bring suicide prevention to the forefront of the conversation.
What Suicide Looks Like Around the World
Like most things in global health, there’s no single causal factor and no “one-size-fits-all” solution. Preventing suicide globally will require an understanding of the way individual, interpersonal, societal, and cultural factors interact to affect suicidality. High income countries, on average, have higher rates of suicide than low- and middle- income countries (LMICs), with the exception of LMICs in South-East Asia where the regional suicide rate is the highest in the world (17.7 deaths per 100,000 people). While rates may be higher elsewhere, suicide isn’t just a problem for high-income countries. The majority of suicides actually occur in LMIC settings, highlighting these countries as important stakeholders in the global conversation around suicide.
Like the rates themselves, at-risk sociodemographic groups vary from region to region. Suicide is the second leading cause of death, globally, for young adults (18-29 years of age). Middle aged men in high-income countries generally have a higher risk, while adolescents and aging adults in LMICs are more likely to take their lives.
Globally, males are 2-3 times more likely to complete suicide than women. This has long been blamed on differences in care seeking behaviors and socially acceptable coping mechanisms deemed acceptable for different genders. But it’s important to keep in mind that women are generally more likely to experience suicidal ideation and more likely to attempt suicide. Men, however, have historically used more lethal methods of suicide and more likely to take measures to prevent intervention.
The means of suicide attempts vary drastically and adapt to environments. Pesticide poisoning accounts for about one-third of global suicides. Almost all of these deaths occur in rural subsistence farming communities. Self-inflicted firearm injuries account for a large proportion of suicides in the Americas. Urban contexts with much stricter firearm regulations, such as Hong Kong and Singapore, experience a higher number of deaths related to jumping from buildings and bridges.
What We Can Do
Suicide may look differently depending on where we sit on a map, but the truth remains that the pain and suffering that causes and is caused by suicide cuts across every sociodemographic variable and exists in every corner of the world. Despite its inclusion in both the WHO’s Mental Health Action Plan and the United Nation’s Sustainable Development Goals (Target 3.4), suicide remains a low-priority agenda item for policy-makers worldwide. Only about 40 countries currently have national strategies or action plans in place to respond to suicide, and even fewer of these are in LMIC settings where the majority of suicides occur.
While national strategies with government engagement will be crucial to eliminating suicide, suicide prevention requires multisectoral and multilevel approaches that treat suicide as the complex public health problem that is. It is the community and the individuals close to a victim of suicide that will suffer the most in the aftermath and have the most power in targeted prevention efforts delivered to the individual.
Primary care professionals, especially those serving communities that are underserved by specialists, can and should be more familiar with using depression screeners like the Patient Health Questionnaire or Beck Depression Inventory to assess suicidality in the exam room. Educators can advocate for school-based intervention and encourage (not punish) help-seeking behaviors. And while we can’t all be psychiatrists, suicide crisis line volunteers, or counselors, we can all be kind people to those around us. Use today to raise awareness for the issue. Educate yourself (and others) about suicide prevention resources available in your community. As friends and family members, we can all do a better job of dismantling the stigma around mental health and identifying when those close to us are experiencing acute stress or grief that may serve to trigger or exacerbate existing suicidality.
Where we live might affect what suicide looks like, who is at risk, and how often it happens. Our professional roles may dictate at what level we help break the cycle. But today is a reminder that we are all responsible, as stewards of humanity, for reducing the number of suicides in our world. In the time it took you to read this article, five people will have taken their own life. Every suicide death is one too many, so now is the perfect time to consider: what will YOU do to make sure it doesn’t happen again?
Looking for a starting point? I’ve compiled a wealth of resources that may be helpful, in addition to the links embedded in the text throughout the article.
Successful partnerships between pharmaceutical companies and global health organizations have been increasing access to medicines and vaccines since the 1970s. From early partnerships in theExpanded Program on Immunization, toGAVI, the Vaccine Alliance andAccess Accelerated the research-based pharmaceutical industry, which spends over$149 billion on research and development (R&D) every year, has an important role to play in global health.
Over the last 50 years the pharmaceutical industry has learned that global health is about more than just medicines and vaccines, and with the integrated nature of the Sustainable Development Goals, public-private partnerships are increasingly important. According to the International Federation of Pharmaceutical Manufacturers and Associations, the industry understands that global healthrequires building and supporting strong health systems, developing public health education and strengthening standards and regulations. This is why in 2018, 17 out of the 20 largest pharmaceutical companies (accounting for 70 percent of global pharmaceutical revenues) developed a business strategy, supported by goals and targets, to address access to medicines in low-and middle-income countries (LMICs), according to an Access to Medicine Foundationreport.
Good, but not good enough
However, much of the increased access to medicines has been made by a small percentage of pharmaceutical companies, and has overwhelmingly been focused on a handful of diseases. Of the 20 companies assessed by the Access to Medicine Foundationreport, five companies (GlaxoSmithKline, Johnson & Johnson, Merck KGaA, Novartis and Sanofi) were found to be conducting 63 percent of R&D on products urgently needed by people in LMICS; and nearly all of the R&D from these companies was focused on five diseases: malaria, HIV/AIDS, tuberculosis, Chagas disease and leishmaniasis.
While overall, pharmaceutical companies are entering LMIC markets, the industry still puts profits first. Between 2008 and 2018 more medicines for profitable non-communicable diseases were developed for people in high-income countries, than medicines for diseases of poverty. Additionally, only four out of 20 pharmaceutical companies supported international trade agreements designed to ensure the world’s poor benefit from innovative medicines and vaccines.
Closing the gaps
Public perception does matter to the pharmaceutical industry. According to the Reputation Institute, between 2017 and 2018 the pharmaceutical industry saw a 3.7 percent decline in itsreputation score, and overall the industry had a significant decline in the public’s perception of industry transparency, openness and authenticity. The decline of public trust and confidence in the industry has also led to a decline in the public’s willingness to buy by eight percent between 2017 and 2018. One way to improve company reputation is through global health partnerships, and with recent negative media attention on the industry, between the opioid epidemic and price-fixing drugs, it is no secret that the industry could use a reputation boost.
So how can the global health community capitalize on this? The Access to Medicines Foundation has an effectiverecipe for engaging pharmaceutical companies in global health: one, setting clear priorities endorsed by global health experts; two, advocating for publicly funded mechanisms to reduce investment risk and shape less profitable markets; and three, finding sustainable funding support from multiple donors, including the government. One example of a mutually beneficial partnership is GAVI, which usedpooled procurement mechanisms to encourage pharmaceutical companies to enter fragile markets in LMICs to strengthen the global vaccine market.
In 2018 thereputation scores for the top 22 pharmaceutical companies were made public, creating an opportunity for global health organizations to engage poorly ranked companies. Global pharmaceutical sales are expected to reach over $1 trillion by 2022, so resources for global health partnerships are abundant, and organizations should consider targeting partnerships with companies impacted by negative public perception; turning a bad reputation into increased affordable access to life-saving medications.
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