Global News Round Up

Politics & Policies

China is willing to cooperate with other countries to reduce health injustice and achieve better health services for everyone, Ma Xiaowei, minister of China’s National Health Commission, has told the just-concluded 71st World Health Assembly (WHA).

Speaking to United States lawmakers in a congressional hearing on Thursday, U.S. Global AIDS Coordinator Deborah Birx questioned whether the 3 billion spent on supply chain technical assistance since 2008 had been used effectively.

The Centers for Disease Control and Prevention (CDC) is preparing to deploy staffers to several cities and towns deep in the Congolese jungle amid a new Ebola outbreak that has claimed at least two dozen lives.

The World Health Organization has released its first ever Essential Diagnostics List, an inventory of tests to diagnose common conditions and global priority diseases.

Programs, Grants & Awards

The World No Tobacco Day on May 31st will focus on the impact of tobacco use on cardiovascular health.

World Health Assembly delegates have agreed to the new ambitious five-year strategic plan that aims to achieve the SDGs with a special focus on SDG 3.

At the Intel International Science and Engineering Fair, first place was awarded to 2 high school students from Salt Lake City (Utah) for their project on testing a bioinformatics program to identify under reported suicides linked to drug overdoses.

Research

Health care access and quality improved globally between 2000 and 2016 due to gains in many low- and middle-income countries, according to data from the Global Burden of Disease study.

A survey among 540 internally displaced persons in Syria and refugees in Turkey reveals a high prevalence of mental disorder in both populations but major depressive disorder was more frequent in refugees in Turkey.

Women who did strenuous exercise regularly in their teens appear to be protected from height loss later in life, a new study shows.

Diseases & Disasters

More than a dozen people have died after an outbreak of a rare disease in southern India that health officials warn could cause a global epidemic.

The financial mechanism, Pandemic Emergency Financing Facility (PEF), that was set up after the 2013-2016 Ebola epidemic has been activated for the first time, in response to an Ebola virus outbreak in the Democratic Republic of Congo.

Based on a report from the Famine Early Warning Network which said that about a fifth of households in Pibor (South Sudan), could be classed as hitting famine levels of hunger, Oxfam has called for urgent action to help avert this crisis.

Technology

For the first time in Madagascar, a novel, portable DNA sequencing method allowed rapid identification of bacteria causing TB and its drug resistance profile.

Engineers have developed a new device to detect malaria by taking advantage of the tiny crystals with magnetic property produced by malarial parasites in the infected blood.

Environmental Health

An extensive analysis of biomass distribution of all organisms on this planet shows that humans are very efficient in exploiting natural resources.

According to a new study, rice grown in increasing CO2 levels has poor nutritional quality including declines in vitamins B1, B2, B5 and B9.

Despite being linked to risk of prematuredeath, noise pollution in major cities is often overlooked.

Equity & Disparities

The UN’s peace building efforts must include ways to address social, economic and cultural rights to effectively tackle violence.

According to Kenya’s National Council for Population and Development, 51% of all new HIV infections are occurring among young people between 15 and 24 years of age.

Researchers who conducted analysis of data from the National Family Health Survey report that despite improvement in childhood stunting in India, the prevalence of high rates of malnutrition is “rooted deep in inequality between men and women”.

Women, Maternal, Neonatal & Children’s Health

Evidence gathered over a 30-year period reveals the possibility of immune cells becoming cancerous “if it does not see enough bugs in early life.”

Tanzania is scaling up surgical services, developing specific health policies and upgrading health centers in an effort to lower the maternal and neonatal mortality rates.

Nearly 350,000 children and adolescents die each year from road traffic accidents and millions more are serious harmed and injured, according to a new report.

Empowering Women to Take Control of their Sexual Health

Two weeks ago, I attended a powerful and motivating summit hosted by Florida International University (FIU) Robert Stempel College of Public Health and Social Work on empowering women to take control of their sexual health through knowledge of biomedical HIV prevention methods, connecting to community resources, and mobilizing key community stakeholders and providers.

What was most unique about this summit was the rawness of the various conversations. These conversations included voices of state congresswoman Frederica Wilson and Ileana Ros-Lehtinen, community women and activists, a panel of diverse physicians and nurse practitioners, researchers, and LGBT and minority women working across different sectors in the HIV prevention field. When it comes to empowering women surrounding their sexual health, pre-exposure prophylaxis (PrEP) is viewed as the driving vehicle. The problem is that there is a lack of awareness among women particularly LGBT and minority women, and providers about PrEP and post-exposure prophylaxis (PEP). During the engaging providers panel comprised of various physicians working in South Florida, a Haitian physician expressed that before the conference he decided to call several of his provider friends that practice within the local Haitian community and asked them if they have heard of PrEP. How many do you think said, “Of course, I know about PrEP”? The answer is…0. Not one single doctor whom was asked said they have heard of PrEP. We have a lot left to do. The work has not yet been done!

Miami’s HIV Epidemic

So maybe you are wondering…well why host this conference? The county of Miami-Dade continues to lead the nation in new HIV infections. Not too far away is the neighboring county of Broward which continues to compete with Miami when it comes to high prevalence rates as well.

Due to the rising rates of HIV in Miami-Dade County, city officials have responded to the epidemic with the development of a “Getting to Zero” task force comprised of city commissioners and individuals representing various public health agencies throughout Miami-Dade County as well as the state of Florida. The task force devised a multi-pronged action plan with priority goals for the next two years. The plans include to (1) reduce the rates of reported AIDS cases, (2) reduce the percentage of newly diagnosed HIV cases among residents aged 13-19 (3) increase the percentage of newly identified HIV-infected persons who are linked to care within 90 days of diagnosis and are receiving appropriate preventive care and treatment services in Miami-Dade County and (4) reduce the number of newly reported HIV cases in Miami-Dade County (http://www.miamidade.gov/releases/2016-09-29-mayor-getting-to-zero.asp).

Prep around the globe

PrEP has served as a vehicle for prevention and is being used worldwide. Countries such as the United States has large scale PrEP programs while others are still in the stages of development and some have not implemented as of yet. There has been many PrEP initiatives enacted. The US Agency for International Development (USAID) is currently supporting 5 Microbicide Product Introduction Initiative (MPii) projects in Kenya, South Africa, Zimbabwe, Malawi, and Uganda from 2015-2020 focused on gender-based violence, drug resistance, creating demand, introducing new products, and models for delivering services. Another program is the DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) initiative, a collaborative effort between US President’s Emergency Plan for AIDS Relief (PEPFAR), Bill & Melinda Gates Foundation, Girl Effect, Johnson & Johnson, Gilead Sciences and ViiV Healthcare. DREAMS aims to reduce the incidence of HIV by 40% among adolescent girls and young women by 2020 in the highest HIV burden countries including Kenya, Lesotho, Malawi, Mozambique, South Africa, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe. Of the 10 countries, 5 have included PrEP for adolescent girls and young women in their strategic plans to address HIV. Recent data from PEPFAR shows significant declines in new HIV diagnoses among adolescent girls and young women. In the 10 African countries implementing PEPFAR’s DREAMS partnership, the majority of the highest HIV-burden communities or districts achieved greater than a 25 percent–40 percent decline in new HIV diagnoses among young women (https://www.usaid.gov/what-we-do/global-health/hiv-and-aids/technical-areas/dreams). In other areas of the globe such as Latin America and the Caribbean, a combination of biomedical, structural, and behavioral interventions is greatly needed in order to reach target objectives and goals and ultimately increase HIV prevention efforts. I am excited to see the future of PrEP.

Women’s Perspectives

During the women’s perspectives breakout sessions, workshops were broken down into specific focus groups including African American, Latina and Haitian. Amongst the African American women breakout session, some key topics that were addressed included stigma, specifically communication between the medical provider and client such as clear language on how to ask questions during the appointment while also considering time constraints, policy, and the need for funding toward effective behavioral interventions for HIV negative black women in the community.

Sistas Organizing to Survive (SOS) is a grassroots mobilization of black women in the fight against HIV and AIDS. In Florida, one in 68 non-Hispanic black women are known to be living with HIV/AIDS and has been the leading cause of death among black women aged 25-44 years within the state. (http://www.floridahealth.gov/diseases-and-conditions/aids/administration/minority-initiatives.html)

Call to Action

Miami is the #1 city in the United States with new HIV infections. This is a huge public health issue. We have a call to action to advocate for ourselves and others when it comes to ending the epidemic. We have made significant strides, but the work has not yet been done. Sexual health including HIV prevention should be something that we freely discuss with our family, colleagues, peers, physicians, and anyone that we come in contact with that is willing to listen. It is these conversations that we can decrease stigma surrounding HIV. Women across the counties of Broward, Miami-Dade, and Palm Beach have answered the call to action by organizing and advocating for all women. We have accepted the call to action together that we can get Miami to Zero!

“A future where new HIV infections are rare, and when they do occur, every person, regardless of age, gender, race/ethnicity, sexual orientation, gender identity, or socio-economic circumstance will have unfettered access to high quality, life-extending care, free from stigma and discrimination.”

–Quote from the National HIV/AIDS Strategy Updated to 2020: Strategy Vision

For additional information, please visit http://www.who.int/hiv/topics/prep/en/ http://amp4health.org/ and http://getting2zeromiami.com/

Global News Round Up

Politics & Policies

Rear Adm. Tim Ziemer, the head of global health security on the White House’s National Security Council, left the Trump administration on Tuesday.  The news was announced one day after an Ebola outbreak was declared in the Democratic Republic of the Congo.

A judge in Riverside County on Tuesday overturned California’s controversial assisted death nearly two years after it took effect, ruling that the Legislature improperly passed the measure during a special session on health care funding.

When global health leaders convene in Geneva next week for the 71st World Health Assembly, they’ll gather under one banner: universal health coverage.  

The World Health Organization (WHO) announced on Tuesday that a new Ebola outbreak has emerged in the Democratic Republic of Congo — and thanks to the Trump administration, we are woefully under-equipped to deal with it.

Research

Migrant children have specific health needs, and may face difficulties in accessing health care, but enough is known about their health service use. This study aims to describe patterns of use of health services of international migrant children and differences to respective native populations.

Although uncomplicated urinary tract infections (UTIs) are often self-limiting, most patients will be prescribed antibiotic treatment.  We assessed whether treatment with ibuprofen was non-inferior to pivmecillinam in achieving symptomatic resolution by day 4, with a non-inferiority margin of 10%.

Scientists have successfully reconstructed genomes from Stone Age and Medieval European strains of the hepatitis B virus.  This unprecedented recovery of ancient virus DNA indicates that hepatitis B was circulating in Europe at least 7,000 years ago.

Diseases & Disasters

The World Health Organization announced Friday that it hopes to deploy an experimental vaccine against the developing Ebola outbreak in the Democratic Republic of the Congo, even as the agency plans for the “worst case scenario.”

Healthy diet is not just about how many calories you consume, it’s also about how many calories you consume, it’s also about what kind of calories you consume.  A paper published this week in Obesity Reviews, Pathways and Mechanisms Linking Dietary Components to Cardiometabolic Disease: Thinking Beyond Calories, examined how calories from different foods affect the body.

The WHO and not-for-profit organization Resolve to Save Lives have teamed up to build a scheme for governments to use to tackle industrially-produced trans fats.

People who have their body clock disrupted by being awake at night risk developing mood disorders and depression.
People who ate diets full of vegetables, fruits, nuts and fish had bigger brais than their less well-nourished counterparts the large study from the Netherlands found.

Heart failure is a global health problem, affecting about 26 million people worldwide.  The disease presents a major and growing health-economic burden that currently costs the world economy 108 billion dollars every year, which accounts for both direct and indirect costs.

The Ebola virus has reared its head again, this time in the Democratic Republic of Congo. While it is impossible to predict exactly where and when the next outbreak will occur, we now know much more about how to prevent a crisis.

Dr. H.D.B Herath, Director, Anti Malaria Campaign speaks at the World Malaria Day Press event in Colombo, Sri Lanka.
In the jungle-rich landscape of Sri Lanka, mosquitoes are everywhere. But, thanks to a decades-long eradication campaign, the country hasn’t seen a single native case of malaria since 2012.

Sudan is a fragile developing country, with a low expenditure on health. It has been subjected to ongoing conflicts ever since 1956, with the Darfur crisis peaking in 2004. The conflict, in combination with the weak infrastructure, can lead to poor access to healthcare.  Hence, this can cause an increased risk of infection, greater morbidity and mortality from tuberculosis (TB).

Technology

Tools to diagnose and monitor HIV, hepatitis B and C, and tuberculosis, as well as resistance to first-line TB treatment are among the tests included in World Health Organizations’s first List of Essential In Vitro Diagnostics, released Tuesday.

Environmental Health

More than 80% of people living in urban areas that monitor air pollution are exposed to air quality levels that exceed WHO limits.  While all regions of the world are affected, populations in low-income cities are the most impacted.

Equity & Disparities

WHO recommends that every child should receive at least three doses of hepatitis B virus (HBV) vaccine, with the first dose being given ideally within 24 h of birth (referred to as HBV birth dose vaccine), regardless of burden of disease in the country.  However, despite this recommendation, only 101 (52%) of the 194 WHO member states provide universal HBV birth dose vaccination, with nine (19%) of 47 countries in the African region providing the vaccine.

A class-action lawsuit has been filed against the Canadian government on behalf of a group of Indigenous people who say they were subjected to medical experiments in residential schools and sanatoriums without their consent.

Global News Round Up

Politics & Policies

A Government Accountability Office report has found that USDA has taken steps to establish pathogen standards for only some meat and poultry products. Commonly consumed products such as turkey breasts and pork chops don’t have any standards.

The United Nations is being criticized for failing to help cholera victims in Haiti. The U.N. Haiti Cholera Response Multi-Partner Trust Fund has raised only about 2.2.% of total amount needed and has spent only less than half thus far.

There are potentially two options as we risk entering a post-antibiotic era: one is to discover new antibiotics and the other is to manage our current antibiotics better so that they remain effective for as long as possible.

Doctors and other specialists in Bangladesh are working under a One Health Initiative to prevent the development of antibiotic resistance.

Programs, Grants & Awards

Bill Gates and Larry Page have pledged $12 million to support the development of a universal flu vaccine.

Women-led movements in France and South Africa exposed damaging environmental policies – and won the prestigious Goldman Environmental Prize for 2018.

Research

Fiber gets well-deserved credit for keeping the digestive system in good working order — but it does plenty more. In fact, it’s a major player in so many of your body’s systems that getting enough can actually help keep you youthful.

More Americans are living in wooded suburbs near dear, which carry the ticks that spread Lyme disease, anaplasmosis, Rocky Mountain spotted fever, babesiosis, rabbit fever and Powassan virus.

Handgrip strength, a measure of muscular fitness, is associated with cardiovascular (CV) events and CV mortality but its association with cardiac structure and function is unknown.  The goal of this study was to determine if handgrip strength is associated with changes in cardiac structure and function in UK adults.

Diseases & Disasters

The HIV and AIDS epidemic could become uncontained if current funding trends continue, warned one of the founding architects of the US President’s Emergency Plan for AIDS Relief.

Three African countries will soon start rolling out the world’s first malaria vaccine.  Last year, more than 200 million people around the world were affected by the disease.  Most of those cases were reported in Africa.

Chronic wasting disease (CWD) did not cross the species barrier to infect cynomologus macaque monkeys during a lengthy investigation by National Institutes of Health scientists exploring risks to humans.

Technology

“Si-Low”, a low-cost alternative to the sterile silicone bags could help treat babies who are born with portions of intestines outside the body due to incomplete closure of the abdominal wall.

Purdue University researchers are developing an app and wearable technology to enable pregnant women to use a smart phone to detect whether they have or are susceptible to a condition that could lead to serious health complications for them or their unborn child.

Environmental Health

An experimental “reinvented toilet”, a system designed to reuse water, has been installed at a textile mill in the city of Coimbatore in India.

A new study found that China’s future emissions trajectory has the potential to measurably impact methylmercury levels in the rice being consumed by people in parts of China.

Equity & Disparities

A new report confirms what many residents suspected: living conditions in the city’s ‘resettlement’ blocks are little better than the slums they replaced.

For millions of displaced people around the world – many of them refugees, living in often overcrowded, temporary shelters – an outbreak of disease can be devastating. Each year, the measles virus kills more than 134,000 people globally, and another 100,000 children are born with the medical effects of congenital rubella syndrome. Both diseases are preventable by vaccination.

Women, Maternal, Neonatal & Children’s Health

Results from the Mordor trial conducted in 3 African countries, reveal 14% fewer deaths among children under the age of 5 getting azithromycin doses every 6 months for a 2 year period.

According to a new study, preterm babies should be given freshly expressed breast milk in order to allow slow degradation of hydrogen peroxide to preserve its bactericidal action.

Conference Reflections: Emergency Preparedness & International Health – Different Fields, Same Goals

Last week I was given the opportunity to attend the Preparedness Summit in Atlanta. This conference is the first and longest running national conference that discusses and revolves around the world of public health preparedness (think: natural disasters, medical countermeasures, flu, Zika and Ebola responses, biological threats and much more). There were many different opportunities to learn about preparedness activities including plenaries, small discussions, learning sessions and networking with local, state and federal partners. It was overwhelming, but in a good way!

As an epidemiologist, I have some experience and background in public health preparedness activities, but my main interests and time have always been spent with infectious diseases and global health initiatives. When I worked for the state health department, I actually was on a team that was half epidemiologists and half preparedness staff and we continually supported each other’s activities. Those experiences helped me with preparedness lingo and acronyms used during the conference so that things didn’t go completely over my head. However, I would not consider myself a preparedness expert by any means and soaked up as much as I could from the various sessions I attended.

One of the most exciting activities from the week was visiting the Emergency Operations Center (EOC) at the Centers for Disease Control and Prevention (CDC). This EOC is the center that gets activated in a public health emergency and where experts gather and get ready to respond. The main room of the EOC is spacious, with many computers, television screens and telephones set up and ready to be filled with points of contacts from different divisions and organizations. When there’s not an emergency response going on (like on our tour), it’s actually pretty quiet. However, staff are still on call working to monitor information and sift through potential threats. During a response, I’m sure the place is bustling with people, calls, information sharing and meetings. It was a neat experience to be in the center communication hub where past emergency responses like Hurricane Katrina in 2005 or the 2014 Ebola outbreaks took place.

I did some research after attending the summit and found that the EOC has become an integral part of meeting the goals of the “Global Health Security Agenda (GHSA)”. This agenda is focused on “accelerating progress toward a world safe and secure from infectious disease threats and to promote global health security as an international security priority.” Over 50 countries have joined in partnership with the U.S. to meet this objective and the CDC aims to activate the EOC and respond within 2 hours of any mandated public health emergency. There’s even a fellowship offered by the CDC called the “Public Health Emergency Management Fellowship” that provides an opportunity for public health workers to learn and train over a four-month course then go back to their respective countries and create their own local EOCs. Emergency management experts can also be sent to these countries and help guide and train responders in their own environment if needed.

This post-tour research made me start thinking about the importance of the EOC and preparedness in relation to international health. Public health threats (like pandemic flu, Zika, Ebola) of any degree can happen at any time at the local, state, national, or international level. Bill Gates recently spoke out about the necessity of being prepared for public health threats such as these at the Massachusetts Medical Society 2018. He stressed how unprepared we are for the next epidemic and the world’s need for a “global approach” with “better tools, an early detection system, and a global response system”. Gates’ is most likely alluding to the poor handling of the Ebola outbreaks in the recent past. These are a perfect example of why the field of preparedness is so important to global health. During Ebola, public health response was “too late” and there were too many “deaths that could have been prevented”. There were many disagreements among global health leaders over things like travel bans, how to handle public panic and how to best respond. The aftereffects of the outbreak point to the integral link between a strong preparedness field and international health that was lacking. Gates’ argues that we weren’t prepared to handle prior outbreaks, but we are capable and should spend time and money on planning and preparing for similar epidemics in the future.

Overall, these events – the conference, EOC tour and recent news and outbreaks – have helped hit home that these different public health fields, although working in slightly different capacities, are really aligned and influential on each other. Ultimately, preparedness and global health are working to reach the same goals of keeping our planet safe and healthy and we must first be prepared for any global threat in order to achieve these goals. Today, I feel refreshed in my perspective of the field and inspired and hopeful of future preparedness efforts. I no longer feel that preparedness and international health belong in the different boxes or divisions I’ve created in my mind, but as two parts to the same path.

I challenge other public health workers to also think about the important link between preparedness and global health and advocate for changes that strengthen this partnership. The Preparedness Summit conference is a great starting place and I encourage all fields of public health workers to look into it! I truly believe the more you learn, the more you see how everything is connected and the better you are able to achieve your public health goals … and maybe find some new teammates from other fields to help you along your journey, too.