Global News Round Up

Politics & Policies

With a budget on the table that leaves science and lives around the world vulnerable, we’re reading about impacts and a better way.

Cutting the NIH budget is bad for health and business, says Kenneth C. Anderson, president of the American Society of Hematology and a hematologic oncologist at Dana-Farber Cancer Institute.

Programs, Grants & Awards

The University of North Carolina at Chapel Hill’s Gillings School of Global Public Health and 2U announced a partnership today to offer a suite of online graduate degrees for public health professionals across the country.

June 14th is World Blood Donor Day. This year’s theme stresses the importance of donating now before a disaster strikes.  This requires good storage facilities (and strong systems) in countries where disasters may occur, which may not always be the case.

The Duke Medical Alumni Association announced recently that it will honor Duke Global Health Institute (DGHI) director Michael Merson with the Distinguished Faculty Award during Medical Alumni Weekend in November.

To those of us who knew Babatunde Osotimehin, MD, he was simply “Prof.”
Yes, he had many distinguished titles in his career.  At the time of his death, Babatunde was the 4th executive director of the UN Population Fund (UNFPA) and the under-secretary-general of the UN. He also co-chaired the Family Planning 2020 (FP2020) Reference Group, alongside Christopher Elias of the Bill & Melinda Gates Foundation.

Research

Following the launch of the The Lancet’s Health in Southeast Asia series in Bangkok on 25 January 2011, the series has now been launched in Malaysia.  This Lancet series is the first to address the current and pressing health issues confronting the Southeast Asian region and the launch highlights the key health issues and findings for Malaysian stakeholders.

In a decision public health activists are calling both landmark and long overdue, the World Health Organization has placed snakebite envenoming on its list of top 20 priority neglected tropical diseases — giving it the highest possible ranking for diseases of its kind.

People with low levels of vitamin A who live with individuals who were sick with tuberculosis (TB) were 10 times more likely to develop the disease than people with high levels of the nutrient, according to research led by investigators at Harvard Medical School.

According to a new report in the New England Journal of Medicine, obesity rates have doubled in more than 70 countries and nearly 2 billion people are overweight or obese.

Diseases & Disasters

More than one in eight couples of childbearing age have difficulty conceiving or carrying a pregnancy to term, according to the Centers for Disease Control and Prevention. Delegates at the 2017 AMA Annual Meeting voted in support of WHO’s designation of infertility as a disease.

Gun-related violence killed three people in the US every two hours in 2015, according to data collected by the Global Health Data Exchange. Despite a rather steady decline in gun deaths in the past decade, firearms remain a significant issue for the country.

Nearly a third of the world’s population is obese or overweight and an increasing number of people are dying of related health problems in a “disturbing global public health crisis,” a study said on Monday.

At least two people have died and nearly 750 people fell ill after a meal to break the Ramadan fast in a camp for Iraqis fleeing the Mosul conflict.

Technology

Researchers at Penn State have received a grant through the Grand Challenges Exploration for their project using high-throughput microfluidics screening to identify novel contraceptive agents.

For the past 14 years, Project ECHO (Extension for Community Health Outcomes) has leveraged its innovative technology-enabled model for healthcare education to address global disparities in healthcare access for complex chronic conditions such as hepatitis C, HIV, tuberculosis (TB), and opioid use disorder.

Environmental Health

The rise in multidrug-resistant bacteria is usually attributed to the overuse of antibiotics in human medicine and farming. A new study, published in the journal Infection, suggests that there is a third source: globalized drug manufacturing.

The first national assessment of Canada’s freshwater ecosystem shows that the country’s major watershed face multiple environmental threats. This is a cause for concern since Canada has jurisdiction over 20% of global water supply.

Examination of 740 production systems for more than 90 different types of food has revealed that global diets and farming practices must change in order to reduce the impact of agriculture on the environment.

Equity & Disparities

Earlier this month the WHO published its 20th Model List of Essential Medicines (IPW, WHO, 6 June 2017). This essential list of medicines “have been successful in facilitating access to treatment and promoting affordable prices, particularly in low-resources countries,” the release says, adding that same results would be expected for diagnostic tests.

Researchers have developed a new reliable, validated and brief survey tool to measure resilience among adolescents displaced by the Syrian conflict.

Fifteen years after legalizing abortions in Nepal, researchers find that gaps in equity, quality and access still exist. Some of the gaps identified include small number of private pharmacies that distribute medical abortion medications, costs associated with the procedure, perceived stigma and diverse terrain.

Maternal, Neonatal & Children’s Health

The UK and the US are at the bottom third of the rankings for five of the six dimensions of child well being analyzed in a new UNICEF report. According to the report, 1 in 5 children live in poverty in rich countries.

Religious groups must get more involved in the campaign against HIV/AIDS and educate their followers on the need to have their children screened for the disease.

Global News Round Up

Politics & Policies

Member governments of the World Health Organization are increasingly talking about how to bring about “fair” pricing of medicines.  And what’s clear is that it should not be based on how much you would pay to save your life, a senior WHO official said this week.

“More than 11 million people are alive today thanks to this man’s creation of PEPFAR, the US AIDS program that has been saving lives and preventing new HIV infections for over 10 years, with strong support from political leaders right, left, and center,” the musician captioned a photo of the activists on Instagram. “That progress is all at risk now with President Trump’s budget cuts, which will mean needless infections and lives lost.”

Tom Frieden, head of the CDC from 2009 to 2017, told graduating medical students that we face challenges from pathogens, and from politicians.  “Einstein wrote, ‘Striving for social justice is the most valuable thing to do in life.’”

The Trump administration’s budget recommendation may take a “wrecking ball” to foreign aid but the development community needs to seize this opportunity to build a broader constituency, according to the chief executive officer of CARE USA.
Trump would cut the annual global health budget by about 26 percent, or around 2.2 billion in the 2018 fiscal year that begins October 1, decreasing it from about $8.7 billion in the current fiscal year budget to less than $6.5 billion.  The program that would be hit hardest would be family planning.

Canada has scored well in a global study to assess how effectively countries use their healthcare systems to avoid preventable deaths, but the country still has plenty of room for improvement.

Applause, cheers, Ethiopian flags, mobile phones held high and a crush of well-wishers greeted Tedros Adhanom Ghebreyesus Tuesday evening after his election as WHO’s next Director-General.

Programs, Grants & Awards

UGA’s Global Health Institute begins search for Holbrook Endowed Professor in Global Health.

“When it comes to the issues of health, there are no walls dividing impoverished and the wealthy.  Illness and disability know no borders.  In today’s global environment, disease is no longer confined to one population, but has the potential to impact millions in disparate regions of the world in a very short period of time. That’s why the work of the Old Dominion University Center for Global Health is so vital.”

Research

Inhibition of programmed death-ligand 1 (PD-L1) with atezolizumab can induce durable clinical benefit (DCB) in patients with metastatic urothelial cancers, including complete remissions in patients with chemotherapy refractory disease.

In high-income settings, the prevalence of tobacco use has been shown to be significantly higher in people living with HIV than among HIV-negative individuals of the same age and sex distribution. This at-risk pattern is one of the biggest threats to the number of years of life saved with antiretroviral therapy (ART).

A new study reports the identification and early validation of a drug for treating cryptosporidiosis, a diarrheal disease which is a major cause of childhood mortality in low and middle income countries.

Diseases & Disasters

The Indian health ministry has confirmed its first cases of the Zika virus, the World Health Organization has said, the latest nation to be affected by the mosquito-borne virus that sparked global concern.

A new study led by Colorado State University researchers found that Aedes aegypti, the primary mosquito that carries Zika virus, might also transmit chikungunya and dengue viruses with one bite.

Indian officials who were aware of the country’s first Zika case months ago, failed to alert the public.

With rising number of measles cases, Germany plans to fine parents who do not seek medical advice on vaccinating their children.

A new Ebola vaccine is on its way to the DRC to help fight a recent small outbreak.

Unrefrigerated vaccine and syringe reuse has led to the death of 15 children in South Sudan.

Technology

Alma Sana, an immunization advocacy group has won a share of the $1 million Global Healthcare innovation award for a baby’s bracelet that would be punched every time the child gets vaccinated.

LimbForge, a non-profit organization is training local doctors and humanitarian NGOs in Haiti to create low cost, culturally appropriate prosthetic limbs for using 3D printing technology.

Environmental Health

Kabwe is the world’s most toxic town, according to pollution experts, where mass lead poisoning has almost certainly damaged the brains and other organs of generations of children – and where children continue to be poisoned every day.

Paraguay has made the most progress in providing access to safe water to about 94% of its rural population (up from 51% in 2000).

According to a new WHO report, resource intensive tobacco farming is environmentally costly and its impact include soil degradation and non-biodegradable litter in the form of cigarette butts.

Equity & Disparities

According to a survey conducted by the Human Rights Watch group, people with disabilities and older people are more likely to be caught in the fighting in South Sudan.

The first class of 24 students from 12 countries graduated from the University of Global Health Equity (UGHE) in Kigali (Rwanda) this year.

A new study of the mortality data between 2000 and 2013 after the roll out of universal health coverage in Brazil, reveals greater decreases in mortality rates among blacks and mixed race Brazilians.

An Indian TV soap that tackles domestic violence, acid attacks and abortion of female fetuses has become the most watched TV show with nearly 400 million viewers.

Maternal, Neonatal & Children’s Health

The murder of a 3 year old girl in South Africa has put the spotlight back on the high child and adolescent homicide rates in the country.

UNICEF warns that the number of suspected cholera cases in Yemen might reach up to 130,000 in the next two weeks.

According to a new study that analysed the death rates among twins in sub-Saharan Africa, nearly one in five children born as a twin die before they turn five years old.

 

Global News Round Up

Politics & Policies

Dr. Tedros Adhanom Ghebreyesus has been elected as the new WHO director general.

The State Department on Monday officially announced a broad expansion of the Mexico City Policy, a regulation put in place by every Republican president since Ronald Reagan that prevents foreign nongovernmental organizations that perform or promote abortions from receiving American dollars.

If a serious infectious disease blossomed across the globe today, the US death toll could be double that of all the casualties suffered in wars since the American Revolution.

A report from an expert committee convened by the National Academy of Sciences, Engineering and  Medicine outlines global health priorities and strategies to maintain US leadership.

Programs, Grants & Awards

Each year, the Duke Global Health Institute honors outstanding students and faculty members with several awards.  This year, as is commonly the case, the award conferring committees were hard-pressed to select winners, given the abundance of nominations for highly deserving candidates.

The Global Health Corporate Champions is an activity of USAID’s Global Health Fellows Program (GHFP) II, which is implemented by the Public Health Institute and supported by PYXERA Global. GHFP-II supports the Agency’s thought leadership in building a diverse, technically excellent, culturally competent group of American global health leaders.

Research

The US is on track to end the HIV epidemic within the next decade.

A new report from the WHO and its partners estimates that nearly 1.2 million adolescents die from largely preventable causes every year, that would be 3000 deaths each day.

Researchers have identified the molecular mechanism by which the deadly superbug “Golden Staph” evades antibiotic treatment. These results may provide clues to counter antibiotic resistance.

WHO data shows that nearly half of all deaths are now recorded, a trend that implies improvement in collection of vital health statistics and progress towards attaining sustainable development goals.

Diseases & Disasters

USAID is exploring the merger of its disaster and food assistance offices to create an entity that would manage a $4 billion humanitarian operations.

According to the WHO, there are now 29 suspected Ebola cases in Congo.

According to a new study, risk of dementia is significantly decreased among retirees who volunteer.

A state of emergency has been declared in Yemen after Cholera killed 157 people between April 27 and May 13.

The Nuclear Threat Initiative has joined the global health council to broaden its biosecurity mission.

Technology

The Indian government’s decision to include pneumococcal conjugate vaccine in its Universal Immunization Program is a big public health win.

A severe shortage of the injectable polio vaccine is threatening to hinder polio eradication.

Environmental Health

Stanford University has produced a new report that outlines recommendations to mitigate health impacts of climate change.

There is concern that continued destruction of forests in Asia-Pacific region will hamper the advancement towards meeting the sustainable development goals.

Equity & Disparities

According to a recent UNICEF analysis of 11 countries in the Middle East and North Africa, at least 29 million children live in poverty in the region.

A new Lancet Global Health article discusses lack of gender parity in leadership positions in the field of global health.  Women make up for about 84% of the student body but this number declines sharply to only about 24% in leadership positions.

Maternal, Neonatal & Children’s Health

The underground sex industry notoriously eludes any efforts to officially measure its size, but those of us who study it can say one thing for sure: It’s a booming industry in the US and it’s bigger than you think.

According to a new WHO report, pregnancy related complications are the leading cause of death globally among adolescent girls between 15 and 19 years of age.

Human Rights

About 2 migrant domestic workers die each week in Lebanon; there is growing and urgent need for better policies, laws and enforcement.

UNHCR has opened a 12th camp for residents fleeing the Mosul conflict.

 

 

Mark Green: USAID pick could be a silver lining if he does it right

This post was developed collaboratively by the Section’s Communications Committee.


The Trump administration’s nomination of Mark Green, former congressman, ambassador, and frequent NGO board-sitter, was one of those hard-to-find silver linings in the current political thunderstorm (or downward spiral, if you prefer). He is a political unicorn of sorts, enjoying both bipartisan support from Congress and respect from development professionals, someone who knows how to navigate both the political and technical aspects of the job. Green, a four-term Congressional representative from Wisconsin, also served as the ambassador to Tanzania under George W. Bush and was involved with the creation of PEPFAR. He has served on the board of directors for Malaria No More and the Millennium Challenge Corporation, a bilateral aid agency that administers grants to countries for recipient-led initiatives based on a series of economic and governance indicators. He is currently the president of the International Republican Institute, which promotes democracy, civil society, and good governance practices abroad. Politicians like him, old USAID hats like him, think tanks like him – even aid groups (including ONE and Save the Children) like him.

All of this is lovely, but hold the champagne. The inevitable next question is, what will Mark Green be able to accomplish as head of a hamstrung agency with no money?

As many have been quick to point out, USAID is not without its problems and could benefit from some major reforms. The agency has certainly not been immune to criticism from global health and development commentators, including this Section. Many of its programs have been of questionable utility or badly managed (or both), and it has been slow to respond to calls for its programs to be rigorously and transparently evaluated.

However, USAID may at this point be facing a more fundamental, existential crisis. Explains the AP, “[t]he agency faces a starkly uncertain future, including potentially big budget cuts and the possibility of being folded entirely into a restructured State Department.”

Restructured” in this case meaning disorganized, rudderless, and full of disgruntled and anxious employees.

An additional wrench was thrown in this week (although completely buried under ever more sensationalist headlines) with the announcement that the Global Gag Rule would be expanded to apply to all global health programs:

[T]he State Department [Monday] confirmed that, indeed, a massive expansion of the Global Gag Rule is underway. Whereas previous iterations of the Global Gag Rule only affected funds earmarked for reproductive health, the Trump version encapsulates all US global health programs. This includes programs for AIDS, Malaria, Measles, cancer care, diabetes, child nutrition — everything except emergency humanitarian relief.

In monetary terms, this expands the scope of the Global Gag Rule from about $600 million in reproductive health assistance to $8.8 billion in global health assistance around the world, including the $6 billion anti-AIDS program created by President George W. Bush known as PEPfAR.

So even if Congress pushes back against the administration to preserve USAID’s budget, Mr. Green may not have any recipients to give the money to.

“You’re #fired”: Why the firing of the US @Surgeon_General matters to #globalhealth

This post was developed collaboratively by the Section’s Communications Committee.


The capital and the news media are in a collective tizzy over the abrupt firing of FBI Director James Comey. Cable news chatter is reaching a fever pitch as talking heads make frequent references to Nixon’s Watergate, though we cannot yet know for sure whether Trump’s house of cards will fall the same way (or, frankly, why on earth he thought this was a good idea).

There is no shortage of rolling heads, and plenty of screaming headlines have rolled with them. While each decapitation dismissal is significant for its own reasons, one that has unfortunately not received as much attention was the firing of US Surgeon General Vivek Murthy at the end of April. Quiet chatter about the sacking has percolated through the domestic public health community, accompanied by a prickly letter from Senate Democrats last week demanding to know why Murthy was axed “[e]specially in light of your Administration’s pattern of politically motivated and ethically questionable personnel decisions.”

As this piece from Vox points out, the reasons why are pretty obvious:

Murthy…holds views on gun control that are at odds with those of the new administration. When President Obama nominated Murthy back in November 2013, the Senate blocked his nomination for more than a year, particularly after the National Rifle Association criticized a letter Murthy had co-signed in support of gun control measures.

Murthy was also a strong supporter of Obamacare. He co-founded Doctors for America in May 2009 — around the time the fight about the Affordable Care Act was heating up. “The country’s main doctor trade group, the American Medical Association, remained neutral on the Affordable Care Act. In founding Doctors for America, Murthy says he saw an opportunity to organize the doctors who very much did support Obamacare,” Sarah Kliff reported.

Most recently, Murthy’s office came out with a report that included clear, evidence-based suggestions about what steps need to be taken to combat the opioid epidemic — but Murthy wasn’t tapped to join President Trump’s recently announced opioid commission.

The implications for public health in the US are pretty obvious. However, this matters on the global health front as well – and not simply because the US is part of the global health picture. In addition to being “America’s doctor,” the surgeon general is in fact a kind of “general” of sorts (technically a vice admiral, equivalent to a lieutenant general). She or he leads the PHS Commissioned Corps, a uniformed service that deploys in public health emergencies, including global ones. PHS officers have deployed in response to humanitarian crises and global health pandemic responses including 2009 influenza pandemic, the 2010 Haiti earthquake, and the west Africa Ebola outbreak.

Past surgeons general have been vocal about the importance of global health. Perhaps more importantly, they also have a distinguished history of being a thorn in the side of the US presidents under which they serve by speaking truth to power on controversial public health issues. One of the most famous examples is C. Everett Koop’s educational brochure on AIDS that he mailed to every household in America in 1988, flying in the face of Reagan’s refusal to publicly reference anything related to the virus or its devastating epidemic. Considering that the position itself has relatively little authority, this kind of thought leadership that champions evidence-based approaches to public health problems, even when they are politically uncomfortable, is all the more important in a world that often looks to the US to set the standards for both science and practice in public health.

Of course, the next surgeon general’s ability to do that is limited under an administration led by a president who still acts like he’s the star of The Apprentice.

Since the election, there has been much (and very much justified) hand-wringing over clear global health setbacks, including looming budget cuts, the Global Gag Rule (and the future of reproductive rights in general), and the potential for ramped up defense spending to drive even more devastation to health through conflict. Doctors take an oath to always do what’s best for their patients. As public health professionals, we have a parallel responsibility to carry out our mission to benefit all people. Dr. Murthy’s legacy of fighting for every life – through his stances on gun control and affordable health care – are an example of this duty exercised faithfully. His final thoughts as surgeon general are striking:

We will only be successful in addressing addiction – and other illnesses – when we recognize the humanity within each of us. People are more than their disease. All of us are more than our worst mistakes. We must ensure our nation always reflects a fundamental value: every life matters.

While there is plenty to ring the alarm about outside the border, it is critical that those of us in global health also lend our voices to our public health allies whose work is focused stateside. We cannot afford to sit out US domestic public health issues, because they inevitably impact the whole world.