Global News Round Up

by ihsection, posted in News

Politics & Policies

The House Appropriations Committee on Thursday approved the fiscal year 2020 Department of State and Foreign Operations (SFOPs) appropriations bill, which includes funding for international development, global health, gender equality, and humanitarian assistance programs.

Alabama passed a near-total ban on abortion this week, strict enough to rival abortion rules in countries like Brunei, Guatemala and Syria.

The Trump administration pushed the G-7 nations to water down a declaration on gender equality last week as part of its broad effort to stamp out references to sexual and reproductive health in international institutions, according to people involved in the process and drafts reviewed by Foreign Policy.

Health Ministers from G7 countries wrapped up a two-day meeting today in Paris that focused on strengthening primary health care, health inequalities for developing countries and the elimination of HIV/AIDS, tuberculosis and malaria.

The increase in the number of infectious-diseases outbreaks (e.g., Ebola, Zika, and yellow fever) around the world and the risk posed by an accidental or deliberate release of dangerous pathogens highlight the need for a sustained, multi-sectoral, and coordinated United States response. U.S. Agency for International Development (USAID) is proud to be working with more than ten other Federal Departments and agencies in this critically important effort.

Today, May 18, 2019, Health and Human Services Secretary Alex Azar participated in a meeting with the Pasteur Institute.  He and other U.S. health officials met with Stewart Cole, President of the Pasteur Institute, and other members of the Pasteur Institute, and other members of the Institute’s senior leadership team.

Programs, Grants & Awards

Since childhood, Cynthia Luo knew she wanted to be a physician. In high school, she discovered a passion for cancer immunology research while working in the lab of a biotech company.  After spending part of a gap year volunteering at a rural health clinic in Uganda, she aspired to have an impact on global health.

Research

The World Health Organization (WHO) reports there are more than 112,000 confirmed cases of measles worldwide, as of this month – a 300% increase from the 28,124 cases this time last year.

New research suggests that coxsackievirus decreases the number of insulin-producing beta cells, raising the risk for type 1 diabetes in lab mice, according to findings published Wednesday in Cell Reports.

The legalization of recreational marijuana is associated with an increase in its abuse, injury due to overdoses, and car accidents, but does not significantly change healthcare use overall, according to a new study.

Avian malaria parasites (genus Plasmodium) are cosmopolitan and some species cause severe pathologies or even mortality in birds, yet their virulence remains fragmentally investigated. Understanding mechanisms and patterns of virulence during avian Plasmodium infections is crucial as these pathogens can severely affect bird populations in the wild and cause mortality in captive individuals.  The goal of this study was to investigate the pathologies caused by the recently discovered malaria parasite Plasmodium homocircumflexum (lineage pCOLL4) in four species of European passeriform birds.

Diseases & Disasters

There have now been 880 measles cases reported in this year’s outbreak, already the largest since 1994, federal health officials said on Monday.  An additional 41 cases were reported last week, according to the Centers for Disease Control and Prevention. Of those, 30 were in New York State, which is having the country’s most intense outbreak, largely in Orthodox Jewish communities.

Tuberculosis (TB) may be an ancient disease, but it is still the leading cause of infectious death worldwide, affecting more than 10 million people and killing 1.6 million in 2017 alone. Last year, the UN held the first High-Level Meeting on TB. As part of that meeting’s final political declaration, member states committed to fill the $1.3 billion annual funding gap in TB research & development, and to increase overall global investments to 2 billion dollars with the aim of enabling the development and introduction of life-saving scientific innovations for those impacted by TB around the world.

The government is to send new funding and expert personnel to the Democratic Republic of Congo (DRC) amid fears the rapidly escalating Ebola crisis there is spiralling out of control and could spread into neighbouring countries.

Chad’s worst measles outbreak in years will soon spread to all parts of the country as vaccination rates are too low to stop an epidemic that has already hit thousands, the World Health Organization (WHO) said on Thursday.

Technology

Last year’s high-level political declaration on the fight against tuberculosis committed to mobilizing sufficient and sustainable financing for universal access to quality prevention, diagnosis, treatment and care of tuberculosis (TB). To achieve this, we need new ideas and innovation to end TB.

In theory, a terrorist could mass disseminate the hemorrhagic virus by small particle aerosol. It is a possible but unlikely scenario because executing such an attack would take an incredible amount of technology and financing.  However, someone g executing such an attack would take an incredible amount of technology and financing. However, someone with basic skills in virology could infect only a few people with Ebola, and the event would cause worldwide havoc.

Confronting an Ebola outbreak spiraling out of control in the Democratic Republic of Congo, the World Health Organization announced ola s on Tuesday to change its vaccination strategy, offering smaller doses and eventually introducing a second vaccine.

Environmental Health

Concentrations of antibiotics found in some of the world’s rivers exceed ‘safe’ levels by up to 300 times, the first ever global study has discovered.

Māori culture is at risk due to predicted changes in the ranges of two culturally important native plants, kuta and kūmarahou.

Equity & Disparities

In San Francisco, a hub of homelessness in the US, researchers have observed firsthand how living on the streets can accelerate aging. With an average age of 57, homeless study participants suffered strokes, falls, and incontinence at rates more typical of people in their 70s and 80s.

More people on the planet have access to electricity than ever before, however, the world is on pace to fall short on the goal of affordable and sustainable energy for all by 2030, according to an international report on the state of international energy.

Women, Maternal, Neonatal & Children’s Health

Over 20 million babies around the world – about 1 out of every 7 – were born underweight in 2015, a slight improvement over rates in 2000 but not enough to meet goals and prevent global health consequences, according to a new study.

In the eastern Democratic Republic of the Congo, ongoing armed conflict increases the incidence of gender-based violence (GBV) and presents a distinct and major barrier to care delivery for all survivors of GBV. To address the multiple barriers to providing time-sensitive medical care, the Prevention Pack Program was implemented. The Prevention Pack Program was able to provide timely and consistent access to emergency contraception, HIV prophylaxis and treatment for sexually transmitted infections for rape survivors in the eastern Democratic Republic of the Congo.

31,285 Human Rights Violations and Counting: Hypocrisy in America’s Liberal Bastion

by hanstewart, posted in Health Equity, Human Rights

On February 8, 2019, city councilors in Los Angeles met to approve a resolution declaring LA a “city of sanctuary.” It was hailed as a victory amid growing political tension and derision, a “symbolic welcome sign,” according to Councilman Gil Cedillo, that was supposed to “set the tone for the way we want our residents to be treated.” However, for the 31,285 Angelenos who are experiencing homelessness, Los Angeles is anything but a sanctuary.

You know you’ve stumbled into LA’s Skid Row the moment you arrive. Trash clings to the streets in heaps, stacked haphazardly against rows of tents so densely packed it’s difficult to find the sidewalk. It’s a stark contrast to the dazzling city skyline that frames the neighborhood. This isn’t a part of Los Angeles you can see from the sterile aerial shots that punctuate film and television, but it’s the reality of a county with over 10,000,000 residents and wage growth that can’t keep up with the rising cost of living.

Everyone in Los Angeles, from City Hall to residential streets, agrees that more must be done. Inevitably, however, most attempts to build temporary or permanent supportive housing in Los Angeles is met with public resistance. NIMBY, the acronym for “Not in My Back Yard,” refers to the opposition of development in one’s own neighborhood, even if they would otherwise support such a project somewhere else. NIMBYism is rampant in LA’s complex and powerful network of neighborhood associations and councils. When city officials met with residents of Sherman Oaks, a wealthy neighborhood on the west side of the city, to show proposals for homeless housing projects, residents turned out in force to oppose the plans. One resident went so far as to propose his own solution to the need for emergency shelters in Los Angeles:

“You want me to have compassion for people who don’t care about themselves?…I’m proposing maybe you build a reservation for these homeless somewhere out in the desert…when we interned the Japanese during the Second World War, we didn’t intern them in the city”.    

Much of this resentment and stigmatization comes from the deeply held American belief in the “prosperity gospel.” In other words, those who work hard and are free from vices are protected against material scarcity. Homelessness, then, is a personal failing and not a societal one. It’s time we reframe homelessness.

Public officials, public health professionals, and advocates across Los Angeles need to change the way we talk about homelessness to end the rampant NIMBYism in the city. It’s time to adopt a rights-based approach that focuses on the systemic failures that are determinants of homelessness. We need to abandon the “treatment first” approach to combating homelessness, where we attempt to fix the precipitating effects of inadequate housing (substance abuse, mental illness, poor health) before providing stable housing. Instead, programmatic and policy efforts should focus on “housing first” approaches that satisfy basic human needs before attempting to solve complex behavioral and lifestyle issues. The model is evidence-based and, unlike many interventions designed to combat homelessness, it’s effective. Investments in housing first approaches reduced homelessness by 91% in Utah, and research efforts in Seattle show that the savings generated by reducing the need for crisis intervention services more than makes up for the cost of housing first projects.  

Image Credit: The Spotlight

Los Angeles has the opportunity to lead by example in a world that is growing increasingly less empathetic to the plight of the vulnerable. However, we cannot be the city that birthed the “Me Too” movement and turn away from the fact that half of all women who are homeless report that they are domestic violence survivors. We cannot say that we are a city that believes that black lives matter when we know that while only 8% of LA County identifies as black or African American, they make up over one-third of the unsheltered population. It is unconscionable that our city turns out in force for Pride but fights efforts to house homeless youth, nearly half of whom cite whom they love as the reason they are homeless.

In December, Los Angeles hosted the UN’s celebration of the 70th anniversary of the Universal Declaration of Human Rights, a document that states in no uncertain terms that housing is a right of every person everywhere. If we are to be taken seriously in our defiance of increasingly discriminatory national rhetoric, we must do better here at home.

“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.“
-UDHR, Article 25.1

Read more about evidence based messaging campaigns around homelessness.

Webinar/In-Person Event (5/29/2019): Universal approaches to promoting healthy development A Princeton -Brookings Future of Children event

by scanyatonwu, posted in APHA IH Section

Universal approaches to promoting healthy development
A Princeton-Brookings Future of Children event

Wednesday, May 29, 2019, 9:00 – 11:00 a.m. EDT

The Brookings Institution, Saul/Zilkha Room
1775 Massachusetts Avenue, N.W. Washington, D.C. 20036

RSVP to attend in person
RSVP to watch the webcast
On Wednesday, May 29, Princeton University and the Brookings Institution will release the latest volume of The Future of Children—a journal that promotes effective, evidence-based policies and programs for children, along with a policy brief, “Achieving Broad-Scale Impacts for Social Programs.” This volume, titled “Universal Approaches to Promoting Healthy Development,” explores universal social programs designed to serve entire communities as they move toward achieving population impact in reducing child maltreatment, strengthening parental capacity, and improving infant health and development.

Following an overview of the volume and the accompanying policy brief, Cynthia Osborne, associate dean for academic strategies at the LBJ School of Public Affairs at the University of Texas, will give keynote remarks and provide an overview of the home visiting landscape. Presentations will then highlight the Family Connects program and give an overview of the First 5 LA program in Los Angeles County. The event will conclude with an expert panel discussion moderated by Ron Haskins, a senior editor of the volume and the co-director of the Center on Children and Families at Brookings.

This event will be live webcast. Join the conversation on Twitter at #FutureofChildren.

Welcome and overview of volume

Ron Haskins, Senior Fellow and Co-Director, Center on Children and Families, The Brookings Institution

Keynote address

Cynthia Osborne, Associate Dean for Academic Strategies, LBJ School of Public Affairs, University of Texas at Austin

Overview of ‘Family Connects’

Kenneth A. Dodge, Pritzker Professor of Early Learning Policy Studies, Duke University

Overview of home visiting in Los Angeles County

Deborah Daro, Senior Research Fellow, Chapin Hall, University of Chicago

Panel discussion

Ron Haskins, Senior Fellow and Co-Director, Center on Children and Families, The Brookings Institution
Deborah Daro, Senior Research Fellow, Chapin Hall, University of Chicago
Kenneth A. Dodge, Pritzker Professor of Early Learning Policy Studies, Duke University
Cynthia Osborne, Associate Dean for Academic Strategies, LBJ School of Public Affairs, University of Texas at Austin

 

1000 Deaths and Rising: The Complexity of DR Congo’s Ebola Outbreak

by pragmaticsolidarity, posted in APHA IH Section, Conflict and Health, Infectious Disease

The Ebola epidemic in the Democratic Republic of Congo (DRC) has officially taken the lives of over 1000 individuals, according to the country’s Ministry of Health. These statistics, which were released at the end of last week, have been accumulating since the outbreak’s onslaught in August 2018. This occurrence is considered the second deadliest in the history of this Filoviridae Virus in the world and the deadliest in the DRC. This specific incidence afflicting humanity is often referred to as the Kivu outbreak due to the initial emergence in this northeastern DRC province; however, the identified virulent strain is the Zaire Ebola Virus which happens to carry the highest rate of mortality of all strains.

The following is an up-to-date timeline of the current Ebola outbreak’s transition to an epidemic:

  • August 1st, 2018: The DRC’s Ministry of Health declares an Ebola outbreak in Mangina, North Kivu
  • August 7th, 2018: Laboratory findings confirm this outbreak is caused by Zaire Ebola
  • October 17th, 2018: World Health Organization (WHO) convenes a meeting about the Kivu outbreak. WHO declares this situation does not constitute the classification of a “Public Health Emergency of International Concern”
  • October 20th, 2018: An armed attack occurs in Beni, Kivu at a health care facility leaving 12 people dead
  • November 9th, 2018: The number of cases in DRC reaches 319 which marks the largest outbreak in the country’s history
  • November 29th, 2018: The Kivu epidemic becomes the second largest recorded outbreak of the Ebola virus in the history of the disease on this planet.
  • December 27th, 2018: There is an announcement of postponement of elections in Benin & Butembo which are two largest cities in Kivu.
  • February 24th, 2019: An MSF health care facility is partially burned down and MSF suspends activities in North Kivu by unknown militants
  • February 27th, 2019: A second MSF health care facility is attacked also by unknown militants and the NGO is forced to evacuate staff and suspend all operations in the province of Kivu
  • March 20th, 2019: The outbreak reaches the 1,000 confirmed cases mark of the Ebola Virus
  • April 12th, 2019: WHO holds an additional meeting but finds the Kivu outbreak still doesn’t qualify as a “Public Health Emergency of International Concern”
  • May 3rd, 2019: The number of deaths secondary to the Ebola virus reaches 1000

Although each explicit manifestation of this deadly communicable disease carries with it seemingly insurmountable barriers in the form of human resources, supply logistics, social tendencies, and global support, the Kivu is particularly devastating due to political uncertainty, lack of trust in the health care system, and civil unrest.

Despite the increase in novel innovations for treating Ebola and even a promising vaccine that can prevent the virus virology, the Kivu outbreak continues to surge ahead and torture the human species in large part to a break down of trust in the medical system. The surge has lead to identifying 126 confirmed cases over a seven day stretch at the end of April 2019 in addition to the aforementioned data confirming this outbreak to be the second largest in the history of Ebola. Despite this, the mistrust has amassed in a disbelief that the outbreak even exists. A study conducted by the Lancet in March 2019 revealed that 32% of the respondents believed that the outbreak did not exist in the DRC, it only served as a way serve the elite’s financial interests. Another 36% stated that the Ebola outbreak was fabricated to further destabilize the surrounding areas. With these sentiments, the responders marked that fewer than two-thirds would actually want to receive the vaccine for Ebola. These perceptions of fellow humans provides an additional barrier to overcome for health care professionals in addition to treating a high mortality rate disease in resource limited settings.

While the mistrust in the healthcare system provides a tremendous intrinsic challenge for the DRC, the civil conflict that has targeted Ebola treatment centers delivers a physical and emotional component of the devastatingly uniqueness of this outbreak. With over 100 armed groups thought to be estimated within Kivu province, this has led to widespread violence causing this area to be difficult to maintain access. Due to the high rate of armed groups and the political unrest, there has been 119 incidents of Ebola treatment centers and/or health workers that have been attacked since the start of this outbreak. A few shocking examples include the murder of Dr. Richard Mouzoko who was a Cameroonian WHO physician and the two torched MSF facilities in the northern part of Kivu that were mentioned in the timeline.

The Kivu Ebola outbreak has been unanimously christened one of the most complex humanitarian crises that faces this fragile planet today – the global health community is attempting to treat a disease with a 50% mortality rate, with inadequate but effective evidence-based treatment options in a resource-limited setting, all while in a treacherous war zone. Although these are insurmountable odds, health care professionals across Africa and other parts of the world are addressing the needs of their patients and communities to defeat this ailment. These physicians, nurses, pharmacists, and so many others are generating trust in the health care system at a grass-roots level in the DRC to combat the negative perceptions and the actual outbreak. This example, that the global health community can learn from, highlights the role each person dedicated to global health needs to undertake before an outbreak batters a part of this fragile planet. The vitality of trust can start to be built through having individual/group conversations truly listen to health beliefs, coming in with an open mind to acknowledge local health treatments to complement evidence-based treatment, providing patient centered care that encompasses their culture and values, supporting capacity-building initiatives that allow humanity to act accordingly, investing both time and resources in local public health care infrastructure, and expressing empathy ubiquitously socially and professionally.

Being part of the global health community, it is imperative that this outbreak is adequately supported by humanity. As fellow humans striving towards a healthier society, health care professionals and public health experts must accompany those tormented by the social factors associated with Ebola and the actual virus through global awareness of the situation, an un-stigmatized compassion for those who contract the disease, and a pragmatic solidarity to address this humanitarian crisis.  

Global News Round Up

by ihsection, posted in News

Politics & Policies

At the urging of the White House, Germany nixed language referring to “sexual and reproductive health” in a signature UN resolution taking aim at rape in conflict situations, Foreign Policy reports.

Programs, Grants & Awards

The DMU Department of Global Health’s Distinguished Global Health Internships are highly selective research opportunities that enable students to explore global health research topics at various organizations. Students have the opportunity to work with researchers on projects such as conducting systematic reviews to create evidence-based educational materials for worldwide distribution.

Research

A swarm of micro-robots, directed by magnets, can break apart and remove dental biofilm, or plaque, from a tooth. The innovation arose from a cross-disciplinary partnership among dentists, biologists, and engineers.

Diseases & Disasters

Imagine your house is gone. And yet the TV set is still standing.  That’s one of the scenes that photojournalist Tommy Trenchard documented as he visited parts of Mozambique hit by Cyclone Kenneth on Thursday.

Measles continues to spread in the United States, federal health officials said on Monday, surpassing 700 cases this year as health officials around the country sought aggressive action to stem the worst outbreak in decades.

Nearly three weeks since fighting began near the Libyan capital Tripoli, the UN health agency warned on Tuesday that “large numbers” of people are sheltering in medical clinics, while civilians continue to be killed or injured, and refugees and migrants remain exposed to clashes.

Students are currently being quarantined in Los Angeles. Mandatory-vaccination policies have been implemented in Brooklyn. Even President Donald Trump, contrary to prior assertions, today urged people to get children vaccinated.

The Democratic Republic of the Congo (DRC) today reported another double-digit rise in Ebola cases, as local leaders such as traditional chiefs and provincial representatives stepped up their efforts to convince community members to support the response efforts to end the outbreak.

In South Sudan mind-bending horrors abound of war, ethnic violence, rape, hunger and displacement.  But for civilians living in the shadow of conflict, the greatest danger is often being cut off from health services, whether due to violence or lack of development in the vast, remote areas that make up much of the country.

Technology

The CDC is issuing new guidance to clinicians for the treatment of severe cases of malaria.  The action follows discontinuation of quinidine, the only FDA-approved intravenous (IV) antimalarial drug in the United States.

Devout parents who are worried about vaccines often object to ingredients from pigs or fetuses. But the leaders of major faiths have examined these fears and still vigorously endorse vaccination.

Ghana’s long unsung health tech sector is getting global validation with two of its most promising startups being named among five winners for one of the most prestigious social enterprise awards in the world.

Environmental Health

Dozens of cities across the world have declared a climate emergency. Now, students behind the school climate strikes are bringing the movement to Switzerland and Germany. But what does that mean exactly?

Equity & Disparities

Sometimes it is important to go back to basics. For human interaction, one of the basics is language, the system of communication that, when applied at its best, allows us to understand each other, share, cooperate, and pull each other towards a better place. When on a collective journey towards a common objective such as the Sustainable Development Goals, with a rallying cry of “leaving no one behind” and a central aim of “reaching the furthest behind first”, this system of communication is fundamental to move beyond just the rhetorical: to be truly reached, the furthest one behind will need to understand what she is being told, and most likely, that exchange will have to be done in her own language. That principle should apply to all aspects of development, including global health.

The Sustainable Development Goals (SDGs) set by the United Nations (UN) would “remain beyond reach” without adequate financing, an International Monetary Fund (IMF) official said.

Women, Maternal, Neonatal & Children’s Health

Anyone following international development is probably familiar with “stunting” — which in nontechnical terms means children being too short for their age. Over the past decade, as the world has focused unprecedented attention on undernutrition, stunting has taken center stage.

Help is needed urgently from the international community to help some 2,500 apparently stateless “foreign children” at a camp for the displaced, in north-east Syria, a top UN official said on Thursday.

Malnutrition is detrimental to the health of children. As a result of malnutrition, a child’s growth can be stunted. Additionally, both brain damage and physical impairments can arise from malnutrition.

Rates of sexual violence in El Salvador rose by a third last year, with the majority of cases involving teenage girls.

Over 19 million children in Bangladesh are vulnerable to the forces of climate change, says a new study released this month (April) by the UNICEF.

Children in some disaster-prone regions are twice as likely to be living in chronic poverty, according to new research.