Exitus Acta Probat: Negotiating humanitarian access

As I write a commentary about how the CIA’s attempt to locate Osama bin Laden under the cover of a hepatitis vaccination drive endangered the polio eradication effort (and vacciation efforts everywhere), I realize that I am beating a dead horse (so to speak). The collective global health and development community has complained about how ill-advised and irresponsible the plot was until it was blue in the face. We all understand the ramifications; we all shake our heads in unison when reports of health workers being attacked roll in. I saw no point in hashing it out again.

That is, until I shared my views with my non-professional network on Facebook.

Those of you who are more avid Facebookers know that in addition to it being a place to share pictures of new babies, social antics, culinary ventures, and personal details that no one really wants to know, it is a space for people to air out their political and religious beliefs, and to comment (and flame) others’ similar beliefs. Election season can be particularly miserable. While I refrain from doing this most of the time, I will occasionally share stories on things that I find interesting or (in this case) frustrating. In response to this article on the consequences of the CIA’s scheme, I got the following comment:

I fail to see what the CIA has to do with polio. It’s the Taliban that is attacking workers and keeping the vaccine from getting to people.

On the surface, my friend’s comment is true: it is the Taliban, not the CIA, that is attacking health workers and reversing out progress toward polio eradication. But the fact of the matter is that public health and humanitarian workers will always have to work around unsavory characters to reach those most in need. That is why the medical workers are negotiating with the Assad’s government to gain access to the wounded in Syria; it is why health providers worked with al-Shabaab and local warlords in Somalia; it is why midwives work through armed rebel groups to educate ethnic minority communities in Burma. Though affected by all of it, people’s health goes beyond foreign policy, diplomatic relations, and political stalemates. Whether an area is controlled by government forces, extremist groups, or local warlords, its people – and in the case of polio, most critically, its children – will get sick if they can’t access disease prevention. More importantly still, if health workers lose access to these vulnerable populations, progress made in containing disease will be lost – and they can spread even further. Letting up the pressure of polio vaccinations in Pakistan has allowed the virus to rear its ugly head in China and, more recently, Egypt.

After some discussion, he conceded that I had a point. Now I just wish that Obama would do the same and ban the CIA from implementing this kinds of bad ideas to gather intelligence. Bad guys come and go, but negotiating with them to obtain humanitarian access is a reality that will never go away.

WHO Video: Dr Bruce Aylward interview regarding attacks on health workers in Pakistan

During the week of 18 December 2012, at least six people working on a polio vaccination campaign have been reported shot dead in several locations in Pakistan – Gadap, Landi, Baldia and Orangi towns of Karachi city, Sindh Province and Peshawar, Khyber Pakhtunkhwa Province. Those killed were among thousands who work selflessly across Pakistan to eradicate polio.

The Government of Pakistan and the affected provinces temporarily suspended the vaccination campaign due to concerns over safety of health workers.

Such attacks deprive Pakistan’s most vulnerable populations — especially children — of basic life-saving health interventions. of the children of Pakistan.

Polio is a highly infectious disease caused by a virus that can cause permanent paralysis in a matter of hours. Safe and effective vaccines protect children from the disease. Currently the disease remains endemic in only three countries: Afghanistan, Nigeria and Pakistan.

Global Health News, Week of September 26-30

SECTION NEWS
The Advocacy/Policy Committee would like to invite you to participate in our first Advocacy Day, led in partnership with the Global Health Council. The day, scheduled for Thursday, November 3rd, 2011, immediately following the annual meeting in Washington, D.C., will be an opportunity for us to voice support for a continued focus on international health to our elected officials. With the intense Congressional pressure to cut the budget, our voices can make a real difference. As a participant during this exciting day, you will be provided with training materials on effective advocacy techniques to ensure your message is clearly heard. Even if you do not have advocacy experience, you need not hesitate to sign up because you will be teamed with others. Please consider joining your fellow International Health Section members on Thursday, November 3rd, 2011 on Capitol Hill to advocate for a healthy globe. Interested parties should register here. Please note that registration will close on October 14th. Any questions should be directed to Peter Freeman, Advocacy/Policy Committee Chair, at pffreeman@gmail.com or 773.318.4842.


The University of Washington has launched the first full year of its Global Health Minor program!

POLITICS AND POLICY

  • Tobacco companies knew that cigarettes contained a radioactive substance called polonium-210, but hid that knowledge from the public for over four decades, a new study of historical documents revealed.
  • Latin American leaders have agreed to accelerate their efforts to address maternal health at the 51st Directing Council of the Pan American Health Organization/World Health Organization.
  • Journalist Georgianne Nienaber looks at the impact of PEPFAR and how it may be impacted by budget battles in Congress.
  • Earlier this week, the World Health Organization released a report analyzing air pollution levels in nearly 1100 cities in 91 countries. The analysis was based on air particulate levels between 2003 and 2010.
  • When it came out a while ago that the CIA had used a fake vaccination scheme to try to find out where Osama bin Laden might be in Pakistan, many said it would undermine real health and humanitarian efforts. Here’s one group’s story.
  • Foreign aid has acquired a bad reputation in recent years, as something usually wasteful and useless. Yet all this sound and fury has overshadowed the evidence that aid often can work.
  • A report by the Partnership for Maternal, Newborn & Child Health finds that over 100 countries have increased financing for maternal and child health initiatives.
  • The humanitarian impact of the world economic crisis became clearer this week, as the UN warned of huge job losses, a rise in the number of people afflicted by chronic undernourishment, and the “extraordinary price” being paid by children as “austerity programs” constrict the developing world.
  • There is enough water in the world’s rivers to meet the demands of the expanding global population, but the rivers have to be better managed, according to a series of studies released today at the 14th World Water Congress in Porto de Galinhas, Brazil.
  • UNICEF has called on the IMF and World Bank to ensure that children are not negatively impacted by austerity measures carried out by various countries.

PROGRAMS

  • The New York Times shows how male circumcision is one of the most effective and simple solutions in HIV reduction, but has so far been hard to implement.  Meanwhile, a group of economists, including Bjorn Lomborg, are casting doubt on the cost-effectiveness of voluntary male circumcision campaigns as an HIV prevention measure.
  • The New York Times features an article about the simple innovation of using vinegar to detect if a woman has cervical cancer by applying it with a brush to the cervix.
  • The Global Fund, the world’s largest funder of global health, is set to radically shake up the way it disburses and manages donor money, in a move to boost efficiency that could reallocate a third of its financing in order to save more lives.
  • On Tuesday, the Global Alliance for Vaccines and Immunization announced that it will be expanding its target vaccine areas to directly address diarrhea and pneumonia.
  • UNFPA has announced that it is now collaborating with UNICEF to combat Female Genital Mutilation.

RESEARCH AND INNOVATION

DISEASES AND DISASTERS

  • Roads may accelerate spread of antibiotic resistance: Samples from villages by major roads in Ecuador compared to more rural villages shows antibiotic resistant E. coli is spreading along roads.
  • The recent heavy flooding caused by the monsoon in Pakistan, most devastating in Sindh, has affected the lives of over five million people. The Health and Nutrition Cluster is appealing for US$45.9 million. WHO requires US$14.8 for response for Health, Nutrition and Water and Sanitation intervention.
  • New enterovirus causes respiratory disease: Promed reports on 6 clusters of respiratory illness associated with human enterovirus 68 in Asia, Europe, and the United States during 2008–2010.
  • More than 20 percent of the population of Latin America and the Caribbean lacks basic sanitation and 15 percent has no access to drinking water because of poor management, said experts at a meeting that ended Thursday in Brazil.
  • The likelihood of water-borne disease outbreaks is high in areas in Philippines recently devastated by Typhoon Nesat.
  • Aid groups are criticizing the U.S.government delay on deciding whether to resume large-scale food donations to North Korea. The charities warn that many vulnerable people in the impoverished communist state could die from starvation.
  • In a new report on rabies, the WHO finds that 45% of cases in the world take place in Southeast Asia.
  • A decade-long study of 135,000 men found that those who did not have children had a higher risk of dying from heart disease than those who did, raising new questions over the links between fertility and overall health,U.S. researchers said on Monday.
  • More money is needed to save lives in famine-ravaged East Africa, with the UN saying it’s something like $700 million through year’s end. The World Bank announced from Washington it would boost its aid to area countries to nearly $1.9 billion.  As if famine weren’t enough, Nick Kristoff tells us that as Somalis stream across the border into Kenya, at a rate of about 1,000 a day, they are frequently prey to armed bandits who rob men and rape women in the 50-mile stretch before they reach Dadaab, now the world’s largest refugee camp.
  • An explosion of new technologies and treatments for cancer coupled with a rapid rise in cases of the disease worldwide mean cancer care is rapidly becoming unaffordable in many developed countries, oncology experts said on Monday.

TOTALLY UNRELATED TO ANYTHING – Twitter knows what you’re feeling!

Global Health News Last Week

The Supercourse team at the University of Pittsburgh has taken the initiative to spread the WHO’s definition of health, “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”  They have translated the definition into over 60 different languages using Google translate and have asked health professionals to review them to make sure they are correct.  This global health knowledge campaign is being developed by the Supercourse team, WHO Collaborating Centre, University of Pittsburgh.  Please contact Dr. Ronald LaPorte, Director, Professor of Epidemiology, University of Pittsburgh, for more information.

July 28 was the first-ever World Hepatitis Day.

POLITICS AND POLICY

  • As the UN gears up for its Summit on Non-Communicable Diseases this September, blogger Michael Hodin argues that by focusing on this issue, the world body has a “new shot at relevance” in an era where its importance is decreasing (and countries contemplate cutting its funding).
  • Former U.S. Ambassador on HIV/AIDS Jack Chow says the CIA’s fake vaccination scheme in Pakistan, aimed at locating Osama Bin Laden, threatens to undermine a broad set of American global health initiatives.
  • The U.S. government and the Gates Foundation were responsible for 85% of the steep increase in malaria funding between 2007 and 2009. Richard Tren argues that we need to diversify funding sources and focus on control efforts.

PROGRAMS

  • The Bill & Melinda Gates Foundation has teamed up with FC Barcelona to promote the polio eradication campaign.
  • To raise awareness about violence against women in Europe, the UN has opened up a contest to design a newspaper advertisement in support of the UN Secretary-General’s UNiTE to End Violence against Women campaign. View submissions and the winning entries here.
  • Seattle-based development blogger Tom Paulson continues to raise some interesting issues regarding the Gates Foundation’s funding of media coverage for global health issues.  Their latest venture is a weekly program on the BBC.

RESEARCH

  • Researchers have cracked the DNA code of the strain of E. coli that originated in German sprouts and killed over 50 people this summer.
  • A cell phone that doubles as a blood-oxygen tester is one of the 77 mHealth innovation finalists for the Saving Lives at Birth: A Grand Challenge for Development competition.
  • A study conducted by the WHO found that France, the U.S., the Netherlands, and India have the highest rates of depression in the world, while China has the lowest.  Detailed interviews were conducted with over 89,000 individuals in 18 countries.
  • It is becoming more apparent that one of the most effective ways to deal with HIV/AIDS is to address neglected tropical diseases, argues the Public Library of Science in Eureka Alert.
  • A study of the lifespan of HIV patients receiving combination ARV therapy by researchers at University of Ottawa has found that patients can expect to live a near normal lifespan.
  • Researchers at Oklahoma University believe that a protein-based vaccine could prevent many cases of childhood pneumonia.
  • Dutch researchers have found that children who were not breastfed were more likely to develop respiratory problems such as asthma.
  • The first stage of trials for a new malaria vaccine by Swiss researchers in Tanzania have shown promising results.
  • Has announced in a study in Pediatrics that the varicella vaccine for chickenpox has reduced the annual death toll in the United States from 105 to 14. Tests are in progress that could lead to major family planning advances. The New York Times reports on some innovations in male contraceptives that could offer safe and effective contraception.

DISEASES AND DISASTERS

  • The Agbogbloshie slum outside of Accra, Ghana, is a major electronics waste dump.  This site is an example of what happens to “donated” discarded electronics: residents burn them to extract precious metals and simultaneously exposed to a host of hazardous chemicals, as the goods release lead, mercury,
    thallium, hydrogen cyanide, and PVC.
  • A recent article by a global panel uses startling images to call attention to the woeful state of neglect and inadequate treatment of mental illness in developing nations.