MIDEGO Inc. Presents: “Global Health Leaders” with Dr. Elvira Beracochea – Every Friday at 12 p.m. EST.

Below please find an announcement from MIDEGO about a radio show with our own Dr. Elvira Beracochea.

Dr. Elvira Beracochea, global health leader, mentor and coach and MIDEGO CEO will host BlogTalkRadio’s newest show “Global Health Leaders.” This show will present the work of leaders from all over the world who work hard to ensure better health for their countries and citizens. Come and learn about what it takes to succeed in global health and talk with leaders who are helping their patients and country deliver better health for all while at the same time succeeding in their professional careers!

Find out how to become a global health leader and how to support country leaders!

“This radio show is a must-listen for any aspiring global health leader,” says Dr. Elvira Beracochea, host of the program. “A successful career in global health is very much possible and I hope the show helps the next generation of global health professionals achieve amazing results!” Dr. Elvira Beracochea, a global health leader, mentor and coach and CEO of MIDEGO, Inc.—a Global health and development firm dedicated to helping groups and individuals in developing countries meet the Millennium Development Goals.

Callers are welcome to join the conversation during the show by calling (347) 857-3528 or by Skype™ at midegousa. The live, Internet talk-radio show will stream from the host page at http://www.blogtalkradio.com/global-health-leaders.

An archive will be available at the same link immediately following the show or listeners can subscribe to the archives via the RSS feed located on the host page. Follow the discussion at http://www.blogtalkradio.com/global-health-leaders . Read more about host Dr. Elvira Beracochea and MIDEGO Inc. at http://www.blogtalkradio.com/global-health-leaders and http://

Conference Calls and Radio Shows of Interest

Our very own Mini Murthy and Elvira Beracochea are co-hosting a radio show on the MDGs! The inaugural episode aired last week, but you can listen to it in the archives and tune in for future episodes. They will be on every Thursday at 12 p.m. EST. More information can be found below.

Millennium Development Goals: Progress and Challenges

PROGRAM: Millennium Development Goals
TOPIC OF DISCUSSION: Millennium Development Goals: Progress and Challenges


In 2000, 189 nations made a promise to free people from extreme poverty and multiple deprivations. This pledge became the eight Millennium Development Goals to be achieved by 2015. The MDGs provide a framework for the entire UN system to work coherently together toward a common end. UNDP, global development network on the ground in 177 countries and territories, is in a unique position to advocate for change, connect countries to knowledge and resources, and coordinate broader efforts at the country level. In September 2010, the world recommitted itself to accelerate progress towards these goals.

The declaration established eight Millennium Development Goals (MDGs) and time-bound targets by which progress can be measured. With the 2015 deadline looming, how much progress has been made? And is the pace of progress sufficient to achieve the goals? The MDGs break down into 21 quantifiable targets that are measured by 60 indicators.

In our inaugural episode we hope to give a brief over view of the progress and challenges made from the year 2000- 2005 and focus on Sub Saharan Africa to review the progress made with reference to MDGs 1 and 4.

Join us as we explore this very important topic on MDGs.

Padmini (Mini) Murthy is a physician and an activist who did her residency in Obstetrics and Gynecology. She has practiced medicine in various countries. She has a Master’s in Public Health and a Masters in Management from New York University (NYU). Murthy has been on the Dean’s list at NYU stein hart School of Education and named Public service scholar at the Robert F Wagner Graduate School at New York University. She is also a Certified Health Education Specialist.

Elvira Beracochea, MD, MPH, has more than 25 years of experience that encompass her work as physician, public health and international development expert, human rights advocate, epidemiologist, health policy advisor, researcher, health systems and hospital manager, consultant, professor and coach. She has worked in over 30 countries in Latin America, Africa, Asia, Eastern Europe and the South Pacific. Dr Elvira is committed to helping realize the right to health and the right to development and to improving the effectiveness of development assistance. For this reason, in 2005, she founded MIDEGO, an organization with an urgent rights-based mission: accelerate the achievement of the Millennium Development Goals (MDGs) approved by the United Nations in the year 2000.

The Millennium Development Goal is a weekly discussion on AV Radio based on the Millennium Declaration, adopted by all 189 United Nations Member States in 2000, promised a better world with less poverty, hunger and disease; a world in which mothers and children have a greater chance of surviving and of receiving an education, and where women and girls have the same opportunities as men and boys. It promised a healthier environment and greater cooperation-a world in which developed and developing countries work in partnership for the betterment of all.

LISTEN TO THIS RADIO PROGRAM ARCHIVES AT: http://www.africanviews.org/index.php/av-radio/av-radio/AV-Radio/womens-education_c1021_m157/

Next month, APHA’s Trade and Health Forum will be holding an open Educational Session on Tobacco and International Trade Agreements. It will take place on April 12 at 2:30 PM Pacific/5:30PM Eastern.

The first 30 minutes of the call will be an educational session about recent activity pertaining to alcohol and tobacco in trade agreements and the question of “carve outs”. Donald Zeigler, PhD, Director of Prevention and Healthy Lifestyles at the American Medical Association (AMA) will lead the session. Dr. Zeigler has been active in the Trade and Health Forum, representing the Alcohol, Tobacco and Other Drug Section of the American Public Health Association and has been interested in trade and health issues for almost a decade. He was instrumental in getting the AMA to adopt policy on trade and has worked with other medical specialty societies to adopt policy, as well. The AMA recently called on the US Trade Representative to carve out tobacco and alcohol from the proposed Trans-Pacific Partnership agreement.
The second 30 minutes of the call will be dedicated to Trade and Health Forum business. You are welcome to join for the full call, and we welcome your input.

To dial in, please call (605) 475-4850 and use the following access code: 810329#. If you have questions, please direct them to Natalie Sampson (nsampson@umich).

Very best,

American Public Health Association’s
Trade & Health Forum Leaders

Rave Review of “Rights-Based Approaches to Public Health,” by our own Dr. Elvira Beracochea

Congratulations, Dr. Beracochea! A glowing review of her new book, Rights-Based Approaches to Public Health, was recently published in PsycCritiques, a collection of reviews from the American Psychological Association. I have posted the review below. This is a wonderful accomplishment for Dr. Beracochea and her fellow editors and authors of this book. The IH section is fortunate to have you!

Public Health and Human Rights: Realigning Approaches to Improve Global Health Problems

Reviewed by
Will Ross

At a time of heart-crushing stories of human deprivation due to regional conflict, forces of nature, or uncaring and at times immoral state policies, the world’s attention turns to the public health community for problem assessment and effective deployment of resources and programs to stabilize critical conditions on the ground. With great timing, the editors of Rights-Based Approaches to Public Health offer a targeted and innovative strategy to
combat global health problems. Balanced, comprehensive, and steeped in the historical traditions of human rights, the book persuasively moves the reader from abstract conceptions of inalienable human rights to evidence-based, pragmatic solutions that highlight the systematic integration of human rights principles in human development work.

For the audience of public health students, seasoned and novice public health
professionals, health care practitioners, and policy experts, the editors provide an overview of a rights-based approach that is elegant in simplicity and highly executable in design, referencing the UN’s (2000) General Comment 14 on the Right to the Highest Attainable Standard of Physical and Mental Health: “Every human being is entitled to the enjoyment of the highest attainable standard of health conducive to living a life of dignity” (para. 1).

The editors and authors present a framework for a rights-based approach that is
normatively based on international human rights standards and that cannot be easily dismissed as political in nature or hegemonic. Most important, the editors charge some of the world’s most respected public health practitioners and human rights advocates to craft sensible methods of operationalizing the basic human rights principles outlined in the UN’s (2003) Human Rights-Based Approach: Statement of Common Understanding, which posits that human rights are universal, inalienable, interdependent, and interrelated. In essence,
they have created a veritable “how-to” guide that, when implemented, can in sustainable fashion uplift the human condition worldwide.

Universality of Rights-Based Approaches: Uniting Us All?

As detailed by the editors, a cardinal feature of a rights-based approach is its timelessness and universality, increasing its appeal to professionals who labor to keep the plight of marginalized communities on the global radar screen. By using the universal language of rights-based approaches, public health professionals may be better positioned to leverage greater social and political capital and enhanced resource allocation for their cause. Striking examples of rights-based approaches in diverse settings are outlined in the book, from demands for water rights in Haiti to conflict-affected settings such as the Gaza Strip and advocacy of children’s rights in Kosovo.

If the dramatic contemporary examples outlined in the book are not sufficient, the authors could easily extend the discussion further and call attention to the severe drought and attendant famine in Somalia, where the UN’s Food Security and Nutrition Analysis Unit (2011) found that nearly 250,000 people continue to face imminent starvation, or the Democratic Republic of the Congo, where U.S. researchers note that more than 400,000 women are raped each year (Peterman, Palermo, & Bredenkamp, 2011). In all instances a rights-based approach can reverse the erosion of socioeconomic stability that fosters such
injustices while holding the state accountable for protecting and fulfilling the rights of individuals in affected communities.

Inherent in a rights-based approach claim that individuals have the right to the highest attainable standard of health is the realization that health professionals cannot disentangle physical health from the myriad social and economic factors that influence health. If a rights-based approach empowers rights holders in asserting that human rights are universal and inalienable, then it is the incumbent responsibility of the duty bearer—entities sanctioned to protect society—to ensure the fulfillment of those rights. This conceptual framework is in contradistinction to traditional needs-based approaches, whose altruistic intent and actions may be perceived as both patronizing and lacking in accountability, and thus not amenable to legal redress in the event of adverse outcomes.

Marrying Rights-Based Approaches to Health Care Reform

A critical chapter for U.S. readers (Chapter 4) is “A Rights-Based Approach to Health Care Reform.” In the United States, profligate health care spending has not translated into improved health outcomes when compared with those of other developed countries. A fundamental, if not fatal, flaw in the U.S. health care delivery system is the disconnect between the high-quality acute, specialty care available to some who have the ability to pay in a system rooted in free enterprise and the haphazard primary and preventive care that is unevenly distributed across locales. Although unintended, this result is not unexpected in a country that has failed to embrace a full definition of health.

The divide on the proper role of government in health care in the United States was presaged in the response to the World Health Organization’s (1946) definition of health, promulgated in the 1948 UN convention:

a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity. . . . Governments have a responsibility for the health of their peoples which can be fulfilled only by the provision of adequate health and social measures. (p. 2)

This provision was rebuffed on the grounds that it was outwardly socialistic in intent and lacked legal standing, on the basis of the interpretation that health care was not among the enumerated rights in the U.S. Constitution.

The perennial argument surrounding the government’s role in health care has since devolved into rants about market-based reforms as opposed to moral-based claims of health care as a right for every citizen. Such a false dichotomy only promotes greater social division; consensus will be gained when every country affirms the connection between health and human rights. A rights-based approach to health, which has been relatively absent from the contemporary discourse on health reform, could effectively realign staunch political forces around the unassailable conceptual framework of health as a public good rather than a commodity.

The rights-based approach permits a more nuanced view of the roots of health
inequities; consequently, more systematic steps can be taken to ameliorate inequities since a framework exists that addresses the social determinants of health. Rights-Based Approaches to Public Health outlines several international treaties, such as the 1977 International Covenant on Economic, Social, and Cultural Rights, which would reduce stillbirth rates and infant mortality by paving the way for special protection for mothers in the childbirth period. Although the United States signed the treaty, it did not ratify it and so failed to allocate the requisite resources to enforce the treaty.

Hopefully there will be greater U.S. embrace of the UN’s Millennium Development Goals—explicit milestones for the realization of global human development that offer an opportunity to reduce health inequities by spurring economic development. The United States, in its effort to reduce health inequities as outlined in the Centers for Disease Control and Prevention’s (2011) “Health Disparities and Inequalities Report,” will find willing partners in realizing two seminal Millennium Development Goals: reducing child mortality
and improving maternal health.

Limitations of Rights-Based Approaches

The authors and editors of Rights-Based Approaches to Public Health rightfully
acknowledge that the still-nascent field of rights-based public health has limitations that have constrained its widespread adoption. Rights-based approaches rest on the belief that individual empowerment and restored human dignity can be ensured through programmatic efforts that address the social determinants of health. Social determinants of health, as espoused by the World Health Organization’s Commission on Social Determinants of Health (2008, p. 2 of Executive Summary), are “the conditions in which people are born, grow, live, work and age . . . . In their turn, poor and unequal living conditions are the consequence of poor social policies and programmes, unfair economic arrangements, and bad politics.”

Criticism abounds that such an approach is too costly, time intensive, and inherently difficult to measure since it involves restructuring the social fabric of disadvantaged communities and raises the potential for conflicts due to encroachment on national sovereignty. There is correspondingly a lack of solid evidence supporting the effectiveness of rights-based approaches. Finally, a rights-based approach in public health can come across as canonical, even prescriptive in its assertion that individual rights warrant the same protection as societal ones (Berman, 2008).

The book concludes, in powerful tones, that rights-based approaches provide public health professionals the framework and the infrastructure to address the needs of vulnerable populations and society at large. Public health students, academicians, and both medical and public health practitioners should feel empowered to act with this transformative approach that asserts the dignity of humankind.

Berman, G. (2008). Undertaking a human rights-based approach: Lessons for policy, planning, and programming. Bangkok, Thailand: UNESCO Asia and Pacific Regional Bureau for Education.

Centers for Disease Control and Prevention. (2011, January 14). CDC health disparities and inequalities report—United States, 2011. MMWR: Morbidity and Mortality Weekly Report, 60(Suppl).

Peterman, A., Palermo, T., & Bredenkamp, C. (2011). Estimates and determinants of sexual violence against women in the Democratic Republic of Congo. American Journal of Public Health, 101, 1060–1067. doi:10.2105/AJPH.2010.300070

United Nations. (2000). The right to the highest attainable standard of health. Retrieved from http://www.unhchr.ch/tbs/doc.nsf/(symbol)/E.C.12.2000.4.En

United Nations. (2003). Human rights-based approach: Statement of common
understanding. Retrieved from http://www.unicef.org/sowc04/files/AnnexB.pdf

United Nations Food Security and Nutrition Analysis Unit. (2011, November 18). Famine continues: Observed improvements contingent on continued response. Retrieved from http://www.fsnau.org/in-focus/famine-continues-observed-improvements-contingentcontinued-response

World Health Organization. (1946). Constitution of the World Health Organization. Geneva, Switzerland: Author.

World Health Organization Commission on Social Determinants of Health. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health. Geneva, Switzerland: World Health Organization.

Global Health News Last Week


The IH Section hosted its third topic-focused conference call, on Current Developments in MCNH, took place on Monday, June 27, 2011 from 1:00 to 2:00 EST. We had several members of the IH section offer their commentary and expertise on current issues concerning maternal and child health.  Speakers included Laura Altobelli, Elvira Beracochea, Carol Dabbs, Miriam Labbock, and Mary Anne Mercer.  Read the summary here.

IH Section Communications Chair Jessica Keralis attended APHA’s Mid-Year Meeting on healthcare reform.  There were several interesting sessions on technology implications of reform, the public health workforce, advocacy, and others.  Read all about it on the IH Blog.


  • In the first part of a two-part series called “The great billion dollar drug scam,” investigative journalist Khadija Sharife questions the accuracy of figures given by the pharmaceutical industry to justify the high cost of drugs.
  •  The American Chronicle reports how Brazil has been implementing numerous programs to reduce the rate of HIV infection within the country.



  • At the 7th annual meeting of the World Conference of Science Journalists, several speakers said clinical research trials done in the developing world lack adequate patient protections as well as an ethical and legal framework.
  •  Arizona State University Scientists have developed recombinant attenuated salmonella vaccines which they believe will make vaccines more effective.
  •  A test for dengue through saliva has been developed by researchers from Singapore.
  • Researchers believe that they have discovered the precise mechanism by which drugs attack and beat malaria. In doing so, they believe that they can gain a more precise understanding of how resistances are forming and develop better malaria medicines.
  • A recently published report on research and development by the Malaria Research Initiative examines the current state of malaria research and offers six recommendations in going forward to improve R&D.
  • A dramatic increase in support for malaria R&D since the mid-1990s puts the world well on the way to achieving global malaria control, treatment and elimination goals in the next five to six years.
  • A study has found that AIDS patients who take nucleoside analog reverse-transcriptase inhibitors experience premature aging.


  • The WHO has put together a series of graphs based on 2008 global health data to illustrate the 10 leading causes of death by broad income group. Heart disease, stroke and other cerebrovascular disease represent the top two killers in middle and high-income nations while they sit as number three and five respectively for low-income countries.
  •  A report published in Emerging Infectious Diseases, a journal of the CDC, has determined that UN peacekeepers from Nepal brought cholera to Haiti, which led to an outbreak last fall.
  • More than 350,000 women die in childbirth every year and 8 million children will die of preventable diseases before their fifth birthday. A new report concludes that more trained midwives could help save prevent millions of such deaths.
  • In a recently released report, UNICEF says as many as 70% of the world’s children are exposed to violence amounting to 1.5 billion children each year.
  • The drug misoprostol is saving women’s lives around the world by preventing excessive bleeding after childbirth, the leading cause of maternal death in the developing world; it is also causing controversy, as the drug can also be used to induce abortion.
  • Multi-drug resistant tuberculosis is on the rise and hard to cure. Médecins Sans Frontières wants people with the disease to blog about it, to find out what they really need.
  • A new study in The Lancet shows that over the past thirty years the number of adults diagnosed with diabetes has doubled to 350 million.
  • Ghana’s Food and Drugs Board (FDB) issued a statement to warn the public against the sale of counterfeit Artesunate tablets on the market, which it claims are from China; laboratory analysis had confirmed that contained no active anti-malaria ingredient.

Many thanks, as usual, to the Toms – Tom Murphy and Tom Paulson.

Notes on IH Section Conference Call: Current Developments in MCNH (June 27, 2011)

The IH Section held its third topic-focused conference call on Current Developments in MCNH on Monday, June 27, 2011 from 1:00 to 2:00 EST. We had several members of the IH section offer their commentary and expertise on current issues concerning maternal and child health.

Laura Altobelli (Future Generations)
Elvira Beracochea (Midego)
Carol Dabbs (U.S. Department of State)
Miriam Labbock (Carolina Global Breastfeeding Insititute)
Mary Anne Mercer (University of Washington)

Laura Altobelli: Brief presentation of the APHA policy resolution proposal submitted by the IH section entitled, “Call to Action to Reduce Global Maternal, Neonatal, and Child Morbidity and Mortality.”
Laura discussed the new APHA policy proposal on MCH. There was nothing previously on the APHA policy regarding global action on this issue per se – one previously existing resolution focuses on reducing maternal and child mortality in the US, and one focuses on breastfeeding and has both domestic and global aspects. This, then, is the first policy proposal on global MNCH. Justification for the policy proposal is lack of progress on the MDGs and lack of policy commitment to protect vulnerable populations. APHA will be joining important other organizations that are putting out strategies, including the Partnership for MNCH (WHO), and the UN, and attended global meetings in 2010 in observation of the Year of Maternal Health (some of these mentioned below). There is also an effort to increase attention to this in the Global Fund and GHI. Six other sections/forums are co-sponsoring the resolution.

Elvira Beracochea: Update on the Millennium Development Goals 4 and 5.
A factsheet has been sent out (available upon request – please contact jmkeralis [at] gmail [dot] com). These MDGs and their targets have served us well to measure our progress so far. There have been improvements, though progress has been uneven. MDGs 4 and 5 focus on reducing mortality but not necessarily on improving health, development and well-being, and we need to address this as well. We know where women and children die and how. We also have the knowledge to prevent these deaths. We need to coordinate work at global scale and have a concerted strategy to ensure the rights of all women and children are met. We need to take global health goals to a new level of effectiveness using efficient strategies and a human-rights-based approach. A rights-based approach does not focus on only survival, but also on development. We need new targets and indicators that measure not only deaths but also number of children whose right are fulfilled; the children that are breastfed, fully immunized, drink clean water, are protected from malaria, and that that attend school. We need targets and indicators that measure not only the number of women that died or delivered with assistance of a skilled attendant, but that also measure the number of pregnancy complications effectively treated. We need new MDGs and targets.

Miriam Labbok: An update on reproductive health continuum (birth, breastfeeding and birth spacing promotion, protection, support) as an essential MNCH intervention approach.
It is vital that we pay attention to the reproductive health continuum within the life-cycle approach: birth, breastfeeding and birth spacing. Programming must include not only promotion, but also skill- and capacity-building so that support can be provided. In addition, policy change is needed to: support treating women with dignity, provide NFP knowledge (at least for the times that family planning supplies run out), and create the capacity to support health-supportive birth, breastfeeding and spacing practices. All such programming and policy creation should be carried out with recognition of the rights of both women and children to the best possible health support and with attention to appropriate technologies, as one size does not necessarily fit all. In addition, programs that address cultural change and intimate family and social decisions demand the building of trust that comes with reliability and long-term relationships. Programming should be designed for the long term, with a strong base and phased in activities, and with excellence and sustainability as the focus.

Mary Anne Mercer: Partnership for Maternal, Neonatal and Child Health – what it does and how one can get involved.
The Partnership for Maternal, Neonatal and Child Health is a WHO-based coalition of organizations that support increased funding commitments to MDGs 4 and 5. Any organization that supports MCH can be a member simply by filling out an application from the PMNCH web site at http://www.who.int/pmnch/. Be sure your organization is a member (it’s free!) by checking the member list. Also check out the ‘Knowledge Portal’ that aims to maintain updated programmatic information on current approaches to improving MCH. I am on the Board of Directors of the Partnership as an NGO representative, and we will be electing a new member of the Board this year that will represent an Africa-based NGO or the Africa office of an international NGO — please let me know if you have any suggestions for good candidates for that position.

Carol Dabbs: Trends in US government funding levels for global MNCH.
Funding has increased and is overseen by the State Department. Global Health targets are to be achieved with funding from FY 09-14, generally for implementation in FY 10-15. The Global Health Initiative includes principles supporting country-led plans and to coordination with other partnerships and donors, as well as between USG agencies and health programs. Eight countries have been selected as “plus” countries (places to conduct learning laboratories): Ethiopia, Kenya, Mali, Malawi, Rwanda, Bangladesh, Nepal, and Guatemala. Almost all of the Global Health Initiative funding is from USAID and State (there is also some DHHS funding, but that was not included in this discussion). There are two stages in the fiscal year: requesting funds from Congress and appropriation of funds by Congress. Unfortunately, delays have been a reality this year. However, we should look at trends and context of the rest of foreign assistance and of overall health fundig. The budget now includes nutrition as a separate item, and it’s included in the MNCH numbers here. There has been a trend of increased funding; funding for MNCH has increased about by 22% over two years (FY 2008 to FY 2010), but the full year continuing resolution for FY 2011 allocation to MNCH is still pending. We do not know what the appropriations for FY 2012 and FY 2013 will be.

Discussion: Is this in addition to Dept of State HIV funds? Yes, there are additional funds in USAID for HIV/AIDS, as well as funds for MCH and the rest of the health programs.