Occupational Health – The Need to Go Global

Guest blogger: Dr. Isobel Hoskins

I never come away from the APHA meeting without being inspired.

This year, the inspiring speech for me came right at the end. I attended the closing session almost by chance when I realised I had a little time. The theme was occupational health so as someone keen on global health I didn’t think it would be all that relevant. When the second speaker took the stand I realised how wrong I was.

Leo Gerard from the United Steelworkers Union showed how health and safety is a global issue and exactly why we need to address occupational health worldwide to match the globalisation of trade. Have you ever thought about who made the clothing you wear, the conditions they work under and the impact that has on their health?

He showed a short video about the Triangle fire – a fire that happened in 1911 in New York at a garment factory. Fire broke out in the factory and panicked workers rushed to the two exits only to find them blocked by fire or locked. The workers couldn’t get out and in desperation some even threw themselves from the upper floors to escape the fire. 146 of them died. This event was one of the drivers of health and safety regulation in theUSA. Those workers were low paid and not allowed to unionise and so negotiate their conditions.

Fast forward to 2010. Gerard described a fire at a garment factory in Bangladesh and guess what? The exits were locked. 29 people died trying to get out, some threw themselves from the upper floors. No regulations prevented this accident in Bangladesh and there was no union to help protect the low paid workers.

Nothing has changed except the geography.

In the rush of globalization, developed country companies are getting round regulation at home by exploiting places where there is none. What does this mean for regulation at home? It means it is under pressure. We could lose all that has been gained since the Triangle fire. In the race to the bottom and the lowest prices, people’s health is being put on the line.

Trade regulations preventing import into the US of goods made in sweatshops or by children, for example, could be a way of forcing global companies to adopt safe working conditions, said Gerard. Having stronger more global unions is another way. Leo’s union the United Steelworkers Union has just gone global – forging partnerships and mergers with other unions worldwide.

Individually I think we can make a difference as well- reading the label and knowing the reputation of companies you buy from could help prevent exploitation. Consumers have power….

Triangle fire: http://en.wikipedia.org/wiki/Triangle_Shirtwaist_Factory_fire
Bangladesh fire: http://www.guardian.co.uk/world/2010/dec/14/bangladesh-clothes-factory-workers-jump-to-death

Dr Isobel Hoskins manages the Global Health database at CABI.

Global Health News Last Week

SECTION NEWS

The following announcement, from Eric Williams, calls for any IH section members interested in assisting efforts to address federal global health and HIV/AIDS funding.  Please see the text of the announcement below.  Eric can be contacted by e-mail at ericwms@gmail.com.

Dear Colleagues,

I’m writing to request assistance in a “grasstops” effort to address federal global health and HIV/AIDS funding. As you are likely well aware, there have been serious threats and concerns regarding global health funding over the last several years. There is a real need to mobilize influential members of our community in an effort to ensure that Congress does not backtrack on our global health commitments.

I am doing some consulting work with amfar and they want to identify experts, donors, high-profile individuals and/or organizations in select states who can reach out to key Senate leadership. We need these individuals/organizations to show and voice their support for continued and sustained commitments for global health.

States of focus include Nevada (Sen. Harry Reid), Iowa (Sen. Tom Harkin), and Washington (Sen. Patty Murray). We believe these senators are in key positions to influence appropriations decisions and sure up support for global health.

The aim of this effort is to:

  1. identify grasstop individuals/organizations and
  2. plan, coordinate, and carry out outreach efforts to Senate leadership in a variety of ways, including state-level meetings, Hill visits, op-eds, sign-on letters, and so forth.

If you are interested or able to provide assistance in helping to identify and/or reach out to the above stakeholders, I would be very interested in speaking. If there is strong support for this I would be happy to facilitate a conference call to discuss in full.


August 19 was World Humanitarian Day.

POLITICS AND POLICY

  • The CDC has made updates to its flu vaccination recommendations aimed at children and people with egg allergies.
  • The United Nations has released a list of 248 organizations from 48 nations that are accredited to attend the UN High Level Meeting (HLM) on non-communicable diseases (NCDs) during September 19-20, 2011.  Meanwhile, as has been widely reported (including here and here), negotiations have stalled over an “outcomes document” that is to be approved at the meeting.
  • The World Health Organization is calling for a ban on a common blood test for TB, saying the test is unreliable.
  • Twenty-two children in Kancheepuram, Indiawho were not allowed to go to school because they are HIV positive have been ordered to return to school after a court ruled in favor of the students.
  • International funding for HIV fell by 10 percent in 2010 from the previous year, according to the Kaiser Family Foundation and UNAIDS; activists worry that a continued reduction will undermine progress in global HIV prevention and treatment efforts.

PROGRAMS

RESEARCH

DISEASES AND DISASTERS

  • The WHO Says Libya is facing a medical supply crisis.
  • The United Nations food agency called on Thursday for long-term aid for farmers in the Horn of Africa, saying constant crises in the region should shame the world.
  • A report by the National Institute of Malaria research in Delhi has found that climate change will enable malaria to move to new areas.
  • New research finds that radiation from the nuclear plant accident in Japanin March reached Californiawithin days, showing how quickly air pollution can travel, but scientists say the radiation will not hurt people.
  • According to an article published in Science, 19 August, cases of Chagas disease are rising outside Latin America, because large numbers of people who are already infected are migrating fromLatin America.
  • Len Rubenstein comments on the attacks on healthcare personnel inBahrain and the recent progress made to protect healthcare workers in conflict zones.

INFOGRAPHICS AND OTHER INTERESTING VISUALS

Thanks to Tom Murphy and Mark Leon Goldberg, Larry Johnson (filling in for Tom Paulson), Isobel Hoskins, and Jeff Meer.

Cancer: the Next Challenge for Global Health

Guest blogger: Dr. Isobel Hoskins

We think of cancer as a disease of affluent countries. That may have been true in the 1970s, but since then, cancer levels in developing countries have risen alarmingly. This massive rise in cancer is one reason why a UN summit in June is addressing chronic diseases, including cancer, with the aim of kickstarting the fight against these illnesses.

Some figures: 5.5 million of the nearly 8 million deaths from cancer in 2008 happened in the developing world. Back in 1970 only 15% of cancers were found in the developing world. However, by 2008, according to the World Cancer Report, more than half of cases were in developing countries. These numbers hide a burden of misery – cancers in developing countries are often detected at a late stage – too late for many treatments. These patients often don’t even have access to pain medications.

What drove this increase? The WHO Director General, in a recent address to the IAEA, cited ageing, urbanization and the globalisation of unhealthy lifestyles. Population growth has also driven the numbers up. Isn’t it ironic that improved life expectancy leads to increased cancer burdens?

Many papers can be found indicating the enormous problem that cancer is for developing countries. Given the expense of treatment is there anything that can be done to reduce the cancer burden? Fortunately there is – I read a paper in the Lancet that gives a ray of hope…

Farmer et al. say that we shouldn’t accept that cancers in developing countries will remain untreated. Instead, we should make cancer prevention and treatment broadly available as rapidly as possible. We should consider the example of HIV and TB a decade ago: critics asserted that HIV and TB treatments were too complex and long term for weak health systems. These arguments proved unfounded. Farmer et al. point out examples of successful treatment and prevention of cancer in low resource settings that we can build on.

The approach should concentrate on curable and preventable cancers. Farmer et al. have come up with a list. These cancers can be prevented by reducing risk factors such as tobacco use or infection, or they can be cured by early detection and surgery methods or specific low cost systemic drugs. It includes some very common cancers: lung cancer, breast cancer, cervical cancer and liver cancer.

Many problems posed by cancer care, including cost of drugs and lack of infrastructure and specialists, was a big obstacle for HIV, too. The solutions could be similar: Farmer et al. suggest reducing drug cost by drug purchasing and production negotiations, as well as the use of primary and secondary caregivers to deliver services. The paper cites an example of cancer care in Malawi that uses such workers with remote support from specialists.

And if there is no suitable treatment, pain control is low cost, and the paper asserts that all should have access to that as a human right.

Farmer and co-authors have formed the Global Taskforce on Expanded Access to Cancer Care and Control in Developing Countries to address cancer care worldwide. I for one hope this taskforce prospers!

Dr Isobel Hoskins is Co-Editor of the bibliographic database Global Health which covers public health research worldwide. Global Health is produced by CABI, an international not-for-profit information provider. She’s usually found blogging on the Global Health Knowledge Base and on Twitter here: @CABI_Health.