Category: Health (page 1 of 2)

The hills are alive…with malaria?

When I was 16, I went to Switzerland. It was my first time outside of the US, and I worried about the normal things that a worry-wart teenager might fret about—Where is my passport? (In my handy-dandy passport holder.) Did I remember to get gifts for all of my family members? (Yes, and you’re welcome.) How much fondue can I possibly eat? (Lots, and yet somehow not enough.)

Here’s one thing I didn’t worry about: Am I going to get malaria?

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Health promotion & Mugabe. For real.

When you think great diplomats—the sorts of folks who can inspire large numbers of people, bring together disparate groups, and raise public awareness of key international issues—Robert Mugabe probably isn’t the first person who springs to mind.

And yet…guess who the World Health Organization just announced as its new goodwill ambassador for noncommunicable diseases in Africa?

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The Book Nook: The Authority Trap: Strategic Choices of International NGOs

Our second Bridging the Gap Book Nook entry comes from Sarah Stroup of Middlebury College and Wendy Wong of the University of Toronto, who discuss their new book The Authority Trap: Strategic Choices of International NGOs (Cornell, 2017).

Where’s the Charlie’s Angels of global health?

Does the international community need a Charlie’s Angels of global health?

You remember Charlie’s Angels. Kate Jackson, Farrah Fawcett, and Jaclyn Smith were three detectives in Los Angeles who worked for a never-seen Charlie. Charlie would call the Angels whenever there was some sort of emergency, and they would go wherever in the world in order to take care of the problem. They were highly competent and glamorous, though we can rightfully criticize the show for emphasizing the Angels’ sex appeal over their crime-fighting skills. I mostly remember the show for being on WGN in the afternoon when it wasn’t pre-empted by the Cubs. (Cubs baseball also frequently pre-empted Super Friends, leading to my distaste for the Cubs to this day…but that’s neither here nor there.)

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Resolve to Save Lives has a lot of money. Does it have the authority to lead?

What happens when three major philanthropies come together to form some sort of global health Voltron?

Mark Zuckerberg, Bill Gates, and Michael Bloomberg are among the world’s most accomplished people. Zuckerberg is one of the founders of Facebook, the social media site we all love to hate. Gates not only has one of the nerdiest mugshots in history, but he’s also the man who unleashed Clippy on the world as the cofounder of Microsoft. Bloomberg  created a financial services and technology company, served three terms of mayor of New York City, and even had a cameo on “30 Rock.” They’re also loaded, with a combined net worth of roughly $210 billion.

It’s that wealth that makes them central to the politics of global health. All three have created foundations that have made health central to their missions. The Gates Foundation is the world’s wealthiest foundation, with an endowment of more than $40 billion and spending more than $1 billion annually on global health programs. Bloomberg Philanthropies has made public health one of its five key areas, focusing on issues like tobacco control, improving health-related data, and addressing the unique health challenges in urban areas. The Chan Zuckerberg Initiative, started less than two years ago, is structured less like a traditional charity and more like a tech start-up as it tries to address ambitious goals in health and education.

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The Borg are bad. Antimicrobial resistance is worse.

Microbes are turning into the Borg; our resistance is becoming futile. As any Star Trek: The Next Generation nerd knows (and this is an IR-related blog, so I’m guessing the Venn diagram of DoM readers and ST:TNG fans shows quite a bit of overlap), this is incredibly worrisome for humanity and threatens to give all of us the life expectancies of a red shirt. The international community may yet have a chance to fight back, but it will require both forward thinking and a willingness to cooperate.

The basic problem is the growth of antimicrobial resistance (AMR). An antimicrobial is something like an antibiotic—it kills or inhibits a microorganism like a virus or bacteria, but doesn’t harm the host. When you take penicillin to treat an infection, the penicillin goes after the bacteria causing the infection, but it generally doesn’t cause side effects or do damage to the rest of you. This is what makes antimicrobials so powerful and useful. They gave humanity a fighting chance against infections that had once been a death sentence. With Alexander Fleming’s accidental discovery of penicillin in 1928, health professionals had a powerful tool on their arsenal. Between 1944 and 1972, life expectancy increased by eight years—an increase largely attributed to antibiotics and other antimicrobials.

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On Race, Nationalism and “White Pride” in America

This is a guest post (begun as a set of hasty scribbles on Facebook in the wake of Charlottesville) by Sean Parson, Assistant Professor in the  Departments of Politics and International Affairs and the MA program in Sustainable Communities at Northern Arizona University. He is the author of Cooking up a Revolution: Food Not Bombs, Anarchist Homeless Activism and the Politics of Space (forthcoming).

So the modern racial system is a result of early colonial American history. In the mid to late 1600s (see Abolition of White Democracy or The Invention of the White Race) early southern colonies, in the middle of riots and work slow downs and a growing coalition between indentured servants and slaves “freed” white people from bondage and defined that black=slave, white= free labor. This approach spread throughout all the slave colonies because, well it worked, at quelling revolt and led to an interesting fact: poor, newly defined, whites began policing the race line.

That equation of black=slave and white = free was the guiding logic of the US democracy (nation wide due to laws about slave catching even in the north, see 12 Years a Slave) and the American political conceptions of citizenship were defined in this equation.* Every new group that entered the US were put into this spectrum: were they white or non-white? And every new “ethnicity” was original positioned as “not white,” because whiteness meant benefits and you do not just give away benefits to new immigrants if you are in power.

So the Irish came and were originally “non-white” after a few decades of intentionally devised actions to make them more white via being the most racist immigrants around, they were given access to the space of whiteness (see How the Irish Became White). This became the model of expanding whiteness from then on and the German, the Italian, the Greek, the Northern Europeans, and lastly the Jews (in the 1960s) were granted legal and social status of whiteness (see both Working Towards Whiteness and Black Face, White Noise. With that they gain, what is called “the wages of whiteness” which are small (but meaningful) social, economic, and political benefits that subsidize the working class or middle class wages (see Wages of Whiteness).

From 1776 to 1964, these wages were directly paid for via the state. So the New Deal, for instance, exempted from Social Security jobs that were primarily non-white and funded jobs that were white. This meant that only white folks, for the most part, got the first generation (and second) of social security benefits. Similarly the US government would redline neighborhoods and that allowed them to not provide the support for home ownership to non-white people (until 1964) and even the first round of the GI bill there were ways to remove the benefits for black soldiers (See When Affirmative Action Was White). In effect this led to a cascading wave of problems. I can look at many but here is just one -“the racial wealth gap” – which is slowly decreasing but at this rate they expect it would take over 300 years for that to balance out.

So now back to contemporary race. What is race? Race is a political filtering of people within certain categories for social, political, and economic reasons. What does that mean for the “white race”? Continue reading

Ebola 2.0?

Ebola is back, but that doesn’t mean that the world should panic.

A little more than a year ago, the World Health Organization (WHO) declared that the West African Ebola outbreak, which killed more than 11,000 people in the largest outbreak of the disease ever, was officially over. On May 11th, WHO announced that the Democratic Republic of Congo had identified 9 suspected cases of Ebola over the past three weeks. Three people had already died, and laboratory testing has confirmed that at least one of the cases has tested positive for the Zaire subtype of the Ebola virus.

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It’s Not Easy Being Green

A dilute alcoholic solution of Brilliant Green (Viridis nitentis spirituosa) is a topical antiseptic, effective against gram-positive bacteria, also known under a Russian colloquial name zelyonka. If you grew up in the Soviet Union and ever had chicken pox, zelyonka turned you into a green-spotted leopard for at least a week: it’s hard to get it out of your skin. Brilliant green has, however, some serious safety issues: when ingested it can induce vomiting and contact with eyes can lead  to grave injuries, even blindness. This is what a prominent Russian opposition leader Alexey Navalny learned the hard way this week: after unknown men splashed zelyonka into his face he had to be hospitalized.

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First Thoughts on the Trump Budget and Global Health

I’m not going to lie. When I heard that the Trump Administration was going to release its budget blueprint, I didn’t have high hopes for global health. The new administration’s commitment to global health has been ambiguous at best, and early word was that medical and scientific research was in for some massive cuts.

So what does the budget blueprint tell us about the future the US’ commitment to global health? It’s not all bad. In fact, for a budget that goes so far as to zero out funding for Meals on Wheels, global health comes out relatively well in some very specific ways, but the cuts in medical and scientific research and support are likely to have ripple effects that will ultimately work against the US’ interests in global health. This is a budget that may allow the US to react once crises happen, but it’s not one that will help the US prevent future crises from occurring.

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Wanted: A New Executive Director for the Global Fund

There’s a lot of turmoil in global health governance these days, and it looks like it’s only getting more chaotic. The Global Fund to Fight AIDS, Tuberculosis, and Malaria is hitting the reset button in its quest to identify a new leader “due to issues in the recruitment process”—precisely at a moment when there are real fears about the future of funding for global health initiatives.

What’s happening within the Global Fund may at first glance speak to dysfunction within that specific organization, but it’s better to think of the problems as emblematic of larger questions about legitimacy and the future of multilateralism under the Trump Administration.

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WHO and PEPFAR Are Good. Leaving Them Is Bad. Any Questions?

In the words of Seth Meyers and Amy Poehler from Donald Trump’s favorite television show, “Really!?!

Shortly after noon Eastern time in Washington, Donald Trump gave his inaugural address. In it, he proclaimed his desire “to free the Earth from the miseries of disease.” That’s not a bad sentiment. Health is important, the US has played a major role in developing and funding the global health system that currently exists, and there are a host of health challenges that continue to bedevil the world. Trump has made ambiguous statements about his global health commitments in the past, so this is seemingly a good sign. Right? Continue reading

The Rashomon-ization of the World Health Organization

An event happens. Four different people tell four different versions of what happened. How do we figure out how to move forward?

This is a very rough plot summary of Akira Kurosawa’s 1950 masterpiece Rashomon, but it’s also a pretty accurate description of what is happening to the World Health Organization these days. There’s probably a generation of folks who know Kurosawa because he was name-checked in Rent, but the Japanese director also gives us a window for thinking about international politics.

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Sorry Seems to Be the Hardest Word

It’s the eternal quandary of thinking about the intersection of international politics and global health: where does Elton John fit in? We now have an answer. It’s where we try to understand issues of moral and legal responsibility of an international organization.

About a month ago, I wrote about cholera and global health. One of the reasons cholera is such a big issue is because of the ongoing outbreak in Haiti—the worst in recent history, and one that we can directly trace to the 2010 earthquake and Hurricane Matthew in October. Natural disasters can obviously disrupt the sanitation systems that keep cholera from spreading. Haiti’s cholera outbreak is different, though; the disease came to the country with UN peacekeepers from Nepal. The soldiers’ untreated waste went into open pools, where it easily leaked into important waterways and spread to a population already grappling with a lack of sanitation infrastructure.

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Poo Haikus (and Other Unconventional Ways to Raise Awareness about Global Health)

Writing about poo

Raises awareness, saves lives

Oddest line on CV

I am definitely not a poet. Fortunately, the organizers of Poo Haiku had nearly 150 other entries from which to select 12 winners to have their haikus memorialized on the 2017 Poo Haiku calendar.

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World AIDS Day 2016

December 1 is World AIDS day.  Throughout the 2000s, AIDS received unprecedented attention and resources, particularly to support ten of millions of people’s access to life-extending anti-retroviral therapy. Attention and resources peaked in recent years, and while the problem in some respects has gotten better, it hasn’t gone away. More than 35 million people have died from AIDS already.  And yet,  there are still more than 35 million people living with the virus that causes AIDS, only half of whom have access to ARVs. While new infections and deaths have come down from their peaks, there are still more than 2 million new infections a year and more than a million deaths from AIDS.  We still have never gotten very good at AIDS prevention strategies, as changing risky behavior is hard.

AIDS funding largely held steady after the financial crisis, and with the U.S. the world’s largest source of foreign aid for AIDS, that reflected the durability of the bipartisan consensus to address AIDS that emerged under President George W. Bush. However, for the first time in five years, we saw a significant drop in resources for AIDS, and we’re starting to see negative signs in some places and some countries as new generations grow up without as much safe sex messaging.

With a Trump administration, we have almost no signs of what it intends to do on global health, as Jeremy Youde suggested here and Laurie Garrett wrote about yesterday.

Below, I’m going to embed some tweets from Jennifer Kates from the Kaiser Family Foundation who has done tremendous work in tracking AIDS finance over the years. I’ll try to say more what’s needed going forward in a separate post, as there is a need hold the line on efforts in the AIDS space but also do wider health systems strengthening. Accomplishing those twin tasks without adequate and even more resources is impossible so global health advocates will need to make their case on why doing the right thing now will avoid unnecessary deaths and expense later.

Finally, two books are worth your attention. David France, director of the Oscar nominated documentary How to Survive a Plague, is out with a print version of the story of US AIDS activists from ACT UP who made the cause a national issue in the era of Reagan and hastened the faster development of anti-retrovirals and wider changes in AIDS policy. There may be some lessons learned about civil disobedience and speaking truth to power that will be important in the years to come.

LGBTQ activist Cleve Jones, who was close to the gay activist Harvey Milk, is also out with a memoir on his life and advocacy including his work in founding the AIDS Memorial Quilt. Continue reading

What Do You Do with a Problem Like Zika?

Two years ago, more people probably knew that Stephen Breyer is on the Supreme Court (hint: it’s a really low number) than had even heard of the Zika virus. I certainly hadn’t, and I make my living studying global health politics. The entirety of published research on Zika could fit in a shoebox. Since the first reports of the virus appeared in Brazil, though, Zika has grabbed international attention, leading to travel warnings and even causing some athletes to pull out of the 2016 Summer Olympics in Rio.

Zika’s emergence changed the dialogue on global health and forced states and organizations to get involved. On 1 February 2016, the World Health Organization (WHO) declared Zika-related microcephaly to be a Public Health Emergency of International Concern (PHEIC). Nine months later, WHO ended the PHEIC for Zika, arguing that the organization should shift to a “robust longer-term technical mechanism.” Is WHO’s decision a reflection of the changing strategy necessary to tackle Zika, or is it evidence that the organization is waving the white flag and admitting defeat?

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What does Trump mean for global health?

Well, that was unexpected.

But it’s happened. The question now is, how will the election of Donald Trump change international relations?

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What Cholera Tells Us About Global Health

I’ve been marking essays for the past week (two big advantages of Australian academia: November is a spring month, and second semester ends before Halloween), and a lot of my students were writing about the right to health and what it would take to realize it in a meaningful sense. That, naturally, led me to thinking about cholera.

Few diseases can kill as rapidly as cholera. That alone should make it a key issue for global health. What makes cholera particularly important and interesting, though, is how much it says about our larger global health system and the interconnectedness between health and other issues.

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Patient Zero and Global Health

With any luck, the myth of Patient Zero being responsible for HIV/AIDS in the US will finally be completely put to rest.

Gaétan Dugas may not be a household name for most, but he’s the man who has largely been blamed for HIV/AIDS in the United States. Dugas was a gay French-Canadian airline steward who worked for Air Canada in the 1970s and 1980s. Because his work involved a significant amount of travel and because of the number of his sexual contacts, a 1984 study linked him to some other early cases (though it could not necessarily prove a direct line of infection).

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