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International Health
Section Newsletter
Fall 2007

Greetings from the Chair

Global health, Our Section and APHA

 

Dear Colleagues, it is my pleasure to communicate with you as we are approaching the APHA Annual Meeting in Washington D.C., Nov. 3-7, 2007. Last year, our Section celebrated its 30th anniversary. Perhaps it is suitable now to explore where we are and what we can do to advance our mission and goals.

 

The situation of Global Health - It seems that “the glass is half full and half empty.” The full half refers to the continuing growth of awareness about global health and welfare of international communities. The world community, represented by the United Nations and world leaders, adopted eight Millennium Development Goals (MDG’s) in the year 2000. Four of these goals are direct health goals (reducing child mortality, improving maternal health, combating HIV/AIDS and other diseases, and ensuring environmental sustainability). The other four goals are strong health determinants (eradicating extreme poverty and hunger, universal primary education, gender equity and women empowerment and developing global partnership). The Institute of Medicine (IoM) in 1997 stressed the fact that “America has a vital interest and direct stake in health of people around the world.” Global health was identified as one of eight essential content areas for education in public health  by the IoM in 2003 (The Future of Public Health in the 21st Century). Bill Gates, the co-founder of the largest charity organization in the world, recently explained why the future looks bright for the developing world.  by stating “Through better financing, more equipment and heightened awareness and commitment, the international community is now truly on its way towards boosting health in most corners of the world” (Newsweek, Oct. 1, 2007) This is not a wishful thinking but a factual statement by a person who is strongly supporting the development of a vaccine for malaria that kills 1-3 million a year. It is really promising to see that global development assistance reached about $100 billion during 2005 and is always on the rise.

 

The “empty part of the glass” is illustrated by the challenges we face as public health threats in the 21st century (WHO, World Health Report, 2007). These include:

·      Emerging and re-emerging diseases, where 40 new diseases that were unknown in 1970 appeared since then, with a rate of one disease per year; and 110 epidemics were reported to WHO in the last five years. We are living with the AIDS pandemic and we are guarding for the N5H1 influenza virus if it mutates.

·      Globalization, which we expected to improve the socioeconomic welfare of the developing world, seems to compound this situation through the fast and expanded movements of persons and goods. During 2006 there were 2.1 billion air passengers, and a much higher number used land transportation to cross borders.  In such environment, pandemics are likely to spread more than ever.

·      Environmental degradation, climate change and adverse impact on humans, biodiversity and agriculture.

·      Natural disasters that killed more than 500,000 persons and caused $750 billion in damage between 1990 and 1999.

·      Person-made disasters including armed conflicts, political unrest, terrorism and above all chemical, biological and nuclear threats. The number of refugees and internally displaced persons under the UN increased from 6 to 20.5 millions between 1980 and 2005. It is most unfortunate to realize that, in this civilized world of the 21st century, there are still people loosing their lives because they have a different skin color, worship a different God, or even sometimes worship the same God but in a different church or temple or speak the same language yet with a different accent. The public health burden of such madness is excessive since the health authorities have to deal with victims, casualties, internally displaced persons and refugees, as well as facing the shifting of the scarce resources from health and social development to military expenditures and handling damage and population dislocations.

 

Therefore we need to operate between the “half full and half empty glass portions,” where our role as international public health professionals is more challenging and exciting than ever.

 

Our Section - Our Section, with more than 30 years of existence and with 1,600 members, is searching for all means of collaboration to serve its mission. Our position has three dimensions:

·      A diversity of public health disciplines within the Section, from epidemiology to health policy and management, MCH, population/family planning, HIV/AIDS, pharmaceuticals, and health promotion to mention a few.

·       Partnership with APHA sections, interest groups caucuses, and state affiliates.

·      Global affiliation with the 73 members of the World Federation of Public Health Associations that are gathering for a noble global cause from all over the world.

Within these dimensions, we can:

·      Serve the global community and improve the image of the United States in a world that is deteriorated more than ever before, and show the humanitarian face of America to the world.

·      Serve our nation by relating our success stories to our national health problems, where the number of the uninsured reached more than 47 million, with an increase of 2.2 million during 2006 alone, and the child completed immunization rate in some developing counties we serve is higher than some of our large cities.

·      Save more human lives and lower suffering from disease, disability, distress and discomfort all over the world including the United States, and help our world to achieve its determined development goals.

 

Given this unique situation, we are embarking on ambitious plans to multiply our efforts and refine our procedures to serve the global community.

Our standard committees are receiving more support from established and new members to maximize performance. These are essential for conducting the business as in any Section (membership, nominations, awards, annual program, advocacy & resolutions, and emerging health professionals).  Other Section functions were organized in two committees: Communication & Information, that includes the Web site, Newsletter, publications, and communications; and the Section Organization & Management Committee that involves meeting arrangements and management, documents, and fund raising.

To reach out, three new committees were established last year:

·       APHA global Health Connections, leading a consortium of sections with interest in global health within APHA.

·       External Global Health connections, reaching out to partners and international global health organizations such as PAHO, US-AID, Global Health Council, NGO’s and FBO’s.

·      Global Health Strategies, conducting research and developing a position paper on global health strategies.

Our Working Groups on Community-Based Primary Health Care and on Pharmaceuticals are proceeding with their excellent plans, and our Section formed a representative group within the APHA-wide Forum on trade and Health.

Our Web site has a new look that you can see yourself by visiting the site at www.apha.org/membergroups/sections/aphasections/intlhealth/.

Our scientific program for the annual meeting this year reached 53 oral and poster sessions.

We are pleased to have Dr Cristina Beato, the deputy director of PAHO, to present the keynote speech of our luncheon meeting during the APHA Annual Meeting.

In conclusion, the credit for such achievements totally goes to the group of dedicated leaders of the Section serving as chairs, co-chairs, and members of the committees and working groups.

 

I was honored to be elected for the second time after being the chair in 1992-94, to join this finest group of global health professionals. My congratulations go to the newly elected officers who will actively join forces with their dedicated colleagues. I hope that our Section is moving to satisfy your expectations. Your input will be well appreciated. All our meetings, including our bi-monthly teleconference meetings of the Section Council and leadership, welcome all members. Your active participation by joining a committee or a group in the Section can boost its success since our limit is the sky, and our ambitions certainly exceed our human resources.

 

--Samir N. Banoob, MD, DM, DPH, PhD, E-mail: sbanoob@aol.com

 

 

CHAIR: Samir N. Banoob, MD, DM, DPH, PhD 

Phone: (813) 949-8855 or (813) 245-7808 (mobile);

E-mail: sbanoob@aol.com

 

EDITOR: Josefa Ippolito-Shepherd, PhD

Phone: (246) 426-3860 ext 5025 (Office) or (246) 236-2264 (mobile); E-mail: ippolitj@cpc.paho.org 

 

From the Editor

It is, and it has been, a pleasure, an honor, and a challenge to coordinate the production of our Section’s Newsletters for the last eight years. A pleasure, because of the great sense of accomplishment for every issue that was completed, submitted to APHA, and published. An honor because it allowed me to collaborate with a great team composed of colleagues interested and committed in international and global health issues. It has also been a challenge, because of the difficulty to get a significant number of submissions that addressed themes and areas of interest to our membership, as well as to document the great work of our Section. This year, particularly, was especially difficult due to my change of duty station to Barbados, which partly limited the face-to-face communication and my participation in our Section meetings. Still, thanks to electronic channels, we have continued with the production of our Newsletters, as is the case with the present issue. I hope you enjoy reading this issue of the Newsletter and that you consider authoring or co-authoring future pieces for inclusion in our next issues of the IH Section Newsletter. I do encourage you to write about your innovative ideas and especially about your international/global health experiences, which will certainly enrich us all both at the professional and personal levels.

 

The IH Section Newsletter can be, and must be, a great platform to present our experiences tackling international and global health issues, as well as to present innovative ideas to better the health and quality of life worldwide. As such, I encourage you to allow some of your precious time to summarize your thoughts and ideas, to share them through the IH Section Newsletter.

 

The IH Section Newsletter is published twice a year.  The deadline for the spring issue is April 15 and for the fall issue July 15. Submissions should not exceed 400 words and should be presented as Verdana, Font Size 10. You are invited and encouraged to submit material for inclusion in the next issues of the Newsletter.

 

A special thanks to all members who provided material for this issue of the Newsletter. Submissions were included as presented, with minor editing. Opinions, views and information published represent the authors and not necessarily APHA or the International Health Section.

 

--Josefa Ippolito-Shepherd, PhD, E-mail: ippolitj@cpc.paho.org

 

DOES APHA HAVE YOUR E-MAIL ADDRESS?

If you are not sure that APHA has your e-mail address on record, send an e-mail to membership.mail@APHA.org identifying yourself and asking to be on the list so we can send you information through APHA’s "broadcast e-mail" function. You will also receive information about the IH Section Newsletter via e-mail.

 

VISIT THE IH SECTION WEB SITE
http://www.apha.org/membergroups/sections/aphasections/intlhealth/ is the address of the IH Section’s Web site. The Section is always seeking contributions from its Section members and non-members to make our Web site up-to-date on Section activities and global health issues, and to make it interesting and useful for APHA members and the public.

 

For contributions or questions, please contact the Webmaster and Information Communications Committee Chair Eckhard Kleinau  ekleinau@masimax.com.

Reports from the IH Section Committees

INFORMATION COMMUNICATIONS COMMITTEE (ICC)

The Information and Communications Committee produces the overall Communications Plan for the Section, which focuses on integrated communication through coordination with other parts of APHA and the organization’s leadership. The overall purpose of the committee is to leverage the work of various Section committees and its members and foster a broader base of support, understanding and recognition of global health issues, opportunities, challenges and accomplishments. Each Section committee is encouraged to appoint a representative to serve on the Communications Committee. The Section chair appoints the chair of the Information and Communications Committee.

 

The Web site and e-mail are the primary communications tools for the Section, to disseminate information relevant to the Section and about global health issues and actions. They will also alert members to postings of new material. The Web site contains the Section manual, the Leadership Team roster, news items, advocacy opportunities, APHA resolutions sponsored by or pertaining to our Section, and much more.

 

The ICC is also responsible for preparing the Section newsletters with input from the Section Leadership Team and the various Section committees and working groups, and sending it for publication on the APHA and IH Section Web sites. For further information on the newsletters, please see Part VI of the IH Section Manual.

 

Eckhard Kleinau, DrPH, MD, Chair, E-mail ekleinau@masimax.com

Josefa Ippolito-Shepherd, PhD, Co-chair, E-mail: ippolitj@cpc.paho.org

Members: Tom Hall, Ray Martin, Stacey Succop, Fran Tain, Morgan Taylor

 

MEMBERSHIP COMMITTEE

The IH Membership Committee is responsible for active recruitment for our Section.  Committee members encourage IH Section members to recruit new members from their universities, organizations, and associations involved in international and global health.  The Committee also works with overall APHA Membership Committee to expand membership. 

 

In 2007, the Membership Committee has worked with APHA to contact each new IH Section member and to encourage him/her to become involved actively in the Section.  The Committee has also contacted each lapsed member to encourage him/her to not only rejoin APHA, but to become more actively involved in the IH Section when they rejoin.  To follow up on this outreach, the Chair has personally responded to new members and addressed their specific interests and provided contacts and resources to encourage their active involvement.  Committee members have visited George Washington and other universities to encourage students and faculty to join APHA and become involved in the IH Section. 

 

Working with the Global Health Fellows Program, current Fellows have been contacted to encourage them to join the IH Section. The Membership Committee has met with the Global Health Council to support effort to develop groups of interested international professionals to address international health policy, advocacy and programmatic issues in cities around the United States.  The Membership Committee plans to help staff the IH booth at the APHA Annual Meeting in November. 

--Rose Schneider, RN, MPH, E-mail: RoseSDC@aol.com   

 

ADVOCACY COMMITTEE

The Advocacy Committee established five priorities for action during 2006-2007:

 

  • Ensure that U.S. international aid policy is aimed at advancing a humanitarian agenda as its top priority.
  • Build a health workforce capacity in low-income countries. 
  • Advance international Maternal Child Health.
  • Promote universal health care coverage.
  • Promote aid harmonization by supporting the three ones (one plan, one coordinating body, one monitoring and evaluation system).

With regard to promoting the humanitarian agenda, we worked on advocating for substantial increases in the PEPFAR reauthorization budget, petitioned the G8 nations meeting to keep their promises to advance health to impoverished people, advocated for the Bulgarian nurses and Palestinian doctor in Libya who were imprisoned (and eventually released), and joined Health GAP in responding to the World Bank’s 10-year strategy on health.  Further, we played a role in opposing the USAID proposed “Partner Vetting System” that would have collected a massive set of personal information on all USAID contractors, at home and abroad. Michele Forzley attended a hearing on behalf of the IH Section on this matter. The vetting system is now on hold, with a pilot program moving forward only in the West Bank/Gaza area.

To promote workforce strengthening, we worked with Physicians for Human Rights to promote the Africa Health Capacity Investment Act. The “Durbin Bill,” as it has become known (S. 805 sponsored by Sen. Richard Durbin), passed out of the Senate Foreign Relations Committee on Sept. 11.  Two IH Section members (Wendy Johnson and Amy Hagopian) lobbied a member of Congress who serves on the House Foreign Affairs committee, who then become a primary sponsor of this bill in the House.

To promote maternal and child health abroad, our Section’s chair-elect, Miriam Labbok, worked with the MCH and Food and Nutrition Sections on developing a resolution for APHA consideration at the upcoming meeting, “A Call to Action on Breastfeeding: a Fundamental Public Health Issue.”  You can find it on the 2007 proposed policies page of the APHA Web site, item C-3.

Universal coverage is a major APHA priority, and we applauded APHA Executive Director Georges Benjamin in his statement to the press on August 28 reflecting on new U.S. Census Bureau data that 47 million Americans are now uninsured.  We further supported efforts to pass an expansion of the State Children’s Health Insurance Program. 

 

On promoting aid harmonization and the Three Ones, the Section is sponsoring a scientific session, “Accountability and Aid Effectiveness: What has Happened to the Spirit of the Paris Declaration?” Dr. Elvira Beracochea is organizing and moderating that session.

--Amy Hagopian, PhD, E-mail: hagopian@u.washington.edu

GLOBAL HEALTH APHA CONNECTIONS COMMITTEE

Charge - Responsible for strengthening relations, partnership, and coordination with APHA Sections and Committees in the field of global/international health, namely, MCH, Population Family Planning and Reproductive Health, HIV/AIDS, International Human Rights Committee, and Trade and Health Forum, and organizing communication and choosing liaison members with other Sections.

 

Goal - Assist the International Health Section in forming the APHA Global Health Consortium*.

 

Work Plan for 2006-2007:

 

  • Invite and establish liaisons from IH Section to other Sections of APHA.
  • Invite and establish liaisons form other Sections of APHA to the IH Section.
  • Facilitate communication between all members of the Committee through regular conference calls and e-mails.
  • Develop action items to facilitate formation of APHA Global Health Consortium, and implement and evaluate them.
  • Hold networking opportunities through business meetings twice a year (at GHC and APHA) and a social hour annually (at APHA).

 

Actions taken

  • Connected with chairs and co-chairs of APHA Sections, SPIGs and Caucuses to nominate their members to serve as liaisons to the IH Section.
  • Coordinated with members of IH Section to serve as liaisons with other Sections of APHA, SPIGs and Caucuses.
  • Developed a list of chairs of APHA Sections, SPIGs and Caucuses and shared with all members of the GH APHA Connections Committee to facilitate communication.
  • Held monthly conference calls. Shared information, elicited ideas and feedback, developed action items with enthusiastic participation by members! 
  • Conference call summaries shared with members of GH APHA Connections Committee and IH Section leadership.
  • Presented a report on the Committee’s work to the IH Section at the Mid-year Meeting of the IH Section at the Global Health Council Annual Meeting on June 1, 2007.

 

Upcoming Events (All are invited to both events!)

Global Health APHA Connections Committee Business Meeting

Sunday, Nov. 4, 2007

11:00 a.m. – Noon

Room 157, Washington Convention Center, Washington, D.C.

 

Global Health APHA Connections Committee Social Hour

Sunday, Nov. 4, 2007

2:00 p.m. – 3:30 p.m.

Room 156, Washington Convention Center, Washington, D.C.

 

*APHA Global Health Consortium

International Health, a specialized Section of APHA, invites members who belong to other APHA Sections and are interested in international and global health to come together and work toward common goals. The proposed Global Health Consortium (GHC) is different from a secondary section or a forum. While a secondary section is chosen by individual members based on their interest, a forum is 75 or more members coming together based on their interest in one specific topic.  In contrast, the proposed GHC is a collection of Sections that have substantial interest in global health. 

 

The purpose of the GHC is to harness the experience and expertise of members belonging to different sections to focus on global health issues and effectively address them. This inter-sectoral group, when formed, will allow for APHA sections to present a united front in addressing policy, fiscal, political, and programmatic issues that have an impact on international and global health.

--Gopal Sankaran, MD, DrPH, Co-Chair, E-mail: gsankaran@wcupa.edu

--Michele Forzley, Co-Chair, E-mail: mforzley@comcast.net

 

STUDENT ASSEMBLY OPPORTUNITIES COMMITTEE
The Student Assembly Opportunities Committee has been working to revamp the Student Assembly Alumni Database. These database is meant to not only allow the Student Assembly to keep track of their past members, but to also provides current and potential students access to possible careers in the public health field. To increase participation of Student Assembly alumni and to ensure the success of the Alumni Database it is vital for alumni to complete an informational form online. For further information contact Jennifer Cremeens, MSPH at E-mail: jlcremeens@bama.ua.edu
-- Jennifer Cremeens, MSPH

Call for Awards Nominations

Recognize our finest in International Health through the IH Section Awards

 

Each year, the International Health Section of APHA recognizes outstanding contributions of its members through its Lifetime Achievement Award for Excellence in International Health, its Mid-Career Award in International Health and the Gordon-Wyon Award for Community-Oriented Public Health, Epidemiology and Practice. 

 

The Lifetime Achievement Award in International Health was created by the IH Section to honor the visionaries and leaders in APHA who have shaped the direction of International Health.  The evaluation criteria for the Lifetime Achievement Award include:

 

·         Quality/creativity/innovativeness of the individual’s contributions to the field of international health.

·         The individual’s contributions to the development of APHA or the International Health Section.

·         Application of the individual’s work to service delivery (as opposed to primarily theoretical value).

·         The individual’s contributions as a leader/visionary/role model.

·         The volunteerism/sacrifice associated with the individual’s contributions.

·         Membership in APHA (preferably with primary affiliation with the International Health Section), a state affiliate, or a national public health association that is a member of the World Federation of Public Health Associations. No self-nominations are allowed.

 

Prior winners of the IH Lifetime Achievement Award are: Dr. Richard Morrow, Michael Latham, William Foege, Clarence Pearson, Stanley Foster, Joe Wray, Carl Taylor, Milton Roemer, Warren and Gretchen Berggren, John Wyon, Derrick Jelliffe, Tim Baker, Cicely Williams, Bud Prince, Veronica Elliott, Moye Freymann, Jeanne Newman, and Jack Bryant.

 

The Mid-Career Award in International Health is intended to recognize outstanding young professionals in the IH Section.

 

The evaluation criteria for the Mid-Career Award include:

 

·         The individual must have committed herself/himself to the promotion and development of primary health care in a cross-cultural setting over a period of 5-15 years [Primary health care is meant here to encompass a broad array of public health issues, including HIV/AIDS prevention and environmental health].

·         The individual must have demonstrated creativity in expanding the concepts pertinent to the practice of public health with an international focus.

·         Membership in APHA (preferably primary affiliation with the IH Section), a state affiliate, or a national public health association that is a member of the World Federation of Public Health Associations.

·         No self-nominations allowed.

 

Prior winners of the Mid-Career Award in International Health include are: Dr. Clyde “Lanny” Smith, Mrs. Theresa Shaver, Tim Holtz, Kate Macintyre, Sarah Shannon, Adnan Hyder, Stephen Gloyd, Luis Tam, Marty Makinen, Colleen Conroy, Mary Ann Mercer, Irwin Shorr, Walter K. Patrick, and Dory Storms.

 

The Gordon-Wyon Award for Community-Oriented Public Health, Epidemiology and Practice is intended to reward outstanding achievement in community-oriented public health epidemiology and practice. This award was established in 2006 by the International Health Section.  It is administered by the Community Based Primary Health Care Working Group. John Gordon and John Wyon were pioneers in this field, so encouraging and recognizing others in this field is one important way of honoring their memory.

 

The evaluation criteria for the Wyon Award for Community-Oriented Public Health, Epidemiology and Practice include:

 

·         The candidate must have had a central role in an outstanding achievement in community-oriented public health and practice.

·         The candidate must have demonstrated creativity in expanding the concepts pertinent to the practice of community-oriented public health with an international focus.

·         The candidate must have membership in APHA or one of its affiliates (either a state affiliate or a national public health association that is a member of the World Federation of Public Health Associations). The candidate must be nominated by someone other than the candidate.

 

Winners of the initial Award (2006) were Warren and Gretchen Berggren.

 

Award nominations should include a letter explaining why the individual nominated should receive the award and the curriculum vitae of the nominee.  Nominations should be submitted by e-mail to the Awards Committee Co-Chairs Paul Freeman (freeman.p.a@att.net) and Luis Tam (luis.tam@planusa.org) by April 15, 2008.

Announcements

 

PUBLIC HEALTH IN COMPLEX EMERGENCIES TRAINING

The Public Health in Complex Emergencies training program (PHCE) is a two-week residential course that focuses on critical public health issues faced by NGO/PVO personnel working in complex emergencies. The goal of the course is to enhance the capacity of humanitarian assistance workers and their organizations to respond to the health needs of refugees and internally displaced persons affected by these emergencies.  Participants will master key competencies in the following sectors:

 

Context of Emergencies                              Reproductive Health

Epidemiology                                        Weapons, Violence and Trauma

Communicable Disease                                 Protection and Security

Environmental Health                                     Psychosocial Issues

Nutrition                                                        Coordination

 

Who should take this course?

  • NGO/PVO personnel responsible for making decisions that affect the health of refugees and internally displaced persons.
  • District medical officers and other Ministry of Health staff working in regions affected by complex emergencies.
  • Staff from international and governmental organizations instrumental in planning services for people affected by complex emergencies.

 

Medical coordinators, health coordinators, program managers and district medical officers from international and national health organizations are typical candidates for the course.

 

What makes this training program different?

Field staff from humanitarian, international and academic organizations have developed the curriculum specifically to meet the needs of NGO/PVO organizations working in complex emergencies. 

 

Participants are expected to meet with their supervisors prior to attending the course to discuss an action plan for applying their new skills and knowledge.  A structured exercise during the course will help to finalize these plans.  Participants will be contacted approximately three months later and asked to report on their progress.

 

Language and teaching methods

The course is currently offered in English only. Extensive reading and participatory learning methods are used. 

 

Application process

You need to apply at least one month prior to the date of the course you wish to attend. These are 2007 dates. Please contact the relevant agency for 2008 dates.

 

A  American University of  

     Beirut – FHS

L   Lebanon

Asian Disaster Preparedness Center

Thailand

Makerere University- IPH

 

Uganda

A  April 16-28, 2007

August 13-25, 2007

December 3-15, 2007

W Web site: ht http://fhs.aub.edu.lb/phce

Cli Click on Continuing Education

Web site: http://www.adpc.net

Click on Trainings and Workshops

Web site: http://www.iph.ac.ug

Click on Upcoming Events

--Susan Purdin, E-mail: Susan.Purdin@theIRC.org

 

2007 CALL FOR NOMINATIONS - FRED L. SOPER AWARD FOR EXCELLENCE IN HEALTH LITERATURE

The Fred L. Soper Award for Excellence in Health Literature 2007 is one of five awards presented by the Pan American Health and Education Foundation through its Awards for Excellence in Inter-American Public Health Program, a partnership between the Foundation and the Pan American Health Organization. 

 

The Soper Award promotes the highest standards of research and emphasizes its impact on public health across the Americas.  The winner is recognized with a certificate of honor and a cash prize of $2,500.

 

The foundation advises you to carefully read and abide by the guidelines. The deadline for submission is Nov. 30, 2007. To learn more, please visit www.pahef.org, e-mail info@pahef.org or call (202) 974-3416. The Foundation encourages you to submit nominations and invites you to share this information with others.

--Dana Weckesser, E-mail: weckessd@paho.org

 

GLOBAL HEALTH EDUCATION CONSORTIUM

 The Global Health Education Consortium* has a number of resources relevant to members of APHA's IH Section. Go to www.globalhealth-ec.org and click on "resources" for:

·         a major update of its global health bibliography (~800 citations in 27 topic categories, many available on the Internet).

·         an annotated and categorized list of Web sites relevant to students.

·         a guidebook for developing a global health curriculum.

·         guidance for those interested in a global health career.

·         by late 2007, a guidebook on developing and improving global health residencies.

·         other resources.

Go to www.globalhealthedu.org and click on "modules" to access 18 teaching modules now online plus the list of ~90 additional modules in preparation. These draft modules will start receiving peer and student reviews by December before going into final draft. The modules combine PowerPoint slides with more detailed background information accessible via a click to a Word file. GHEC has also started collaborations with four innovative medical schools who will be working to develop a common evaluation framework. These schools, in Canada, Cuba, South Africa and Venezuela are dedicated to caring for chronically underserved communities and have a strong public health focus. Contact Tom Hall (thall@epi.ucsf.edu) for more information on any of these projects.

*GHEC is a consortium of >70 medical and other health professional schools (and >400 faculty at these schools) involved in global health education.

--Thomas L. Hall, MD, DrPH, E-mail: thall@epi.ucsf.edu

Minutes of IH Section Meetings and Conference Calls

 

MINUTES IH SECTION MID-YEAR MEETING, June 1, 2007

(Washington, D.C., Omni Shoreham Hotel – Executive Room, 12:45 – 2:15)

 

Opening remarks - Samir Banoob opened the meeting asking for a minute of silence in memory of Al Henn, who died in the Kenyan Airlines crash last month. He also invited Ray Martin to say a few words to remember Al Henn’s life and many achievements. Al was awarded an additional Lifetime Achievement Awards, a plaque and  homage during the APHA Annual Meeting this year.

 

The meeting agenda was approved unanimously.

 

Samir Banoob summarized the state of the Section this year, establishing three new outreach committees for global health connections and strategies. New activities included discussions with the Global Health Council (GHC), after meeting with its leaders to strengthen the collaboration and synergy between the International Health Section of APHA and the Council’s work. As a model of that, this mid-year meeting was conducted as part of the GHC conference program and hosted by GHC that lead to its success and increased attendance by more than 80 members and visitors.  Sarah Albert, the GHC director of public outreach, and Leanne Rios, director of community outreach from the GHC, attended the meeting and presented the conclusions that emphasized the many opportunities to collaborate, particularly in policy coordination, advocacy and community outreach and MCH/FP policy.

 

Samir reported on the World Health Assembly 2007 meeting in Geneva. He noted that more resources are being directed to Africa and to new initiatives: action in crises and emergencies, neglected diseases, revisiting PHC, new ICD-11, pandemic flu and diabetes and other chronic diseases. He also met with Dr. Kent Hill, assistant administrator of global health at USAID; Lou Valdez at DHHS; Dr. Mirta Roses, PAHO/WHO regional director; and Dr. Christina Beato, PAHO/WHO deputy director, to explore various potential partnerships and collaboration. These organizations expressed interest in collaboration with the Section in several ways, including sharing draft strategies, participating in its meetings and involving the Section in its various activities.

 

Committee Reports - The following committees and working groups reported briefly on their progress during the first half of the year:

 

  • Program Committee - Chair: Malcolm Bryant, MBBS, MPH; Co- chair: Omar Khan. The Committee received over 100 more abstracts than last year and therefore, the Section will have at least two more sessions is next year’s Annual Meeting according to APHA rules. Also, the Committee is very grateful for the support of the many reviewers who volunteered their time to review the submitted abstracts. This allowed for each abstract to have about five reviewers.

 

  • Nominations Committee: Chair: Mary Anne Mercer DrPh; Co-chair: TBA. Please be reminded to vote before the June 22.

 

  • Membership Committee: Chair: Rose Schneider, RN, MPH; Co- Chair: Alison Gernand.   Rose reported on the Committee’s efforts to increase membership. They are working to spread more information about the Section’s activities to attract members from other Sections and returning and new members. They liaise with the GHC and other organizations. They will work with Information and Communication Committee to strengthen our Section’s Web site.

 

  • Awards Committee: Chair: Luis Tam, M.D, DrPh; Co-chair: Paul freeman, DrPh, MBBS, MHP. Paul reported that the Committee has made its recommendations and a second Lifetime Award will be awarded to Al Henn, the first one for William Reinke. The Section Distinguished Service Award was shared between Mary Anne Mercer and Amy hagopian. Jean capps was awarded the Mid-Career Award. Researchers will be given a Special Award for Research in Conflict Epidemiology at Risk. The chair approved these recommendations and asked for the vote of the Section council. The vote carried by consensus.

 

  • Information and Communication Committee: Chair: Eckhard Kleinau;  Co-chair and Newsletter EditorJosefa Ippolito-Shepherd PhD.  Web site update procedures will be strengthened now that APHA has completed the migration of the Web site to the new content management program. Eckhard will contact APHA to follow up on this. With Josefa, the Newsletter editor, in a new post, there may be a need for a co-editor to help produce our Newsletter, especially for getting submissions.

 

  • Advocacy and Resolutions Committee: Chair: Amy Hagopian, MHA, PhD;  Co-chair: Diana Silimperi, MD. Diana reported on progress in the Committee’s five focus areas: advancing humanitarian agenda, health workforce capacity, universal coverage, aid effectiveness and MCH. For more information, see the Committee’s Report.

 

  • Emerging Global Health Professionals (formerly Students and New Professionals Committee): Chair: Sharon Rudy; Co-chair: Helene Carabin. This Committee is planning to support mentoring and sharing job openings.

 

  • Committee on Global Health External Connections  Chair: Kyle Kinner;  Co-chair: Theresa shaver. 

 

  • Committee on Global Health APHA Connections: Chair: Gopal Sankaran, MD, Dr.PH; Co-chair: Michelle Forzley, JD. This Committee is forming the APHA Global Health Consortium across all other Sections at APHA and is organizing a number of events at the APHA Annual Meeting, including a social hour on Nov. 4, 2:00 to 3:00.

 

  • Global Health Strategies Committee: Chair: Miriam Labbok, MD, MPH, FACPM, FABM, IBCL; Co-Chair: TBA. The Committee is working on an International Health Strategy position paper.

 

  • Section Organization and Management Committee: Chair: Betsy Bassan; Co-chair: Padmini Murthy, MD, MPH,MS. Betsy has been active in fundraising for the Section’s Awards meeting and other activities of the Section.

 

  • Community-Based Primary Health Care Working Group: Chair: Henry Perry, MD, PhD, MPH;  Co-Chair: Paul freeman, DrPH, MBBS, MHP. Henry reported that the work of the Working Group is gaining momentum and completing the survey of CBPHC initiatives. Henry also reported on the progress of our Section mobilizing support for the U.S. Coalition in Child Health and encouraged Section members to support the ONE Campaign.

 

  • Pharmaceuticals Working Group: Chair: Maggie Huff-Rousselle, MA, MBA, PhD; Co-chair TBA.

 

Samir repeated his request for more Section volunteers to cope with the new outreach plans that need new blood and more efforts by the different committees and working groups. He asked new members participants to sign up for the committees.

 

Dr. Barbara Hatcher reported on the Bellagio, Italy retreat of the World Federation of Public Health Associations to formulate its new strategies and the efforts to support PHA in Africa and Asia.

 

Meeting adjourned at 2:15 p.m.

 

MINUTES IH SECTION CONFERENCE CALL

(Conference Call[1] for July 25, 2007, 12 p.m. Eastern Time)

Present: Samir Banoob, Gopal Sankaran, Mary Ann Mercer, Morgan Taylor, Vina HuLamm, Donna Barry, Alison Gernand, Kyle Kinner, Theresa Shaver, Selin McCurdy, Martin Gittelman, Sharon Rudy, Amy Hagopian, Elvira Beracochea

 

Topic/Issue for Discussion

Presenting

Decision/Action

Updates from Committees and Working Groups:  Progress according to work plans. Every Committee chair or rep. will report on progress according to:

-Committee goals.

- 2006-07 Work Plan.

 

If you have not done it yet, please send list of Committee membership: chair, co-chair, and members by name and contact info. E-mail, telephone. (needed to update our Web site)

 

All Chairs

·         Morgan Taylor (Communications Committee) reported Vina HuLammis working on Web site. Please send materials to be posted in the Section’s Web site to Eckhard Kleinau (ekleinau@aimglobalhealth.org) Brochures will be updated.

·         Gopal (GH APHA Connections) the Committee is working on the social hour and business meeting. Please send Gopal contacts in other organizations to participate (gsankaran@wcupa.edu) and see the annual conference program on Sunday, November 4 for information about the meeting.

·         Kyle Kinner (External Connections Committee). Alternatives: organize a meeting to invite others to come to meet our Section, invite other organizations to join one session only in the conference without paying for the whole conference, develop a paper to share what our Section is doing, the upcoming “Global Health Series” may also attract other organizations

·         Sharon Rudy (Emerging Young Professionals) There will be a reception funded by “Global Health Fellows Program/Public Health Instituteto put students and domestic PH professionals with IH professionals. Invite students to also attend the session on “Building a GH Career.” Tom Hall is coordinating all the job search resources. “Exploring careers in IH” will be a panel hosted by the Student Assembly.  Samir will send the new PAHO fellowship program. Martin Gittelman will send a suggestion to sponsor students to meet GH professionals overseas.

·         Advocacy Committee: Aid Effectiveness, Code of Conduct on Recruitment, Rose to liaise with GHC to join in advocacy efforts. Invite Michael Moore to the conference.

·         Alison (Membership Committee) thanks for your feedback on the letters to new members and lapsed members to get them involved. These letters are now going out by e-mail on a quarterly basis.  There is a proposal to charge $30 for a second membership. The Section will appeal.

·         Selin for Betsy Bassan. The Committee has raised $6,000 for the awards dinner and continental breakfast for the Section’s business meetings.

·         Nominations Committee. Mary Anne Mercer.  Tied on two positions so a tie-breaker vote will be held soon.

Program  for Annual Meeting

 

Malcolm Bryant

Omar Khan

All 52 sessions are now organized, individual presenters notified and accepted.  Most moderators have been identified although a few decisions are pending.

 

We have 13 preformed panels, 10 solicited panels, 21 submitted panels, and 9 poster sessions.  This is a total of 266 presentations and papers - roughly 40 percent of submitted abstracts were accepted for presentation.

 

Next stages are finalization of objectives to qualify for Continuing Education credit - a task for session organizers and moderators.  We are also in the process of working with the section and other section chairs for co-sponsorships.

 

The program formally closes on August 10, so for those with outstanding tasks there is some urgency to make sure that they are complete by this time.

 

We are also now working with the APHA leadership and interested groups on the film submissions for the film festival.

 

Collaboration with other institutions, GHC, World Bank, USAID, WHO/PAHO, etc.

Samir

Rose

Advocacy: Discussion on how to interact with GHC on priority issues since GHC focuses on legislation and funding (Rose).This topic will be discussed at the next meeting.

 

Newsletter

Josefa

Josefa needs to receive the submissions ASAP, by the end of July at the latest, in order to have the Newsletter ready to meet the APHA deadline for the fall issue. Submissions are to be about 400 words, Verdana 12. Please Committee chairs send them to Dr. Josefa Ippolito-Shepherd, at ippolitj@cpc.paho.org  

Other business:

 

TBD

Trade and Health Forum – Mary Anne Mercer. How would the Section like to be represented in this Forum? Mary Anne is our representative in the forum, and she knows others are interested. She welcomes help, ideas and comments. Please write to mamercer@u.washington.edu

 

 

 

Notes:  Samir would like to remind everyone to please appoint a representative for the call if you cannot join. Vina and Morgan will be busy during May and won’t be able to provide all the usual support. Please plan accordingly.

 

Reminder: Committees may use this toll number to have conference calls: (719) 867-7624. Use the same code. Please note this call is not free but you can have a conference call. When funding permits and we have a fundraising plan, the committees’ conference calls will also be toll free. Please let Morgan Taylor (morgan.taylor@apha.org) know when you plan to have the call to make sure there are no conflicts.

 

SHOWCASE YOUR WORK AT THE IH SECTION BOOTH
Every year the IH Section has a booth at the APHA Annual Meeting. For the last two years, we have also showcased the work of the Section's members. We always have very good contributions and excellent feedback on the display.

On behalf of the IH Section, I would like to invite you again to share a year's worth of peer-reviewed papers, books, other publications and innovative perspective papers at the International Health Section Booth at the upcoming APHA Annual Meeting in Washington, D.C.

Any paper that has been published with the last three years is admissible for showcase at the IH booth. Please send your paper, book, manual, monograph, etc. to Dr. Elvira Beracochea at elvira@midego.com
and bring hard copies to the booth on Saturday, Nov. 3 or Sunday, Nov. 4.

Please include your contact information in case people attending the booth want to get copies or get in touch with you. As we did last year, we'll make a list of the titles and authors for easy reference.

The deadline for submissions is Oct. 27. Please come to the Section booth during the last day of the Meeting to collect your papers if you want them back.

Thank you very much in advance for your submissions. Our goal is to make the booth a dynamic venue for the Section. We appreciate your involvement and hope you enjoy the booth!

--Elvira Beracochea, MD, MPH, E-mail: elvira@midego.com


[1] The conference calls of the IH Section take place in odd months: January, March, May, July and September to allow for committees to work on during the other months.

Update of Annotated List of GH Web Sites

 

Noted below is an update of the GHEC list of global health Web sites.  This project was greatly helped by three students, Laura Frye, Meiqi Guo, and Emily White, representing SUNSIH/Canada, AMSA and IFMSA, respectively. If you want to suggest additions, deletions, corrections, or any annotation changes, send them to Thomas Hall (thall@epi.ucsf.edu) or Karen Lam (lamK@globalhealth-ec.org).  For existing entries be sure to make it clear what has been changed.  Upon receiving your suggestions, these will be reviewed and final revisions and posting will be made on the GHEC Web site.  Student organizations may wish to link directly to this site.

 

  • Educational programs and courses
  • International - multilateral organizations
  • Governmental organizations
  • Membership & non-governmental organizations
  • Job and field placement opportunities
  • Language training programs
  • Information resources
  • Online teaching-learning resources
  • Planning your IH field experience
--Thomas L. Hall, MD, DrPH, E-mail: thall@epi.ucsf.edu

IH Section Award Program

SPONSORED BY COLGATE-PALMOLIVE and COMMUNITY-BASED FIELD RESEARCH GRANTS TO YOUNG FACULTY AND STUDENTS AT SCHOOLS OF PUBLIC HEALTH FOR BEHAVIORAL HYGIENE PROMOTION AND GLOBAL HEALTH

 

The IH Section of APHA, in collaboration with Colgate Palmolive, is pleased to announce the Small Grants Program to support young faculty and students in schools of public health or tertiary institutions with an established public health program to carry out community-based field research in behavioral hygiene. These competitive grants will be awarded for community-based research projects investigating the role of hygiene (especially hand washing with soap) in personal and community health and infection control, including investigations about the knowledge of proper hygiene habits, hygiene motivation and behavior change. The research should focus on mothers, families and children in resource-poor settings. Each award will be in the range of $10,000 - $15,000. A total of $30,000 is available to support this initiative each year.

 

Awards will be made on the basis of merit as determined on independent review by five senior reviewers. Three awards will be made, with preference being given to projects to be carried out in the one the following countries: Puerto Rico, Mexico, Colombia, Guatemala, Honduras, Nicaragua, Costa Rica, Panama, Thailand, Malaysia, South Africa, Senegal, Kenya, Mozambique, or the United States. The U.S. investigation would need to focus on migrant or immigrant populations. Awards will be made through schools of public health or tertiary institutions with an established public health program. The institution concerned can be based in the United States or in another country as long as the field research is carried out in one of the above countries or another developing country, if the proposal is of superior merit. Those projects which are funded will be presented and/or recognized at the APHA Annual Meeting at the World Federation of Public Health meeting there.

 

APHA, working in collaboration with the Working Group on Community- Based Primary Health Care of the International Health Section, will take responsibility for administering the program. This round of the competition is formally announced with this notice.  The deadline for the submission of proposals is Nov. 17, 2007, with funded projects beginning on Feb. 1, 2008.

 

Only proposals submitted according to our guidelines will be accepted. These guidelines can be obtained from Morgan Taylor at E-mail: morgan.taylor@apha.org

 

For further information, contact: Paul Freeman at E-mail: freeman.p.a@att.net

 

--Morgan Taylor, Global Health Manager APHA, E-mail: morgan.taylor@apha.org

The Global Child Survival Act of 2007

A BIG STEP FOR CHILDREN: THE GLOBAL CHILD SURVIVAL ACT OF 2007

According to UNICEF, for the first time in history, the number of children dying worldwide has dropped below 10 million every year. Cost-effective life-saving interventions like breastfeeding, vitamin A supplementation, insecticide-treated bed nets, and vaccinations are reaching many children in developing countries. Still, much more needs to be done. Through a grant from the Bill and Melinda Gates Foundation, the U.S. Coalition for Child Survival seeks to maintain this momentum by calling for increased funding for child and maternal health programs through passage of the Global Child Survival Act, which is now pending in the U.S. Congress. Child survival funding has remained stagnant for over 12 years. The Act also aims to increase accountability for in-country organizations and improve the coordination of programs to combat largely preventable and treatable diseases like pneumonia, diarrhea, measles, malaria, and HIV/AIDS.    

Representatives Betty McCollum, D-Minn., and Chris Shays. R-Conn., introduced H.R. 2266 on May 10, 2007; the Senate measure (S. 1418), which was put forward by Sens. Christopher Dodd, D-Conn., and Gordon Smith, R-Oregon, followed a week later. The House bill has 50 co-sponsors; the Senate version has 16. The House bill is pending in the House Foreign Affairs Africa and Global Health Subcommittee, chaired by Rep. Donald Payne, D-N.J. Action is expected to be taken on the legislation by the end of the year.

 

The Coalition has more than 30 members, including some of the most influential private and non-profit organizations, academic institutions, and faith-based groups working on behalf of children and their families in developing countries. The Coalition has been working actively at the policy level with partners like the GAVI Alliance, the Global Health Council, PATH, Save the Children, and the U.S. Fund for UNICEF. It also has a strong grassroots presence through members such as Christian Connections for International Health, the CORE Group, RESULTS, and the Student Campaign for Child Survival. Finally, the Coalition has been collaborating with the ONE Campaign (see http://www.one.org), a grassroots campaign focused on raising public awareness about the issues of global poverty, hunger and disease, including child survival and health.

 

Today, join the Coalition and urge your representative and/or senator to support the Global Survival Act. Our children are worth it, and we can make a difference! For further information visit www.child-survival.org or write to the Coalition at info@usccs.org. 

--Elizabeth Creel, E-mail:ecreel@usccs.org

Membership in the IH Section

 

Why are you a member of APHA and the IH Section?  Many people join because they believe it is important to support one’s professional organization.  Although sometimes the benefits seem intangible, there is a plethora of benefits to your membership, and I have polled the IH Section leadership to share what they value most in APHA.

 

The most important benefits to membership include:

 

·         networking and interaction with colleagues;

·         keeping abreast of public health issues worldwide; and

·         mobilizing around important issues to have more influence as a group on advocacy and policy.

 

There is much to be gained when we all work together — each and every member of this Section has something to contribute.  Our emphatic desire is to get everyone involved, however large or small the availability of each person’s time and effort.  So what’s there to get involved with?

 

I encourage everyone to look at the IH Section Web site (http://www.apha.org/membergroups/sections/aphasections/intlhealth/) and specifically the “About Us” section.  This will give you an overview of the IH Section and what we do.  There are many activities the Section needs help with.  The easiest way to get started is to find a committee that you are interested in and contact the Chair.  You can also attend the bi-annual business meetings at the Global Health Council Annual Conference and the APHA Annual Meeting & Expo (details printed in the program each year).  We welcome everyone to these meetings — just show up and you will have the opportunity to talk with the leadership.  This method was my personal path to involvement.

 

The Section leaders are doing a tremendous amount of work and can do even more with your help.  The Annual Meeting is the biggest event of the year. This is an opportunity to advocate for issues that you think are important. 

 

Other organizational activities include assisting with our Newsletter (every APHA member is welcome to submit articles), Web site, Awards, and membership activities.  And finally, there are opportunities to serve on the leadership through elected positions (voting each spring) and appointed positions (appointed by Section chair).  Many committees have co-chairs to share responsibilities, so consider pursuing this option to get your feet wet with the leadership. 

 

Students, there are special ways for you to be involved.  First, to be clear, all students are welcome to participate in the aforementioned activities.  We need students to share their unique perspective in all areas of the IH Section.  We also solicit your help in working at the IH Section booth at the APHA Annual Meeting.  This is a great way to meet the members and everyone at the Expo.  There is need for help in planning conference sessions, including career development sessions.  We need your input to shape the student needs and work with schools of public health.  Getting involved is one of the best ways to learn from leaders in international organizations worldwide and be mentored to enter the field successfully.  The best way to get started is to contact the student committee of the IH Section.  As a side note, there is a great resource on our Web site for job opportunities in international public health http://www.apha.org/membergroups/sections/aphasections/intlhealth/.  Together we can improve global health.

--Alison Gernand, E-mail: Alison.D.Gernand@uth.tmc.edu

International Health/Medical Corps

A PROPOSAL FOR THE FORMATION OF AN INTERNATIONAL HEALTH/MEDICAL CORPS

 

It is long past time when an International Health/Medical Corps (IH/MC) should be formed to serve the poorest one-third of nations who cannot afford the proper preparation of their own public health and medical care personnel. Our Section should make contact on this matter with WHO and major foundations and urge the call for an IH/MC Planning Conference. WHO, Doctors without Borders, and others with experience in offering public health and medical care in the poorest countries should be asked to participate. WHO could be the official organizer of such a conference. Topics to consider should include:

  • Institutions which would train Corps members.
  • Recruitment of students from poor countries who would return to serve in their home countries.
  • The curriculum, including medical and health social sciences and development (recalling the role of health care in development in the Mound Bayou Mississippi experience, among others).
  • Organization and administration of the IH/MC.
  • Identification of task group to plan details and prepare a proposal to a major foundation.
  • Other topics.

The campaign approach to single diseases -- AIDS, Malaria, etc. -- has not worked. The world requires a health systems approach, with primary and public health care at the periphery and fully regionalized health care systems to back up and serve this base. A well-fashioned and fully functioning IH/MC would contribute immensely to improve health and development in the poorest nations of the world and thereby would contribute to economic and social development and world peace.
--Ray Elling, PhD, E-mail: relling58@hotmail.com

Get More Involved

WANT TO GET MORE INVOLVED IN THE IH SECTION?

A number of IH Section members, some new and some continuing, want to know how they can “get involved” with the Section.  Since much of our organizing work originates during the Annual Meeting, attendance at that meeting is a good first step in further engagement with the Section.

 

Serving as a member or chair of a standing Committee is one specific way to have input into IH Section activities.  Committee chairs are formally appointed by the Section chair in consultation with the Section Council, and committee members are selected by the Section chair and committee chair.  Members are encouraged to volunteer their availability for positions of interest, as most years several committees are in need of members and/or chairs.  The best way to investigate these possibilities is to attend the business meetings at the Annual Meeting, and contact the Section chair about your interests.  You can also contact the chair of standing committees and let him or her know that you would like to volunteer to work on that committee.  For a list and description of the standing committees, see the IH Section manual on our Web site. 

 

The Section officer positions, in contrast, are elected each year in a Section-wide ballot.  Officers include the Section chair, secretary, Section Council members and Governing Council members.  Service on the Section Council is a good way for new members to find out about how the Section works, while the other positions, including Governing Council, are generally held by members who have been involved for some time in other capacities.  The APHA elections are held around May of each year.  If you are interested in running for office, please contact the nominations chair, Mary Anne Mercer, at mamercer@u.washington.edu.

 

This year's slate of candidates for IH Section officers was outstanding and resulted in two tied races that had to be decided in a runoff election.  Congratulations to the newly elected members of the leadership team.

 

Newly elected members of the Section Council, to take office in 2008, are Wendy Johnson and David Olufemi Adesanya.

 

Newly elected Governing Council members, also to begin their terms in 2008, are Laura Altobelli, Malcolm Bryant, and Carlos Castillo-Salgado.

 

We hope to see many of you at the annual meeting in Washington, D.C. in November.

 

--Mary Anne Mercer, mamercer@u.washington.edu 

Experiences from the Field

 

ACTION FOR HEALTH PROMOTING SCHOOLS IN RURAL CAMBODIAN

Cambodia is one low-income country in Asia. People get up early at 5:00 in the morning with the rising sun. The big family happily eats breakfast together. After eating breakfast, they work in vast green rice fields. This is a small story of a health-promoting school program (HPSP) in rural Cambodia. 

 

Beginning in 2001, Earthly Health Cantata (EHC), a small, nonprofit Japanese agency, introduced a school-based oral health program in the Puok district. We consist of a variety of volunteers from many fields including teachers, nurses, doctors and economists. In addition, in 2005, this program evolved into a comprehensive school health program in cooperation with the Ministry of Education Youth and Sports (MOE) in Cambodia.

 

When we stated the HPSP, we shared our idea with schools and health centers of the District. A school is an efficient place for all members of the school sector, health sector and community sector to work together to promote and protect the health of all individuals, from schoolchildren to community members. Then, we introduced the school health framework and assessment tool of HPSP. The assessment tool consists of five components with a total of 76 checklist items. The five components are: Personal Health Life Skills, Healthy School Environment, Health and Nutrition Services, Common Disease Control and Prevention, and School and Community Partnership.

 

In the initial work conducted from November to December in 2005, nine cluster principals and nine nurses interviewed 40 school principals and 600 schoolchildren and observed 40 schools’ conditions to understand baseline situations. After assessing the school conditions, 23 school principals, including the nine cluster principals, and the nine nurses developed school health action plans. In August 2006, the school principals and nurses evaluated and discussed the solutions to improve their plans. Regarding effective plans, over 70 percent of plans were implemented to create educational classes and encourage schoolchildren. In order to improve ineffective plans, the school principals have focused on improving parents' participation and the physical environment, and developing school policies in cooperation with the ministry of education.

 

In December 2006, the program was implemented in two rounds for assessment of school conditions and development of school health action plans by the 40 school principals and the nine nurses. In August 2007, those plans were reevaluated by the same members. Because of its success, this program will be sustained and expanded in other districts. If you are interested in this program, please feel free to contact me.

Emiko Koito Shidara, DDS, at koito@med.kawasaki-m.ac.jp

 

INSPIRING PEOPLE, STRENGTHENING COMMUNITIES

World Neighbors, an international development organization working in 18 countries in Asia, Africa and Latin America, has developed a unique integrated approach to HIV/AIDS in its East Africa (Kenya and Tanzania) program. Our first program focus is on dissemination of information and support.  We do this in the following ways:

 

  • Training of Community Health Workers (CHWs) on HIV/AIDS.
  • Working collaboratively with Ministry of Health (MOH) on the trainings .
  • Revision of the MOH curriculum.
  • Work directly with people living with HIV/AIDS (PLWHA)1, helping with farming and agriculture.
  • Working with a theatre group of young people, providing information on prevention, testing, care and support with drama, dance and music.

 

Our second program focus is working with and training home-based caregivers who are community volunteers certified by the government.  These caregivers provide:

 

  • Care for PLWHA.
  • Counseling and moral support.
  • Support with ADLs.2
  • Training for family caregivers.
  • Assurance that the PLWHA are getting adequate care (nutrition, medical, rest, etc.).
  • Dispense minor medication (pain medication, antibiotics).
  • Wound dressing, referrals to hospital, and mobilization of the community regarding transport.

 

Our third program focus is support for people living with HIV/AIDS, including the following:

                  

  • Create support groups.

o        Receive psychological support from the group.

o        Share experiences as PLWHA.

o        Visit each other.

o        Support each other, family members and community members to getting tested.

 

  • Initiate income-generating activities (IGAs).3

o        Light scale farming along with community health workers.

o        Plant fertilizer trees – these are planted to help loosen the soil to make it easier to plant.  The people living with HIV/AIDS have reduced energy to farm, so this helps them.

o        Jump planter – a planting mechanism that allows the person to plant seeds while standing since leaning over is difficult if you are not feeling well.

o        Sell produce; get cash to buy ARVs4 (they are not free in all places) and to buy food.

o        Basket weaving and horticulture.

 

  • Nutrition

o        Set up kitchen gardens – help to till the land, provide seeds, plant and harvest.

o        Integrated approach between agriculture and health (the health coordinator identifies healthy foods, food preparation, need for clean water and the agriculture coordinator assists with planting, seeds, soil, irrigation, etc.).

o        Provide dairy goats so they’ll have the milk to boost their immune system.

o        Establish fruit farms (orchards), especially guava.

o        Lessons on nutrition based on local available foods.

 

HIV/AIDS is a crosscutting theme.  It is integrated in all sectors of our work (agriculture, health, economic development, gender, capacity building).  Helping people living with HIV/AIDS to be healthy requires nutritious food, clean water, access to care and treatment and support.

 

1 PLWHA – People living with HIV and AIDS

2 ADLs – Activities of daily living

3 IGAs – Income generating activities

4 ARVs - Antiretrovirals

-- Linda Jo Stern, MPH, E-mail: ljstern@wn.org

-- Ruth Okowa, MA, E-mail: rowoka@wneastafrica.org

 

GICUMBI, RWANDA - PERFORMANCE-BASED FINANCING OF HIV SERVICES NETS IMPROVED RESULTS WITH REDUCED SERVICE COST

 

USAID and PEPFAR are collaborating with the MOH in Rwanda to roll-out the national performance-based financing initiative to improve access to and quality of HIV services. The system assures resources are available to contribute to service costs and also pays a performance bonus to health facilities, rewarding both outputs and efficiency.

 

Paying a performance bonus for HIV services is an attractive proposition from multiple angles.  The health facility gains discretionary income that managers can use to increase staff motivation (individual performance bonuses) or for improving infrastructure. Communities benefit from better access to improved services.  The health system benefits from both reduced per-service costs and enhanced leverage over quality (since service data are validated as a condition of the program).  For PEPFAR (or any donor sponsoring such a program) we have shown in Gicumbi district that an input financing investment (the cost of supporting CAs ‘maintenance’ of support to HIV service sites) has garnered a higher quantitative result and a greater efficiency of PEPFAR resource use in reaching its own output goals.   In addition there is a constant stream of health returns due to earlier diagnosis and treatment (VCT being the port d’entrée into HIV services) and better-targeted palliative care.

 

Return on PEPFAR investment: The USG paid a standard of $10,000 for annual maintenance of a ‘mature VCT site’ in June 2005 in the Gicumbi District, which produced 3,008 tests for Mukono, Rutare, Rwesero and Munyinya health centers. The cost to USG was $13.30 per test (4*10,000)/3,008). The cost to the provider was $4.68 excluding the HIV test.[1]

 

Performance-based financing's impact has been dramatic. For instance, in just nine months of 2006/7 these health centers increased the production of VCT tests by 155 percent (on average) to 7,670. All other things kept equal, the USG will have paid less than $6.14 for each VCT test in Gicumbi (4*10,000/7,670).[2]  In terms of payment for results, this is a saving of $7.16 per VCT test (over 53 percent)!

 

It would only have taken 18 percent increase in the number of VCT tests in Gicumbi district for the investment in performance-based financing to ‘break even’ (totally neutralizing the cost of the program itself).  Beyond that increase, the additional 137 percent improvement in performance has been free…  every single incremental unit of VCT production has simply lowered the cost of a VCT test!

--Gyuri Fritsche, E-mail: gfritsche@msh.org;

--Thomas McMennamin, E-mail: tmcmennamin@msh.org

--David Collin, E-mail:E-mail: dcollins@msh.org

--John Pollock, E-mail: jpollock@msh.org

 

SURGICAL BURDEN OF DISEASE: A GLOBAL PUBLIC HEALTH CRISIS

The World Heath Organization’s Global Burden of Disease (GBD) text has become the definitive scientific account and principal framework for integrating, analyzing, and quantifying the impact of diseases, injuries, and risk factors on population health globally and by region. Its comprehensive approach has made the GBD the most relevant document for health policy and strategic planning purposes, often used to argue for allocation of resources where they are most likely to yield the greatest good. The beginning of the 21st century celebrated, for the developed world, an end to inevitable death from communicable disease and major public health advancements.

The leading burden of disease for the developed world is now non-communicable chronic disease (1). Historically, before antibiotics, surgery was a dominant force in saving lives by removing the offending part. With concomitant advances in technology, many of these chronic diseases are known to have surgical cures or treatments.  Even HIV/AIDS may be impacted by surgery (2).  But the promises of such public health advances have not been realized in the developing world, where basic surgical care and reproductive health care including routine access to Caesarean section coverage is often a distant luxury. Focus on emergency and essential surgery (3) by the WHO and other organizations, is bringing attention and, hopefully, resources to the issue, but the lack of access to surgical care is an overwhelming reality in much of the world.

The impact of surgery in public health and the burden of disease has gained renewed attention among many providing medical aid and intervention in the developing world. Recent WHO data and a World Bank publication, estimated as DALYs, suggests that 50 percent of diseases leading to death, including cardiovascular disease, maternal conditions, trauma, cancer, chronic illness and some infectious diseases, may be impacted by surgical intervention (4,5). 

 

The worldwide surgical community has responded both in the literature (4, 6-11), and in organizing and promoting aid in the provision of surgery to underserved areas.  Several academic institutions have received grants to study problems of surgical access and provision of care.  With support of the Rockefeller Foundation, UCSF, in partnership with the World Bank, held an initial working group in Bellagio, Italy in June 2007 to explore the crisis situation brought about by lack of surgical access in sub-Saharan Africa.

 

The supporting infrastructure that allows surgical care to be practiced in these countries is also in crisis.  “Health worker” shortages are at critical levels in many countries (1), especially where surgeons and anesthesiologists are so rare that programs are compelled to train “non-physician clinicians” (NPCs) to be the principal providers of basic surgical and anesthetic care. (11-14).  

 

Surgeons and anesthesiologists have long understood the importance of the knife in public health. The time has come for surgical burden of disease to be recognized as a critical risk to global public health. Unfortunately, such awareness and recognition must come before any resources will be mobilized to support basic access, infrastructure, personnel, education, training, and materials for these desperate countries. Support of this concept by public health organizations, international donors, academic institutions and humanitarian aid and development organizations must first meet the existing emergency requirements of this crisis. However, it is crucial that the surgical community remain a strong ally and advocate if long-term solutions will be realized. If not, such neglect will simply erase any semblance of advancement that may have once appeared in the Global Burden of Disease framework.

--K A Kelly McQueen, MD, MPH

--Frederick M Burkle, MD, MPH

 

References:

  1. World Health Organization.  The World Health Report 2006:  Working together for health.  Geneva, WHO.  http://www.who.int/whr/2006/en/index.html.  Accessed Sept. 5, 2007.
  2. Quarraisha AK.  Prevention of HIV by male circumcision.  BMJ.  2007; 335(7609):4-5.
  3. World Health Organization.  Global Initiative for Emergency and Essential Surgical Care.  Geneva, WHO.  http://www.who.int/surgery/en.  Accessed Sept 20, 2007.
  4. Debas, HT, Gosselin R, McCord, M, et al.  Surgery.  Disease Control Priorities in Developing Countries.  World Bank.  2006: 1245-59.
  5. World Health Organization.  World Health Report 2005:  Make every mother and child count. Geneva, WHO.  http://www.who.int/whr/2005/en/index.html.  Accessed Sept. 5, 2007.
  6. Debas, HT.  Surgery:  A Nobel Profession in a Changing World.  Annals of Surgery.  2002; 236(3):263-69.
  7. Massey B, Howard A.  The Burden of Othopaedic Disease in Developing Countries.  Journal of Bone and Joint Surgery.  2004:86A(8) 1819-22.
  8. Duda RB, Hill AG.  Surgery in Developing Countries:  Should surgery have a role in population-based healthcare?  Bulletin of the American College of Surgeons.  2007; 92(5):12-19.
  9. Schecter WP, Farmer D.  Surgery and Global Health:  A mandate for training, research and service – A faculty perspective from UCSF. Bulletin of the American College of Surgeons. 2006; 91(5): 36-8.
  10. Ozgediz D, Roayaie K, Wang J.  Surgery and global health:  The perspective of UCSF residents on training, research and service.  Bulletin of the American College of Surgeons.  2006; 91(5):  26-35.
  11. Spiegel DA, Gosselin RA.  Comment:  Surgical services in low-income and middle income countries.  Lancet 2007; 370:1013-1015.
  12. Hodges SC, Mijumbi C, Okello M et al.  Anaesthesia Services in Developing Countries:  Defining the problems.  Anaesthesia. 2007; 62:4-41.
  13. American Society of Anesthesiologists.  Overseas Teaching Program.  http://www.asahq.org.  Accessed Sept. 19, 2007.
  14. Mullan F, Frehywot S.  Non-physician clinicians in 47 sub-Saharan African Countries.  Lancet. 2007; DOI: 10.1016/S0140-6736(07)60785-5.

CHANGING DYNAMICS OF HIV/AIDS IN THAILAND

 

The complexity of preventing and treating AIDS is exacerbated by the multiple and intertwined social, economic, political, and cultural forces that shape and divide the epidemic into sub-groups that require specific interventions based on these forces.  Out of the approximate 40 million people with HIV/AIDS, an estimated 18 million are women (UNAIDS 2004). In some regions, commercial sex workers are an important mode of transmission.

 

The Thai sex industry is striving to recruit younger girls from villages who are perceived to be safe from the AIDS epidemic. Young girls are at a higher risk for HIV infection due to their physiological immaturity (Human Rights Watch 2004). After the initial period in which virgin girls and women are sold to a few men, the number of customers may rise to 10 or 15 a day (Human Rights Watch 2004). Clearly, the increase of men equals the increased chance of infection. Also, these girls lack the power to negotiate the terms of the sexual interaction and even the use of condoms.  The official Thai AIDS prevention programs heavily rely on the use of condoms; however, this propaganda becomes almost irrelevant when workers are unable to negotiate the terms of the contract, the use of condoms, and even the number of customers. 

 

The tourist industry is also a large factor in this complex problem. Just one province in Thailand is a multi-billion dollar multinational sex industry (CATW 2004) and approximately $12-$15 billion per year of Thailand’s GDP is through the prostitution industry (Beadle 2003).  AIDS education in the official media was also banned by the government, but a nationwide AIDS program began in 1991 (Nakashima 2004).

 

Thailand registered a drop in annual new infections from an estimated 143,000 to about 19,000 from 1991-2003 (Nakashima 2004). Despite these encouraging numbers, approximately 12 percent of commercial sex workers are still infected, and HIV is beginning to spread to the general population (Nakashima 2004). 

 

Whereas commercial sex work is still a large factor in the transmission of HIV/AIDS in Thailand, the country is experiencing a new pattern of risky behavior — unsafe injection drug use.  A decade ago, approximately one-twentieth of all new HIV cases were occurring through this method; the current estimate is that one-fifth of the new HIV cases are through unsafe injection drug use (Thai Working Group on HIV/AIDS Projections, 2001). Prevention policies must be constantly reassessed as regions and even sub-groups undergo dynamic changes. 

 

References

Beadle, Monique.  The Sangha and the Thai Sex Industry.  2003.  The Institute for

Global Engagement.  Retrieved Sept. 24, 2004, from http://www.globalengagement.org/issues/2003/08/sangha.htm

 

CATW: The Factbook on Global Exploitation: Thailand. Coalition Against Trafficking in Women http://www.catwinternational.org/fb/Thailand.html

 

Forced Prostitution and AIDS.  Human Rights Watch.

http://www.hrw.org/about/projects/womrep/General-137.htm.

 

Global Summary of the HIV/AIDS Epidemic.  December 2004.  Joint United Nations

Programme on HIV/AIDS. http://www.unaids.org/wad2004/EPIupdate2004_html_en/epi04_00_en.htm. 

 

Nakashima, Ellen.  “Record Numbers Infected with HIV: U.N. Cites Rapid Rise in Asia

and E. Europe.”  July 7, 2004.  Washington Post Foreign Service.

http://www.washingtonpost.com/ac2/wpdyn/A302732004Jul6?language=printer.

 

Nakashima, Ellen.  “Thailand’s AIDS battle falters: Anti-AIDS effort, hailed as model

for Asia, loses steam.”  July 10, 2004.  Washington Post Foreign Service.  http://www.msnbc.msn.com/id/5407073/.

--Asma Hussain, MPH, E-mail: Ahussain@nfpmedcenter.org

 

DIFFERENCES IN MATERNAL AND CHILD/INFANT MORTALITY RATES IN RURAL AND URBAN PAKISTAN

 

Maternal mortality rates are considered one of the best indicators of women’s health and their quality and accessibility to health services (UNFPA 2005). In Pakistan, this rate is among the worst in the world (ADB 2005).

 

Pakistan remains a largely rural country, although its urban population is steadily increasing. Approximately 33 percent of the population lives in urban areas (PRC 2004).   

 

Women in urban areas have a literacy rate two times higher than women in rural areas (PRC 2004) and this clearly has an effect on mortality rates. The mother’s education directly affects infant mortality rate — the higher her education, the less chances of infant mortality occurring (Ali 2001). Zahid (2004) also concluded that the mother’s education and her age at the birth of the child are strongly correlated with neonatal and infant mortality. However, a difference occurs when location is considered. Acquisition of primary or less education by urban mothers brings a substantive decrease in the incidence of child mortality; however, rural women with the same level of education do not produce much change in child mortality (Ali 2001). Women in rural areas must acquire higher education in order to bring a visible decrease in child mortality (Ali 2001).

         

According to Ali’s study of the variables that affect maternal and child mortality, 39 percent of rural women who were married at younger than 16 years of age reported at least one death of her child, whereas 27 percent of urban mothers reported the same. For every age at marriage category (<16, 16-18, 19-21, 22+), rural mothers reported a higher percentage of at least one child death. Despite the fact that women are the same age when they get married, their chances of having at least one child die is greatly affected by whether they reside in an urban or rural area.

 

The total percentage of women in urban areas who experienced one child death — after calculating age at marriage, current work status, educational status, poverty rate, crowding, and SES — was 21.79 percent, whereas this percentage jumped to 29 percent for women in rural areas (Ali 2001).

 

In Pakistan, one researcher offered the following account: “I asked a group of health workers in a village how many mothers they would expect to die out of 100 births, and one doctor responded with 10 or 15. I asked if he thought this was too much and he said no, this was to be expected.” (UN-OCHA 2005).

 

References

Ali, Mubashir Syed. Poverty and Child Mortality in Pakistan( 2001) Pakistan Institute

of Development Economics. http://web.idrc.ca/uploads/user-S/10281438670mimap23.pdf.

 

Country Assistance Plans-Pakistan (2005) Asian Development Bank.

http://www.adb.org/Documents/CAPs/PAK/0103.asp.

 

Demographic Profile of Pakistan. Population Resource Center (2004)

http://www.prcdc.org/summaries/pakistan/pakistan.html.

 

Pakistan: Special Report on Maternal Mortality (2005) Irinnews.org. United Nations

Office for the Coordination of Humanitarian Affairs. http://www.irinnews.org/print.asp?ReportID=35704.

 

Zahid, Mustafa. Impact of Maternal Education and Health Related Behaviors on

Infant and Child Survival in Pakistan. University of Western Ontario. London, Ontario. www.canpopsoc.org/2004/secure/Zahid.ppt.

--Asma Hussain, MPH, E-mail: Ahussain@nfpmedcenter.org

 

STRUCTURAL ADJUSTMENT PROGRAMS AND THEIR EFFECTS ON INCREASING POVERTY, HIV/AIDS

 

In the early 1980s, the International Monetary Fund and World Bank created structural adjustment programs (Werner, Sanders 1997), designed to assist countries during economic hardships. In order to qualify for loans, poor countries had to comply with the requirements of the northern market system (Werner, Sanders 1997). Components of the structural adjustment programs include sharp cuts in public spending on education and health; privatization of public services; and the devaluation of the local currency (Werner, Sanders 1997).

 

Structural adjustment programs have serious consequences. In countries with these policies, the majority of citizens have seen their real earnings cut in half, while the consumption of the wealthiest citizens has increased (Samir 1993). The World Bank and the IMF claim that an increase in poverty in most of the countries that have adopted structural adjustment programs could have just as easily occurred without these programs (Werner, Sanders 1997). Werner and Sanders (1997) compare this claim to one made by the tobacco industry that there is no proof that smokers who die of heart disease would not have otherwise perished if they had not consumed the tobacco products. 

 

In 1995, a controversial article titled “Socioeconomic Obstacles to HIV Prevention and Treatment in Developing Countries: The Roles of the International Monetary Fund and the World Bank” was published in the British journal AIDS (James 1995).

 

The article focused on four main consequences of structural adjustment programs that the authors believed to be central to the increasing rates of HIV/AIDS (James 1995). First, rural farmers are forced to leave their families in search of work in cities due to the decline of the rural subsistence economy. There, they are more likely to contract HIV and have a worse nutritional status, which then increases vulnerability to HIV (James 1995). Second, the development of a transportation infrastructure increases the chances of infection, for HIV is easily spread along truck routes (James 1995). Next, migration and urbanization result in increased chances of men having multiple sex partners and since women are generally financially dependent on their husbands, they are less likely to negotiate safe sex when their partners return (James 1995). Lastly, structural adjustment programs decrease spending on health (James 1995). Such programs have been responsible for a 56 percent increase of maternal mortality deaths in northern Nigeria (James 1995).

 

Clearly, even with the negative consequences of structural adjustment programs, these programs are implemented. The World Bank and IMF require a profound transformation of their policies and vision.

         

References

James, John, World Bank in AIDS Prevention Controversy (1995) AIDS.ORG. http://www.aids.org/atn/a-225-14.html.

 

Samir, Amin. “Don’t Adjust—Delink!” April/May 1993. Toward Freedom.

 

Werner, David and David Sanders. Questioning the Solution: The Politics of Primary Health Care and Child Survival with an In-Depth Critique of Oral Rehydration Therapy. 1997. HealthWrights. Palo Alto, CA.

--Asma Hussain, MPH, E-mail: Ahussain@nfpmedcenter.org

 

TEACH OR SELL THE KNOWLEDGE? THE BATTLE BETWEEN COMMERCIAL AND HOME ORAL REHYDRATION THERAPY

 

The field of international health experienced a revolutionary breakthrough in the early seventies with the advent of oral rehydration therapy (ORT), a simple mixture of water, salt, and sugar that enabled families to replenish their dehydrated children.  ORT decreased the number of children younger than five dying of diarrhea by 60 percent between 1980 and 2000 (JHBSPH). Despite its success, financial considerations have played a crucial role in its administration.

 

There continues to be a battle between those who advocate a bottom-up approach that ORT should be taught to the poor to enable them to treat diarrhea on their own. Strongly opposing them is the top-down belief held by international agencies that ORT packets are “developed and tested by highly qualified doctors, chemists, and physiologists” and that poor families do not have the knowledge to carefully mix the correct amount of sugar and salt.

 

Despite the research supporting ORT, this method only received wider recognition for its potential when the information in the reports was put to practical use.  In 1962, Bangladesh was hit by a cholera epidemic, and desperate doctors in one hospital began administering the same solutions that were in the drip by mouth (Werner 35).  They received stunning results by being able to rehydrate a greater number of people and reported a death rate of near zero, as compared to 27 percent and 47 percent in other hospitals (Werner 35). 

 

In the early years of campaigns, packets of ORT were manufactured in industrialized countries and distributed free of charge in developing countries. However, with cutbacks in budgets, distribution became commercialized. Erroneous marketing also led mothers to believe that the ORT packets are a medicine. Thus, mothers administered the solution in small portions, preventing the dehydrated child from receiving adequate amounts of fluids. There is a lack of ORT packets even in areas where they are aggressively marketed. 

 

Apart from the lack of access, cost is another issue. In its 1994 State of the World’s Children Report, UNICEF commented, “A quarter of a century has now passed since its discovery…the technique is virtually cost free” (Werner 49). On the contrary, a study in rural Bangladesh found that the cost of a commercially produced ORT packet was seven times greater than that of a liter of a home ORT solution (Islam).  Seven times greater.  The cost difference here undoubtedly equals the difference between life and death.

 

References

Islam, M.R. Common Salt and Brown Sugar: Oral Rehydration Solution in the Treatment of Diarrhea in Adults.

 

New Formula for Oral Rehydration Salts Will Save Millions of Lives (2002) World Health Organization http://www.who.int/inf/en/pr-2002-35.html.

 

Prologues of Public Health.”  John Hopkins Public Health (2003) http://www.jhsph.edu/Magazine/prologue/page3.html.

 

Werner, David, David Sanders, Jason Weston, Steve Babb, Bill Rodriguez (1977) Questioning the Solution: The Politics of Primary Health Care and Child Survival with an In-Depth Critique of Oral Rehydration Therapy.  California: Healthwrights

--Asma Hussain, MPH, E-mail: Ahussain@nfpmedcenter.org

 

THE EFFICACY OF NEEDLE EXCHANGE PROGRAMS: IMPLEMENTING LESSONS LEARNED FROM AUSTRALIA

 

Injecting drug-users are a high-risk population who face the possibility of contracting blood-borne illnesses. In order to help reduce their harm, needle exchange programs (NEPs) are on the rise — programs in which drug users can exchange a dirty needle for a clean one. Although such programs cause much controversy, they are evidence-based reduction strategies.

 

The major argument against the development of NEPs is that providing needles to drug users “undercuts the credibility of society’s message that drug use is illegal and morally wrong” (Bertram 1996). NEPs are viewed as a temporary solution to a social crisis that demands a permanent end.

 

These allegations have been countered with strong evidence for the efficacy of NEPs. The premise of such programs lies on the notion of harm reduction or minimization (CAPS 1993). In a study conducted in the Netherlands and Australia in the mid-1980s, health officials found that NEPs were an effective means of reducing the incidence of blood-borne diseases (Martin 2005). In 2002, health officials from Australia released a report assessing the 10-year investment of NEPs, titled “Return on Investment in Needle Exchange and Syringe Programs.” The report — in which researchers examined a total of 778 combined years worth of data from 103 cities worldwide — estimated that NEPs resulted in the avoidance of 25,000 HIV cases in Australia (Martin 2005). Researchers used the data from the Australia report and found that state and federal governments spent $72 million to implement NEPs but they saved $1 billion in long term HIV and Hepatitis C costs alone (JTO 2002). 

 

Opponents of NEPs also argue that these programs will result in an increase of discarded needles which could subsequently harm others (CAPS 1993). According to CAPS (1993), NEPs in the United States have not been shown to increase the total number of discarded syringes.

 

Despite all the evidence supporting needle exchange programs, the fact that only one legal needle exchange program exists in the state of Ohio demonstrates that public opinion still may be a far more powerful force in shaping policies.

 

References

Bertram, E, Blachman, M, Sharpe, K, Andreas, P. “Drug War Politics—The Price of Denial (1996) Berkeley, University of California Press. Retrieved April 10, 2005 from http://www.bakerinstitute.org/Pubs/wp_needles.pdf.

 

Center for AIDS Prevention Studies (CAPS). The Public Health Impact of Needle Exchange Programs in the United States and Abroad (1993) School of Public Health, University of California, Berkeley; Institute for Health Policy Studies, University of California, San Francisco. Retrieved April 8, 2005 from http://www.caps.ucsf.edu/publications/needlereport.html.

 

Martin, William. Needle Exchange Programs: Sending the Right Message (2005) James A. Baker III Institute for Public Policy, Rice University. Retrieved April 8, 2005 from http://www.bakerinstitute.org/Pubs/wp_needles.pdf.

 

25,000 New HIV Cases Prevented Via Australia’s Needle Program (2002) Join Together Online (JTO), Boston University School of Public Health.

http://www.jointogether.org/sa/news/summaries/reader/0,1854,554927,00.html.

--Asma Hussain, MPH, E-mail: Ahussain@nfpmedcenter.org



[1] Data are from the CORE-Plus R costing study carried out in Gicumbi District by the HIV/PBF Project implemented by Management Sciences for Health.

[2] This increase in services will larger once the service data for the 4th quarter are included.

Are You Moderating a Session?

ARE YOU MODERATING A SESSION AT THE ANNUAL MEETING?

 

by Samir N. Banoob, MD, PhD, Section Chair

 

Here are some tips for consideration.

 

A. Before the session:

 

1. Meeting with the speakers: It is essential to meet the speakers, in person or via e-mail or teleconference, and surely at least 15-20 minutes before the session. the purpose is to:

 

- Strictly assign time for each, and agree about time

signal alerts.

 

- Going through the contents to avoid repetition, asking for review to fit in the allocated time.

 

- Agree about succession of the speakers.

 

-Each presenter should prepare for you one paragraph on her/his bio data that include: qualifications, current position, and experience relevant to the topic.

 

2. Check the meeting room: Location, light, audiovisuals, staff assigned.

 

3. Seating at the stage: Place yourself in the center, next to the podium, (unless it is located on the side) and seat speakers on the stage (possibly from left to right), in the order of succession of presenting.

 

4. Ask the speaker to acknowledge co-workers/sponsors.

 

B. Beginning the Session:

 

1. BEGIN ON TIME, even with a small number of attendants. If so, encourage them to get closer not scattered in a large room.

 

2. If crowded, encourage people at the door to move to empty seats or sit against the wall, on the floor. If feasible, ask for more seats.

 

3. Turning off the lights is the sure way of getting sleepy attendants. Modern audiovisuals do not need that.

 

4. Introduction: Introduce yourself, specify position in APHA and provide a brief introduction on the session topic, indicating the page no. in the program book.

 

5. Indicate that Q& A to be held to the end (allowing it after each speaker is the sure way of loosing track of time).

 

6. Introduce the first speaker & topic only& and adjust the microphone position.

 

C. During the Session:

 

1. Control the time, signals at three minutes then one minute.

 

2. For late arrivals, remind attendants with topics presented before presenting the next speaker.

 

3. Strictly preserve the allocated discussion time.

 

4. Directions for discussants may be: Introduce yourself by name and position, ask a brief question to be directed to a speaker or to the panel, and if a comment, it should be brief and relevant. If feasible, ask the participants to use a microphone, or at least you repeat the question. Lengthy comments or announcements may be gently interrupted.

 

5.  If no more questions/comments and time is still left, initiate questions and encourage comments from people you know among the attendants.

 

6. No handouts to be distributed during presentations. Materials can be left at the door or the front table.

 

D. Closing:

 

1. On time.

 

2. Brief conclusions.

 

3.Thank the presenters and attendants.

 

4. Make short announcements on the program for topics related or events as feasible.

 

5. Encourage attendants to approach speakers with personal questions outside the room if next session is due.

 

6. Complete the session report/evaluation form.

IH Section Leadership

IH SECTION LEADERSHIP - SECTION OFFICERS AND COUNCILORS

(as of September 2007)

 

Section Officers:

Chair: Samir N. Banoob, MD, DM, DPH, PhD (2006-2008), sbanoob@aol.com

Immediate Past Chair: Joe Valadez (2004-2006)   

Secretary: Elvira Beracochea, MD, MPH (Secretary 2005-2008), elvirabala@cox.net  

 

Section Councilors:

Sharon M McDonnell, BSN, MD, MPH (2005-2007), smcdonnell@cdc.gov

Bryn Sakagawa, MPH (2005-2007), bsakagawa@usaid.gov

Carol Dabbs, MPH (2005-2008) cdabbs@usaid.gov

Theo Lippeved, MD, MPH (2005-2008), tlippeveld@jsi.com

Wendy Johnson (2008-2010)

David Olufemi Adesanya (2008-2010)

 

Governing Councilors:

Amy Hagopian, MHA, PhD (2005-2007) hagopian@u.Washington.edu

Maggie Huff-Rousselle, MA, MBA, PhD (2005-2007) mhuffrousselle@ssds.net

Laura Altobelli (2008-2009)

Malcolm Bryant (2008-2009) mbryant@msh.org

Carlos Castillo-Salgado (2008-2009)

 

IH Section Roles*

Program Committee - Chair: Malcolm Bryant, MBBS, MPH; Co- chair: Omar Khan

Nominations Committee - Chair: Mary Anne Mercer, DrPh; Co-chair: TBA

 

Membership Committee - Chair: Rose Schneider, RN, MPH; Co- Chair: Alison Gernand

  

Awards Committee - Chair: Paul Freeman, DrPh, MBBS, MHP

 

Information and Communication Committee: Chair: Eckhard Kleinau; Co-chair: Josefa Ippolito-Shepherd, PhD

--Newsletter Editor:  Josefa Ippolito-Shepherd PhD

--Web-Site designer/postings - Russell Kingston

 

Advocacy and Resolutions Committee - Chair: Amy Hagopian, MHA, PhD;  Co-chair: Diana Silimperi, MD

 

Emerging Global Health Professionals (formerly Students and New Professionals Committee) - Chair: Sharon Rudy; Co-chair: Helene Carabin

 

Committee on Global Health External Connections  Chair: Kyle Kinner;  Co-chair: Theresa Shaver 

 

Committee on Global Health APHA Connections - Chair: Gopal Sankaran, MD, Dr.PH; Co-chair: Michelle Forzley D, MPH

 

Global Health Strategies Committee - Chair: Miriam Labbok, MD, MPH, FACPM, FABM, IBCL; Co-Chair: TBA

 

Section Organization and Management Committee - Chair: Betsy Bassan; Co-chair: Padmini Murthy, MD, MPH,MS

 

Community-Based Primary Health Care Working Group - Chair: Henry Perry, MD, PhD, MPH;  Co-Chair: Paul freeman, DrPH, MBBS, MHP

 

Pharmaceuticals Working Group - Chair: Maggie Huff-Rousselle, MA, MBA, PhD; Co-chair TBA

 

*     Appointed by the chair