Title: INTERNATIONAL HEALTH SECTION ADVOCACY COMMITTEE - COMMENTARY ON 2006 PROPOSED POLICIES
Author:
Section/SPIG: International Health
Issue Date:
The IH Section reviewed all the policies proposed by various individuals and APHA Sections for adoption at our November Annual Meeting. The perspective our Section brings to analysis of proposed APHA policy is to look for opportunities to bring an international perspective. In that light, below are the comments submitted to the Joint Policy Committee that reviews policies before they go to the Governing Council for final vote.
GROUP - A: Health Disparities
1. Addressing the Needs of Immigrants in Response to Natural and Human-Made Disasters in the United States (LB5)
This proposal seems reasonable and we believe it includes sufficient international perspective.
2. Enhancing Sexually Transmitted Disease Surveillance and Research Activities to Improve Health Outcomes for American Indian and Alaska Native Persons
This proposal intends to address the needs of a particular US-based population and there is no need for international content.
3. Ensuring Access to Public Health Care and Health Care Services Following Hurricanes Katrina and Rita (LB4)
This proposal seems reasonable and we believe it includes sufficient international perspective.
4. Reducing Racial/Ethnic and Socioeconomic Disparities in Preterm and Low Birthweight Births (PP)
While this proposal references the U.S. International Ranking with regard to birthweight status, it may miss some opportunities to discuss ways in which to address the problem internationally. Perhaps the authors could be encouraged to consider that. Further, the use of the acronym ART for assisted reproductive technology is confusing, as ART in international settings refers to anti-retroviral therapy. Best to avoid acronyms altogether.
GROUP - B: Environmental and occupational health
1. Addressing Potential Environmental and Occupational Health And Safety Risks of Nanotechnology (LB7)
This proposal discusses an important potential international health problem, but addresses it entirely from a domestic perspective. Could the authors consider adding some language about the role of international environmental health monitoring agencies in regulating this material? Typically, hazardous wastes that become too odious in the United States are simply manufactured off-shore, with potential for international health consequences.
2. Conduct Crosscutting Research to Build an Evidence-Base of Effective Community Health Assessment Practice
This is a thoughtful paper on the topic and do not seem to be any opportunities for a real international perspective. The authors, however, are encouraged to talk with our Community Based Primary Health Care Working Group – Henry Perry <henry@future.org>.
3. Promoting the Use of Protective Eyewear in Sports
This proposal is entirely U.S.-focused and may miss some opportunities to discuss ways in which to address the problem internationally. Even if you want to keep it entirely domestic, you must surely recognize the issue of the high cost of protective equipment and that low-income and immigrant families, whose children may benefit disproportionately from organized sport activities, will have no way to pay for the cost of acquiring the equipment.
4. Resolution on Support for Freedom to Form Unions: The Employee Free Choice Act
This proposal seems reasonable, and since it pertains almost entirely to U.S. law, we believe it does not need to contain an international perspective. Authors are urged, however, to consider the international context in which union-busting occurs.
5. Resolution on Support For Overtime Pay Protection
This proposal seems reasonable and since it pertains almost entirely to U.S. law, we believe it does not need to contain an international perspective. Authors are urged, however, to consider the international context in which these policies occur. Refer to new book by Jeff Faux, "The Global Class War: How America's Bipartisan Elite Lost Our Future - and What It Will Take to Win it Back" (ISBN: 0471697613).
6. Response to Disasters: Protection of Rescue and Recovery Workers, Volunteers, and Residents Responding to Disasters (LB3)
While this proposal has a deliberately domestic perspective, it mentions immigrants appropriately. Therefores, however, are not very well written, too lengthy, and contain too many capital letters.
GROUP - C Access to health care
1. Abstinence and U.S. Abstinence-Only Educations Policies: Ethical and Human Rights Concerns
The language in the preamble mentions international issues, such as PEPFAR, international treaties and human rights statements, but then the action steps include no international content. We urge the authors to take the opportunity to recommend U.S. foreign policy changes that pertain to reproductive rights.
2. Ensuring that Patients are Able to have Contraceptive Prescriptions filled at Pharmacies
This proposal seems reasonable and since it pertains almost entirely to U.S. law, we believe it does not need to contain an international perspective. Authors are urged, however, to consider the importance of a dedicated EC product internationally. In many countries, pharmacists must cut up birth control pill packets to produce a cobbled-together product.
3. Hand Hygiene in PreK-12 Schools
Always hard to argue with hand-washing. Authors are cautioned, however, about piling more responsibilities on under-resourced public schools without resources to help.
4. Over-the-Counter Oral Contraceptives
This proposal seems reasonable and since it pertains almost entirely to U.S. law, we believe it does not need to contain an international perspective.
5. Pandemic Flu
We will need more time to review this lengthy document in more detail for its international implications.
6. Regulating Drugs for Effectiveness and Safety: A Public Health Perspective (PP)
The APHA IH Section fully endorses the policy initiative “Regulating Drugs for Effectiveness and Safety: A Public Health Perspective.” U.S. citizens are at risk by the lack of FDA transparency in what has become a regulatory environment that values the economic interests of industry over the public health of citizens. The pharmaceutical regulatory environment within the United States is not only a risk for the U.S. public; it sets a very poor example for developing countries. Pharmaceutical regulation within Australia, Canada, and Western Europe (particularly the British “yellow card scheme”) actively encourage post-marketing surveillance (or pharmacovigilance). Early warning systems for pharmacovigilance were often inspired by the thalidomide tragedy in Western democracies, and that tragedy should be kept in mind as the U.S. funds support to introduce “new essential drugs” for malaria and HIV/AIDS in developing world environments, where their introduction can hardly be considered too far beyond that of a large uncontrolled clinical trial.
7. Support for the Alaska Dental Health Aide and Therapist and Other Innovative Programs (LB1)
This proposal intends to address the needs of a particular U.S.-based population and there is no need for international content.
8. The Role of the Pharmacist in Public Health 8024 (PP) Updated
While we would not argue with any of this content, we note there is no international perspective. Authors may wish to investigate the roles of pharmacists in low-resourced countries, which offer a model for a much more expansive approach to the pubic health activities of pharmacists.
GROUP D - Public Health Science and Infrastructure
1. A Call for a Framework Convention on Alcohol Control
An admirable effort to address health problems related to alcohol from an international perspective.
2. Ethical Restrictions on International Recruitment of Health Professionals to the United States
This was our own proposal.
3. Opposition to the Continuation of the War in Iraq
War in Iraq has created huge public health and environmental health problems that call for APHA to take a strong stand.
4. Reducing Nutrition-Related Disparities Through Food Stamp Nutrition Education & the 2007 Farm Bill
This proposal is entirely U.S.-focused and may miss some opportunities to discuss ways in which to address the international dimensions of the problem. Authors may want to consider the implications of the 2007 Farm Bill for international agriculture workers (especially in low-income countries) and food security internationally.
5. Urgent Call for Nationwide Public Health Infrastructure and Action to Reverse the Obesity Epidemic
This proposal is entirely U.S.-focused, and may miss some opportunities to discuss ways in which to address the international dimensions of the problem. Even if it is kept entirely domestic, the concepts in a new article on the obesity epidemic should be explored, which suggests a role for psycho-social stress. This has international implications. Publication by Rodrick Wallace, et al: "Fat people and bombs: HPA axis cognition, structured stress, and the US obesity epidemic."
6. Vote for Health
This proposal seems reasonable and since it pertains to US voting practices it may not need to contain an international perspective. The authors could consider expanding the effort, however, to suggest a universal role for health workers in promoting democracy and citizen participation. These are arguably determinants of health in all countries.
--Amy Hagopian, MHA, PhD, Phone: (206) 685-3676 (o); (206) 616-4989 (o); (206) 706-0989 (h)