Joanne Silberner

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The challenge of determining cancer’s burden in Africa | 

Guest post by Katie Leach-Kemon, a policy translation specialist from the University of Washington’s Institute for Health Metrics and Evaluation.

Nurse, Sierra Leone
Nurse, Sierra Leone
Wikipedia

In last week’s Humanosphere podcast, former National Public Radio health reporter and current University of Washington journalism educator Joanne Silberner spoke about the stigma surrounding cancer in Uganda. (Yesterday, she also talked to NPR.)

Cancer is a big killer in poor countries as well as in the rich world, but it has not been high on the global health agenda in part because many saw most forms of cancer as either too complex or too expensive to treat in the developing world.

That is not always the case and many advocates are trying to push cancer higher up on the list as part of a broader effort to move from a predominant focus on infectious disease to include non-communicable diseases like heart disease, cancer and diabetes.

Many Ugandan women who find lumps in their breast see it as a death sentence, Silberner reports, in part because of lack of access to many therapies we take for granted in the West. But Ugandan women with breast cancer are also unlikely to seek medical care partly for fear that their husbands will leave them if they have a mastectomy.

Another challenge to building the case for cancer care in the developing world is getting accurate information about the disease burden.  Continue reading

PRI’s The World: Cancer’s global reach | 

PRI’s The World, in collaboration with the Pulitzer Center for Crisis Reporting, today launched a series of stories examining cancer in the developing world which includes a fantastic interactive map (below is a just a screen grab):

PRI's The World

Joanne Silberner, a Seattle journalist, friend and colleague who formerly produced many prize-winning reports on health for NPR, traveled across the planet to document the fight against cancer in poor countries with few resources.

Silberner’s extensive radio series, to be aired beginning this week on PRI and also published online as written text and podcasts, begins in Uganda where a number of Seattle efforts — like this project focused on breast cancer — have been underway for years aimed at boosting the ability of poor nations to fight this killer and to also get cancer higher on the global health agenda.

Another neglected disease: Cancer in the Developing World | 

IHME UW

Breast cancer rates worldwide, 1980-2010

Freelance (and former NPR) health journalist Joanne Silberner of Seattle is doing a series of reports on cancer in the developing world for a number of news organizations with funding from the Pulitzer Center for Crisis Reporting.

The gist of it is that cancer in poor countries is often a neglected disease. As Silberner says in announcing her reporting tour starting in Uganda, moving on to India and Haiti:

Worldwide, more people die from cancer than from HIV/AIDS, tuberculosis and malaria – combined. Yet until recently, cancer was almost ignored by the global health groups, charitable organizations and governments working to improve conditions in developing countries.

Continue reading

It’s World Most-Neglected-Health-Problem Day | 

Flickr, by Dierk Schaefer

Neon Brain

It’s actually World Mental Health Day, and also Columbus Day.

Neither of these calendrical milestones are likely to get much public attention, unless perhaps someone can combine them for a story suggesting that Christopher Columbus only discovered the New World in 1492 thanks to his megalomania and narcissistic, obsessive-compulsive disorder.

I am not doing much this year for Columbus Day (the state of Hawaii officially refuses to celebrate it, by the way) and would like to focus most on World Mental Health Day.

Not much to celebrate really. Overall, I think it’s fair to say we’re doing a lousy job on mental health.

As I’ve reported before, mental illness is one of the leading causes of death and disability worldwide, yet it remains a very low priority on the global health agenda. Leading mental health researcher Vikram Patel has noted that mental illness kills more women than maternal mortality.

My friend and colleague Joanne Silberner recently reported on this disparity — between the global burden of this disease and the low attention it gets — on PRI’s The World, after a visit she paid to a clinic in Uganda. Said Silberner:

The World Health Organization estimates that more than 450 million people suffer from mental disorders, and a new report by the World Economic Forum figures the annual global costs of mental and neurological illnesses at $2.5 trillion. That is three times the economic cost of heart disease.

Here are some of the stories today about World Mental Health Day:

The Independent World Mental Health Day: Time to Invest

Voice of America Treatment for Mental Health Underfunded, Inadequate

Huffington Post World Mental Health Day — A revolution needed

UN News Centre UN Secretary General Ban Ki-moon urges more resources for mental health

Actualitie news Afrique WHO highlights global under-investment in mental health

The gist of most of the news stories is that we aren’t spending enough on mental health and so many experts and leaders are calling for more money.

Talk is cheap, of course, and these are tough economic times. Donations are down for the global AIDS response. I recently attended a UN meeting focused on chronic diseases where advocates called for expanding the global health agenda to better respond to problems like diabetes, heart disease and cancer. There’s a push to expand the number of slices despite a shrinking pie.

Many argue we need to increase the size of the pie, that investment in global health provides many times more in return. In lieu of that happening, perhaps the best chance for mental health issues — as well as other neglected diseases — of receiving more attention and resources is if the experts can finally agree on how best to set priorities in the global health agenda.

One would think it should be based largely on the burden of disease as well as the socioeconomic and health benefits of reducing that burden. We’re not there yet, partly because some problems are easier to solve than others, despite the disease burden, and partly because achieving that cost-benefit analysis I mentioned is also easier said than done.

Still, many say the gross neglect of mental health is perhaps the strongest evidence of our misplaced priorities.

PRI’s Joanne Silberner on Mental illness in Uganda | 

Joanne Silberner

Uganda works to improve mental health care

Health journalist Joanne Silberner, former health policy correspondent based at NPR’s flagship in DC and now (lucky for us) based here in Seattle at the University of Washington, has done an excellent report on the lack of mental illness care in Uganda for PRI’s The World.

I’ve done a few stories here about the mental health in the global health context, noting it is both a massive contributor to the burden of disease yet gets almost no attention when it comes to the global health agenda.

As Silberner reports, the first in a PRI series she’s doing on mental health in the developing world, improved acess to work training for the mentally ill is perhaps just as important as improving and expanding access to treatment: Continue reading