public health


Private health care for diarrhea in Africa kills 20,000 kids annually | 

A nurse gives oral rehydration salts to a two-year-old in Sierra Leone.
A nurse gives oral rehydration salts to a two-year-old in Sierra Leone.

Children in sub-Saharan Africa who suffer from diarrhea are receiving lifesaving treatment at a lower rate when visiting private hospitals as compared to public ones. Closing that gap would save an estimated 20,000 lives each year.

When a child present signs of diarrhea, hospitals are supposed to instruct parents to give the child oral rehydration salts (ORS). The basic mixture of water with a little bit of sugar and salt prevents the child from dying from dehydration. It’s wide use over the past few decades has saved millions of lives. However, it is not always available nor is it recommended in every case.

“Clearly the private sector is not following public health guidelines in the way that the public health sector is doing,” said Zachary Wagner, co-author and doctoral student in public health at the University of California, to Humanosphere.

The findings from his research, with Neeraj Sood, PhD, the study’s senior author and director of research at the Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, were published yesterday in the American Journal of Tropical Medicine and Hygiene.

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If you like affordable health care, you won’t like what’s in the TPP | 

Judit Rius

What is the TPP, you ask?

The Trans-Pacific Partnership, of course! What, you didn’t know? That’s because, despite it being a huge trade agreement between over a dozen Pacific Rim countries, from the United States to Chile to Vietnam, it’s being negotiated in secret. And yet it’s going to affect agriculture, manufacturing, copyright, healthcare – just about everything.

The last item is of particular concern to the intrepid group Doctors Without Borders (also known as Medecins Sans Frontieres or MSF), which works in dozens of countries around the world delivering healthcare in difficult circumstances. On today’s podcast with speak with Judit Rius, MSF’s US Access Campaign Manager, about why the group is so alarmed by aspects of the TPP, which it says could be “the most harmful trade pact ever for access to medicines” in an open letter to President Obama.

We’ve covered the TPP before on Humanosphere, including activist efforts to oppose it and wonky arguments against it. But Judit explains just how dangerous the TPP is for the sick and infirm around the world, as well as the significance of brand new disclosures from WikiLeaks that show how isolated the US government is in its trade demands.

In the headlines portion, Tom P. and I discuss why clinical trials of important medicines have ground to halt in India (spoiler: it’s not the TPP’s fault) and whether Nicholas Kristof is right about how aid works, or whether it does at all, in Haiti.

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A renewed push to ban spies from overeas health and aid work | 

Is it foreign aid or covert aid?
Is it foreign aid or covert aid?
Flickr, johanoomen

Co-authored by Tom Murphy

The latest assassination of health workers vaccinating kids against polio in Pakistan may be the tipping point.

Or not.

It remains to be seen if a new surge of efforts — a letter of protest from leading public health experts, a petition — asking the Obama Administration to prohibit spies from pretending to be overseas aid and health workers will force a change in policy.

Such protests didn’t even garner an official response the last time.

When it was learned in mid-2011 that the CIA had conducted a fake vaccination scheme in Pakistan aimed at gathering evidence to locate the then still-alive-and-in-hiding Osama Bin Laden, many in the global health and humanitarian community (including Humanosphere) cried foul and predicted a lot of collateral damage.

The problem, said 200-plus aid groups in a letter of protest sent by Interaction, was not just that this would undermine international vaccination projects in Pakistan, which it arguably did in this nation with one of the world’s highest rates of polio and other infectious diseases.

Many experts said it would more broadly undermine trust and credibility for all humanitarian work – and likely endanger aid workers. Many of these tragic predictions have since come true, prompting many in the global health, aid and development community to push again for policy prohibitions against such schemes.

Frumkin“Public health programs overseas offer a very special opportunity … as a bridge to creating peace and mutual understanding,” said Howard Frumkin, dean of the University of Washington’s School of Public Health and a signatory to the letter of protest sent by leading health academics to President Obama. Unlike many other kinds of aid and assistance programs with inherent political or economic complications, Frumkin said, health initiatives done correctly overseas can forge intimate bonds of trust and respect for life that transcend politics.

“This is why it’s so important not to subvert the credibility and integrity of these kind of health programs,” he said. “The recent killings in Pakistan only underline the importance of keeping our intelligence activities separate from our health aid and assistance work.”

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Deadly side-effects in Ivory Coast and a Déjà Vu moment | 

Mike Urban

Child getting vaccinated

One of the unfortunate side-effects of the violent political confrontation and deadly civil unrest in Ivory Coast is that basic life-saving activities for many innocent bystanders can also get suspended.

We in the media will cover the political clashes, the riots and the shootings.

But little attention is typically given to the mothers who die at home in childbirth — or to the kids who die because of lack of efforts like vaccination.

So it was good to see that a few media in Africa, the UN’s IRIN news service and AngolaPress, broke out of this rut:

Unrest following Côte d’Ivoire’s presidential election is blocking a nationwide vaccination drive against yellow fever, a fatal mosquito-borne disease that is affecting people throughout the country.

About a dozen people have died so far from this yellow fever outbreak and more will be put at risk for as long as health workers are unable to get out and vaccinate.

I witnessed nearly the same thing there a decade ago.

Mike Urban

On assignment for Seattle PI in West Africa

I happened to be in Ivory Coast almost exactly 10 years ago to cover the intended launch of the Gates Foundation’s largest project — the Global Alliance for Vaccines and Immunization (GAVI).

At the time, I was working for a dearly-departed print newspaper, the (now much staff-reduced, online only) Seattle Post Intelligencer, with my friend and PI photographer Mike Urban. Mike took the photos featured here. The Gates Foundation had earlier announced it was giving a billion dollars to create GAVI and get basic vaccines out to kids in poor countries.

The plan was to launch GAVI in Ivory Coast because it was, at the time, one of the most stable countries in West Africa with a fairly functional if basic health system. So the Seattle PI decided to send us to get a look at the beginning of this historic project.

When Mike and I arrived, we instead found a powder keg situation. Armed soldiers were all over Abidjan and people were nervous, worried. We still went out to visit clinics and talk to health workers. My newspaper paid good money to get us there and my editor thought an impending civil war was no excuse for not doing our job.

So we reported on the folks trying to do public health amid a brewing civil war. Things didn’t look good. And soon after we left the country to go travel in Nigeria on another assignment, Ivory Coast exploded. Here’s the story I wrote about what happened and what this did to the Gates Foundation’s plans for vaccinating kids.

This tale of collateral damage is little more than a footnote to the standard way we cover political turmoil and civil unrest in these countries (or anywhere, for that matter).

But the current strife in Ivory Coast has produced a major Déjà Vu moment for me. A disturbing one. I can’t help but think of all the children, pregnant women, sick eldery folks and others who suffer, and die, to little notice when these political struggles for power erupt.

A side note: It isn’t just civil unrest that can kill. Loss of donor interest in supporting something so mundane as child vaccinations can kill just as well. As the Seattle Times recently reported, the Gates Foundation, PATH and others are big on pushing immunization as a cheap, effective way to save millions of lives.

But GAVI is now facing a serious funding shortfall and, unless rich nations step up, kids will die from apathy just as surely as from civil war.