UN Week

[caption id="attachment_17460" align="left" width="150" caption=" " credit="Flickr, Ashitakka"][/caption] Humanosphere's coverage -- with original reporting from Tom Paulson in N.Y. and hand-picked content shared by others -- of the United Nations High-Level Meeting on Non-communicable Diseases, the Social Good Summit, the Clinton Global Initiative, and other events the week of Sept. 19, 2011. (Stories are in reverse chronological order.)

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October 10, 2011 | 8:59 AM | By  | 

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.

FILED UNDER: Health, Joanne Silberner, mental health, UN Week, Vikram Patel, World Health Organization
September 23, 2011 | 2:57 PM | By  | 

Final wrap on UN Week and the ‘historic’ global health confab | 

Tom Paulson

Someone important going to the UN

A news analysis:

As I head home from the Big Apple, the big news here today is that Palestine formally requested membership at the United Nations as a step toward becoming an independent nation. The actual vote comes later but the UN isn’t really a democracy. The U.S. has vowed to kill it with a veto in the UN Security Council.

Iranian President Ahmadinejad’s antics at the UN are already old news. Other top stories today include a satellite coming down and some Swiss nerds claiming they sent subatomic particles faster than Einstein said they can go.

An earlier meeting by the UN General Assembly was repeatedly hailed by those who care about poverty, health and social justice as “historic.” But it seemed to come and go with little notice.

I reported earlier this week on this much lower-profile UN High-Level Meeting on Non-Communicable Diseases (NCDs), admitting the entire time that I wasn’t quite sure what happened at this global health confab, or if it will matter much.

I couldn’t tell in part because of the byzantine manner which the UN does things, beginning with the apparently common UN practice of deciding on the outcome of a meeting before you have the meeting. I also couldn’t tell because the media is highly constrained and can only talk to participants at about the same level of engagement as someone jailed in solitary confinement.

That said, the UN meeting on NCDs does have the potential for something great … to emerge from this fog of sound-bites, press briefings and celebrity appearances. This could actually turn out to be historic, an expansion and re-ordering of the global health agenda.

It isn’t yet, however. As several of us who follow global health closely (obsessively, sometimes angrily) have noted, the UN didn’t really accomplish much of substance this week. As Laurie Garrett, perhaps the top global health journalist (or former journalist?) now with the Council on Foreign Relations, wrote on her blog:

After months of haggling, millions of dollars’ worth of meetings and travel costs and a prodigious mountain of studies and documents prepared in anticipation, the final Declaration of the UN High Level Meeting  is little more than a wishy-washy rendition of problems and vague solutions that are obvious to even casual observers….

Laurie, who is a friend, goes on to cite my earlier reports saying much the same thing and then calls me “super-insightful.” Wow, and I only paid her $20. Others just call me cranky. But I think we all want this thing to move forward, to expand the reach of the fight against the diseases of poverty. Continue reading →

FILED UNDER: Health, Ann Keeling, Jamie Love, Lautrie Garrett, NCD Alliance, non-communicable diseases, UN Week, United Nations
September 22, 2011 | 4:57 PM | By  | 

At Clinton Global Initiative: Landless women at root of many problems | 

I’ve been reporting this week on the United Nations’ declared support (however vague) for expanding the global health agenda to go beyond the traditional focus on infectious diseases like AIDS, TB, measles or malaria and include non-contagious, chronic disease like cancer or heart disease.

Across town, the Clinton Global Initiative was also in New York City this week and has been exploring how to fight hunger, poverty, unemployment, gender discrimination as well as disease.

One organization from Seattle in attendance here at this high-caliber, invitation-only event, Landesa, is dealing with all these at the same time.

“Land rights are at the root of many of these problems,” said Tim Hanstad, president and CEO of the non-profit organization (formerly known as RDI, Rural Development Institute) which works to help poor people around the world obtain legal ownership of their land.

Tom Paulson

Seattle film-maker Stan Emert talks with Landesa CEO Tim Hanstad at Clinton Global Initiative

Did I mention that the Clinton Global Initiative (CGI) is pretty high-faluting? Only select folks are invited. People like Archbishop Desmond Tutu, President Obama, Burmese activist Aung San Suu Kyi — and actually quite a few people representing organizations from Seattle such as PATH, Microsoft and a creative nerd working on a literacy device.

Media are allowed in, within limits. I got kicked out of a room (where I was interviewing physician-activist Paul Farmer) because I had inadvertently left the media quarantine area. For more on what it’s like to be a journalist at CGI, read this hilarious piece by the Wall Street Journal’s Ralph Gardner Jr.

But I digress. The point is it’s a high honor to be invited to attend the CGI event. It is also often a sign that your issue — aimed at creating a social good — is rising up on the political and philanthropic radar screen.

Hanstad’s been to this luminous event before, but he said there’s no question the issue of land rights for the poor is gaining more recognition. Part of this, he said, is due to the so-called “land grab” going on in many parts of sub-Saharan Africa. See this Oxfam spoof video for one view.

“It’s hard to get precise numbers on what’s happening out there, but it’s clearly huge,” Hanstad said. Continue reading →

FILED UNDER: Basics, Justice, Clinton Global Initiative, girls, land rights, Tim Hanstad, UN Week, United Nations, women
September 21, 2011 | 12:00 PM | By  | 

Why we still don’t have a cure for AIDS — a novel explanation | 

Open Door Press

If someone discovered a cure for AIDS, would the pharmaceutical industry be able to – or even want to — develop it?

That’s one of the questions explored in Through These Veins, the first novel by Anne Marie Ruff, a veteran journalist who has covered AIDS, medical research, biodiversity and other international issues for many publications.

It’s perhaps also a question worth asking in reality this week as international leaders have been meeting at the United Nations and throughout New York City to debate, among other things, how best to fight disease in poor countries.

HIV infection is today, in rich countries at least, no longer a death sentence but rather a manageable, chronic disease almost like diabetes thanks to the development of effective anti-HIV drugs.

That’s obviously of life-saving benefit to millions of people infected with HIV who can get these drugs.

It’s also one of the great success stories for what some might call the “medical-industrial-complex.” At the risk of sounding a bit crass, people with HIV, like people with other chronic diseases, have to keep buying these products in order to stay alive.

Is there just as much market incentive for a drug company to spend hundreds of millions of dollars to find a cure for AIDS? Ruff doesn’t think so.

“I would challenge you to show me a pharmaceutical company that can afford to undertake the very expensive, risky, and long-term research necessary to develop a cure for HIV/AIDS, or almost any other disease for that matter,” she told me. “The sales model simply will not support the effort.”

(Maybe not for drug companies. But I should note that there are medical scientists at the Fred Hutchinson Research Center exploring a gene-modification approach to curing HIV infection.)

Ruff says she isn’t necessarily criticizing the drug industry (though one fictional company, Klaus Pharmaceuticals, is certainly the bad guy in her novel). Drug makers are simply responding to market forces, she says, and are legally required to their shareholders to pursue the most lucrative business strategy.

Unfortunately, she says, the money is in treating and not curing. And the scientific community, Ruff adds, tends to follow the money also. Continue reading →

FILED UNDER: Health, Anne Marie Ruff, drug industry, HIV-AIDS, UN Week
September 21, 2011 | 10:04 AM | By  | 

Did something that matters happen at the UN global health summit? | 

Tom Paulson

The media covering the media covering President Obama speaking at the UN

The big global health meeting at the United Nations has come and gone I still can’t quite tell if anything actually happened.

Maybe that’s normal, when it comes to how things get done at the UN.

After all, the Obama Administration has said if the UN were to recognize Palestine as a state, it would be “merely symbolic.” And yet they’re still fighting like hell to keep it from happening.

I came to New York to cover a meeting called the UN High-Level Meeting on Non-Communicable Diseases, which concluded yesterday. This was billed as a historic moment in global health, only the second time the UN has held such a meeting. The last one, in 2001, launched the Global Fund to Fight AIDS, TB and Malaria — a massive, if imperfect, effort that has saved millions of lives.

The aim of this week’s special session on global health at the UN General Assembly meeting is potentially even more significant than it may sound.

On the surface, it was a call to expand the already strained global health agenda to include non-infectious killers like cancer, diabetes and heart disease — the NCDs (or non-communicable diseases). That’s a big deal because it adds a lot to the agenda, given that chronic diseases kill more people (about 36 million per year) than AIDS, TB and malaria combined.

But it may be even bigger than that.

If you dig a little deeper here, this is the big — mostly unspoken — question: Is this move to get chronic disease on the agenda actually a move away from the standard disease-oriented approach to global health — and toward a more “systems” approach? Continue reading →

FILED UNDER: Health, GAVI, Gro Harlem Brundtland, non-communicable diseases, Seth Berkley, UN Week
September 21, 2011 | 4:37 AM | By  | 

Paul Farmer explains why global health has to first focus on poverty | 

I caught up with physician-activist Paul Farmer at the Clinton Global Initiative, the other big meeting in New York full of heads of state, celebs and bigwigs.

Farmer, the inspiring and controversial cyclist-celeb Lance Armstrong and others have joined in the clarion call to expand the global health agenda to include all the big killers (as per the UN meeting on chronic disease). Here’s more on Armstrong’s pitch.

I asked Farmer why he thought it necessary for his organization, Partners in Health, to emphasize that the UN focus not just on disease, but on diseases of poverty:

 

 

FILED UNDER: Health, Politics, Lance Armstrong, Paul Farmer, poverty, UN Week
September 20, 2011 | 6:30 PM | By  | 

Best of the UN Week coverage | 

Tom Paulson is at UN Week for Humanosphere, but with so many meetings and side discussions going on in New York this week, we’re assembling the best tweets, blog posts and other social media coverage from the High-Level Meeting on Non-communicable Diseases, the Social Good Summit and other events. The information in this window will be continuously updated throughout the week, so keep checking back for updates (and we’ve also linked to a live-video stream).

– Curated by Robin Cedar and Jake Ellison of KPLU.

 

FILED UNDER: UN Week
September 20, 2011 | 7:03 AM | By  | 

UN health summit makes food, beverage and drug industries nervous | 

Flickr, Roadsidepictures

Members of the United Nations General Assembly met this week to come up with a plan to combat chronic disease in poor countries that appears to have some in the food, beverage and drug industries worried.

Ten years ago, a similar meeting here produced a massive global response to the AIDS pandemic, most notably with the creation of the Global Fund for Fighting AIDS, TB and Malaria (which yesterday, despite clearly saving many millions of lives, got slammed for not working as well as advertised).

The expectation at the UN meeting is that delegates will decide that somebody should do something … and would like to be more specific, but then say they are late for another meeting, grab their hats and coats and make for the door.

Part of the problem is that many chronic diseases are “lifestyle” diseases — lifestyles that a lot of corporations want us to buy into.

The need for action is clear: Chronic or non-communicable diseases (aka NCDs) are the world’s big killers, representing about 60 percent of all causes of death. Cancer, heart disease, stroke, lung disease (mostly from tobacco), diabetes and the like kill many more people — most of them in the developing world — than do infectious diseases like AIDS, TB or malaria.

But governments, donors, the drug industry and health agencies don’t set their global health priorities simply on the basis of the burden of disease, as reasonable as that might sound. Some diseases are too complex, their treatment too expensive, to feasibly act against in poor countries.

Many of the NCDs are, however, easily and cheaply treated or prevented. High blood pressure can be treated with drugs costing pennies per day. Tackling some of the biggest killers, the World Health Organization says, can be done at a cost of about $1.20 per day.

Simply educating people about a healthy diet and the risks of tobacco or excessive alcohol use could do a lot.

It all sounds do-able, this aim to shift the global health agenda to include these non-contagious killers. So why the pessimism about getting a meaningful game plan out of this UN meeting?

Part of the problem is the concerns of industry. These health goals sometimes run up against powerful commercial interests in the food, beverage and pharmaceutical industries.

UN

UN Secretary General Ban ki-Moon

“There is a well-documented and shameful history of certain players in industry who ignored the science, sometimes even their own research, and put public health at risk to protect their own profits,” UN Secretary General Ban Ki-moon said Monday in a speech on the NCDs.

Ban cited the tobacco and alcohol industries, but also makers of processed foods high in salt, sugar and fat — and the media companies that advertise unhealthy products. Continue reading →

FILED UNDER: Health, Politics, Ban Ki-Moon, industry, intellectual property, Jamie Love, non-communicable diseases, UN Week