University of Washington


Guest Op-Ed: Is global health about gizmos or people? | 

By Julia E. Robinson, director of advocacy programs for Health Alliance International at the University of Washington.

In Liberia, a health worker takes child's temperature at the FJ Grant District Hospital in Greenvile in the Sinoe County.
In Liberia, a health worker takes child’s temperature at the FJ Grant District Hospital in Greenvile in the Sinoe County.

It’s an exciting time to be fighting for the “End of AIDS.”

Everyone from Hillary Clinton to Pope Francis is talking about the possibility of turning a corner on the pandemic. Advances in treatment and vaccine research hint there could be an AIDS-free generation in the near future. International donors are ponying up huge amounts of money for developing these new technologies.

Just last week, the United States Agency for International Development  (USAID) announced a $1 billion initiative called the Global Development Lab to keep churning out high tech solutions to some of the toughest public health problems facing the planet, including HIV.

Meanwhile, many poor countries and communities lack enough nurses, doctors and health workers to even carry out the most basic health services.

Global health experts talk about a ‘delivery bottleneck’ for new vaccines – a euphemistic way of describing the fact that Western innovations are piling up because the global south simply lacks the health care workforce and systems to deliver these new health technologies.

Continue reading

Ugandan prof cites western roots of Africa’s anti-gay movement | 

Stella Nyanzi
Stella Nyanzi

Stella Nyanzi is an anthropologist who studies gender and sexuality issues in Uganda, at Makerere University in Kampala.

Talk about being at the eye of the storm.

Uganda has become ground zero for what some characterize as an explosion of homophobia and increased criminalization of homosexuality in Africa. Hostility toward gays is hardly new or confined to Africa, of course, as Humanosphere has noted. Nearly 80 countries worldwide consider homosexuality a crime, with some making it a death penalty crime.

“In Africa, I think it’s worth noting that the countries with the most severe laws are former British colonies,’ said Nyanzi, who will be the keynote speaker at a Seattle conference focused on sexuality, health and human rights. “You don’t see this so much in the former colonies of other countries.”

The conference, hosted and run by students at the University of Washington, is the 11th annual Western Regional International Health Conference, which opens with Nyanzi speaking on Friday and runs through the weekend.

The meeting will also screen a powerful documentary, Call Me Kuchu, that describes the plight of gays in Uganda – and the murder of a gay activist.

“This is happening in many places but I’m not sure everyone recognizes why, and how,” said Nyanzi. Continue reading

The cure for global poverty: Health | 

Mother and child, Madhya Pradesh, India
Mother and child, Madhya Pradesh, India
Flickr, DFID

Researchers Discover Powerful Cure for Poverty and Inequality – Health

If you could only do one thing to reduce poverty and inequity around the world, say experts in global development, the best thing you could do is reduce the disproportionate burden of disease on those living in the poorest communities.

Improving health, according to a relatively new and perhaps still under-appreciated report written by a blue-ribbon panel, remains the most powerful tool for improving lives and reducing extreme poverty worldwide.

But it’s still a woefully underused tool that, as Humanosphere will report on tomorrow, is actually losing ground on the anti-poverty agenda even as the evidence of its import swells.

Dean Jamison
Dean Jamison

“We have an unprecedented opportunity, unlike any time before in human history, to significantly reduce the level of inequity in the world,” said Dean Jamison, a health policy expert at the University of Washington and, with Harvard University’s Lawrence Summers, one of the lead authors of the report, dubbed Global Health 2035.

“Even in the United States, the single largest cause of poverty is medical expenditures, usually due to some health crisis,” Jamison said. “Europeans have a hard time understanding this, because for the most part they don’t experience medical bankruptcies. But the connection between illness and poverty is also especially the case for the poor in developing and middle-income countries.”

Not everyone agrees, of course, that improving health should be at the top of the anti-poverty agenda.

Some say improving governance, human rights or business development are more powerful means for fighting poverty. Some say we need less targeted efforts and an agenda that emphasizes sustainable development (whatever that means….). The aid and development community, it should be noted, argues about almost everything. Continue reading

Fighting poverty with mushrooms, green things & social enterprise | 

Most people might not think growing mushrooms could make the world a better place.

Most might not see natural disasters like the Philippine’s catastrophic Typhoon Haiyan (aka Yolanda) as a business opportunity.

But then, most people aren’t creative entrepreneurs looking for innovative and profitable ways to fight poverty and human suffering.

Pitching Fargreen, a Vietnam-based business aimed at helping smallholder farmers, at the UW's global social enterprise contest.
Pitching Fargreen, a Vietnam-based business aimed at helping smallholder farmers, at the UW’s global social enterprise contest.

“Mushrooms were big this year, for some reason, as was disaster relief,” said Kirsten Aoyama, director of the University of Washington’s Global Business Center. Continue reading

Business fighting poverty: Water wheels keep on rolling | 

Cynthia Koenig and her Wello
Cynthia Koenig and her Wello
Tom Paulson

Everyone knows that access to water is essential for life, but for the poor we should add ‘cheap’ and ‘easy’ to the access part.

One of every seven people on the planet, a billion or so of the poorest people worldwide, lack ready access to clean drinking water. In many communities, women and girls have the daily responsibility of traveling long distances every day carrying plastic jugs to collect water.

Progress against extreme poverty is being hamstrung so long as the poorest have to spend a big part of their day doing what we all take for granted.

The best solution, arguably, would be for governments to invest in building the basic infrastructure – water and sewer pipes – that make access to water and sanitation relatively cheap. But until that happens, one entrepreneur has decided to re-invent the wheel.

The water wheel. The Wello water wheel, to be precise:

I met Wello’s CEO Cynthia Koenig a few years ago in Seattle, at a social enterprise competition sponsored by at the University of Washington Foster Schoold of Business.

Back in 2011, all Koenig and her colleagues had was a business plan and an idea. Her concept – of using some kind of rolling container to transport water – wasn’t that new. But her business plan was innovative, in that the idea was not to invent a gizmo and then get poor people to use it; rather it was to test the gizmo among the poor and refine it according to their needs. Continue reading

Scientists identify China’s mysteriously massive cancer burden | 

Tai Chi in the park

Flickr, PTorrodellas

Tai Chi in the park

Scientists in Seattle, Australia and China report in The Lancet today on the leading causes of death and disability – as well as the many positive health trends – in a rapidly modernizing China.

Perhaps unsurprisingly, the study, based on Global Burden of Disease data compiled at the University of Washington’s Institute for Health Metrics and Evaluation (IHME), found that China’s rapid economic development over the past few decades has been accompanied by a decline in ‘diseases of poverty’ like malaria, vaccine-preventable infectious diseases and child malnutrition.

The world’s largest nation and new emerging superpower also has seen remarkable progress at lowering childhood and maternal mortality, along with an equally unsurprising rise in the burden of diseases and disorders familiar to wealthier countries such as heart disease, stroke and dementia. Air pollution gets special attention as well.

NPR reported As China Gets Richer, First World Diseases Take Hold, which was the primary theme of the The Lancet special report on China. Similarly, Forbes reported that China’s health problems mirror wealthy nations.

Not quite.

One surprising – and not completely understood or explained – finding out of the study is that China appears to be the undisputed world leader for certain cancers: Liver, stomach and esophageal.

I asked a policy translation specialist at IHME, Katie Leach-Kemon, to dig into this a little deeper using one of IHME’s data visualization tools known as a ’cause pattern’ analysis. Leach-Kemon compiled this graphic below showing age-standardized rates of years-of-life-lost due to different cancers around the world. Here’s a link to the active chart online. Notice my red highlights:

China Cancer GBD CompareMarked


Continue reading

A King County Yankee amid Kenya’s Electoral Count | 

Voting Kenya 1Apologies to Mark Twain, for bastardizing the title of his novel about a Connecticut engineer transported back to King Arthur’s time. But it seemed like a nice, phonetic headline for this guest column by Michael Golomb, a University of Washington student who, with his physician fiance Aliza Monroe-Wise, is in Kenya working on a variety of development & health issues. I asked Mike for his perspective on Kenya’s recent elections. More about both of them at bottom.


By Michael Golomb

As an American student temporarily living in Kenya and witness to the recent elections here, I’ve gained a unique perspective on how distinctly different a story looks depending upon how it’s covered and by whom.

Polling station in a Maasai village. Laikipia district, central Kenya
Polling station in a Maasai village. Laikipia district, central Kenya
Mike Golomb

Leading up to Kenya’s election, western media mostly ran with headlines playing up the fear of political violence while Kenyan newspapers reported on the problems, but also on the progress being made, the many peace parades and positive political dynamics.

On March 9th, Uhuru Kenyatta was announced the winner of the election by both the Kenyan government and international observers. His challenger, Raila Odinga, condemned the process as fraudulent – but also called upon his supporters to refrain from violence and said that the matter would be taken up by the Kenyan judiciary at a later date.

So far, only isolated demonstrations have occurred. There have been no widespread demonstrations or violence like what took place here in 2007 and 2008.  Odinga’s camp has made numerous public statements urging peace and denouncing violence as a roadblock to electoral justice.

In Nairobi, the day after the announcement of Uhuru’s win, one Kenyan told me, “We are just happy to move past this.  It is time for Kenyans to go back to our lives.”

Continue reading

The burden of a new global health agenda | 

Flickr, Oliver Erdmann

A massive study of death, disability and disease on Earth, coordinated out of Seattle and to be officially published in The Lancet on Friday, could do for global health something like what Galileo did for the solar system.

It’s called the Global Burden of Disease (technically, the Global Burden of Disease, Injuries and Risk Factors Study 2010) and it is, like its earlier incarnations dating back to 1990, almost guaranteed to provoke and disrupt the international community’s approach to improving global health.

The good news is that people, in general, are living longer.  The bad news is more of them seem to be fatter, still smoking too much and suffering from disabilities.

Just as the 16th century astronomer Galileo – much to the dismay of the religious orthodoxy of the time – displaced Earth from its celestial prominence in favor of the Sun, the new Global Burden of Disease may displace infectious disease from its position as the categorical center of the global health universe.

Think the top three killers in the world are scourges like AIDS, tuberculosis and malaria? Think again, of heart disease, respiratory infections and stroke.

Think preventing death is the best way to tell if we’re winning the war on disease? You better think again about that as well since rates of obesity, chronic pain, injury and mental illness may say more….

Chris Murray

“We were surprised by many of the findings,” said Chris Murray, one of the founders of the study and director of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.

“The simple purpose of this study has always been to provide the best scientific evidence on patterns of disease and disability to help us make sense of what’s happening out there and set priorities,” Murray said.

Sounds simple enough. So why did it take some 500 researchers more than five years to do it? Continue reading