SmartGlobalHealth Video: Spotlighting the NCD Problem

Global Health Weekly News Round-Up

Politics and Policies

• Texas has passed regulations on barring Planned Parenthood clinics and other “affiliates of abortion providers from participating in the state’s Medicaid program starting March 14 (Source: http://thehill.com/blogs/healthwatch/state-issues/212301-texas-defies-obama-administration-bars-abortion-providers-from-state-medicaid-program ).
• A program created to help insurance-seekers in Texas cut through the complexities of federal health care reforms is shutting down in April (Source: http://www.nytimes.com/2012/02/24/us/texas-to-shut-consumer-health-assistance-program.html?_r=1&ref=policy ).
• Medicare covers Yoga for heart disease (Source: http://www.cnn.com/2012/02/25/health/medicare-covers-yoga-heart-disease/ ).

Programs

• A national immunization campaign to eradicate polio was launched on 23^rd February in the Central African Republic (CAR) to reach all children in the country (including those who have limited access to health services) (Source: http://allafrica.com/stories/201202241273.html ).
• The Department of Health (DH) of Hong Kong has issued a warning on the slimming product (name Sheng Yuan Fang) with undeclared and banned drug ingredients (Source: http://www.moviemazaa.com/node/1068362 ).
• The Philadelphia city Health Department will begin offering free, confidential testing for human immunodeficiency syndrome virus (HIV). The free testing site will be in Tuscarawas County (Source: http://www.timesreporter.com/communities/x1618024551/Phila-to-offer-free-HIV-testing ).

 

Research

• A study published in Australian Journal of Law and Medicine has cited numerous flaws in the Kenya, South Africa and Uganda studies which claimed that male circumcision provides protection against HIV transmission (Source: http://www.newzimbabwe.com/news-7273-Circumcision%20HIV%20impact%20doubted/news.aspx ).
• A study reveals that Zelboraf, a drug to treat advanced cases of deadly shin cancer melanoma, nearly doubles length of patient’s lives (Source: http://vitals.msnbc.msn.com/_news/2012/02/22/10480484-advanced-melanoma-drug-nearly-doubles-survival-time ).
• According to a study pregnant females who get vaccinated for influenza vaccine have less likely babies with low birth weight (Source: http://www.voanews.com/english/news/health/Moms-Flu-Vaccination-Boosts-Baby-Birth-Weight-140341143.html ).
• Research demonstrates the use of antibiotics in food production can lead to the development of Methicillin resistant Staphylococcus aureus (MRSA) Strain (Source: http://www.chicagotribune.com/news/sns-201202221120usnewsusnwr201202210221staphfeb22,0,635726.story ).
• According to a research study, colonoscopy reduces the chances of colon cancer death risk (Source: http://articles.boston.com/2012-02-23/lifestyle/31087870_1_colon-cancer-colonoscopy-growths ).
• A study reveals that a chemical found in the Chilean fruit Avocado has the property to combat multi-resistant bacterial strains (Source: http://zeenews.india.com/ayurveda/avocado-can-help-combat-multi-resistant-bacterial-strains_1063.html ).
• A study published in journal Stroke has provided evidence that consuming more citrus fruits as a part of the daily fruit and vegetable intake reduces the risk of ischemic (blood clot related) stroke (Source: http://health.einnews.com/picture/9053 ).
• According to a recent study Hepatitis C kills more Americans than by the HIV/AIDS infection. According to the Centers of Disease Control and Infection (the CDC) data, published in the Annals of Internal Medicine, in 2007 more than 15,000 people died of Hepatitis C infection as compared to 12,734 deaths due to HIV-related causes (Source: http://health.einnews.com/picture/9056 ).

Diseases and Disasters

• E.coli outbreaks in Michigan linked to consumption of raw sprouts (Source: http://www.huffingtonpost.com/2012/02/25/e-coli-outbreak-linked-to_n_1300994.html ).
• About forty people died across Nigeria from the outbreak of Lassa fever in last four weeks (Source: http://allafrica.com/stories/201202220127.html ).
•  The health authorities in the Republic of Congo have warned the spread of Cholera in the northern district of Likouala (Source: http://www.trust.org/alertnet/news/congo-cholera-continues-spreading ).
• A 16^th case of the measles has been confirmed in central Indiana. According to health officials, visitors to a popular Carmel county club may have been exposed to the highly contagious virus. The outbreak has been traced to a family who was infected during a trip overseas (Source: http://www.theindychannel.com/news/30537578/detail.html ).
• According to Shaoguan city government (China), about 64 children have been diagnosed with elevated blood lead levels (Source: http://english.cri.cn/6909/2012/02/24/2724s683087.htm ).
• Four babies were identified as carrying Methicillin-resistant Staphylococcus Aureus  (MRSA) in the neonatal ward of Queen Elizabeth Hospital (QEH) of Hong Kong (Source: http://7thspace.com/headlines/406545/queen_elizabeth_hospital_mrsa_cases_and_update_on_vre.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:%207thspace%20%287thSpace%20Interactive%29 ).
• A Haiti aid group warns on cholera surge during the rainy season (Source: http://www.washingtonpost.com/world/americas/haiti-aid-group-warns-of-cholera-surge-on-eve-of-rainy-season/2012/02/24/gIQAg7bvXR_story.html ).

Get Excited: AIDS2012 Arrives in Washington, DC July 2012

From July 22 to 27, 2012, Washington, DC will host the nineteenth international AIDS conference, known as AIDS 2012. The AIDS 2012 conference theme, “Turning the Tide Together,” reflects organizers’ recognition that in 2012 the global AIDS community finds itself at a unique juncture: research advances have made it possible to envision an end to the epidemic at the precise moment when funding challenges threaten to slow progress on scientific discovery and program implementation.

The CSIS Global Health Policy Center is pleased to present a video featuring the perspectives of many of the participants in the Friends of AIDS 2012 group, as well as the insights of government officials, private sector representatives, advocates, and program implementers who have been long-time conference participants.

Global Health Weekly News Round-Up

Politics and Policies

• The Food and Drug Administration (FDA) has advised consumers not to purchase or use “Japan Weight Loss Blue”, for weight loss as it contains sibutramine which increases blood pressure and pulse in some patients. It may interact in life threatening ways with other medications (Source: http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/MedicationHealthFraud/ucm292591.htm ).
• The U.S. Environmental Protection Agency (EPA) has finalized that exposure to dioxins does not produce a significant health risk (Source: http://www.power-eng.com/articles/2012/02/epa-finalizes-dioxin-emissions-assessment.html ).
• U.S. Food and Drug Administration (FDA) officials plan to investigate whether inhalable caffeine sold in lipstick-sized canisters is safe for consumers and if its manufacturer was right to brand it as dietary supplement (Source: http://online.wsj.com/article/AP773d0f156fa74d008ded67c088784eb2.html ).
• India’s second free healthcare center for students inaugurated in the state of Tripura (Source: http://twocircles.net/2012feb19/tripura_gets_indias_second_free_healthcare_center_students.html )
• An international panel of health and flu experts assembled by the United Nations health agency have agreed for the full public press release of research showing how to create lethal mutant flu virus (Source: http://chronicle.com/article/UN-Panel-Pushes-for/130870/ ).
• Russia has blocked a U.S. plan designated to help stem the flow of drugs from Afghanistan through Central Asia in a sign of Moscow’s continued wariness about Washington’s intentions in a region often thought of as “Russia’s background” (Source: http://www.rferl.org/content/russia_reportedly_blocks_us_plan_central_asia_opium_drugs_narcotics_afghanistan/24488075.html ).

Programs

• In an effort to treat cancer patients throughout Africa and World on February 24^th, 2012, Nigeria will mark the launch of the first bone marrow registry (Source: http://ncdaction.org/profiles/blogs/nigeria-to-launch-its-first-bone-marrow-registry?xg_source=activity ).
• S.Korea to build $3.2 billion cancer center in Astana, Kazakhstan (Source: http://www.inform.kz/eng/article/2441204 ).

Research

• A study done by San Francisco VA Medical Center shows that tenofovir (anti HIV drug) used as a single pill combined with other drugs increases the risk of kidney infection in patients suffering from this deadly HIV infection (Source: http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2012/02/18/MNAS1N8SHA.DTL ).
• An ongoing study by University of Montreal, on the HIV-resistant sex workers in Africa could pave the way for effective AIDS vaccine (Source: http://www.vancouversun.com/health/Study+resistant+workers+could+lead+better+AIDS+vaccine/6146767/story.html ).
• A new animal study suggests genetic mutation might make it easier to gain pounds on high-fat diets (Source; http://health.usnews.com/health-news/news/articles/2012/02/19/gene-might-boost-risk-for-obesity ). According to a study published in the Journal Nature, defects in a protein that functions as a dietary fat sensor may be a cause of obesity and liver disease (Source: http://medicalxpress.com/news/2012-02-faulty-fat-sensor-implicated-obesity.html ).
•  Scientists at Kings College London and the National Diabetes Center (Sri Lanka) have found evidence of a high number of risk factors for type 2 diabetes among the young urban population of Sri Lanka. It has provided with evidence that the region is rapidly becoming a hotspot in the growing international diabetes epidemic (Source: http://medicalxpress.com/news/2012-02-diabetes-factors-young-sri-lankans.html ).
• In a study, records of Medicare patients with prostate cancer show that those treated with a more precise form of radiation known as proton therapy had more bowel complications, than those who underwent the conventional technique (Source: http://www.chron.com/news/houston-texas/article/Study-questions-prostate-cancer-therapy-3340528.php ).

Diseases and Disasters

• According to the report released by Save the Children Tanzania, Tackling Child Malnutrition, four out of ten children under the age of five years have stunted growth. About 17 % are severely stunted and nearly 130 children die in this country every day from malnutrition (Source: http://allafrica.com/stories/201202170198.html ).
• Bat disease expected this winter at most Western Pennsylvania sites (Source: http://www.pittsburghlive.com/x/pittsburghtrib/news/pittsburgh/s_782368.html ).
• Poison alert on chemical (pesticide called Lasso) used in South America (Source: http://www.peherald.com/news/article/4878 ).
• Vietnam is grappling with a new strain of bird flu virus that has outsmarted vaccines that was used to protect poultry flocks. Recent human deaths in Asia and Egypt indicate that the H5N1 virus is still alive (Source: http://www.huffingtonpost.com/2012/02/17/bird-flu-asia_n_1284038.html ).
• Rota virus outbreaks in North Malaysia have resulted in death of two children. About 3,000 children have been reported by the Health officials of Malaysia being ill due to this virus outbreak since late January (Source:  http://bikyamasr.com/57181/malaysia-battling-rotavirus-in-north-two-children-dead/ ).
• Brazilian Health Minister has warned that Rio de Janeiro could face the worst dengue epidemics in its history this year. He said the virus strain is prevalent but not fatal (Source: http://www.google.com/hostednews/afp/article/ALeqM5gTVdQE35p6eaB5Z6PXVHhlA5HgLg?docId=CNG.8b32ad461489ab05113fc900b5f26049.9e1 ).
• Mystery epidemic devastates Central American region (Source: http://www.msnbc.msn.com/id/46352358/ns/world_news-americas/t/mystery-epidemic-devastates-central-american-region/ ).

 

Global Health Weekly News Round-Up

Politics and Policies:

• The Public Health committee has plans to examine prescription drug shortages during a legislative oversight hearing on Beacon Hill (Source: http://www.bostonherald.com/news/regional/view/20120211public_health_committee_to_examine_prescription_drug_shortage/srvc=home&position=recent ).
• The Therapeutic Goods Administration (TGA) has issued a safety advisory for Strattera (ADHD drug- atomoxetine hydrochloride), warning about ‘clinically significant increases in heart rate and blood pressure’ (Source: http://www.perthnow.com.au/news/new-warning-on-adhd-drug/story-e6frg12c-1226268557617 ).
• Dr. Francesaca Condradie is appointed by the Southern African HIV Clinicians Society as their new president (Source: http://www.sowetanlive.co.za/goodlife/2012/02/10/new-head-for-hiv-society ).
• Shortage of primary care doctors- biggest threat to health care law (Source: http://www.washingtonpost.com/blogs/ezra-klein/post/the-health-reform-laws-biggest-threat-30000-too-few-doctors/2012/02/10/gIQALEQp4Q_blog.html ).
•  New Delhi has given its final approval to set up Integrated Vaccine Complex (IVC) at Chengalpattu, near Chennai to ensure vaccine security in India (Source: http://expressbuzz.com/topnews/tn-vaccine-complex-gets-central-nod/362303.html ).
• A major reform of the US health insurance system – in birth control, has created uproar (Source: http://news.monstersandcritics.com/health/news/article_1690468.php/ANALYSIS-Birth-control-uproar-echoes-fracture-over-US-health-care ).
• The Crossville City Council (Tennessee) unanimously has approved the third and final reading of two ordinances designated to police- the sale and consumption of synthetic marijuana, bath salts and other synthetic materials within the city of Crossville (Source: http://crossville-chronicle.com/local/x741512153/Synthetic-drugs-ordinance-now-in-effect ).

Programs:

• Jewish Healthcare International (JHI) has send healthcare missions to Haiti and Ethiopia as a part of their mission to improve healthcare services in at-risk communities worldwide (Source: http://www.prnewswire.com/news-releases/jewish-healthcare-international-jhi-sends-healthcare-missions-to-haiti-and-ethiopia-138949059.html ).
• The United Nations, International and human rights organizations are appealing for legislation to halt the practice of Female Genetic Mutilation on the Ninth International Day of Zero Tolerance. It involves partial or total removal of external genetalia in women and girls (Source: http://www.voanews.com/english/news/health/Health-Rights-Groups-Demand-Anti-FGM-Laws-138782694.html ).
• The United States controlled Global Fund has recently announced termination of its funding to the underfunded Zimbabwe’s health sector (Source: http://allafrica.com/stories/201202061234.html ).

Research:

• The researchers at the University of Melbourne, Royal Melbourne Hospital, Australia and the Brigham and Women’s hospital, Harvard Medical School, US together has discovered treatment to slow the progression of Chronic Obstructive Pulmonary Disease (COPD) (Source: http://ecancer.org/news/2420 ).
• Researchers from Singapore have developed a small crab like robot to get remove early stomach cancer (Source: http://www.theatlantic.com/health/archive/2012/02/the-tiny-crab-like-robot-able-to-remove-early-stomach-cancers/252543/ ).
• Researchers in Australia have found a possible link between drinking soda and lung disease and asthma (Source: http://www.cfnews13.com/article/news/2012/february/380845/Health-Headlines:-Soda-could-increase-lung-disease-risk ).
• The genetics of Y chromosome can contribute to heart risk for men.  Man can inherit heart disease from father (Source: http://www.littlehamptongazette.co.uk/news/health/1_in_5_men_has_heart_risk_gene_1_3507600 ).
• A research study published in JAMA, shows a smaller amount of nourishment in  acute lung disease patients results in no improvement in infectious complications than those receiving full caloric nourishment (Source: http://www.medicalnewstoday.com/articles/241422.php ).
• A research study published in Diabetes Care reveals that in patients with type 1 diabetes, by their late adolescence and early adulthood, the brain volume and T2 relaxation time declines as compared with similarly aged healthy peers (Source: http://www.veridianbh.com/poc/view_doc.php?type=news&id=144059&cn=21 ).
• A research study shows that exposing children to cigarette smoke can lead to acute lymphoblastic leukemia (ALL) in them (Source: http://www.khaleejtimes.com/Displayarticle09.asp?section=health&xfile=data/health/2012/February/health_February29.xml ).
• In a recently published literature review the authors have found an association between the phosphates in fast food and health risks (Source: http://www.newstrackindia.com/newsdetails/2012/02/11/267408-Phosphate-additives-used-in-fast-food-pose-risk-to-health-.html ).

Diseases and Disasters:

• Zimbabwe courts are shut down due to fear of typhoid outbreaks (Source: http://www.reuters.com/article/2012/02/11/zimbabwe-typhoid-idUSL5E8DB0B020120211 ).
• Zimbabwe is reported to be treated about 50 cases of typhoid per day (Source: http://allnewsghana.com/more-news/africa/24370-zimbabwe-treats-more-than-1500-typhoid-cases.html ).
• Africa recorded 347 cases of wild poliomyelitis in the year 2011 (Source: http://www.afriquejet.com/health-africa-recorded-347-cases-of-wild-poliomyelitis-in-2011-2012021133151.html ).
• Research is still going to find the cause of the sporadically occurring Nodding Disease which has claimed hundreds of lives in some parts of Africa  (Source: http://allafrica.com/stories/201202110014.html ).
• Nine people reported to be positive for monkey disease (Kyasanur Forest Disease) in India. This disease is caused by Kyasanur forest disease virus (KFDV), a member of the virus family Flaviviridae (same facility to which the dengue virus and yellow fever virus belong to) (Source: http://www.examiner.com/infectious-disease-in-national/nine-people-test-positive-for-monkey-disease-india ).

Upcoming conferences: New Frontiers in Global Health Leadership Conference and World Health Care Networks (WHCN) Conference

NEW FRONTIERS IN GLOBAL HEALTH LEADERSHIP: Building Strong Health Systems to Respond to Non-Communicable Diseases
INAUGURAL FORUM

Register Online at: http://ghi.arizona.edu/reg_elp

Partners:  The Global Health Institute at Mel & Enid Zuckerman College of Public Health University of Arizona, Tohono O’odham Dept of Health & Human Resources, the US-México Border Health Commission and the Arizona Public Health Training Center

Where: Tohono O’odham Nation and The University of Arizona Health Sciences Center, Tucson
When: March 28 – April 1, 2012
What: This 5-day Forum features presentations by global experts and global and local case studies of working models in NCDs prevention and health systems strengthening, including; quality assurance, health work force development, integration and health information systems & referral.  Delegates will apply the local and global best practices & evidence during facilitated small group discussions. Site visits show-casing NCD prevention & care models will take place each day. Transportation will be provided. A professional training toolkit with all instructional content will be disseminated following the Forum.
Who: Public health policy makers, program managers, community health clinic coordinators, health systems managers, work force development specialists, community health workers & leaders

Speakers: Richard H. Carmona, M.D., M.P.H., FACS, 17th Surgeon General of the United States and Distinguished Professor, University of Arizona, Richard Smith, Director, UnitedHealth Group & former editor British Medical Journal, Gene Bukhman, MD, PhD Harvard Medical School, Director, Program in Global Non-Communicable Disease and Social Change & Partners In Health, Catalina Denman Champion, PhD, former President, El Colegio de Sonora, James Hopkins, LL.M./ITP, UA College of Law, Neeraj Kak, PhD, URC – University Research Co., LLC, Francisco Garcia, MD, MPH, Director, University of Arizona’s National Center of Excellent in Women’s Health, Susan Kunz, MPH Mariposa Community Health Center, Martha Moore-Monroy, MA Pima County REACH, and the Tohono O’odham Nation Leadership.

Special Attractions: Located 70 miles from the U.S.-Mexico border, surrounded by Native American lands, and hosting the largest proportion of Peace Corps graduates; Tucson, The University of Arizona & Tohono O’odham Nation provide an appropriate site for the study of global & local, as well as understanding the role of culture and community in integrated prevention and health systems. Delegates will be welcomed at the Tohono O’odham Nation Cultural Center & Museum at the foot of the sacred Baboquivari Peak near the U.S.-Mexico border.

Early Registration Rate of $400 extended until February 29, 2012. Registration includes lunches, receptions, transportation to TO Nation and site visits. Rate increases by $50 thereafter and ends March 15, 2012. (Please contact KAHeckert, PhD, Forum Chair about limited partial scholarships at kheckert@email.arizona.edu.)

CONTACT US: Global Health Institute & Health Promotion Sciences Division,
Mel and Enid Zuckerman College of Public Health, The University of Arizona
(+1) (520) 626-3877
kheckert@email.arizona.edu

FOR MORE INFORMATION:
Mel and Enid Zuckerman College of Public Health, www.publichealth.arizona.edu
Tohono O’odham Nation (www.tonation-nsn.gov) and the Tucson Convention & Visitors Bureau (http://www.visittucson.org/

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ABOUT THE WHCN CONFERENCE:

The Australian General Practice Network (AGPN) is hosting the second biennial World Health Care Networks (WHCN) Conference in 2012. WHCN was founded by the AGPN and General Practice New Zealand (GPNZ) in 2010 in recognition of the role that clinically–led and organised general practice and primary health care plays in health planning, resource allocation and health system development more broadly.

The 2012 Conference will explore how health care networks are forming and maturing and, more importantly, the integrative and coordinating roles and functions they fulfill in creating a well-developed primary health care system.

WHCN 2012 fuses health and social care policy, research, program implementation and service development to explore the value of networks at the micro, ‘meso’ and macro levels. The Conference will examine the capacity of networks in improving health service delivery and outcomes; attracting health system managers, researchers, policy makers and clinical and community leaders from around the world.

Keynote speakers include:

• Professor Jan De Maeseneer (Belgium)
• Dr Brian Evoy (Canada)
• Professor Helen Keleher (Australia)
• Dr Judith Smith (UK)
• Professor Philip Davies (Australia)
• Dr Jason Cheah (Singapore)
• Dr Johnny Marshall (UK)
• Ms Fiona Thomson (New Zealand)
• Dr Emil Djakic (Australia)
• Dr Bev O’Keefe (New Zealand)
• Mr Mark Boutros (US)

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Rave Review of “Rights-Based Approaches to Public Health,” by our own Dr. Elvira Beracochea

Congratulations, Dr. Beracochea! A glowing review of her new book, Rights-Based Approaches to Public Health, was recently published in PsycCritiques, a collection of reviews from the American Psychological Association. I have posted the review below. This is a wonderful accomplishment for Dr. Beracochea and her fellow editors and authors of this book. The IH section is fortunate to have you!

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Public Health and Human Rights: Realigning Approaches to Improve Global Health Problems

Reviewed by
Will Ross

At a time of heart-crushing stories of human deprivation due to regional conflict, forces of nature, or uncaring and at times immoral state policies, the world’s attention turns to the public health community for problem assessment and effective deployment of resources and programs to stabilize critical conditions on the ground. With great timing, the editors of Rights-Based Approaches to Public Health offer a targeted and innovative strategy to
combat global health problems. Balanced, comprehensive, and steeped in the historical traditions of human rights, the book persuasively moves the reader from abstract conceptions of inalienable human rights to evidence-based, pragmatic solutions that highlight the systematic integration of human rights principles in human development work.

For the audience of public health students, seasoned and novice public health
professionals, health care practitioners, and policy experts, the editors provide an overview of a rights-based approach that is elegant in simplicity and highly executable in design, referencing the UN’s (2000) General Comment 14 on the Right to the Highest Attainable Standard of Physical and Mental Health: “Every human being is entitled to the enjoyment of the highest attainable standard of health conducive to living a life of dignity” (para. 1).

The editors and authors present a framework for a rights-based approach that is
normatively based on international human rights standards and that cannot be easily dismissed as political in nature or hegemonic. Most important, the editors charge some of the world’s most respected public health practitioners and human rights advocates to craft sensible methods of operationalizing the basic human rights principles outlined in the UN’s (2003) Human Rights-Based Approach: Statement of Common Understanding, which posits that human rights are universal, inalienable, interdependent, and interrelated. In essence,
they have created a veritable “how-to” guide that, when implemented, can in sustainable fashion uplift the human condition worldwide.

Universality of Rights-Based Approaches: Uniting Us All?

As detailed by the editors, a cardinal feature of a rights-based approach is its timelessness and universality, increasing its appeal to professionals who labor to keep the plight of marginalized communities on the global radar screen. By using the universal language of rights-based approaches, public health professionals may be better positioned to leverage greater social and political capital and enhanced resource allocation for their cause. Striking examples of rights-based approaches in diverse settings are outlined in the book, from demands for water rights in Haiti to conflict-affected settings such as the Gaza Strip and advocacy of children’s rights in Kosovo.

If the dramatic contemporary examples outlined in the book are not sufficient, the authors could easily extend the discussion further and call attention to the severe drought and attendant famine in Somalia, where the UN’s Food Security and Nutrition Analysis Unit (2011) found that nearly 250,000 people continue to face imminent starvation, or the Democratic Republic of the Congo, where U.S. researchers note that more than 400,000 women are raped each year (Peterman, Palermo, & Bredenkamp, 2011). In all instances a rights-based approach can reverse the erosion of socioeconomic stability that fosters such
injustices while holding the state accountable for protecting and fulfilling the rights of individuals in affected communities.

Inherent in a rights-based approach claim that individuals have the right to the highest attainable standard of health is the realization that health professionals cannot disentangle physical health from the myriad social and economic factors that influence health. If a rights-based approach empowers rights holders in asserting that human rights are universal and inalienable, then it is the incumbent responsibility of the duty bearer—entities sanctioned to protect society—to ensure the fulfillment of those rights. This conceptual framework is in contradistinction to traditional needs-based approaches, whose altruistic intent and actions may be perceived as both patronizing and lacking in accountability, and thus not amenable to legal redress in the event of adverse outcomes.

Marrying Rights-Based Approaches to Health Care Reform

A critical chapter for U.S. readers (Chapter 4) is “A Rights-Based Approach to Health Care Reform.” In the United States, profligate health care spending has not translated into improved health outcomes when compared with those of other developed countries. A fundamental, if not fatal, flaw in the U.S. health care delivery system is the disconnect between the high-quality acute, specialty care available to some who have the ability to pay in a system rooted in free enterprise and the haphazard primary and preventive care that is unevenly distributed across locales. Although unintended, this result is not unexpected in a country that has failed to embrace a full definition of health.

The divide on the proper role of government in health care in the United States was presaged in the response to the World Health Organization’s (1946) definition of health, promulgated in the 1948 UN convention:

a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity. . . . Governments have a responsibility for the health of their peoples which can be fulfilled only by the provision of adequate health and social measures. (p. 2)

This provision was rebuffed on the grounds that it was outwardly socialistic in intent and lacked legal standing, on the basis of the interpretation that health care was not among the enumerated rights in the U.S. Constitution.

The perennial argument surrounding the government’s role in health care has since devolved into rants about market-based reforms as opposed to moral-based claims of health care as a right for every citizen. Such a false dichotomy only promotes greater social division; consensus will be gained when every country affirms the connection between health and human rights. A rights-based approach to health, which has been relatively absent from the contemporary discourse on health reform, could effectively realign staunch political forces around the unassailable conceptual framework of health as a public good rather than a commodity.

The rights-based approach permits a more nuanced view of the roots of health
inequities; consequently, more systematic steps can be taken to ameliorate inequities since a framework exists that addresses the social determinants of health. Rights-Based Approaches to Public Health outlines several international treaties, such as the 1977 International Covenant on Economic, Social, and Cultural Rights, which would reduce stillbirth rates and infant mortality by paving the way for special protection for mothers in the childbirth period. Although the United States signed the treaty, it did not ratify it and so failed to allocate the requisite resources to enforce the treaty.

Hopefully there will be greater U.S. embrace of the UN’s Millennium Development Goals—explicit milestones for the realization of global human development that offer an opportunity to reduce health inequities by spurring economic development. The United States, in its effort to reduce health inequities as outlined in the Centers for Disease Control and Prevention’s (2011) “Health Disparities and Inequalities Report,” will find willing partners in realizing two seminal Millennium Development Goals: reducing child mortality
and improving maternal health.

Limitations of Rights-Based Approaches

The authors and editors of Rights-Based Approaches to Public Health rightfully
acknowledge that the still-nascent field of rights-based public health has limitations that have constrained its widespread adoption. Rights-based approaches rest on the belief that individual empowerment and restored human dignity can be ensured through programmatic efforts that address the social determinants of health. Social determinants of health, as espoused by the World Health Organization’s Commission on Social Determinants of Health (2008, p. 2 of Executive Summary), are “the conditions in which people are born, grow, live, work and age . . . . In their turn, poor and unequal living conditions are the consequence of poor social policies and programmes, unfair economic arrangements, and bad politics.”

Criticism abounds that such an approach is too costly, time intensive, and inherently difficult to measure since it involves restructuring the social fabric of disadvantaged communities and raises the potential for conflicts due to encroachment on national sovereignty. There is correspondingly a lack of solid evidence supporting the effectiveness of rights-based approaches. Finally, a rights-based approach in public health can come across as canonical, even prescriptive in its assertion that individual rights warrant the same protection as societal ones (Berman, 2008).

The book concludes, in powerful tones, that rights-based approaches provide public health professionals the framework and the infrastructure to address the needs of vulnerable populations and society at large. Public health students, academicians, and both medical and public health practitioners should feel empowered to act with this transformative approach that asserts the dignity of humankind.

References
Berman, G. (2008). Undertaking a human rights-based approach: Lessons for policy, planning, and programming. Bangkok, Thailand: UNESCO Asia and Pacific Regional Bureau for Education.

Centers for Disease Control and Prevention. (2011, January 14). CDC health disparities and inequalities report—United States, 2011. MMWR: Morbidity and Mortality Weekly Report, 60(Suppl).

Peterman, A., Palermo, T., & Bredenkamp, C. (2011). Estimates and determinants of sexual violence against women in the Democratic Republic of Congo. American Journal of Public Health, 101, 1060–1067. doi:10.2105/AJPH.2010.300070

United Nations. (2000). The right to the highest attainable standard of health. Retrieved from http://www.unhchr.ch/tbs/doc.nsf/(symbol)/E.C.12.2000.4.En

United Nations. (2003). Human rights-based approach: Statement of common
understanding. Retrieved from http://www.unicef.org/sowc04/files/AnnexB.pdf

United Nations Food Security and Nutrition Analysis Unit. (2011, November 18). Famine continues: Observed improvements contingent on continued response. Retrieved from http://www.fsnau.org/in-focus/famine-continues-observed-improvements-contingentcontinued-response

World Health Organization. (1946). Constitution of the World Health Organization. Geneva, Switzerland: Author.

World Health Organization Commission on Social Determinants of Health. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health. Geneva, Switzerland: World Health Organization.

Save the Children video: Felix from Guatemala – Save the Children Introduces Health Worker

Felix, a local health worker in Guatemala, helps deliver life-saving care to children who need it the most. Save the Children and the Ad Council are working together to mobilize citizen action in the U.S. to help local health workers help save more children worldwide.

Noncommunicable Disease conference – March 2012

APHA members may be interested in an upcoming conference concerning Non Communicable Diseases (NCDs) in Children and Adolescents in Global Health.  The conference is being organized by a consortium known as NCD Child, which includes Caring and Living and Neighbors, the Public Health Institute, and the Global Health Council.  It will take place in Oakland, California during March 19-21, at the California Endowment’s conference center.  Themes to be covered include prevention, access to essential medicines, and health systems strengthening/work force development for NCDs in these vulnerable groups.  Individuals working in the field of NCDs, maternal and child health, social determinants of health, prevention as well as those advocating on behalf of these issues, are warmly welcome to apply.  A limited number of scholarships for students and individuals from outside the United States is available.

A draft program and application is here: www.ncdchild.com

This link also contains a call for abstracts, which closes on February 6.

Questions about this conference may be directed to APHA International Section member Jeff Meer of the Public Health Institute, at jmeer@phi.org.