Wednesday, May 28, 2014

Global Health Careers - Resources

Hi Everyone,
 
Some folks have asked for information on global health career opportunities.   Shoe leather, networking, serendipity, and timing have all been mentioned as factors to success, as we heard from many of our lecturers this semester.  So, to bolster your prospects, I offer below over 20 resources you may wish to consider. These are wide ranging, both here in the US and aboard.

Recall from Jen's lecture where the money for global health is located:  the US government, non-governmental organizations, philanthropies, and private business, not necessarily in that order, save for the US being the largest contribution to global health programs worldwide.  So, in some respects one should follow the money.  In others, follow your heart.  Hopefully, the two will become one in landing that perfect global health career for you.

Good luck!   Jim

20+ Resources for Global Health Careers
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Thursday, May 22, 2014

Call 911, 991, 112! Distracted Driving, Seatbelts, Airbags, and ER Care - Trauma and Injuries

"Drifting" was officially outlawed in Saudi Arabia in 2005 but still continues
Hello Everyone,

As we heard from Amber's lecture this week, trauma and injuries account for about 10% of all reported mortality in the world, with road traffic crashes being the leading cause of death for individuals between the ages of 15 and 29 years.   According to the CDC, every year about 1.3 million people in the world are killed in motor vehicle crashes and 20–50 million more are seriously injured.  By 2020, motor vehicle crashes are expected to become the third most serious threat to human health in the world. 



According to the WHO 2013 Global Road Safety Report, "92% of road traffic deaths occur in low- and middle-income countries, yet these countries have only 53% of the world’s registered vehicles.  Only 28 countries, covering 7% of the world’s population, have comprehensive road safety laws on five key risk factors: drinking and driving, speeding, and failing to use motorcycle helmets, seat-belts, and child restraints."  In the U.S., thanks to consumer advocate Ralph Nader, who published "Unsafe At Any Speed" in 1965, which described the health hazards of automobiles, safety modifications such as seat belts, airbags, and other designs, are now standard in all cars and have proven to be highly effective in reducing occupant serious injuries and fatalities.  Although, it should be noted that the U.S. auto manufacturers for 10 years resisted installing these safety devices, when faced with a mandate from the National Highway Traffic Safety Administration (NHTSA), stating customers did not want them, they would be ineffective, and, most importantly, these features would be costly to the customer.  

Regarding drink driving, evidence-based research indicates that someone’s ability to drive is affected if they have any alcohol in their blood. Drivers with a blood alcohol content (BAC) of between 0.02 and 0.05 have at least a three times greater risk of dying in a vehicle crash. This risk increases to at least six times with a BAC between 0.05 and 0.08, and to 11 times with a BAC between 0.08 and 0.10, according to the Centre for Public Health Excellence. Further, enforcement of administrative penalties, such as license suspension, jail time, and vehicle confiscation, are effective deterrents to drink driving behavior and reduce alcohol-related road traffic injuries and fatalities.


The exponential increase in mobile communication devices has led to increased rates of distracted driving.  Americans ages 18­­–64 read or sent more texts or emails while driving than their European counterparts.   While emergency services in the U.S. are exceptional and an injured person can be treated within the golden hour, when life saving efforts are essential to survival, most people around the globe have little or no access to trauma care.  For example, although 111 countries have a universal national access emergency number, only 59 countries have ambulance services available to transport over 75% of injured patients to a hospital.  Thus, there is much to be done in making emergency services universally available.

We watched four film clips related to trauma and injuries after Amber's lecture:
And I've also included some interesting evidence-based research literature on this topic:
Driving in the Andes


Buckle up, wear a helmet if you cycle ("look Ma no hands!") and DON'T TEXT OR TALK ON YOUR CELL PHONE WHILE DRIVING!


Take care,

Jim


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Thursday, May 1, 2014

Neglected Tropical Diseases and Corporate Social Responsibility

Hello Everyone,

Child leading two individuals blinded
by the parasite that causes river blindness
During the discussion with Eric regarding neglected tropical diseases, the question was asked why have the pharmaceutical manufacturers, e.g., Merck, Pfizer, GSK, DuPont Chemicals, etc., decided to donate medications and filter cloth (DuPont) to treat dracunculiasis, lymphatic filarisis, onchocerciasis, and schistosomiasis.  Was this decision simple altruism, smart marketing, good for shareholders, or a combination thereof?

Treponema spirochete (bacterium) that causes Yaws
These review articles in Nature and American Scientist suggest that serendipity, not uncommon in scientific discovery, played a major role in moving ivermectin off the veterinarian's shelf and into the treatment regimens to fight river blindness (onchocerciasis) and, later, lymphatic filariasis. 

Management guru Peter Drucker, as early as the 1950s, believed that corporations, in addition to making a profit, also had responsibilities to society, i.e., "corporate social responsibility."  So the idea is not new, but in public health it is only during the past 20 years that CSR has been so vividly illustrated in the free provision of medicines by several pharma companies to treat the above NTDs.

Guinea-worm is slowly rolled on match stick
And this has been good public relations for these companies - a humantarian story about helping the poor in Africa who are afflicted by these terribly debilitating diseases - it is appealing to an often cynical public. But is also good for business, as CSR is becoming more integrated into the business model, as described here and in the business magazine Forbes.

DuPont-designed and donated millions of yards
of cloth to filter Cyclops copepod (water flea) that
hosts the Guinea-worm parasite
Should CSR matter to those of us working in public health?  Yes.  Without the donation of medicines and materials,  these NTD afflicted populations would not otherwise have access to effective treatments.  There is no compelling economic business model for pharma to invest resources in these NTD afflicted regions, expect for CSR.

Aedes aegypti mosquito that transmits the Dengue virus
However, it is also necessary to have watch dog groups like Greenpeace, Public Citizen, and PR Watch, "look the gift horse in the mouth" just to be sure no Trojan soldiers are within, even in the case of CSR. 

Finally, here are the links to the documentary film clips we viewed after Eric's lecture.

Dracunculiasis clip 1 (7 min) and clip 2 (new) (guinea-worm disease) (3 min)
Schistosomiasis (snail fever) 4 min 
Yaws 4 min
Dengue fever 2 min  
Human African Trypanosomiasis 6 min

Qs for thought:  What is the profile of groups/organizations that are committed to combating NTDs?  Of the above NTDs, for which one is transmission of the infectious agent likely to be interrupted in our lifetime?  Is this a realistic possibility for the other above NTDs?  What are the implementation science questions one should consider in controlling and preventing NTDs?

Take care,

Jim

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