Can you spare 50 Cents for Global Health?

Want to know what 50 cents can buy? Watch the video in full, read the press release below (announcement to be made today at Davos) and check out http://www.just50cents.org/:

I will link to the full press release when it’s up, in the meantime here is the intro:

Global Network for Neglected Tropical Diseases Receives $34 Million Gates Foundation Investment to Scale up Prevention and Treatment Efforts

New “End the Neglect 2020” Campaign Aims to Greatly Reduce the Burden of NTDs Davos, Switzerland, January 30, 2009 –

“The Global Network for Neglected Tropical Diseases today announced that it has received $34 million through a grant from the Bill & Melinda Gates Foundation to the Sabin Vaccine Institute to step up the global effort to prevent and treat neglected tropical diseases (NTDs). These debilitating and sometimes deadly diseases affect 1.4 billion people worldwide who live on less than $1.25 a day. With the new grant, the Global Network is launching a campaign to catalyze additional funding and will establish a global alliance to scale up NTD treatment and prevention efforts. ”

Controlling NTDs is considered a “best buy” in public health because of the availability of extremely low-cost interventions and the resulting high return on investment. For approximately 50 cents per person per year, the seven most common NTDs – which together represent 90% of the global NTD burden – can be effectively treated. ”

Designing for Better Health Competition

Ashoka’s Changemakers along with RWJF is sponsoring a very cool competition – “Nudges” – read below for details and please pass along (thanks to Roberto for sending). The competition was named after Cass Suntein’s book Nudge, Cass has been asked to join the Obama administration. In addition to checking out the competition link below, see the RWJF Pioneer Blog which I follow. The “Nudge” competition is about the little reminders, notifications, and encouragements towards action. With health, behavior change is one of the hardest things to impact and we haven’t been very good about designing or focusing on subtle pushes which are fundamentally critical to health care.  While I could name quite a few innovative ideas we have covered on this blog, one that comes instantly to mind is the teachAIDS animation created by Piya Sorcar (it’s got technology, education and behavioral impact components). I am looking forward to seeing what innovations this competition yields.

Designing for Better Health Competition
Ashoka’s Changemakers is collaborating with the Pioneer Portfolio of the Robert Wood Johnson Foundation to launch a global search for “nudges” – innovative little pushes – that help people make better decisions regarding their own health and the health of others.

We are inspired by people and organizations like the Destiny Health Plan that provides “vitality bucks,” an alternative currency that allows people to earn travel and shopping rewards every time they make healthy choices. Another motivating example is CARES, an anti-smoking and savings program in the Philippines that offers smokers the option to invest the money they would normally spend on cigarettes into a savings account. “Designing for Better Health” is investing in the most valuable of all resources – people themselves. Here are the many ways in which you can participate:

Do you know innovators who work to help people make choices that improve their health? By nominating them, you will provide them the opportunity to promote their projects on a global platform and get connected with potential funding.

Visit http://www.changemakers.net/designingforbetterhealth

Simple innovations: surgical safety checklist (+link drop)

Cross posted from Design Research for Health

My ongoing work in Mongolia is focused on how incremental changes – e.g. to forms, protocols, resource allocation – can have significant impacts on improved health, so I read with interest this morning the results of a study examining the impact of a 19-item surgical safety checklist on patient outcomes.  The study – which involved hospitals in Toronto, New Delhi, Amman, Auckland, Manila, Ifakara (Tanzania), London, and Seattle – found that the death rate was nearly halved (1.5% to 0.8%) and that inpatient complications were down more than one-third (11.0% to 7.0%).

Regarding feasibility, the authors – who include Atul Gawande of Complications fame – wrote (link to NEJM article online):

Implementation proved neither costly nor lengthy. All sites were able to introduce the checklist over a period of 1 week to 1 month. Only two of the safety measures in the checklist entail the commitment of significant resources: use of pulse oximetry and use of prophylactic antibiotics. Both were available at all the sites, including the low-income sites, before the intervention, although their use was inconsistent.

A few other links I’ve been meaning to post:

• Whopper Virgins. An attempt by Burger King to show the ability of the Whopper to bridge cultures.  They conducted Big Mac vs. Whopper taste tests with Transylvanians from Romania, Inuit from Greenland, and Hmong from Thailand.  More from WSJ and The Guardian. I’ll give the folks behind this project a pass on the carbon irresponsibility of airlifting a BK grill all over the planet.  I’ll give them a pass on offering up one of our most dangerous exports to people who don’t seem to have as much of a problem with obesity-related disease as we do.  But I can’t ignore the rest.  The commentary, cinematography, editing, and music in this 7 minute film portray these test subjects as animals … or at best “primitive tribesmen”.  Watch and make your own judgement.

• HCD Toolkit from IDEO. Copying and pasting my own thoughts on this from a listserv discussion some weeks back, in response to a colleague who was curious about the utility of such a toolkit: “The symposium hosted by Rockefeller and IDEO in the spring (see the links at the top of page — sent) was focused on the role of design firms in development. This toolkit is quite different.  I don’t really expect it to be used by design firms, since they’ve each got their own set of approaches, but by other groups working in community development – NGOs, social enterprises, applied research initiatives, and the like.  To that end, it can be quite useful as a tool, but of course only if people actually use it.  Just as important it’s a signal that we need to build more human-centered design capacity in development-oriented organizations.  It’s easy to be critical of something like this, especially when the product looks so simple, but if it benefits those that use it, then it has clearly achieved some value.”

• Designed with you in mind. Ziploc’s new (?) slogan.  I just started watching TV again recently. Next up: making sure people in global health start thinking this way.

389 Years Ago…

Click for the bigger picture:

Pharmaceutical Waste Dumped at Record Levels

We are generally focused on solutions and here, but I couldn’t help but post this news story on pharmaceutical “waste” being dumped into the water supply in India and what the subsequent impact might be (drug resistance, unknown clinical damage to those who consume the water, environmental destruction):

World’s highest drug levels entering India stream
AP News, Jan 25 (see full story here or here)

PATANCHERU, India –When researchers analyzed vials of treated wastewater taken from a plant where about 90 Indian drug factories dump their residues, they were shocked. Enough of a single, powerful antibiotic was being spewed into one stream each day to treat every person in a city of 90,000.

And it wasn’t just ciprofloxacin being detected. The supposedly cleaned water was a floating medicine cabinet — a soup of 21 different active pharmaceutical ingredients, used in generics for treatment of hypertension, heart disease, chronic liver ailments, depression, gonorrhea, ulcers and other ailments.

Those Indian factories produce drugs for much of the world, including many Americans. The result: Some of India’s poor are unwittingly consuming an array of chemicals that may be harmful, and could lead to the proliferation of drug-resistant bacteria.

In India, villagers near this treatment plant have a long history of fighting pollution from various industries and allege their air, water and crops have been poisoned for decades by factories making everything from tires to paints and textiles. Some lakes brim with filmy, acrid water that burns the nostrils when inhaled and causes the eyes to tear… “I’m frustrated. We have told them so many times about this problem, but nobody does anything,” said Syed Bashir Ahmed, 80, casting a makeshift fishing pole while crouched in tall grass along the river bank near the bulk drug factories. “The poor are helpless. What can we do?”

Obama’s Organic Farm?

DC is going through the post-election post-inaugural blues. Now the real work begins and there is plenty of buzz around all sorts of issues. One that is receiving some attention is a push to influence food policy. The guys over at WhoFarm.org (White House Organic) have been traveling across the country in an organic farm bus to show that you can do this anywhere. Additionally, leading celebrity chefs are pushing the issue as well. Did you know that the White House did have its own garden before? The Victory Garden planted by Eleanor Roosevelt inspired the rest of the country, so don’t doubt the impact this could have if Obama ripped up the White House lawn. Check out the below video and if you are inspired sign the petition below the video:

Other Sources:
– San Francisco City Hall already has their own Victory Garden, Link
– American Victory Garden, Past and Present, worth checking out, Link
– A lengthy post over at BlogHer debating the issue, Link

Health for All Blue Diamond Ball scheduled to celebrate Obama’s Inauguration

UPDATE: Dr. Paul Farmer, Dr. Jim Kim, jazz singer and UN Goodwill Ambassador Dee Dee Bridgewater are confirmed to be in attendance. That is quite a lineup.

This is a requested post (the info was sent to me to post). For those who are looking for more events during the blockbuster inauguration weekend/week and for those with some serious cash (serious at least for my blood), this certainly will be an interesting event:

HEALTH FOR ALL BALL
WASHINGTON, DC January 9, 2009 – Event Emissary, a DC-based event planning company, and The Vineeta Foundation, a health and human rights organization, announced today that  in celebration of Barack Obama’s Inauguration, the Health for All Blue Diamond Ball will be held January 20, 2009 at the Smithsonian Institution’s Natural History Museum, home of the Hope Diamond.  American and international health-makers will gather to refocus attention on health as a human right as specified in the 60-year old United Nation’s Universal Declaration of Human Rights.

Today in the United States, 45 million people don’t have medical insurance.  Around the world, billions are deprived of the basic human right to health. In December, Moveon.org asked its three-million members “What is the most important issue for the nation?” The survey concluded that Universal healthcare was the number one choice ahead of the war in Iraq and the economy.

The presidency of Barack Obama is a historic opportunity for reforming the health care system in the United States and strengthening support for health worldwide.  The Health for All Blue Diamond Ball supports Obama’s vision of change and will secure a prominent place for health on the presidential and legislative agenda by gathering powerful constituencies that passionately believe that health care is a human right.

Songwriter’s Hall of Fame inductee Jackson Browne and GRAMMY-winner Graham Nash—both also members of the Rock and Roll Hall of Fame—will headline the event. In addition to their enduring legacies as two of the most literate and respected singer-songwriters in contemporary music, Browne and Nash are both known for the social, environmental and political activism they have championed for almost four decades. In 1979, they collaborated on organizing an all-star series of concerts for MUSE (Musicians United for Safe Energy); in 2004, they both participated in the Vote For Change tour. With the Health For All Blue Diamond Ball, they continue their tradition of raising their voices in support of people across the United States and around the world.

Radia Daoussi, President of The Vineeta Foundation, explains, “A true transformation of the health care system in the United States has never been such an urgent priority.  The presidency of Barack Obama offers an historic opportunity for reforming the health care system in the United States and strengthening support for health worldwide”.

Daoussi continued, “In addition to fabulous entertainment, our program will feature many speakers committed to health for all such as: US Congressman John Conyers, Michel Sidibe Executive Director of UNAIDS, Dr. Anthony Fauci, Director NIAID, NIH; Helene Gayle, President of CARE, Georges Benjamin, Executive Director of the American Public Health Association (APHA), Donna Smith, Community Organizer, California Nurses Association; Dr. Oliver Fein, President, Physicians for a National Health Program, Dean Mike Klag of the Johns  Hopkins School of Public Health, and Dr. Renee Jenkins Immediate Past President American Association of Pediatricians will address ballgoers.”

The Health for All Blue Diamond Ball (www.bluediamondinauguralball.com)

Contact:
Jenna Mack, Event Emissary
202-369-5695
jmack@eventemissary.com

Public Health Needs a Rockstar: Paging Dr. Gupta for Surgeon General

As you may have heard by now, Obama might be seriously considering Sanjay Gupta of CNN to be the US Surgeon General. Two good friends had an initially negative reaction to this – “but he is just another TV anchor!”. Well Gupta is much more than that. In addition to his proflic duties as a medical correspondent for CNN where has done in-depth assignments on Iraq and Katrina, he practices surgery on a weekly basis, is the associate chief of neurosurgery at a major university, has traveled the country and the world witnessing first hand major health issues giving him a global sensibility. Also along with his government experience ( as a White House fellow), he knows how to reach mass audiences and will be a media savvy.  Clearly he can handle high pressure situations and his celebrity is a huge plus (how many people can remember the name of the last or current surgeon general or know of any significant issues they have tackled?).

For better or worse we are already far down the path of celebrity endorsed causes (what impact this has, I really don’t know, but it certainly commands some attention in a world with lots of noise and information overload). We have Bono, Bill Gates, and Bill Clinton – all rockstars for global health. Even NextBillion is advocating for rockstars in public health, which I do agree with. Sanjay Gupta is extremely smart and talented and can be a celebrity for public health on a national scale. And actually much more than a rockstar, public health in this country and globally needs an ambassador, a champion and an activist. This pick is good for both domestic and global health, and the two have never been so intertwined (not just with the migration of infectious diseases across borders but also with the explosion in chronic disease (and see here Jan 2009)  in developing countries and issues like brain drain). You would have someone who has appeal beyond the experts and policy wonks, he has strong credibility with the American public. As such, this is a great media strategy by the Obama team – they have found someone who is well known, a media professional (and as some criticize – a propaganda machine), and can deliver complex health policy messages.

As with any candidate there are drawbacks and deficiencies, with Gupta, these will all come out in due time. I understand that some in public health circles and others will consider this pick to be more style than substance, but my main point is that is time for us to think creatively beyond our traditional notions and perhaps take a risk with someone who doesn’t have a strong public health background, but who has the potential to have a major positive impact.  Gupta is someone who can link both local and global health causes together and that is rare and signficant skill. The envirionmental movement over the last decade has made tremendous strides in melting the division and lines between local and global into something that can be grasped at all levels and into something where people understand the connection. Granted health is a very different animal, but as a community and movement we are light years behind the environmental folks – perhaps Gupta helps to push this in another way.

Other sources:

– Krugman on the Trouble with Sanjay Gupta, link
– See Abel and Jake over at Science Blogs on their differing views
– WSJ health blog on Gupta, link
– Read the comments over at Daily Kos, link
– Huff Post on Gupta, link
– Questions about Gupta at KevinMD, link

International Action: Clean Water Solutions in Haiti

I was recently contacted by a non-profit organization based in Washington D.C called International Action (IA) to help them raise awareness about the problems they are tackling in Haiti. IA installs water treatment systems in Port-au-Prince, Haiti using chlorinators. Chlorniators, according to IA, are very cheap, simple, easy to install and maintain. It would be interesting to see how this method stacks up against other water sanitation efforts in terms of costs & financing, logistics, sustainability, adoption/use and impact.

Haiti Innovation recently profiled IA: “At the end of five years, IA aims to have installed 500 chlorinators covering most of the Port-au-Prince metropolitan area, giving clean water for the first time to 2.5 million people.” You can view some of the locations IA is working in with their nifty Google maps mashup:

Below is a guest post from Amelie over at IA:

Guest Post by International Action

Among 147 countries Haiti scores last on the water poverty index scale according to the World Water Council (WWC). This means that Haiti is the country with the worst access to clean water in the world.

In fact, most water sources in Haiti are contaminated with human waste and disease. The result is a tragedy. Haiti has the highest infant mortality rate in the Western Hemisphere and this is due to preventable waterborne diseases such as chronic diarrhea, typhoid and hepatitis.

International Action, a Washington D.C based non-profit installs water treatment systems called chlorinators on top of local public water tanks. They now protect more than 450,000 Haitians with clean, safe drinking water in 23 of the poorest neighborhoods in Port-au-Prince.

International Action’s special tablet chlorinators are easy to install, use and maintain, they do not require electricity and therefore they are ideal for the developing world. The system is simple: 10% of the water runs through the device, dilutes the chlorine tablets and mixes it with the rest of the water in the tank. The chlorine levels are safe, pre-set and regularly tested. A chlorinator can provide clean water for up to 10,000 people for the smaller model LF1500 and 50,000 for the larger one LF2000.

The biggest installation in Jalousie supplies a community of 50,000. The local hospital has instantly noticed a reduction in the cases of waterborne diseases which they must treat. Analyses of the water have shown that germs of typhoid, cholera and hepatitis are no longer present in Jalousie’s water; waterborne diseases have virtually disappeared in the communities which have the chlorinators installed.

During the month of December, International Action has installed 6 new chlorinators in the neighborhood of Delmas 30. The population is thrilled because although they receive water from CAMEP — Independent Metropolitan Water Company — four days a week, they do not drink it because it is contaminated. In early December, CAMEP called International Action for help. 50,000 more Haitians are now protected with clean, safe drinking water provided by International Action.

For more information visit our website at www.haitiwater.org