The Global Pulse Journal Blog

We are very proud of GP editor Jennifer Weinberg, who was the theme editor for the current issue of the AMA’s Virtual Mentor journal!   The theme for the March 2010  issue is global health ethics in practice.  Read the full issue here, or start with any of the following:

• Jennifer’s introduction: Global Health Ethics at Home and Abroad
• The WHO Staging System for HIV/AIDS by Jennifer Weinberg and Carrie Kovarik
• The Physician-Researcher’s Dilemma by Hana Akselrod
• Global Health Ethics and Professionalism Education at Medical Schools by Sujal Parikh

In January 2010 PLoS Medicine published a very interesting four-part weekly series on this subject.  I have posted a few excerpts below:

The study had three aims; (1) to advance current understanding of the interplay of actors in the system; (2) to evaluate its performance; and (3) to identify opportunities for improvement.

Read the rest of this entry →

Home to over 400 million people, the Ganges river winds through India’s history, culture and countryside. Unfortunately, rapid industrialization and urbanization has left an unholy mark on the Ganges as dangerous amounts of untreated industrial pollution and human excrement enter the river every day.  These conditions are all too common in rivers worldwide  and create an environment ripe for diseases ranging from schistosomiasis to Cryptosporidium.

But long time advocacy is finally paying off as the WSJ reports that World Bank and the Indian government are set to spend $4 billion to “to ensure that by 2020 no untreated municipal sewage or industrial runoff enters the 1,560-mile river.”.  The methods proposed also have the benefit of being less carbon and electricity intensive than traditional wastewater treatment plants – key aspects for a country with chronic brownouts in a warming world.  In order to reach their goal, the government and partners will need to engage the most neglected slums which, if done right,  has the potential to create environmental justice at the same time as cleaning the river.

Of course, governments have a tendency of announcing lofty environmental goals which are then forgotten in the next election cycle. The Ganges also had a previous cleanup effort that failed to reach its goals, partly because of lacking public participation. Hopefully things will be different this time, but GP would love to hear from anyone with on the ground insight.

After over 20 years of research, scientists believe that they have discovered a breakthrough that will allow for more effective treatments for HIV/AIDS. In a recent article in Nature, scientists from Imperial College London and Harvard University report success at elucidating the structure of integrase, an enzyme which the HIV virus uses insert a copy of its genetic material into host DNA. Researchers hope that this new knowledge will lead to a better understanding of how integrase inhibitors work, how they can be improved and how we can prevent HIV from developing resistance to them.

For more see http://www.reuters.com/article/idUSTRE6101AQ20100201

Evidence about the role of American physicians, clinical psychologists, and other health professionals in abuse and coercive interrogation at military detention sites has been accumulating slowly but incontrovertibly in the wake of the War on Terror.  In August 2009, Physicians for Human Rights released its most recent report describing in detail how the CIA relied on medical expertise to rationalize, plan, and carry out unlawful interrogations at detention sites.  Licensed health professionals observed physically abusive interrogation sessions and advised on how to increase the prisoner’s suffering.  They kept records of waterboarding, and consulted medical literature on hypothermia to determine “precise gradations” of the procedure.  When not aiding “coercive interrogations” directly, health professionals were still involved in facilitating and monitoring them, and also observed clear medical evidence of abuse without intervening — practices that subverted and violated well-established medical ethical obligations, to say nothing of the Geneva Conventions, the U.S. Constitution, and U.S. military law (JAMA).

To date, the U.S. has barely begun to address the gravity of what has taken place.  In the absence of a meaningful national response, medical professional organizations and the legislatures of individual states are stepping up to the challenge.  With the introduction of the Gottfried-Duane Bill in the State Assembly and State Senate, New York is posed to become the first state  in the country to explicitly prohibit health professionals licensed in the state from assisting in torture, interrogations, and prisoner abuse, while providing them with strong legal protection to resist any future coercion to participate in such acts.

The bill is meant to stop physician-assisted torture ever becoming a reality again, as well as to help health professionals address abuse and medical neglect of prisoners in domestic jails and detention centers.  Co-sponsored by 30 members of the State Assembly from both parties, the bill was favorably reported by Assembly committees last year, and is currently being revised in preparation for the floor vote.  It is supported by the NY state chapter of the American College of Physicians; by nursing, psychology, and social work associations;  and by civil liberties and human rights advocacy groups.

More on the Gottfried-Duane Bill, and why you should care, after the jump.

Click here to sign PHR’s petition in support of the Gottffried-Duane bill.

(There is a link for out-of-staters to show solidarity, too.)

StopTortureNY.org

Read the rest of this entry →

If you are still looking for ideas for that Valentine’s Day date, and have not seen Avatar, you want to check it out.  If you have somehow missed the previews, reviews, and interview specials so far, and are curious, Wikipedia is here to help.   Or you could read my unofficial take, below.

(Movie spoilers, and actual global health relevance, after cut.)

Read the rest of this entry →

From Science Speaks, an excellent blog from the staff of the Infectious Diseases Center for Global Health Policy, comes an interview with Dr. Eric Goosby, the U.S. Global AIDS ambassador.

Q: Roxana Rogers, USAID’s South Africa health team leader, said recently in South Africa that, “US government funding is going to come down dramatically over the next five years.” True?
Read the rest of this entry →

For the past seven years, the United States has supported and expanded its program to fight HIV/AIDS in developing nations, underwriting almost half of the world’s AIDS relief. But some are concerned by recent setbacks in the global campaign to fight disease in the developing world. At a time when the numbers of people infected with HIV is beginning to increase after stabilizing in countries like Uganda and the number of people in need of treatment is rapidly expanding, the US funding has not kept pace. With updated World Health Organization guidelines, the number of HIV-infected people eligible for treatment has expanded to 14 million, a large increase from the only 4 million people current in treatment.

In the face of this expanding pool of people in need, US government funding seems to be staying stable. For example, at the same time that the Obama administration has announced plans to expand HIV treatment to at least 4 million by 2013, they have also signaled no increases in funding budgets through fiscal 2011. Defending the administrations commitment to fight the global pandemic, Eric Goosby, the President’s AIDS czar, stated that “our commitment to universal coverage hasn’t wavered.”

For more on the global fight on AIDS and particularly the fight in Uganda, check out the Wall Street Journal’s January 30th article and slideshow.

A lovely animation explaining why patent pools will help fight the HIV/AIDS epidemic. Please refer to earlier post on GPJ by Hana Akselrod regarding the approval of patent pools by UNITAID.

This Friday January 29, 2010, PBS will air a documentary focusing on maternal health in Haiti on its newsmagazine show NOW. The episode explores the context of the global maternal health crisis with a focus on the work of the Haitian Health Foundation, winner of the 2008 Global Health Council Best Practices Award. The earthquake has further stressed a resource-challenged system, with many centers for maternal health damaged or destroyed. Filming for this episode overlapped with the earthquake and the show touches on the additional challenges facing expecting and new mothers and their children living within this crisis.

Visit http://www.pbs.org/now/sched.html for more information on air times or the documentary will be available online starting Friday night January 29th at http://www.pbs.org/now/.