There is a nice list of global health wins this year from Karl Hofmann, President and CEO of PSI, the world’s largest social marketing firm. You can see his list on the Huffington Post. Highlights include exciting progress on a malaria vaccine, “Treatment as Prevention” for HIV, and progress on the rate of vaccination against pneumonia.
December 30, 2011
December 16, 2011
New WordPress plugins available now!
We are proud to announce the arrival of two new WordPress plugins for nonprofit fundraising. Both work by allowing users to edit an XML file from the admin menus – the XML file can then be used to dynamically generate image maps in a variety of formats, including Flash movies and CSS image maps. Go to the plugins page to learn more, view a demo, download, and donate to the cause!
August 11, 2011
Site Redesign coming for ghtech.org!
Hi all,
As you have no doubt noticed, the blog has been inactive recently. This is because I have been focusing my efforts elsewhere, but also because I have realized that the ghtech site is not doing as much as it could to help global health.
When I first set up this site, I was using it as a learning tool for myself, both to learn about site maintenance and blogging as well as about global health. Now that I’ve been at it a while, it has come time to repurpose the ghtech site to make it more useful to people working in global health. This redesign will remove parts of the site and add new parts, with particular emphasis on the following:
- Tools for global health, including web/communication tools and analysis tools
- Forums for experts in global health technology to gather and share thoughts about their work, present challenges, and hopefully get solutions from other members of the forum
- Blog from experts in the field, highlighting recent work and its applicability to global health and technology
I have already begun this redesign, and I expect the full process to take several months. If you would like to help with this process, become a site co-owner, or have suggestions about how to make the ghtech site better, please don’t hesitate to contact me at:
I thank you for your patience.
June 21, 2011
I refuse the Refusers
I read the story “The Refusers” by Nina Shapiro in this week’s Seattle Weekly, and was alarmed by the extent to which the vaccine refuser movement has spread, especially here in Washington state. Vaccine refusers are people who choose not to vaccinate themselves and/or their children against a host of deadly and disfiguring diseases. The story does a good job of describing proponents of both sides of the arguments. It’s too bad that one side, the vaccine refuser side, is just wrong. Their arguments are weak if not misguided. The “Refusers” (like “The Decider”?) are convinced that there are major side effects of vaccination, and some even believe that the pharmaceutical companies are hiding these side effects in order to sell more vaccine. Among the most prevalent theories being forwarded is that certain vaccines can contribute to, or even cause directly, autism. The “Jenny McCarthy” argument is based on the work of Dr. Andrew Wakefield, who has been firmly disproven and chastised in the reputable scientific community for falsifying his data. Other publications, as mentioned in the article, are not original peer-reviewed literature, but are instead review articles that may or may not be reviewed or even accurate.
Here’s the main point: although there are side effects to vaccines, these side effects are vastly more rare and vastly less serious than the disease the vaccines prevent. And, there’s an important corollary to this point that the Seattle Weekly did a great job of mentioning: herd immunity. If someone does not want to immunize their children, that should be their choice. But what about the child of the family without access to services, or the child of the parents who don’t know to vaccinate? Now they are vulnerable because the Refuser hasn’t vaccinated his children. Herd immunity protects unvaccinated people by vaccinating everyone else, but it doesn’t work unless a certain fraction (usually quite high) of the population is vaccinated! For polio, as I mentioned in a previous post, this percentage is upwards of 85%, and for measles, the percentage of people that need to be vaccinated to protect everyone is as high as 94%. So, even a few Refusers can compromise an entire vaccination program. This, it seems to me, is selfish. I know Refusers are simply trying to protect their children, and this is admirable. But, are they really protecting their children, and is this ethical if it comes at the expense of other peoples’ children? I vote no.
Public health as a discipline was a long time in coming on this planet, and I for one refuse to let the Refusers compromise the amazing advances the field has made. Who reading this post has had polio? Measles? Mumps? Were you vaccinated for these diseases? Do you have autism? I myself had pertussis as a child, and chicken pox, but these are now both vaccine-preventable. I did not have polio, measles, mumps, rubella, or tetanus.
Here’s a suggestion that meets the needs of the Refusers as well as the rest of the population of the planet: you may refuse to vaccinate yourself or your children, but then you will be subject to travel restrictions for the rest of your life so that you do not endanger anyone else who may not be vaccinated. This way, at least the only people who will die of these diseases will have an explanation as to why they are dying. I leave you with some pictures of vaccine-preventable illnesses, noting that these people may be dead as a result of their illnesses. Judge for yourself.
A man with an atrophied leg as a result of polio. Photo from Centers for Disease Control and Prevention (#134).
A boy with diptheria in Vietnam has a pacemaker to keep him alive. Photo copyright Science Photo Library (M935/0102).
A boy with rubella. Photo by US Centers for Disease Control and Prevention.
A child with measles. Of the children with measles in this ward when this photo was taken, several died. Photo by Julian Harneis.
June 2, 2011
Stopping polio for good using technology
“Polio eradication – it’s the ultimate in equity and it’s the ultimate in social justice” – Bruce Aylward
I just watched Bruce Aylward’s TED talk, and it was an amazing display of how new technologies are enabling humanity to meet the most difficult of challenges, the eradication of all three types of the polio virus from the face of the earth. There has been an active debate of late about whether polio eradication is the right thing to do, or even possible to do. This was due in part to a resurgence of polio cases and outbreaks across the world in recent years. However, Dr. Aylward says in his talk that not eradicating polio stands as “a stark reminder that we are failing, as a society, to reach children with the most basic of services”. In this, and the quote at the title of this post, he makes a convincing Rawlsian argument that polio eradication is both just and fair, and that due to the way that such eradication is being attempted, it also serves as a marker of how all childrens’ access to essential medicines is progressing. A huge army of volunteers hikes to the most remote places on the planet, through heat, extreme cold, and war zones, to administer two drops of oral vaccine to every single child. This is the only way to eradicate the virus, and to accomplish this would mean that we can access every child on the planet. Indeed, these same volunteers often bundle many health care services into every visit, including other vaccines, malaria bed nets, and vitamin drops. But how to ensure that every single child is vaccinated? This is where technology is playing a huge role. Satellite imaging provides new views of where the children and the infections are (remote villages, slums, and other areas not on other maps), and GIS sensors given to the volunteers track where they go. Overlaying these two technologies allows teams to see that every street has been walked down, every village visited, and hopefully every child vaccinated. In his talk, he also presented a graph depicting polio cases over time, and showed with digital geographic accuracy that for the first time in history this year, no new polio paralyses have been detected in the two most problematic Indian states, Bihar and Uttar Pradesh. All in all, a tour de force for the eradicationists, and a death knell for the “let’s control it” argument.
One point not covered in the TED talk but worth noting is the effect of herd immunity in eradication of polio. Given that only 95% of vaccinated individuals develop immunity to polio (i.e., 5% vaccination failure rate), there will always be at least 5% of the population that is susceptible to polio. However, it has been estimated that herd immunity will protect these susceptible individuals if between 80 and 86% of all people are immune. So, it is important not only to get the vaccination rate as high as possible, but to keep it there forever.
I think this effort is amazing. Every child on the planet getting the same vaccine, now and forever. Although two other diseases have been eradicated from the planet, smallpox and rinderpest, neither of these involved the scale of the polio effort due to the endemic countries affected and the number of susceptible individuals in these countries. Surely this is the first time in history a global disease eradication of this magnitude has been attempted, and if successful, it will open a new chapter in humanity’s ability care for itself.
May 15, 2011
Global health and vegetarianism
I am beginning to read the book Just Health by Norman Daniels, his follow-up to Just Health Care. In Just Health, Daniels states his realization that the scope of his first book was too narrow in the definition of the factors affecting health. In particular, the social aspects (determinants) of health are of critical importance, he argues. It will be interesting to see the logical underpinnings of this claim further into the book. However, it got me to thinking about one of the major social determinants of health, meat consumption.
There is an abundance of evidence now (and has been for decades) that a vegetarian diet is not only better for individual health, but also better for global sustainability. And yet, those of us vegetarians know that we count for, at most, 10% of the population of developed countries like the US or Canada. The result of that statistic is that the numbers of animals killed for food every year are staggering. Figure 1 shows the annual meat consumption per capita in kg/person. Although even the poorest countries in the world have some level of meat consumption, in the G20 countries the numbers are far higher.
Figure 1. Annual meat consumption per capita. From www.chartsbin.com
Worse, as formerly developing countries become economic powerhouses, the meat consumption there is rising dramatically. Meat consumption, despite the suffering to people and other animals it causes, is a sign of wealth and privilege. This places it outside of the realm of logic and in the realm of emotion, making the changing of attitudes very difficult.
One of my favorite books on vegetarianism is A Vegetarian Sourcebook by Keith Akers, which you can get for free here. Akers dedicates three chapters to an in-depth discussion of the role of vegetarianism and its history across the major world religions, two chapters to the philosophy of vegetarianism, and one chapter to vegetarian ethics specifically, comprising in all a third of his book. Reading these chapters gives a clear view of how the originators of the world’s religions thought about meat consumption, and that even back then, when meat consumption involved a far different process and costs, there was significant debate on the subject. My view: the problem is that diet is tightly linked to views about destiny. If you accept the view that humans are “supposed” to eat animals, or that certain animals are “born to become food”, then you are rejecting any other possible outcomes, and you are frozen in your thinking. The simple facts as I see them now (and I spent 22 years eating meat before I switched) are these: (1) the planet will not sustain the level of meat consumption we currently have, (2) meat consumption is not necessary for human survival or prosperity, and (3) lowering meat consumption improves individual and thus global health.
It’s your choice about what to do, but you’d better decide fast.
February 18, 2011
Changes afoot
Hi everyone,
I know I haven’t posted in a while, and there is a good reason. I will be leaving my position at UBC and returning to the United States (Seattle area) by the end of this academic term. Naturally, this sort of life change brings with it a lot of turmoil and the blog has suffered. The good news is that I am transitioning more fully to a career in global health, which will allow me to turn this site into what I think it can be.
I will be engaging a number of opportunities in global health in the hear future, starting with the Global Health Innovations conference at Yale in April, hosted by Unite for Sight. If you will be attending this conference, let me know, as I would like to meet you.
In the near future (March), you can expect some blog contributions from leaders in global health diagnostics as well as global health technology licensing and the issues around this, so stay tuned through this upcoming period and you will be rewarded!
Eric
February 1, 2011
International surgery organizations
I have started volunteering as a web developer for a nonprofit organization here in Vancouver called the Canadian Network for International Surgery (CNIS). CNIS provides surgical and obstetrical training in low-income countries. They have grown from a group of three local surgeons to the largest international surgical training organization in the world, with twenty centres in eight African countries. Dr. Taylor, one of the founders of CNIS, was recently awarded the Order of Canada for his contributions to global health. I encourage you to check out this fine organization and donate if you like.
Also of note is the group called Global Partners in Anesthesia and Surgery (GPAS), whose mission is to develop and implement strategies to reduce the global burden of surgical disease and to improve the quality of perioperative care in the developing world. GPAS is holding the second annual Conference on Surgery and Anesthesia in Uganda here in Vancouver on April 2.
Finally, there is a good list of global health surgery organizations here if you are interested in learning more (slightly out of date). Organizations specializing in fistulas, cataracts, cleft lip/palettes, and more are present. GiveWell ranked ReSurge International (formerly Interplast) as their top charity in this 2008 list due to transparency and impact.
January 14, 2011
Healthier global health
With the start of 2011 upon us, many people have resolved to be healthier this year. Luckily, you can both make yourself healthier as well as others at the same time. Simply participate in one of fundraiser rides/walks/runs in your area. Perhaps Vancouver is particularly well-suited to this, what with its mild year-round temperatures and wonderful summer weather, but I know of events all across Canada that are wonderful to participate in. As a public service, therefore, I list below the different “healthy global health” events in British Columbia this coming year. Some are easy to do, others more difficult, so I list them all now in case you need time to prepare! Some of these are also held in other provinces and countries – these are marked with an asterisk.
February:
6: Vancouver Sustainability Run
March:
6: Vancouver Sustainability Run
April:
9: Vancouver Sustainability Run
May:
7: Walk of Life for Cardiac Health, Kelowna, BC *
8: Vancouver Sustainability Run
29: Run for Water 2011, Abbotsford, BC (5K,10K, half marathon, marathon)
30: World Partnership Walk, Aga Khan Foundation *
June:
5: Vancouver Sustainability Run
5: CBI Hustle for Hunger, Nanaimo, BC (6K or 10K) *
18: The Ride to Conquer Cancer BC (Vancouver to Seattle) *
26: Run to End Poverty Vancouver, Engineers without Borders (half-marathon) *
July:
9: Underwear Affair, BC Cancer Foundation (run 10K, run or walk 5K) (this one has a rocking after-party!)
September:
19: Terry Fox Run (5K or 10K run/walk) *
October:
3: Run for the Cure Vancouver (1 or 5 km, run or walk) *
November:
January 5, 2011
Higher prices for drug development
As a follow-up to my previous post on the high costs of developing new drugs and vaccines for diseases impacting global health, a new Tufts Center for the Study of Drug Development (CSDD) outlook report states that the average cost of developing a new drug has risen to $1.3B. An excerpt from the press release announcing the report states:
Actions that will help improve R&D productivity, according to Tufts CSDD, include greater reliance on translational science to help identify the right disease targets for new molecules; greater use of partnering with external service providers to share risks, reduce cycle times, lower costs, and improve resource management; and greater use of sophisticated portfolio management techniques.”
The full report is available for purchase at http://csdd.tufts.edu/reports.
