World Aids Day is December 1st!

Double-click on the poster below to view this week's activities commemorating World Aids Day at Tulane::

The First Global Symposium for Health Systems Research

(Tuesday November 23rd)

This Symposium was mandated by the WHO and was an important gathering of 1,200 leading experts from multidisciplinary sectors to discuss health systems research. Where are we now? What are the methods of research we can improve to adequately address health systems? How can we make health systems more efficient and effective? What does the current literature say about these issues? What are the future directions research needs to take?

Universal health care coverage was a major topic discussed pertaining to health systems research. How can we achieve this financially? There seems to be a major gap in research on international financing of health systems. Current literature focuses on national health care financing. We need research efforts to stress international health care financing. It is not possible for some countries to support universal health care coverage, however this does not mean universal health care coverage is not out of reach. It is possible to provide health care financing for a universal health care plan (US $40 per person, per year). Some countries will just need help getting off the ground to begin such a massive global endeavour. The ultimate goal is for nations to be self-sustaining, however, in the beginning this will not be possible. The first reading assigned for this meeting looks at how this is possible, supporting a national interest. A moral/altruistic attitude toward approaching a universal health care plan is not necessary in arguing that this is a good idea for all nations. Read the article below as it really gives a good contextual argument for universal health care.

**Ooma, G., Hammonds, R. & Damme, W. (2010). The International Political Economy of Global Universal Health Coverage.

http://http://www.hsr-symposium.org/images/stories/3international_policy_economy.pdf

On the Global Symposium for Health Systems Research Website, you will find ALL the plenary webcasts and background papers for this symposium. Instead of offering you our meeting's discussion points I highly recommend that you watch the webcasts sessions below and GO TO THE WEBSITE HOME and click around to find the topics of interest to you:

http://http://www.hsr-symposium.org/index.php/symposium-background

Webcast from Plenary from Friday Nov 19th: HSR stewardship, financing and capacity: Opportunities and obstacles to improved research.

http://http://www.hsr-symposium.org/index.php/hsr-webcast

And also read this background paper:

**Mylene, L., Powell-Jackson, T., & Blaau., D. (2010). Managing Incentives for Health Providers and Patients in the Move Towards Universal Coverage.

http://http://www.hsr-symposium.org/images/stories/1managing_incentives.pdf

I learned so much from this website and I hope you will take the time to review some of the information this website has to offer. HSR (health systems research) is a critical topic to understand for our generation and for professionals in medicine and public health that will become leaders in the future.

The Epidemiologic Transition (Part 1)

This session was facilitated by Menal Jham and delved into the various Epidemiologic Transitions we have witnessed over the ages. Omran (2005) breaks these general transitions we have witnessed into the following:

1.The Age of Pestilence and Famine
2.The Age of Receding Pandemics
3.The Age of Degenerative and Man-Made Diseases
4.The Age of Delayed Degenerative Diseases
5. The Age of Obesity and Inactivity (present day)

"The epidemiologic transition in demography and medical geography can be defined as a phase of development witnessed by a sudden and stark increase in population growth rates brought about by medical innovation in disease or sickness therapy and treatment, followed by a re-leveling of population growth from subsequent declines in procreation rates". This theory was posited by Abdel R Omran in 1971.

Our group discussed that these transitions can not necessarily be applied to every country and nation in the world. Some "pockets" in the world are still in the Age of Pestilence and Famine.
Why is this? Does most of the population follow Omran's transistion Ages?

We also discussed if these transition ages be used as a prediction model for those "pockets" in the world which may be in another Age? We think no, as evidenced by the technology transition in Africa with cell phones. We did not witness a transition in many African countries to landlines before the dawn of cell phones. Landlines never were widely distributed before cell phones. Therefore, because we see this technology adjustment which seems to have skipped a transition step, we might see an Age adjustment follow suit. Omran's ages are not linear or predictive of future health and disease experiences. They also seem to be more readily applicable to the developed countries overall.

These transitions offer to us a way to identify patterns and trends in health and disease, in which certain parts of the world have witnessed. They are helpful in recognizing demographic patterns, economic and social determinants and the consequences of these combined.

I am also interested in what would the mirrored "social/psychological" Ages to those Omran has laid out for health? For example, if the US is now in the Age of Obesity and Inactivity, would the Social Age be titled as The Age of Complacency and Indulgence?

This population theory is unique in revealing to us the history of health and disease through a broad lens. Interesting read...anyone have thoughts on how this could be useful to us today?

AMSA National Primary Care Week

We would like to invite you to
AMSA National Primary Care Week
at Tulane School of Medicine!

National Primary Care Week (NPCW) is an annual event to highlight the importance of primary care and bring health care professionals together to discuss and learn about generalist and interdisciplinary health care, particularly its impact on and importance to underserved populations.
– National AMSA

We also respectfully request you to fill out a pre-NPCW survey. It should only take you a few minutes and provides lots of valuable info to the National AMSA.
Here's the link: https://ent.tulane.edu/exchweb/bin/redir.asp?URL=http://www.surveymonkey.com/s/3F69QQR

NPCW will take place
November 8th - November 12th
at the Auditorium of Tulane SOM (1430 Tulane Ave.)
unless otherwise noted.

Food Provided for Every Event!

We have a fun and event-filled week planned and
hope that you can join us!

(Below is the full listing of events)

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Week-long (11/8 - 11/12) Events
Outside cafeteria of Tulane SOM (1430 Tulane Ave.)

LGBTQI White Coat Cards
Concise pocket references for providing a comfortable safe healthcare environment for patients who identify as LGBTQI

Preventive Medicine in Action: Snail Mail Can't Fail!
Write a letter to your favorite senior citizen. Stationary and stamps provided.


Day Events:

Monday 11/8 - 5-7pm
The Business of Being Born*
Film Screening & Discussion with Certified Nurse Midwife Esther deJong, MPH

Tuesday 11/9 - 12-1pm
The Importance of Primary Care*
Dr. Richard Streiffer

Tuesday 11/9 - 4-6pm
The Battle for White Clay*
Film Screening
DeBakey Room, 2nd Floor Murphy Building (131 S. Robertson St.)

Wednesday 11/10 - 12-1pm
The Patient-Centered Medical Home*
Dr. Karen DeSalvo

Thursday 11/11 - 12-1pm
Native American Healthcare*
Dr. MarkAlian Dery

Friday 11/12 - 12-1pm
Primary Care Post-Katrina and Post-Oil Spill*
Dr. Ben Springgate

Monday 11/15 - 12-1pm
Stump the Wiese
Dr. Jeffery Wiese
Room 6065 (1430 Tulane Ave.)

Wednesday 11/17 - 12-1pm
Primary Care in the Context of Healthcare Reform*
Dr. Richard Culbertson
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*FiM Extra Credit given for these events (for Medical Students).
(reflections due to tulanenationalprimarycareweek@gmail.com within 72 hours)

End the Neglect: Neglected Tropical Diseases

Today we discussed Neglected Tropical Diseases.

1 billion people are affected by 1 or more NTD.

What does "neglected" mean?

• international level- NTDs do not travel easy, not an immediate threat to Western society; diagnostic tools remain underfunded (1% of the 1,393 new drugs 1975-1999 were for tropical diseases, .0001% of US $60-70 billion is spent on new drugs that target NTDs; tied to geographic and environmental conditions
• national level-hidden below the radar screens of health practitioners and politicians; marginalized populations have little political voice; prioritization of diseases is HIV/AIDS, malaria, and TB (80% of funding of goes to these diseases, while >NTDs that actually have greater Daily Adjusted Life Years G-Finder Report Mary Moran)
• community level-NTDs cause fear and strong social stigma/prejudice (ie: leprosy, lymphatic filariasis); a misconception of these parasitic diseases

How can we address NTDs?

• Clean Water
• Adequete Sanitation
• Adequate Housing/Nutrition
• Vaccines
• Better Survelience of Diseases
• Integration: multisectorial approach (Agricultural, Education, Environment, and Health Sector communication)
• Innovation: more rapid diagnostic tools and better drugs targeting these diseases; better understanding of immunologic responses to NTDs and humans

What organization(s) can we trust that are fighting NTDs?

*TDR (A Special Programme for Neglected Tropical Diseases): http://apps.who.int/tdr/

------------Tropika.net (Pub-Med of Infectious Diseases): http://tropika.net/

*WHO Department of Control of NTD: http://www.who.int/neglected_diseases/en/

*The Global Network for NTDs: http://globalnetwork.org/

*Sabin Vaccine Institute (have a great interactive mapping tool of NTDs): http://www.sabin.org/map/4

*USAID NTDs: http://www.neglecteddiseases.gov/

*PLOS Journal NTDs- great journal referene that is open access! http://www.plosntds.org/home.action

The First Global Report on Research for Infectious Diseases

(to be published Nov 2011):

• What is this? a research "think-tank" of 125 international experts to map R&D (research and development for infectious diseases) of infectious diseases
• 6 disease specific groups and 4 thematic groups were used to compile this report to bring a snap-shot of the world now
• http://apps.who.int/tdr/svc/publications/tdrnews/issue-85/global-report
• Three Themes in the Final Report will focus on- Health Systems, Innovation and Technology, and Climate Change

Recently Published!!!! WHO report on NTDs, October 2010:

http://www.who.int/entity/neglected_diseases/2010report/NTD_2010report_web.pdf

Read about this important feat at:

http://endtheneglect.org/2010/10/a-little-less-neglected-a-reception-to-celebrate-the-newly-launched-who-report-on-neglected-tropical-diseases/

Text LIFE to 30644 to End Neglect and receive updates from the Global Network for NTDs!!!!

The First 3 Weeks Recap

Thank you everyone who has come out in the past few weeks to make our global health discussion group a success!

Below is a recap of previous weeks....


Week 3-Human Trafficking

Human Trafficking is the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of FORCE, FRAUD, or COERCION for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery.

This week the discussion raised awareness about the different forms of trafficking, laws in the US that protect victims of trafficking, and how human trafficking can be tackled today.

Human trafficking is modern day slavery. Slavery still exists, it is just much more hidden in our society today. Types of human trafficking include; labor trafficking, domestic servitude, and sex slavery. Victims can be found in restaurants, hotels, health spas, massage parlors, cleaning/maintenance, agricultural employment, acupressure centers, brothels, escort services, strip clubs, nail salons, etc.

Human trafficking yields an estimated $34 billion dollars in profits each year. It ties with arms sales (after drug trafficking) as the most lucrative business for organized crime. Unlike drugs and arms, humans can be continually sold over and over again.

56% of victims are women and children
82% of international victims are used in forced labor
27 million persons worldwide are trafficked

For more information please see the Florida Coalition Against Human Trafficking's Website:
http://www.stophumantrafficking.org/


I worked with them for one year and worked with victims of all the forms of trafficking listed above. This work is very hard and rewarding at the same time. The US Laws protect victims of human trafficking. Unfortunately, most cases of human trafficking still do not get prosecuted as such. The US has long way to go in beginning to enforce more consistently the laws which are now in place to protect the victims.

Recommended Books I have read:

**The War on Human Trafficking; U.S. Policy Assessed by Anthony M. Destefano

**Not For Sale; The Return of the Global Slave Trade-and How We Can Fight It by David Batstone

**Trafficking and Prostitution Reconsidered; New Perspective on Migration, Sex Work, and Human Rights edited by Kamala Kempadoo with Jyoti Sanghera and Bandana Pattanaik

**Prostitution, Trafficking, and Traumatic Stress by Melissa Farley

**Pimpology; 48 Laws of the Game by Karen Hunter

Week 2- Inside Look at the Millennium Development Goals

This is an informational blog on the MDGs with all and any information you could want: http://www.guardian.co.uk/global-development/millennium-development-goals

The Millennium Development Goals are an ambitious declaration of world leaders to fight poverty. Eight concrete goals, with measurable indicators are presented and can be found on the United Nation's MDG page. The recent summit in New York on the MDGs seemed to create more hype than success about how we are going to reach these goals by 2015? Is there enough political support and resources for the development these goals are trying to reach? How are the impacts made already and in the near future going to be sustained? Is it just an issue of aid?

To find out what the US is doing about the MDGs read this enlightening and strategic document:

www.usaid.gov/our_work/mdg/USMDGStrategy.pdf

The answers are spelled out for us, but will we (the world) collaborate enough and join together to make these goals a reality by 2015? Highly unlikely. However, it is better to have these goals and priorities as a bar/marker we can strive for than nothing at all. Bettering humanity is more complex than one may think and by starting to tackle these issues more concretely, we can learn from our mistakes and continue the journey. There is no easy answer or solution. How do you think we will make the MDGs successful? Are these goals worth having?

Week 1- What is Global Health?

Dean Pierre Buekens (of the Tulane School of Public Health and Tropical Medicine) led a discussion on how we define global health today, especially in academia. The tide is turning and schools of public health across the country are focusing on creating departments and certificate programs that teach students from a global health perspective. What does this mean exactly?

Global health is public health. When we talk about improving health locally or "at home" (in the US) or Africa, for instance, this actually strengthens health globally for everyone. Check out the following links for more about defining global health. Also, Dean Buekens published a response to the Lancet article below, that is pertinent for understanding how intertwined global health is with any and all health actions:

"Toward a Common Definition of Global Health"
(http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60332-9/fulltext)

"Global Health is Public Health"
(http://image.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60203-6/fulltext)