By Richard Pearshouse, Special to CNN
Editor’s note: Richard Pearshouse is a senior health and human rights researcher at Human Rights Watch and author of Toxic Tanneries: The Health Repercussions of Bangladesh’s Hazaribagh Leather. The views expressed are his own.
Last year, I spoke with a 40-year-old woman working in a Bangladesh leather tannery in the Hazaribagh neighborhood of Dhaka. The Hazaribagh tanneries, which export hundreds of millions of dollars in leather for luxury clothes, shoes and boots around the world, spew noxious pollutants into surrounding communities. They can also make their workers very ill.
Much tannery work involves measuring and mixing chemicals, adding chemicals to hides in drums, or hauling hides saturated in chemicals out of pits. Fungal infections, scabies, hives, and contact dermatitis are common. Others suffer from respiratory illnesses and chest pains.
Asked what she thought of the possibility that Hazaribagh’s tanneries might eventually move out of the city, the woman told me, “It would be very good…They could start garment factories. This would be cleaner work with a better salary.”
By Carter C. Price, Special to CNN
Editor’s note: Carter C. Price is a mathematician at the nonprofit, nonpartisan RAND Corporation. The views expressed are the writer’s own.
Over the past several months, Governors Chris Christie of New Jersey, Rick Scott of Florida, and John Kasich of Ohio – all Republicans – have announced support for the Affordable Care Act’s (ACA) Medicaid expansion. They join 22 other states and the District of Columbia in expanding the health insurance program for low-income Americans.
But more than a dozen of their counterparts in other states have decided against implementing the expansion, and the fight goes on in several states including Florida and Ohio where Scott and Kasich face hurdles in getting expansion through their state legislatures. Many have said these decisions are based on fears that expansion will cost states money in the longer-term. Yet, recent RAND research suggests that the economic arguments against state implementation may be questionable, especially for some lower-income states.
By Laurie Garrett, Special to CNN
Editor's note: Laurie Garrett is a Pulitzer prize-winning journalist and senior fellow for global health and the Council on Foreign Relations. The views expressed are her own.
This week, millions of Chinese visited family cemetery plots for the annual Tomb Sweeping Festival. They left or burned objects they thought their deceased ancestors could use in the afterlife, including chickens, pigeons and other food delicacies. Mao Zedong banned tomb sweeping because he thought it a decadent symbol of China’s Confucian past. But this year, China’s Communist Party had a different concern for tomb sweepers: Don’t handle live birds for your ancestors, or you just might be joining them in the afterlife.
It’s bird flu.
The emergence of the H7N9 avian influenza, mutated into a humanly infectious form, would be cause for concern even if it were a one-off event in a remote Chinese farm village. After all, this class of flu virus has never before infected, sickened or killed human beings – it’s a bona fide bird flu. But the disease drama now is unfolding in five large eastern China cities with a combined population of 48 million. This is a decidedly urban flu, its human victims identified to date span from ages 4 years to 87, and for most of the cases there is no obvious explanation for how they contracted their infections, or why their loved ones, co-workers and neighbors apparently did not.
By Fareed Zakaria
I have long argued that cutting government spending in the midst of a weak recovery is not a path toward growth. But I have also argued that America does have a debt and deficit problem and we need to take it very seriously.
The fact is the vast majority of our debt problems relate to the costs of health care in America. Now that the debate over Obamacare is over, we should start thinking seriously about how to get America's health care costs under control. As it turns out, two new works – a book and a magazine cover story – provide some very useful ways to think about this.
The central debate between Democrats and Republicans is over whether the free market works well in health care. In a new book, Catastrophic Care, David Goldhill makes the case for the market, arguing that people need to become consumers of health care so that they, not insurance companies, not the government, actually see, feel and pay the bills. That will force producers of health care – doctors and hospitals – to push down prices and drive up quality. That's what happens with groceries or television sets or computers.
"Fareed Zakaria GPS," Sundays at 10 a.m. and 1 p.m. ET on CNN
Fareed speaks with David Agus, author of "The End of Illness" and one of the world's leading oncologists, about health in America. To see all of this or other interviews, download the show at iTunes.
You also point out something really interesting, which is that we all think that the path to being fit is to go to the gym. And you say if you go to the gym for 45 minutes, an hour a day – that actually doesn't make much of a difference if...
Well, listen, if you sit the rest of the day, sitting for five hours is equivalent to smoking a pack or a pack and a quarter of cigarettes. It's an amazing thing that we design buildings based on LEED certifications, right? It's going to help the environment and everything is recycled, etc. But we're not doing anything on health. The more important you are, the closer your parking space is to your desk. The more resources you have, the more bathrooms in your house. You don't have to walk place to place.
Well, 1953, they looked at the British Transit Authority. There were 26,000 workers. Half were the bus drivers and half were the ticket takers that walked up and down those double decker buses. Well, it was more than half the death rate of heart disease in the ticket takers and significantly less cancer. And they weighed the same...
Because they're the ones walking around?
They smoked the same, everything the same, it's just moving. Your body was designed to move. That's how your lymphatics work. Yet we've engineered our society to sit. We need to change that.
"Fareed Zakaria GPS," Sundays at 10 a.m. and 1 p.m. ET on CNN
Fareed speaks with David Agus, author of "The End of Illness" and one of the world's leading oncologists, about health in America. To see all of this or other interviews, download the show at iTunes.
The one thing you do say we should take is a drug that is 3,000 years old.
Yes. You know, Hippocrates described, over 2,400 years ago, taking the bark of the willow tree, chewing it and getting rid of pain and fever. That pill, if you take it every day, will reduce not the incidence, but the death rate of cancer, by over 30 percent, and heart disease by over 20 percent. It's called a baby aspirin. So we all have a right to smoke, to drink, to do whatever we want. But the question is, what is the right thing to do? And when scientific data hit a certain point, probably it shouldn't be optional.
GPS special 'Memo to the President' will be repeated this Saturday at 8 p.m. and 11 p.m. ET/PT
By Jason Miks
Next week sees the inauguration of Barack Obama for a second term as U.S. president, making him only the third Democrat in the past 75 years to be returned for a second term in office. But what issues should he be focusing on?
In GPS special “Memo to the President,” which aired last night, Fareed Zakaria argued that fixing the still weak economy is the most urgent crisis facing the United States. But what do you think? We asked viewers and visitors to the show site for their take on what President Obama needs to do in the next four years, and most cited domestic issues, including the economy, as the key considerations.
“Daryl White” argues that the first thing the administration should do is invest more in “the physical infrastructure of the U.S. – highways, communications, bridges, railroads, etc – making them faster, stronger, better.”
This view chimes with a column by Fareed last November in which he noted that the U.S. has been falling behind on this measure. “Only a decade ago we were ranked fifth in overall infrastructure by the World Economic Forum; today we have dropped to 25th. The American Society of Civil Engineers calculates that we have a $2 trillion backlog of repairs that must be done over the next five years to stay competitive.”
By Elizabeth Economy, CFR
Editor's note: Elizabeth Economy is C.V. Starr Senior Fellow and director for Asia Studies at the Council on Foreign Relations. This entry of Asia Unbound originally appeared here. The views expressed are those of the author.
Trying to wrap one’s arms around China today is a significant challenge. It is a global power with a growing economy, rising military, and expanding diplomatic reach. Yet there continues to be a gnawing sense in and outside China that all is not quite right. Whether it is the 180,000 protests annually, the growing flight of capital and people to the West, or the potentially ruinous impact of corruption on the Communist Party’s legitimacy, uncertainty about China and its future is much greater than the country’s impressive global standing might suggest.
In the face of such uncertainty, what we need most is to understand better, issue by issue, what is happening on the ground in the country; and a terrific new book Governing Health in Contemporary China by my CFR colleague and renowned public health expert Huang Yanzhong provides precisely that kind of insight. It details Beijing’s efforts to tackle one critical and politically explosive issue – health care – and helps us understand where and why the country has succeeded and failed, and what more needs to be done.
"Fareed Zakaria GPS," Sundays at 10 a.m. and 1 p.m. ET.
Fareed Zakaria speaks with Ronald DePinho, president of the world’s largest cancer center, MD Anderson in Houston, about the future of cancer research, and whether a cure is within reach. This is an edited version of his interview on Global Public Square.
You believe that we are at a point where we could actually finally cure cancer?
I think we’re at a major turning point in the history of cancer medicine where we have a very deep understanding of how it comes about, and, if it is established, how to deal with it, and we have game-changing technological advances that allow us to do much better care, accurate care, of cancer patients.
What is the game-changing technology? What’s happened? You say this has happened, really, in the last five years.
Well, there have been major events. And what’s unusual about this period in science history, is that it’s occurred in a narrow window and across a very broad front. So it’s not one technology. It’s the fact that we can sequence genomes, the entire genome, your entire tumor profile, in a few hours for a few hundred dollars – what took billions of dollars and a decade. We have the ability to analyze those data through very sophisticated computational structures and artificial intelligence.
“Because of their more limited inequality and more comprehensive social welfare systems, many perceive average welfare to be higher in Scandinavian societies than in the United States. Why, then, does the United States not adopt Scandinavian-style institutions?” asked three researchers in a recent MIT paper that can be downloaded here. “More generally, in an interdependent world, would we expect all countries to adopt the same institutions?”
In this week’s What in the World on GPS this Sunday at 10 a.m. & 1 p.m. ET, Fareed Zakaria takes a look at the surprisingly free market countries of Scandinavia, and what the United States can – and can’t – adopt from them.
By Kent Campbell, Special to CNN
Editor’s note: Kent Campbell is the director of PATH’s Malaria Control Program, and was recently awarded the American Society of Tropical Medicine and Hygiene’s LePrince Medal. The views expressed are his own.
When I began working on malaria in the late 1970s, the disease was rampant. Working for the U.S. Centers for Disease Control and Prevention, I was stationed at a hospital in the Western Kenya district of Siaya. In the pediatric ward there were often two children to a bed, with more than half succumbing to malaria-related anemia.
Kenya didn’t have a strategy to protect children from malaria – at that time no African country did. In fact, bed nets, a cornerstone of today’s prevention efforts, were not being used. They hadn’t yet been proven to be an effective tool for fighting malaria. Instead, the focus was on providing treatment for the sick and trying to delay death that was often unavoidable.
By Navi Radjou, Jaideep Prabhu, and Simone Ahuja, Special to CNN
Editor’s note: Navi Radjou is a Silicon Valley-based strategy consultant and a Fellow at Judge Business School, University of Cambridge where Dr. Jaideep Prabhu is the Jawaharlal Nehru Professor of Indian Business and Enterprise. Simone Ahuja is the founder of Blood Orange.
The U.S. health care system is headed for a train wreck. Costs are poised to balloon from $2.6 trillion in 2010 to a whopping $4.6 trillion in 2020 – accounting then for 20 percent of U.S. GDP. Yet, over 50 million Americans still lack medical insurance. And worse: 63 percent of Americans surveyed by Deloitte complain that their hefty monthly healthcare spending curbs their ability to pay for other essentials like housing or education.
So we face a huge paradox: the world’s wealthiest nation keeps increasing its healthcare spend (which is not economically sustainable) and yet a growing number of its citizens cannot avail of affordable, quality care (which is not socially acceptable). The only way to solve this vexing paradox is through innovation.
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