Migrant health key in TB fight
March 24th, 2014
03:14 PM ET

Migrant health key in TB fight

By Martin Cetron and Davide Mosca, Special to CNN

Editor’s note: Martin Cetron MD is director of the Centers for Disease Control’s Division of Global Migration and Quarantine. Davide Mosca is director of the Migration Health Division, International Organization for Migration. The views expressed are their own.

Today’s ease of travel means more people are on the move than ever before – more than 232 million people across the globe are considered migrants, playing an important role by filling jobs in sectors that face a shrinking national workforce. In the process, they frequently enrich societies with their skills, entrepreneurship, and cultural diversity.

Unfortunately, many also originate from countries that have high rates of tuberculosis and fewer health resources. World TB day, being marked today, offers an important moment to take stock of where we stand – and why this is a problem not just for developing countries, but also for rich nations including the United States.

Of the nine million people around the world who get sick with tuberculosis each year, a third do not get treatment. It is this reality that forms the basis of this year’s theme – reaching the “three million,” through a TB test, treatment and ultimately a cure for all.

The challenge, of course, is that many of the missing three million live in the world’s poorest, most vulnerable communities, nations that often don't have the resources to fight TB. These migrants frequently face high exposure to TB infection because of overcrowded and unhealthy living and working conditions in their home countries. As a result, tuberculosis rates are high among foreign-born groups in many industrialized countries, including here in the U.S.

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Topics: Health • Immigration
February 1st, 2014
04:03 PM ET

Is obesity the next smoking?

By Global Public Square staff

What was this week's most important economic story? No, it was not Obama's State of the Union speech. Nor the stock markets. And no, it has nothing to do with the U.S. Federal Reserve. We are talking about a decision made in Beijing this week to ban smoking in schools across China – all the way from kindergarten through middle school.

Why is this economic news? Well, consider these numbers.

China is said to have 350 million smokers – more than the entire population of the United States. We bring up the U.S. for comparison because the Surgeon General coincidentally released a report last month that really caught our eye. The fallout of tobacco use, the report says, costs Americans $289 billion a year – about four times as much as the U.S. federal budget for education combined. Twenty million Americans have died in the last 50 years as a result of smoking – more than the tally from all of our wars put together, of course. This year, nearly 500,000 Americans will die prematurely because of smoking.

These numbers are just staggering. And in China, the numbers are much, much worse.

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Topics: China • Health • United States
How to prevent the next pandemic
January 31st, 2014
08:49 AM ET

How to prevent the next pandemic

By Tom Frieden, Special to CNN

Editor’s note: Dr. Tom Frieden is the director of the Centers for Disease Control and Prevention. The views expressed are his own.

Today marks the Lunar New Year – and the world’s largest annual migration. There will be more than 3.6 billion transit trips within China, in addition to countless international trips. Yet this celebration comes at a time of growing concern about the H7N9 avian influenza virus. And this concern is not unfounded – should this virus change into a form that easily spreads between people, the world’s next pandemic could occur in the next three weeks.

This combination of mass travel and an emerging virus such as this should underscore the connectedness of health security between countries. Of course, H7N9 influenza is just one example of how the health security of all nations, including the United States, depends on the health security of each individual nation. And regardless of where outbreaks occur, stopping them at the source is the most effective and cheapest way to save lives at home and abroad.

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Topics: China • Health
December 19th, 2013
04:07 PM ET

Time ripe for a new kind of global health aid

By Sir Richard Feachem and Dr Gavin Yamey, Special to CNN

Editor’s note: Sir Richard Feachem is director of the Global Health Group at the University of California, San Francisco. Gavin Yamey is an associate professor at the University of California, San Francisco and leads the Evidence to Policy Initiative in the Global Health Group. The views expressed are their own.

It’s been nearly 100 years since San Francisco was hit by the flu epidemic that swept the world and eventually claimed 50 million lives. In February 1919, the United States Public Health Service released data showing that San Francisco suffered the most of all major American cities, with a death rate approaching 30 deaths per 1,000 people.

In today’s era of mass, rapid international transit, and in the face of rising rates of “spillover” of animal infections into humans, concern is growing that the world could soon face an even deadlier global flu pandemic. The terrifying reality is that the world is shockingly under-prepared.

The 1918 flu pandemic reminds us how interconnected we are as a planet.  The only way that we can adequately prepare for public health emergencies like a flu pandemic is through international collective action. With global health threats, we all win together, or we all lose together.

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Topics: Health
5 health challenges for 2014
December 18th, 2013
08:38 AM ET

5 health challenges for 2014

By Tom Frieden, Special to CNN

Editor’s note: Dr. Tom Frieden is the director for the Center for Disease Control. The views expressed are his own.

The Center for Disease Control’s more than 12,000 public health experts have a simple goal: to help people live healthier, longer lives.  This will increase productivity and reduce health care costs.

We as a country are fortunate there are so many dedicated specialists working 24/7 to protect us from threats.  The skill and hard work of CDC staff allows me to sleep well at night.

Of course, there were those 16 nerve-wracking days in October when most of CDC’s experts weren’t here because of the government shut-down. The uncertainty of that time makes me appreciate CDC’s achievements in 2013 even more. Our work with partner organizations and individuals in the government and private sector – doctors, nurses, pharmacists, and laboratory experts – in this country and around the world made this progress possible.  And our progress this past year enables even more progress in 2014. FULL POST

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Topics: Health
December 16th, 2013
04:43 PM ET

How to make U.S. health care more efficient

By Jody Heymann and Douglas Barthold, Special to CNN

Editor’s note: Dr. Jody Heymann is dean of the UCLA Fielding School of Public Health, an elected member of the Institute of Medicine, and Distinguished Professor of Epidemiology, Medicine and Public Policy at UCLA. Douglas Barthold is an economics doctoral candidate in economics, and a doctoral fellow at McGill University's Institute for Health and Social Policy. The views expressed are their own.

Worried about what your new mandated health insurance will cost next year? We should all be worried, but it has little to do with the Affordable Care Act. Over the past two decades, the United States has run near the top of the pack in a competition no country wants to win – spending the most while getting the least.

The American Journal of Public Health published the results of our study examining health systems of 27 high income countries over 17 years, and their efficiency at turning dollars into extended lives. The United States was near the bottom, ranking 22nd. Every hundred additional dollars spent in the United States was associated with a gain of less than half a month of life. In Germany, more than four months of increased life expectancy were associated with every additional hundred dollars spent.

Not everyone does equally poorly in the United States. Our new study has the U.S. ranking 18th when it comes to the efficiency of investments in reducing men’s deaths.  Worse yet, when it comes to reducing women’s deaths, the U.S. ranks 25th.

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Topics: Health
A nightmare health scenario we can stop
November 20th, 2013
08:52 AM ET

A nightmare health scenario we can stop

By Tom Frieden, Special to CNN

Editor’s note: Dr. Tom Frieden is the director for the Center for Disease Control. The views expressed are his own.

Today’s interconnected world means we’re all linked by the air we breathe, the water we drink, the food we eat – and the antibiotics we use.

Global travel speeds the rate at which infectious disease threats can be delivered to our doorstep. We’ve seen antibiotic resistance travel the globe. Take Carbapenem-resistant Enterobacteriaceae or CRE. This really is a nightmare bacteria, resistant to most, and in some cases all, antibiotics. These microbes are especially deadly, and they can pass their resistance to other microbes through “jumping genes” or plasmids. One type of CRE was first seen in one U.S. state. Now it’s spread to 44. It’s also a recognized problem in other countries.

Right now, CRE are found primarily in hospitals. But if these microbes become more common in the community, then urinary tract infections, wounds and other common infections will be extremely difficult or even impossible to treat. It’s a terrible scenario – one that puts all of us at risk.

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Topics: Health
August 1st, 2013
09:04 AM ET

Don’t ignore health needs of countries in crisis

By Samba Sow, Special to CNN

Editor’s note: Samba Sow is director general of the Center for Vaccine Development in Mali, a collaborative enterprise between the Ministry of Health and the University of Maryland School of Medicine. He is also a professor of medicine at the University of Maryland School of Medicine. The views expressed are his own.

Power outages. Strikes. Security concerns. Equipment shortages. Rumors. These are the routine challenges of conducting scientific research in the developing world. And while researchers are used to working with these challenges, these difficulties are compounded when political instability is added to the equation.

In the past year, my colleagues at Center for Vaccine Development Mali and I have faced immeasurable challenges in keeping research efforts going while an insurgency threatened the capital city of Bamako, where our research center is located. We strive to train Malian health workers and scientists to conduct world-class research through clinical trials and other studies aimed at better designing life-saving interventions, such as new vaccines.

But leading our already complex research projects became even more difficult after the coup in March 2012. A curfew mandated that all activity occur between the hours of 6:00 a.m. and 6:00 p.m. Looting forced petrol stations to close, limiting car travel and transport of supplies. Sporadic gunfire kept most Malians indoors. My family was outside the country when the conflict began, and could not return home, nor could I visit them. Each day brought uncertainty and new dangers, and it was difficult to secure even the most basic supplies, such as kerosene.

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Topics: Africa • Health
U.S. health care’s dangerous profit fixation
July 11th, 2013
11:10 AM ET

U.S. health care’s dangerous profit fixation

By Russell J. Andrews, Special to CNN

Editor’s note: Russell J. Andrews is a neurosurgeon who has been a U.S. Army flight surgeon, a clinician and researcher in both academia and private practice and a medical device developer with NASA. He is the author of ‘Too Big to Succeed: Profiteering in American Medicine.’ The views expressed are his own.

Medicine is big business in America. Nearly one fifth of our GDP is spent on health care – 50 percent more than any other developed country. Yet by many measures we are not getting value for money. Even nearby Cuba, which spends less than one-tenth as much as the U.S. per capita on health care, has outcomes that are as good or better: life expectancy is just as long, and the infant mortality rate is actually lower. Health care in the U.S. is on an unsustainable course, and costs cannot continue to increase while outcomes continue to deteriorate.

This crisis has been blamed on greedy malpractice lawyers, drug companies, health care insurance companies and doctors who over treat patients by practicing defensive or wasteful medicine – unnecessary tests are ordered and unneeded operations are performed. And there is something to all of these. Doctors have failed to address this health care crisis, so other groups offer solutions – notably economists and political commentators. Not surprisingly these proposals represent the expected economic or political views, namely: “Which reform will rein in burgeoning health care costs?” and “Which reform will be politically acceptable?”

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Topics: Health
How to fix America’s health care
July 2nd, 2013
09:39 AM ET

How to fix America’s health care

By William A. Haseltine, Special to CNN

Editor’s note: William A. Haseltine is president of ACCESS Health International, a non-profit that aims to improve access to health care worldwide, and the author of ‘Affordable Excellence: The Singapore Healthcare Story.

The American health care system is failing. Despite spiraling costs compared with other highly developed nations, the outcomes or results we are getting for all of our expenditures often don’t compare favorably. We spend almost 18 percent of our gross domestic product on health care – an astounding amount of money translating to $2.8 trillion dollars per year. In contrast, Japan spends just over nine percent of GDP; France is below 12 percent; and the United Kingdom spends 9.5 percent.

Some argue that we pay more but get the best health care in the world. Unfortunately, that just is not true – we are most definitely not getting what we are paying for. A recent survey by the National Institutes of Health looked at health care outcomes in high-income countries around the world, and we simply did not measure up. We had the highest rates of mortality for newborns and for children less than five years of age. We had the shortest overall longevity rates, and the highest rates of death from lung and heart disease. There are many other comparisons I could cite, but the unavoidable conclusion is that our system simply does not deliver.

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Topics: Health • United States
The battle for affordable drugs
June 3rd, 2013
09:19 AM ET

The battle for affordable drugs

By Thomas J. Bollyky, Special to CNN

Editor’s note: Thomas J. Bollyky is senior fellow for global health, economics, and development at the Council on Foreign Relations and author ofPreventing Pharmageddon.’ You can follow him @TomBollyky. The views expressed are his own.

“No intellectual property should stand in the way of you, the countries of the world, protecting your people. Do you agree or not?”

Margaret Chan, the director general of the World Health Organization (WHO), made international news when she departed from her prepared remarks to ask this question of the national health ministers gathered at last month’s World Health Assembly, the annual WHO meetings. Chan was referring to the contractual restrictions and patent application that some governments and scientists complain are undermining efforts to develop a vaccine against the Middle East respiratory syndrome coronavirus (MERS-CoV), a deadly new virus now emerging in Europe and the Middle East. Chan’s question, however, would apply with equal force to any number of the other controversies over intellectual property (IP) now raging in the global health community.

A long simmering fight over patented cancer medications in emerging markets is escalating. Last month, the Indian Supreme Court rattled the multinational drug industry by refusing to grant a patent application on Gleevec, a leukemia drug that costs $70,000 per year in the United States. Indonesia followed suit, issuing a compulsory license that enables local drug firms to produce low cost generic versions of a liver cancer-causing hepatitis B treatment. China and the Philippines amended their pharmaceutical patent laws, making it easier to issue such licenses. Brazil and South Africa are reportedly pursuing similar amendments.

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Moore must be ready for psychological aftermath
May 31st, 2013
09:11 AM ET

Moore must be ready for psychological aftermath

By Mahshid Abir, Special to CNN

Editor’s note: Mahshid Abir, M.D., is an adjunct behavioral and social scientist at the nonprofit, nonpartisan RAND Corporation. The views expressed are the author’s own.

Last Monday, a massive tornado devastated Moore, Oklahoma, leveling or largely destroying hundreds of homes, businesses and two elementary schools. Plaza Towers Elementary School, where 75 students and faculty had taken shelter, was in the direct path of the tornado. Moore Medical Center lost an entire floor of its facility, requiring many of the injured, including children, some with severe injuries, to be taken to other area hospitals. At least 24 people were killed and hundreds more injured.

The tornado struck only days before the two-year anniversary of the deadly EF5 tornado that hit Joplin, Missouri, causing significant devastation and 155 fatalities. That twister lasted only minutes, but its toll on the mental health of Joplin’s residents lingered much longer. And the incident holds some important lessons for Moore and future disaster areas as they try to recover.

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Topics: Health • Natural Disaster
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