Event at Georgetown: Global Health in the 21st Century: A Perspective from the Fogarty International Center, NIH”

Georgetown University is hosting a seminar on Tuesday, July 28, 2009 by Dr. Roger Glass, Director of the Fogarty International Center (FIC), National Institutes of Health (NIH), Bethesda, MD.  

Dr. Glass will deliver a  talk entitled Global Health in the 21st Century: A Perspective from the Fogarty International Center, NIH” at 10:00am in Warwick Evans Conference Room, Bldg D, Medical Center, Georgetown University.

Bio:

Dr. Glass graduated from Harvard College in 1967, received a Fulbright Fellowship to study at the University of Buenos Aires in 1967, and received his M.D. from Harvard Medical School and his M.P.H. from the Harvard School of Public Health in 1972. He joined the Centers for Disease Control and Prevention in 1977 as a medical officer assigned to the Environmental Hazards Branch. He received his doctorate from the University of Goteborg, Sweden in 1984, and joined the National Institutes of Health Laboratory of Infectious Diseases, where he worked on the molecular biology of rotavirus. In 1986, Dr. Glass returned to the CDC to become Chief of the Viral Gastroenteritis Unit at the National Center for Infectious Diseases. Dr. Glass became the Director of the Fogarty International Center and Associate Director for International Research, NIH on June 11, 2006.

Dr. Glass’s research interests are in the prevention of gastroenteritis from rotaviruses and noroviruses through the application of novel scientific research. He has maintained field studies in India, Bangladesh, Brazil, Mexico, Israel, Russia, Vietnam, China and elsewhere. His research has been targeted toward epidemiologic studies to anticipate the introduction of rotavirus vaccines. He is fluent and often lectures in 5 languages. He has co-authored more than 400 research papers and chapters.

Dr. Glass has received numerous awards including the prestigious Charles C. Shepard Lifetime Scientific Achievement Award presented by the CDC in recognition of his 30-year career of scientific research application and leadership, and the Dr. Charles Merieux Award from the National Foundation for Infectious Diseases for his work on rotavirus vaccines in the developing world.

A word from Howard J. Federoff, MD, PhD -Executive Vice President for Health Sciences, Executive Dean, School of Medicine, Georgetown University Medical Center:

Global health is a major challenge of our time, and a mission focus for Georgetown University.  Our mutual interest in this area and opportunities that FIC provides are vitally important to our faculty, staff and students. I encourage you to join us for Dr. Glass’s seminar and learn more about his vision and priorities at FIC

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“Fighting the Flu with One Hand Tied” – op-ed by Prof. Gostin in the Washington Post

The excellent op-ed by Prof Lawrence Gostin*, “Fighting the Flu With One Hand Tied” in the May 1, 2009 edition of the Washington Post highlights the legal and financial limitations of two of the world’s key public health agencies- the World Health Organisation (WHO) and US Centers for Disease Control and Prevention (CDC).

In reference to the revised 2005 International Health Regulations and the experience with SARS, Prof Gostin points out:

…the frightening truth is that the WHO has no real power. It lacks an effective mechanism for monitoring and enforcing national reporting. Its recommendations to countries are expressly “non-binding.” Countries do not even have to share virus samples with it. Indeed, despite painful negotiations over the past two years, the agency has not been able to persuade Indonesia to share samples of avian influenza, threatening vaccine production and public health preparedness.

Professor Gostin also highlights the grim reality of how the world’s poor are also the most vulnerable to, and the least capable of coping with public health emergencies of international concern.

Perhaps more worrying is the lack of capacity in poor countries to detect and respond to emerging threats. This is of particular concern because influenza often emerges in Asia, where crowded cities and close proximity between animals and humans can breed infectious disease. Although Mexico is the likely center of the current outbreak, the genetic material in the swine flu virus is of Eurasian origin. Many poor countries lack adequate surveillance, early warning systems and modern laboratories; they also have negligible public health infrastructures. Although the revised International Health Regulations urge capacity building, Western governments have donated precious little funding, and the WHO has no mechanism or resources for expanding public health capacities within individual countries.

After shedding some light on CDC’s limited legal authority and resources to effectively respond to swine flu -influenza A (H1N1), Prof. Gostin concludes:

The WHO and the CDC are our frontline defense against infectious diseases that can rapidly mutate and travel across continents. It is easy to criticize these agencies and deprive them of resources. It is much harder, but necessary, to build strong public health agencies to do the vital work that we all rely on, especially in the face of an international public health emergency.

*Professor Gostin is a professor of global health law and faculty director at Georgetown University Law Center’s O’Neill Institute for National and Global Health Law, as well as a member of the World Health Organization International Health Regulations Roster of Experts and director of the WHO Collaborating Center on Health Law.

Smoking Ban Passes in Virginia

The State of Virginia has passed legislation banning smoking in many public places.  Effective December 1, 2009, smoking will be banned in most restaurants and bars, although it will be permitted in private clubs, on some outdoor patios and in separate ventilated rooms.  Civil penalties for violation of the new law will amount to no more than $25.

Virginia will become the first state in the South to ban smoking in both restaurants and bars.  Passage of this type of smoking ban was believed to be unlikely in Virginia, where tobacco has historically played an important economic role (Phillip Morris is now headquartered in Virginia and has had ties to the region since colonial time).

According to Gallup, public sentiment is shifting towards these types of bans, and even a majority of smokers think restrictions on smoking in public are justified.

US Court orders Illinois TB patient into isolation

21 Jan 09- A US judge in Champaign County Circuit ordered 20-year-old tuberculosis (TB) patient Clasance Botembe to be isolated for 30 days after health officials and prosecutors said he failed to take precautions to avoid spreading the disease. He could be charged with a Class A misdemeanor if he defies the judge’s order.

Botembe, a native of Congo, was diagnosed with pulmonary tuberculosis on December 1, 2008. A doctor ordered him immediately to treatment and isolation. When the Public Health District came to Botembe’s apartment for his therapy he had a visitor over and was not wearing a respirator mask. According to court papers, Botembe’s girlfriend got TB after being exposed to him.

After some deliberation about the patient’s privacy, Judge John Kennedy agreed to allow media access to the hearing in a conference room at the Champaign-Urbana Public Health District. N-95 respirator masks were handed to anyone entering the hearing.

The health district will arrange for Botembe to spend his isolation period in a hotel or motel and will pay for his rent, medication, food and the global positioning system device monitoring the patient’s movements.

Although this was the first case of its kind for Champaign, it is reminiscent of the TB case in May 2007 that sparked international public health uproar, where a lawyer, Andrew Speaker, infected with extensively drug resistant tuberculosis (XDR TB) flew on several international flights for his wedding and honeymoon. Speaker became the first person infected with TB to be put in isolation by order of the U.S. government since 1963.

 

 

Obama overturns anti-abortion funding policy

Obama signed the memorandum without coverage by the media on a day following the 36th anniversary of the 1973 landmark Supreme Court ruling in Roe v. Wade that legalized abortion.

The move by Obama to reverse the Mexico City Policy received both praise and criticism from both sides of the abortion debate.

“Women’s health has been severely impacted by the cutoff of assistance. President Obama’s actions will help reduce the number of unintended pregnancies, abortions and women dying from high-risk pregnancies because they don’t have access to family planning,” said Tod Preston, a spokesman for Population Action International.

“Yesterday, President Obama issued executive orders banning the torture of terrorists but today signed an order that exports the torture of unborn children around the world,” said Tony Perkins of the Family Research Council.

“President Obama not long ago told the American people that he would support policies to reduce abortions, but today he is effectively guaranteeing more abortions by funding groups that promote abortion as a method of population control,” said Douglas Johnson, legislative director of the National Right to Life Committee.

In a statement issued with the memorandum Obama said the limitations on funding were “excessively broad” and adding that “they have undermined efforts to promote safe and effective voluntary family programs in foreign nations.” He added that “For too long, international family planning assistance has been used as a political wedge issue, the subject of a back and forth debate that has served only to divide us.I  have no desire to continue this stale and fruitless debate.” Obama also said that he would ask his administration to initiate a “fresh conversation” on family planning and to seek common ground with abortion opponents.

In an accompanying statement, President Obama said he would also work with Congress to restore U.S. funding support for the United Nations Population Fund “to reduce poverty, improve the health of women and children, prevent HIV/AIDS and provide family planning assistance to women in 154 countries.”

According to the Washington Post, lifting the Mexico City Policy would not permit U.S. tax dollars to be used for abortions, but it would allow funding to resume to groups that provide other services, including counseling about abortions.

The U.S. House of Representatives Votes to Expand Health Care Coverage for Children

On January 13, 2009, the U.S. House of Representatives voted 289-139 to expand health care coverage to 4 million children of working families through the government-sponsored State Children’s Health Insurance Program (SCHIP). 

The bill will foot the $32.3 billion cost of expanding SCHIP for 4 1/2 years by increasing federal taxes on cigarettes by $0.61-$1.00 per pack. 

Departing President George W. Bush vetoed similar legislation twice in 2007.

Obama hopes that the U.S. Senate acts with the “same sense of urgency so that it can be one of the first measures I sign into law when I am president. … In this moment of crisis, ensuring that every child in America has access to affordable health care is not just good economic policy, but a moral obligation we hold as parents and citizens.”

The Congressional Budget Office projected that nearly 83 percent of the 4.1 million uninsured children who would gain coverage if the bill becomes law are in families with incomes below current eligibility limits. About 700,000 children would gain coverage because their states broadened eligibility. The measure passed by the House included a provision that would expand coverage to children of legal immigrants as well as pregnant immigrants.

The Senate Finance Committee is scheduled to begin focusing on the matter on January 14, 2009.

Opponents suggested that the tobacco tax increase would not keep pace with rising health care costs; particularly as the number of smokers is decreasing and is likely to decrease further as a result of the tax increase.  Ultimately, these critics suggest, the government will have to cut children’s health care, recruit new smokers, or raise taxes.

Supreme Court permits Maine Residents to Sue Tobacco Company

Continuing its streak,  of tobacco-related cases this term, the Supreme Court ruled in Altria v. Good that cigarette manufacturers could be sued for their alleged deception concerning the health risks of “light” or “low tar” cigarettes. 

In the past, the Supreme Court has not permitted lawsuits from smokers to go forward on the ground that smokers were not adequately warned about the dangers of smoking. Federal laws passed in 1965, the Federal Cigarette Labeling and Advertising Act, and 1969, the Public Health Cigarette Smoking Act, required warning labels on cigarette boxes.  Accordingly, in 1992 in Cipollone v. Liggett Group, the Court ruled that these laws barred claims from smokers who said they were not warned about the health risks.

This 5-4 ruling suggests that the Court has changed course by permitting individuals to bring suits against cigarette manufacturers for deceptive advertising under state law. 

Many American smokers buy “light” or “low tar” cigarettes for their perceived health benefits relative to regular cigarettes.  When smoked by test machines, the cigarettes produce less smoke, tar, and nicotine.  When smoked by actual smokers, however, the cigarettes yield about the same amount of smoke, tar and nicotine as regular brands. Allegedly, the tobacco industry has known these results for at least 30 years.

Writing for the majority, Justice John Paul Stevens said those who sold products had a “duty not to deceive” the public through their advertising or marketing. Justices Anthony M. Kennedy, David H. Souter, Ruth Bader Ginsburg and Stephen G. Breyer joined in the opinion, while Chief Justice John G. Roberts Jr. and Justices Antonin Scalia, Clarence Thomas and Samuel A. Alito Jr. dissented.
Ten years ago, the tobacco industry agreed to a $206-billion Master Settlement Agreement with 46 states to end lawsuits over the health care costs of smoking. That agreement, however, did not block new private lawsuits.  Class-action lawsuits disputing the labeling of cigarettes as “light” or “low-tar” are purportedly set to go forward in Massachusetts, Minnesota and Missouri.