In 1983, during the beginning of the AIDS epidemic, the FDA introduced a lifetime exclusion of sexually active men who have sex with men (MSM) as prospective blood donors. At this time, the ascertainment of HIV status was not possible and not a lot was known about the disease. More than three decades later, we now know how the virus is transmitted and the most modern screening tools can detect HIV in less than 2 weeks after transmission. The lifetime ban, however, remains.
On Tuesday, an FDA advisory panel met to discuss whether or not the federal government should reverse its policy banning gay men from donating blood. The Blood Products Advisory Committee — the group of outside advisors to the FDA — said scientific testing of blood has become far more precise and is adequate to ensure that donated blood remains safe. If the FDA were to lift the ban, gay men would be allowed to give blood if they abstained from sexual encounters with men in the past 12 months. At this point the FDA has not indicated when it would make a decision on changing the ban.
The possibility of change comes amid growing calls from medical groups, gay rights activists and lawmakers to abandon the ban as outdated and discriminatory. The American Red Cross, America’s Blood Centers and the American Association of Blood Banks have opposed the ban as “medically and scientifically unwarranted”. In June 2013, the American Medical Association issued a statement calling on the FDA to change the policy, stating that "The lifetime ban on blood donation for men who have sex with men is discriminatory and not based on sound science.”
With Thanksgiving just right around the corner, there is no better time to highlight the work of Bikers Against Child Abuse International, Inc. (B.A.C.A.), a group that deserves utmost recognition and praise for what they have pledged to do. Embracing the very stereotype that has been created for them, this group of bikers creatively use their image to empower children who are victims of abuse.
In the United States, over 6 million children are victims of child abuse. Approximately 3 million reports are made annually, and they sometimes involve multiple children—one report is made every 10 seconds. What is more, greater than 80% of the cases involve the parent as the perpetrator. In addition to the physical harm, children who are victims of abuse also suffer psychological harm—much of which can be permanent. Such conditions include depression, withdrawal symptoms, anti-social behavior (e.g., personality disorders and violent behavior). It has also been observed that children who are abused are more likely to abuse alcohol or drugs.
Last week, the International Neuroethics Society had its Annual Meeting in Washington, DC. Neuroscientists, ethicists, lawyers and policy makers from around the world gathered to discuss a broad range of topics, from groundbreaking neuroscientific research, to artificial intelligence, neuroscience in healthcare, and the significant investment in brain sciences by the US BRAIN Initiative and the European Human Brain Project. And surprisingly, subsidized housing.
So how did housing become a major focus of a human rights panel at a neuroscience conference?
Recognizing the enormous burden that neurological and psychiatric disorders place on individuals, families and society, one of the major goals of the BRAIN Initiative is to develop better tools to understand how the brain functions in health and disease. This investment is much needed, as the global burden of neurological disorders is recognized by the WHO as one of the greatest threats to public health.
But what are we doing about preventing some of the neurological damage from occurring in the first place? Building on a seminal book from 2000 titled From neurons to neighborhoods, Dr Mariana Chilton, Director of the Center for Hunger-Free Communities, suggested that the most effective solution is safe and affordable housing.
On November 11, an Indian surgeon used infected instruments to sterilize 83 women in about six hours, leaving 10 of them dead and another 69 hospitalized in the central state of Chhattisgarh. The doctor breached guidelines that limit surgeons from performing more than 30 sterilizations a day and also failed to disinfect the instruments before using them between patients. This is not an isolated case; according to India’s previous health minister, Harsh Vardhan, from April 2010 to March 2013 the government paid about 510 million rupees (US$8 million) for 15,264 deaths or failed surgeries.
This incident arises in the context of India’s efforts to control population growth and of its voluntary sterilization drives, where couples choose between a tubectomy or vasectomy.
However, this raises questions of whether these operations can really be regarded as voluntary and whether there is a genuine choice to opt for a vasectomy instead. The Indian statistics show that while 35.8% of women ages 15 to 49 in India have chosen sterilization, a marginal 1.1% of men have chosen the same. This is despite a vasectomy being a simpler procedure that receives more generous financial compensation; in most states, men who choose to have a vasectomy are paid $33 by the Indian government. Women, on the other hand, typically receive less than $23. The advantages of no scalpel vasectomy are many, doctors say; it is an outpatient procedure that can be done within five minutes and has no side effects. A woman who undergoes a tubectomy must be hospitalized for eight days and risks more side effects and future complications. Tubectomies are overall more expensive and much more invasive. Read More
November has been a busy month for the Affordable Care Act. On November 15, the second round of Healthcare.gov’s open enrollment will begin. And on November 7, the Supreme Court agreed to hear a case that threatens to undermine the law in the large majority of states. This blog explores these two issues, concluding with a discussion of two other near term challenges to Obamacare.
2015 Open Enrollment
Last year’s botched rollout of Healthcare.gov was a technological (and political) disaster for Obamacare. All indications are that this year’s open enrollment period will run more smoothly (the website was even made available early for users to preview plans, something that would have been unthinkable last year).
Assuming fewer technological problems, the focus this year will be on two key issues. First is the price of premiums. Because the Affordable Care Act bans price discrimination based on health status (with limited exceptions for tobacco use and age), critics of Obamacare have predicted that the cost of insurance premiums will spike as insurers cope with the new pool of sick enrollees. While early analysis suggests that a feared spike in premium prices has not materialized, more data will be forthcoming once open enrollment begins.
You may have missed this news from mid-October: Due to the plethora of humanitarian disasters demanding global resources, along with the diminishing international combat presence in Afghanistan, the World Food Programme (WFP) has been forced to cut food rations in Afghanistan, affecting up to 1 million people. With its funding appeal experiencing about a $150 million shortfall, the WFP determined that it had to cut rations from 2,100 to 1,500 calories per person to avoid having to cut off some people from food aid entirely. Incredibly, the United Nation’s Afghanistan humanitarian appeal is among the better funded appeals, at 61% funded as of November 10, compared to 46% for UN humanitarian appeals overall, with some appeals many months old still below 40% -- and even below 30% -- funded, including for the Republic of Congo, Somalia, Chad, Burkina Faso, Nigeria, and Iraq.
The major public health story of the past weeks continues to be the Ebola epidemic in Sierra Leone, Liberia, and Guinea, even as U.S. media coverage has been dominated by fears of Ebola in the United States, with states implementing quarantines and other highly restrictive policies -- responses likely unconstitutional in their failure to be based in public health need. The crisis in West Africa persists, with very encouraging but also quite fragile indications of progress in Liberia, yet concerns of the epidemic worsening in Sierra Leone, and stable or worsening in Guinea.
Together, Ebola in West Africa and hunger in Afghanistan – in particular, as emblematic of a world that seems incapable of providing – or unwilling to provide – the required resources and policy focus on the current multitude of global humanitarian and health-related crises, hold a number of lessons for what needs to be incorporated into a more effective global governance for health. And as we will get to, a Framework Convention on Global Health could be a significant step towards embedding these into global governance structures.
Among the lessons are these eight: Read More
Posted in Global Health, Human Rights, WHO; Tagged: Ebola, fcgh, Framework Convention on Global Health, global governance, global governance for health, governance, health governance, health systems, One Health, right to health.
The O’Neill Institute for National and Global Health Law and Women’s Link Worldwide proudly announce the official launch of their joint publication Conscientious Objection and Abortion: A Global Perspective on the Colombian Experience. The publication is available in both English and Spanish.
In 2009, the Colombian Constitutional Court issued a landmark Decision T-388/09 that sets important standards on the use of conscientious objection in the context of abortion services.The publication features comparative regional analyses by experts across the globe on balancing the right to conscientious objection and women's reproductive health and rights. In addition to analyzing the standard set by the Colombian Constitutional Court in the context of abortion, the publication also examines how this standard has been used with regard to LGBT issues and how conscientious objection can be used positively to increase access to health care services by marginalized populations. Read More
Posted in Global Health, Human Rights, National Healthcare; Tagged: abortion, access to health care, conscientious objection, health care provider, health care services, reproductive health, Reproductive Rights.
The recent Ebola outbreak has brought the the tracking and containment of infectious disease to the forefront of global consciousness. Indeed, tracking and monitoring the spread of disease is one of public health's most important (and oldest) tasks. Ever since John Snow removed the handle from the Broad Street pump his hand-drawn maps indicated were at the center of a Cholera outbreak, epidemiologists have appreciated the importance of effective mapping tools. Modern online resources build upon this tradition. This post illustrates some of the best cutting-edge, publicly available mapping tools being used to track infectious diseases.
The best of the comprehensive trackers, Healthmap.org, is a project of Boston Children’s hospital. The site automatically compiles data from a broad range of sources (e.g. WHO, Google News, and PROMed Mail), displaying reports of disease on a map of the world. It also features a fascinating Ebola timeline, showing the progression of the epidemic (including a map overlay showing Ebola's zoonotic niche).
Marketing and advertising are powerful tools to influence behavior. A good ad can have profound effects on our decisions - making us crave the latest gadget, causing us to switch away from a brand our family has trusted for generations, or to vote for a candidate we know little about. When it comes to health, marketing and advertising have traditionally been monopolized by industries promoting unhealthy habits and behaviors. Big tobacco’s advertising strategies are legendary. Their tactics have been dramatized in movies such as Thank You for Smoking, and documented by plaintiffs’ attorneys and judges.
In her judgment and opinion in the US government’s landmark lawsuit against the tobacco industry, Judge Gladys Kessler found that major US tobacco companies have misled and defrauded the American public about the health risks of smoking and about their marketing strategies targeting youth. In order to help prevent the tobacco industry continuing to deceive the public, Judge Kessler ordered tobacco companies to make corrective statements in advertisements on television, in newspapers, on their websites, and on cigarette packets. Judge Kessler’s findings recognize the powerful harmful effects of tobacco industry advertising. Her orders for corrective statements aim to correct the harms by harnessing the power of advertising against the industry that has used it so effectively in the past. Although tobacco advertising is now more strictly regulated, the alcohol, fast food, and sugary drink industries are following in big tobacco’s footsteps. In 2012, the fast food industry spent a whopping $4.6 billion on advertising in the United States. Read More
Posted in Uncategorized;
This Oped was written by Michelle Ratpan and originally appeared on OpedSpace. Michelle works as a Litigation Specialist for the Integrity Vice Presidency of the World Bank and is a graduate of the Global Health Law and International Institutions LLM Program (2010).
In the following Oped, Michelle examines the current Ebola outbreak and the concern around the proliferation of counterfeit medications to treat the symptoms of Ebola. The article suggests that we should rely on the United Nations Convention against Transnational Organized Crime (UNCTOC) and its implementation and enforcement in order to ensure that fraudulent medications are not put into legitimate supply chains.
The complete article can be viewed here.
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The views reflected in this blog are those of the individual authors and do not necessarily represent those of the O’Neill Institute for National and Global Health Law or Georgetown University. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.