03.03.17

Genetically Modified Mosquitoes: The Key to Eliminating Zika?

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This post was written by Laura Malavé-Seda and Rebecca Reingold.

Image courtesy of SynBioBeta

Since 2015, the U.S. and U.S. territories have reported 5,074 and 38,306 cases of Zika, respectively. The Zika virus is spread to people primarily through the bite of an infected Aedes aegypti mosquito. Most people never know that they have been infected with the virus – it is estimated that four out of five people with Zika virus infections have no symptoms at all.  Even in those who develop symptoms, the illness is usually mild and, as a result, may never be diagnosed.

There is no vaccine for Zika so prevention is key. Prevention efforts have included advising people in Zika-affected areas to eliminate mosquito breeding sites, use insect repellent, wear clothes (preferably light-colored) that cover as much of the body as possible, sleep under mosquito nets, etc. However, many countries affected by Zika have struggled to control its spread, particularly during the summer months, and are exploring new prevention methods.

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Posted in Global Health; Tagged: , , , , .

02.24.17

Let’s Get Physical: WHO’s Renewed Focus on Promoting Physical Activity

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In January this year, the World Health Organization (WHO) renewed its focus on physical inactivity, a key risk factor for the worldwide epidemic of non-communicable diseases (NCDs). Encouraging and creating universal opportunities for physical activity is a complex, potentially costly exercise for governments, involving a wide range of public and private actors. Fresh global attention presents both opportunities and challenges for all stakeholders, and an opportunity for WHO to provide leadership on this often-neglected NCD risk factor.

Physical inactivity is a leading risk factor for premature death

Physical inactivity is one of the leading risk factors for premature death worldwide. Lack of physical activity increases the risk of NCDs including heart disease, cancer, and type 2 diabetes. Lee et al. estimate that by reducing rates of physical inactivity by 25%, more than 1.3 million deaths could be avoided each year.  Additional benefits of physical activity include improved mental health, better cognitive function, and enhanced bone health.

High rates of physical inactivity

Globally, 23% of adults do not meet WHO’s recommended levels of physical activity. Of even greater concern, more that 80% of adolescents (11-17 years) are not sufficiently physically active.

Economic growth and urbanization, manifesting in sedentary jobs, leisure activities, and modes of transportation, often correspond with decreases in levels of physical activity. Other factors contributing to high rates of physical inactivity include air pollution and lack of safe, accessible places for recreation.

A lack of global attention (and progress) on physical inactivity

As compared to other key modifiable risk factors for NCDs (tobacco, alcohol, and unhealthy diets), physical inactivity has tended to receive less dedicated attention from the WHO, governments, and civil society.

During the first decade of the 21st century, WHO developed a range of strategies and recommendations to promote physical activity, including the Global Strategy on Diet, Physical Activity and Health (2004), a Guide for Population-Based Approaches to Increasing Levels of Physical Activity (2007), and the Global Recommendations on Physical Activity for Health (2010). More recently, global action on physical activity has been in the context of NCDs more broadly, including as part of the United Nations Political Declaration on the Prevention and Control of NCDs (2012), the Global Action Plan for the Prevention and Control of NCDs (2013), and the Sustainable Development Goals (2015).

For the most part, these global efforts to address physical inactivity have not translated into impactful national action or reductions in persistently high or increasing rates. For example, although around 80% of WHO Member States have polices and plans to address physical inactivity, only 56% of these plans are operational. The International Congress on Physical Activity and Public Health’s 2016 Bangkok Declaration on Physical Activity for Global Health and Sustainable Development identifies the “urgent need to strengthen… the development, prioritisation, financing and implementation of evidence-informed national plans to enable all countries to achieve the WHO global target for reducing physical inactivity… by 10% by 2025.” Read More

Posted in Non-communicable diseases; Tagged: , , , .

02.21.17

Don’t Forget the Forgotten Children

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In our turbulent and oft troubled world, with new threats to people’s rights and health coming at us quickly, whether a new epidemic or a policy against immigrants or refugees that comes with great health costs, it is too easy to forget some of the long persisting health and human rights crises, particularly those that have always seemed forgotten, hidden away. Few such crises are more horrific than the institutionalization of children.

Worldwide, up to 8 million children live (often, if barely) in orphanages, which have been dubbed “dumping grounds for poor children and those with disabilities.” Almost all of these children, more than 90%, have at least one living parent. In these orphanages, the children are often neglected, abused, and denied medical care. Even when they are treated well, children housed in these institutions experience lasting psychological damage and developmental delays. They are simply no place for children. Yet, once placed in an institution, they will often never know life outside of its cold confines.

In Ukraine, for example, where “orphanages are a gateway to lifelong institutionalization in abusive adult facilities” – still more the rule rather than an exception around the world – abuse is rife. As Disability Rights International reported in 2015, “Children with disabilities are…often relegated to the most barren and filthy sections of institutions, left without activities, stimulation or human contact. Many children are left in physical restraints or kept in beds and cribs where their arms and legs atrophy from disuse….children are subject to beatings, rape, and other forms of routine violence.”

The complete loss of liberty, the total control over their lives by the institution (and at times legal guardianship by the state or institution), and the abuse of these children, make their institutionalization akin to slavery, effectively the property of the institution. Even if not legally owned by state or institution, for these children, that is a distinction without a difference. And sometimes, as with slavery, the children are forced into labor. In Ukraine, forced labor among institutionalized children is common, including of the most exploitive sort: sex trafficking, pornography, and sale of bodily organs. One former orphanage resident related: “In Andrey-Ivanovo institution the children were forced to work in the field from 6 am to 6 pm. Sometimes staff members took children home to help in the house and in the fields.” Read More

Posted in Global Health, Human Rights; Tagged: , , , , , , , , .

02.17.17

O’Neill Institute Event this Thursday February 23rd on Georgetown University’s Main Campus

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This post was written by Anita Alvin Nilert, Art Dialogues Curator, please direct any questions or comments to an435@georgetown.edu.

DIALOGUES ON BEING HUMAN: Intersections of Art, Health and Dignity with artist Jesse Krimes in dialogue with Marc Howard of the Prison and Justice Initiative moderated by Alicia Ely Yamin, Director of the Health and Human Rights Initiative.

Jesse Krimes with his work Apokaluptein 1638067 (The title combines the Greek root of the word “apocalypse,” or “redemption,” and Krimes’ Federal Bureau of Prisons ID number) a 15 foot high x 40 foot wide, 39-panel mural on prison bed sheets, created over 3 years, smuggled out, and pieced together when he was released.

Artist Jesse Krimes conveys the dehumanizing experience of incarceration through his compelling body of artwork clandestinely produced over 6 years on the inside while doing time for a non-violent drug offense. Saying that he only survived his odyssey through the criminal justice system by producing art every day, the work embodies themes of alienation, purification, redemption, social stratification and power. Awaiting sentencing in a 23 hour maximum security lock down for one year, he created 292 separate portraits, mostly of offenders, on slivers of prison-issued bars of soap. Then while serving a 70 month sentence, he created a 39-panel mural illustrating heaven, hell and purgatory using contraband prison sheets, hair gel, plastic spoons, and newspaper clippings, that he smuggled out in the mail. Mr. Krimes jail-made art work and compelling story embody issues of prison reform, sentencing and social justice.

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Posted in Human Rights; Tagged: , , , , , .

02.17.17

Carfentanil

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In an international game of Whac-A-Mol, this week China announced that it would be adding four lethal heroin-like narcotics to a list of controlled substances to help combat the growing opioid epidemic in America. The primary target of the ban is Carfentanil, one of the latest and deadliest synthetic opioids to show up in the United States.

Carfentanil is so deadly that an amount smaller than a poppy seed can kill a person, and until recently, was best known as a tranquilizer for knocking out moose and elephants, or as a chemical weapon. Today you can find it on the streets in Ohio and Indiana.

For decades before being discovered by drug dealers, Carfentanil has been banned from the battlefield under the Chemical Weapons Convention. However, last year drug dealers discovered that large profits could be made by cutting fentanyls into illicit drugs, and US customs authorities seized in the first six months of 2016, 295 pounds of a substance they had rarely seen before.

And overdose rates have sky rocketed.

It is clear that U.S. opioid demand is driving the development and proliferation of a new class of deadly synthetic drugs. According to the DEA, most synthetic drugs like Carfentanil that end up in the United States arrive from China – synthetic opioids that are not widely abused in their country of origin. Produced by nimble chemists to stay one step ahead of Chinese law, drugs like Carfentanil proliferate as soon as a similar substance is banned. For example, after Beijing tightened its focus on other fentanyls late last year, the AP documented how Chinese vendors began to actively market alternative opioids.

Ultimately, the fundamental qualities of the global political structure are making it impossible to fully address this problem. Portable substances spill across national borders, and the need to effectively manage their production permeates every State – even those who have no problem with the substance – as the capacity to manage global issues like drug development and consumption has not kept pace with the evolution of its complexity and danger.

Throughout history, autonomy has been paramount to sovereignty. The current international global governance structure is predicated on the idea of a Westphalian State, and until recently, the slow dispersion rates of people, knowledge, and objects did not necessitate a need for change. However, as the world is flattening, the distance between nations and the idea of a purely independent state is becoming less and less of a possibility. Where a cannon was laborious and difficult to move, newly developed drugs can be mailed via domestic postal services.

How do we fight an opioid epidemic in America when the drugs come in so quickly and easily through our own postal service? Without a unified, global plan, independent nation states will continue to play Whac-a-mole. And people will continue to die. We no longer live in the age of the isolated state, and we must change our global health laws protocols to reflect this reality.

Although the actions in China this week are greatly appreciated and highly cooperative, we must not forget that they are not a solution, but merely a temporary fix to a much larger, global issue.

Posted in FDA, Global Health, Health reform, Trade, Uncategorized;

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