Showing posts with label council on foreign relations. Show all posts
Showing posts with label council on foreign relations. Show all posts

Wednesday, 25 April 2012

CFR Report. The New Global Health Agenda


Get the report here   From Council on Foreign Relations

The New Global Health Agenda

Universal Health Coverage

Authors: Oren Ahoobim, Project Manager, Dalberg Global Development Advisors, Daniel Altman, Director of Thought Leadership, Dalberg Global Development Advisors, Laurie Garrett, Senior Fellow for Global Health, Vicky Hausman, Partner, Dalberg Global Development Advisors and Yanzhong Huang, Senior Fellow for Global Health

Overview

The field of global health is witnessing a shift in focus from disease-driven initiatives to projects aimed at increasing the sustainability and strengthening of health systems. A crucial component to this is universal health coverage (UHC), which seeks to address financing schemes for health, separate from efforts to provide both adequate numbers of health workers and structures for health-care delivery. UHC may be provided by government or through a combination of private insurance schemes, public-sector planning, and employer-based programs. Countries across the world, from China and India to Rwanda and Mexico, are beginning to implement different universal health coverage schemes, marking a rise in interest and political will for universal health coverage. In The New Global Health Agenda: Universal Health Coverage, authors Oren Ahoobim, Daniel Altman, Laurie Garrett, Vicky Hausman, and Yanzhong Huang discuss this rise in support for universal health coverage and the financial benefits that may be reaped by implementing such schemes, and provide examples of models used to date by countries in establishing universal health coverage.
The New Global Health Agenda - the-new-global-health-agenda


Tuesday, 20 December 2011

To publish or not publish man-made 'super flu' articles

From Laurie Garrett, Council on Foreign Relations

December 20, 2011


Dear Friends and Colleagues,

Today, December 20, 2011, the National Science Advisory Board for Biosecurity (NSABB) released its decision regarding publication of two scientific papers claiming to have made a “super-flu” variant of the H5N1 avian virus. Two research teams, from the Netherlands and Wisconsin, separately claimed in September to have man-made genetic variants of the widely circulating H5N1 virus, rendering the flu not only transmissible man-to-man, but also more than 50 percent lethal.

As I described last week, the research sparked a range of fears, including concern that what amounts to the most dangerous human pathogen ever known to have existed could escape its laboratory confines, with disastrous repercussions; that publication of the “how-to” aspects of the experiments could constitute handing a catastrophe cookbook to terrorists or malevolent individuals; and that recent proliferation in high security biology labs worldwide has increased the risk of both lab accidents and untraceable bioterrorism research.

The NSABB faced three basic options regarding publication of papers by Ron Fouchier of Erasmus University in Rotterdam and Yoshi Kawaoke of the University of Wisconsin in Madison:
1)      Advise all credible scientific publications to decline release of the papers, essentially censoring the work;
2)      Allow full and free publication of both papers;
3)      Advise publication, but with key passages related to how the feats were performed, deleted.

The NSABB essentially opted for number three, suggesting to ScienceNature, and other major journals that they agree to publish the two studies, but omit some of the materials and methods sections, allowing scientists to know what was done, but not how:

Due to the importance of the findings to the public health and research communities, the NSABB recommended that the general conclusions highlighting the novel outcome be published, but that the manuscripts not include the methodological and other details that could enable replication of the experiments by those who would seek to do harm. The NSABB also recommended that language be added to the manuscripts to explain better the goals and potential public health benefits of the research, and to detail the extensive safety and security measures taken to protect laboratory workers and the public.

The U.S. Department of Health and Human Services released a statement today, responding to the NSABB (which technically is an advisory board to the HHS):

The NSABB recommended that the general conclusions highlighting the novel outcome be published, but that the manuscripts not include the methodological and other details that could enable replication of the experiments by those who would seek to do harm.
The NSABB also recommended that language be added to the manuscripts to explain better the goals and potential public health benefits of the research, and to detail the extensive safety and security measures taken to protect laboratory workers and the public.
HHS agreed with this assessment and provided these non-binding recommendations to the authors and journal editors.
One of the journals likely to publish the research is Science magazine. Science Editor-in-Chief Dr. Bruce Alberts issued a statement today:

Science editors will be evaluating how best to proceed. Our response will be heavily dependent upon the further steps taken by the U.S. government to set forth a written, transparent plan to ensure that any  information that is omitted from the publication will be provided to all those responsible scientists who request it, as part of their legitimate efforts to improve public health and safety.
The British journal Nature is also likely to publish one or both papers, and today its Editor-in-Chief Philip Campbell said:
We have noted the unprecedented NSABB recommendations that would restrict public access to data and methods and recognize the motivation behind them. It is essential for public health that the full details of any scientific analysis of flu viruses be available to researchers. We are discussing with interested parties how, within the scenario recommended by NSABB, appropriate access to the scientific methods and data could be enabled.
Where does this leave us? The papers will be published, and smart scientists working in virology or allied professions will read between the lines, reckoning exactly how the super-flus were created. The University of Wisconsin released a statement this week insisting that Kawaoke has not made a “super-flu” and welcoming the opportunity to clear the air on his research. Rotterdam’s Fouchier, however, has made a form of bird flu that is readily transmitted airborne between mammals (presumably including humans) with a lethality of about 60 percent: the work will be eagerly digested by scientists all over the world.
The NSABB decision will satisfy almost nobody. Advocates for scientific openness will bristle at any censorship, whether it involve a few sentences or an entire article. Conversely, those that fear bioterrorist use of such information will scoff at the notion that deleting a few paragraphs of methodology will in any way deter dedicated miscreants.
In the end the most important, and alarming aspect of this tale is that human beings were able to turn a fairly harmless (to mammals) virus into possibly the worst microbe to have ever co-existed with our species, and did so inside academic facilities. There was considerable debate inside the NSABB regarding whether it should recommend that all future work on the virus be conducted exclusively inside BioSafety-Level 4 (BSL-4) labs, the highest security facilities – significantly more stringent environs than those in which Fouchier and Kawaoke’s teams toil. It seems the Board punted, avoiding the question.
It is now up to federal authorities in the U.S., Netherlands, and elsewhere to decide whether to sequester the deadly microbes, and experiments conducted on them, inside BSL-4 confines.
Sincerely,
Laurie Garrett
Senior Fellow for Global Health


Wednesday, 24 February 2010

Laurie Garrett's Global Health Update Feb 2010

Laurie Garrett's Global Health Update (February 2010)
Council on Foreign Relations

The Obama Administration Global Health Initiative Advances
CFR Roundtable in Cape Town on the Future of Funding for HIV Battle
Murderous Homophobia in East Africa
H1N1 “swine flu” Backlash
H5N1 “avian flu” Returns, AGAIN
Oh Canada! Anticipating the G8/20/+ (and the meaning of “commitment”)
Dangers Ahead for Haiti
Anthrax
Measles and Mumps Return (this time, without Wakefield’s help)