Tuesday, 24 January 2012

Nuffield Council on Bioethics Global Health symposium report

Nuffield Council on Bioethics -  Global Health Symposium June 2011 Report & Slides

 Go to Nuffield Council symposium webpage here



Global health symposium

An international line-up of speakers and 130 guests discussed current initiatives and future challenges in global health inequalities at the Council’s 20th anniversary symposium on Wednesday 22 June 2011 in London.
After exploring the ethical and moral arguments for improving health globally, three specific areas were explored: the social determinants of health; chronic and non-communicable disease; and the role of emerging biotechnologies. Participants agreed that disparities in health are real and ethically troubling, and that there is a complex set of responsibilities for tackling the problem.
Download:
This 8-minute video shows highlights of the day, including interviews with speakers and delegates:
Media coverage

Friday, 20 January 2012

India-UK Public health PhD fellowships studentship funding


PHFI-UKC Wellcome Trust Studentships for Doctoral Studies

Doctoral studies in Public Health (Duration: 3 years)

About the Doctoral Studentships

These studentships are for doctoral studies in public health (PhD/DrPH) under the PHFI-UKC Wellcome Trust Capacity Building Programme for a duration of three years at one of the partner institutions in the UK. It includes course work in the UK, research work in India, and thesis defense in the UK. Broadly, each candidate is expected to spend one year in the UK and two years in India (at PHFI / its institutes) during the doctoral studies. The research is expected to be India-based, India-centric and India-relevant.

It is expected that the candidates will return to work with PHFI or its institutes for five years following the completion of their doctoral study.

Eligibility

Professionals who wish to build upon a substantial and relevant experience for an advanced career in public health through a doctoral degree. The candidate must possess a Masters degree in a relevant discipline from an accredited institution and must have demonstrated significant interest in public health related areas. The thesis work should focus on issues relevant to India. Candidates having significant research and teaching experience would be preferred. Field based work experience in public health will be an added advantage.

Past PHFI Future Faculty fellows are requested to contact the Wellcome Trust team for further details on eligibility.

The current priority technical areas for training are listed below but other areas of public health may also be considered. * Biostatistics * Environmental health including climate change * Health economics * Health information and surveillance * Health policy * Health systems * Occupational Health * Public health management * Public health nutrition

How to apply?
Please email your application to wt.phd@phfi.org in the following two parts.

Part 1: To be sent by the Candidate (in word format: file name - name of applicant.doc)

1. A cover letter stating that you have applied for the doctoral studentship, the technical area where you wish to focus your PhD/DrPH degree, and how your background is suitable for this degree.
2. A five-page (font size 12, single spaced) description of the research that you wish to pursue in the PhD/DrPH that includes background, objectives, methodology and expected impact of the research.
3. A copy of your latest curriculum vitae.
4. Two of your best research publications
5. Transcripts and experience certificates from previous education/training (scanned copies).
6. Valid score sheets in any relevant exams (IELTS) as may be required by the partner institutions. Please refer to the website of the partner institutions for further details on this.

Part 2: Letters of Recommendation
1. Please note that two recommendation letters are mandatory but a third letter is allowed.
2. Please arrange for these recommendation letters to be sent directly by your referees to PHFI (above mentioned email).

Deadline

Applications including letters of recommendations must be received by 29 February 2012. Incomplete/late applications will not be considered. Shortlisted candidates will be intimated by email in about four weeks following the application deadline regarding next steps. The applicant would be responsible for ensuring the completeness of her/his application.

Lancet editorial on Global health, 2012, and Rio+20











Integrating health into a sustainable development framework and agenda

The Lancet, Volume 379, Issue 9812, Page 193, 21 January 2012
doi:10.1016/S0140-6736(12)60081-6


Global health in 2012: development to sustainability

In 2012 there will be a major strategic shift in global health, away from development and towards sustainability. Since 2000, the Millennium Development Goals (MDGs), driven by a macroeconomic diagnosis of global poverty, have focused on investment in a small number of diseases as the most effective approach to decrease poverty. Institutions such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, Roll Back Malaria, and GAVI have been created to respond to that diagnosis.
But this approach is now delivering diminishing returns. The AIDS epidemic has peaked, both in terms of deaths and new infections, non-communicable diseases (NCDs) are increasing, and the climate change crisis is an ever present threat. India is a good example of a country facing these new challenges. It has an NCD epidemic and yet still endures the highest number of maternal and child deaths in the world. The old macroeconomic approach to solving poverty-related disease is simply insufficient to meet the demand of countries. At the same time, institutional tensions are growing—the Global Fund is in difficulty and WHO is facing a financial emergency. And there are new concepts forcing their way into global health agendas—such as integration and accountability. There is a view among some development experts that health has had its decade. It is time now for other sectors to take centre stage, such as agriculture or energy.
All these issues will come into sharp focus later this year at Rio+20, the UN Conference on Sustainable Development in Rio de Janeiro, Brazil (June 20—22). The summit marks the 20th anniversary of the 1992 UN Conference on Environment and Development and the tenth anniversary of the 2002 World Summit on Sustainable Development. World leaders, stakeholders from the public and private sectors, as well as representatives from environment and development communities will convene to define a new roadmap towards economic growth, social equity, and environmental protection. The objectives of Rio+20 will be to review progress on sustainable development from previous summits, identify gaps in implementation, renew political commitment on past action plans, and find ways to safeguard the planet from future destruction from emerging threats. The two core themes will be a move towards a green economy (in the context of sustainable development and poverty eradication) and strengthening the institutional framework for sustainable development, which to date has not fulfilled its potential because of a lack of coordination and coherence. The zero draft outcome document published last week lists seven priority areas for Rio+20. They are: job creation, food security, water, energy, sustainable cities, oceans, and disasters. There will be ten new sustainable development goals to be decided by governments just before the meeting—and introduced in 2015 as part of the post-2015 UN development agenda. There will be no legally binding agreements and countries will set their own targets, working voluntarily towards them. Disappointingly, health is hardly mentioned in this draft.
It is vital that this major shift from development to sustainability is governed by a clear set of principles and values. One report to draw from is The Lancet's 2010 Commission titled: The Millennium Development Goals: a cross-sectoral analysis and principles for goal setting after 2015. The authors of this multidisciplinary analysis represent many different sectors, and explain that much more could have been achieved if the MDGs were better integrated. They conclude that future goals should be built on a shared vision of development across the lifecourse, and suggest five principles: holism, equity, sustainability, ownership, and global obligation. Their report exemplifies the positive contribution the health community can make to sustainability after 2015.
The health sector has a vital part to play during the next 12 months. We need to make a strong case for health as part of sustainable development and future sustainable development goals—to protect the gains of the past decade and ensure that the unfinished agenda of the past decade is continued. However, we also need to embrace a new and emerging health agenda—one that includes NCDs and climate change. And we must sharpen our advocacy for health as we rightly integrate other sectors into this broader vision. We have an extraordinary opportunity to re-vivify global health. But we are unprepared to do so. We must identify the lessons learned from the MDGs, as well as bringing to the fore evidence for new threats and emerging challenges. The Lancet plans to be a strong partner in shaping this future health and sustainability agenda—towards finding equitable solutions to improve the health and lives of people worldwide.

Monday, 16 January 2012

Visiting fellowship, Univ of London school of advanced study


School of Advanced Study, University of London   link here

School Visiting Fellowship

The School offers a single School Visiting Fellowship each year in the humanities and social sciences by open, external competition.
The Fellowship is funded for a period of up to six months and successful applicants are expected to spend at least five months with the School. It is open to both professorial staff and early to mid-career scholars; normally applicants will have a PhD that was awarded between 8 and 15 years prior to the application deadline.
The School Fellow is expected to pursue their work in the context of an active relationship with the multi-disciplinary scholarly community within the School, to play a leading intellectual role in cross-School seminars and other programmes and to engage fully with the research promotion and facilitation mission of the School and its institutes.  Applicants must be able to show that their research can benefit from the resources of one or more of the institutes in the School, and that they will contribute productively to the range of activities across the School.
Applicants are strongly encouraged to visit the websites of the institutes and the Human Rights Consortium to find out more about the various research areas covered. Intending applicants may also find it useful in advance of making an application to make contact with the director of any of the institutes with which they might have an affiliation.
The closing date for applications for the School Fellowship is 17:00 (GMT) on 31 January for the fellowship to take place between September and June in the following academic year.

Further details and application form

Selection process and results

All eligible applications are considered by the School's RPF Programmes Committee, with input from all ten institute directors within the School.  An offer will be made as soon as possible after the meeting.
Please note that it is not possible to give feedback to unsuccessful applicants.

Contact

For further information or if you have a query, please contact the School Fellowships Officer: Peter Niven
E: peter.niven@sas.ac.uk

Friday, 13 January 2012

Global Health Essay Award for UK/Rep of Ireland medical students


Original link at RSM website

Global Health Award

Win a grant of £700 towards your elective (2 prizes of £700)
Launch Date: Friday 11 November 2011
Essay Submission Deadline: Extended until Monday 13 February 2012
Notification Date: Monday 5 March 2012
Prize: The top 5 essays will receive a free year's RSM Student membership (or free renewal) and; 1st and 2nd: £700 each (cash towards an elective). Preference will be given to electives in the field of HIV and related diseases.
Open To: All medical, midwifery or nursing students in his/her 3rd, 4th, 5th or 6th year at recognised teaching institutions within the UK or Republic of Ireland, and with a minimum of 1 year clinical training at the time of application.
Award Ceremony: 28 March 2012 at the RSM Global Health conference.
Topic: 'Managing patients with HIV in communities with severely limited resources'.
Word limit: 1,500 words (+/- 10%), plus references.
Abstract: 150 – 250 words.
To help you write the best essay, we have gathered some useful resources:
Submission: All submissions have to be sent electronically via our website from Friday 11 November 2011.
Selection: The selection process for the Global Health Young Leaders Award will be determined using a mix of social media and academic review.
A maximum of ten shortlisted essays will be presented to Professor Kumar for final selection; a maximum of five essays will be shortlisted by a panel of global health experts and academics (each essay being read by at least 2 people) with a further five (maximum) essays selected by the greatest number of Facebook 'Likes' received.
Terms and Conditions: Click here for a full list of terms and conditions
Enter your essayRead the essays

Wednesday, 11 January 2012

A. Sen: The glory and the blemishes of the Indian news media

Our free media, including our largely unfettered press, are a hugely important asset for democratic India. And yet the celebration of the Indian news media can go only so far — and no further.

One of the great achievements of India is our free and vibrant press. This is an accomplishment of direct relevance to the working of democracy. Authoritarianism flourishes not only by stifling opposition, but also by systematically suppressing information. The survival and flowering of Indian democracy owes a great deal to the freedom and vigour of our press. There are so many occasions when, sitting even in Europe or in America, I have wished for something like the vigour and many-sided balance of the Indian press to confront the vilification of chosen targets.

One longstanding example of some moment is the organised mischaracterisation in the USA of the British National Health Service and similar public health arrangements in most of Europe. Despite the fact that America has some superb newspapers, such as The New York Times, the information industry has managed to undermine thoroughly the understanding of the great accomplishments of public health care in Europe, and its contribution to enhancing health security, life expectancy, and the quality of life. Rather, the National Health Service and other such medical arrangements are often seen as some kind of a “health lock-up,” generating a widespread horror of what is called “socialised medicine” (I have heard of a rumour that American children are persuaded to eat broccoli by threatening them with “socialised medicine” as a dreaded alternative).

Professionalism and accuracy

Despite the limitations of the Indian news media, some of which I will discuss presently, we have every reason to applaud our free media, including our largely unfettered press, as a hugely important asset for democratic India. And yet the celebration of the Indian media can go only so far — and no further. There are at least two huge barriers to quality that are very worth discussing: one is concerned with the internal discipline of the media and the other relates to the relation between the media and society. The first problem is that of some real laxity in professionalism in achieving accuracy, which can be harmed even without any deliberate intention to mislead or misinform. The second is the bias — often implicit — in the choice of what news to cover and what to ignore, and the way this bias relates particularly to class divisions in India.

Indian reporting can be, and often is, extremely good. I always marvel at the skill of the reporters, often very young men and women, in being able to capture and bring out the nuances of points that are hard to summarise accurately. However, Indian reporting is characterised by great heterogeneity, and sometimes serious inaccuracies can receive widespread circulation through the media (or initiating in the media). While I have been personally lucky, most of the time, I am aware of problems that others have had, and sometimes I see them in my own experience. As an Indian reader, I would like to be sure, when I open the morning newspaper, that what I am reading — that A said B — is actually accurate. It is hard to have that assurance.

Let me give a couple of examples, despite — I should re-emphasise — my generally good experience with reporting in the press. Four days ago in a public discussion I said in answer to a question about the Lokpal initiative that the solution to the extremely important problem of corruption would have to be sought within the Indian democratic system (including our courts and Parliament), and also that I had not seen the blueprint of any effective Lokpal Bill – neither from the government nor from any faction of the Opposition.

When, later on, I opened the web, I found reports with the following headlines: “Lokpal Bill well thought out: Amartya Sen” (The Times of India, India Today, Zee News, NDTV, among others); and “Lokpal Bill not well thought out: Amartya Sen” (DNA News, Money Control, The Telegraph [which did not make it a headline], among others). One paper first distributed the former story and then the latter, without noting that there is a correction here, and I was amused because it is a paper — The Economic Times — with which I am personally associated, since I was given the privilege of editing the paper for one day a few years ago (it was a great day for me, though I gather from the Editor that I drove them all mad, by rejecting entries and asking for several rewrites).

Based on another meeting in Kolkata on the same day, a lecture for the Cancer Foundation of India, I found the following headlines: “To smoke is individual option” (The Statesman) and “Curb smokers' liberty: Amartya” (Hindustan Times). All this is just from one day. Unfortunately, a misreport on one day can have quite big consequences. The Times of India said on December 15: “Amartya Sen: People on street can't deal with corruption.” I had said nothing of the sort, as the audio record of the speech confirms, but once that misreporting, coming from a news agency apparently used by many newspapers, is in the public domain, it is hardly surprising that I would be showered with rebuke and moral advice. Dozens of pages of denunciations materialised immediately. Much of the moral advice to me would be sensible enough had the statement reflected something I had said. The one I liked best said: “I think Mr. Sen should keep his mouth shut” — an eminently sensible piece of advice given the constant danger of misreporting by a careless press — or, as in this case, a careless news agency on which many papers mechanically rely.

What I had, in fact, said was that the judgment and penalty for corruption cannot be a matter for street justice, and must come through the democratic procedures that we cherish in India, including the courts and Parliament. I believe the Indian people are fully committed to that democratic priority, rather than “summary justice.” What they really complain about is that the democratic procedures are not being applied sufficiently vigorously and stringently to corruption. This is indeed an important demand, and this understanding is very far from any dismissal of the ability of “street people” to comprehend the political challenge arising from corruption. Since I have taken part in street demonstrations myself, complaining about many injustices in India (one recent activity of this kind was related to the public agitation for the right to food), I must stand up for the right of ordinary folks — what the news agency called the “street people” — to be heard loud and clear.

On enhancing accuracy

So what can the media do to deal with the lapses from accuracy in reporting? I don't know the answer — my main intention here is to raise the question — but one thought that is fairly straightforward is to get all the newspapers to agree to publish corrections of their own stories as a regular feature (and highlight them online, along with the corrected accounts). This is done with much effectiveness by The Guardian and The New York Times, and some Indian papers already have such a section (the host of this essay, The Hindu, has had this for many years), but the practice can be made more universal among the papers, and also more active and more well-known.

There is also an issue of journalistic training. Taking notes in a rush is never easy, and it has become harder still since most reporters today, unlike those in the past, do not know shorthand. But there are marvellous recording devices in our modern world, and they can perhaps be used more uniformly, rather than the reporters tending to rely on memory, as many still seem to do. There are surely other ways of reducing inadvertent inaccuracy, and it would be nice to see more discussion on it. But now I must move to the second problem to which I referred.

Class bias

If greater accuracy is mainly an internal challenge for the media, avoiding — and fighting — class bias involves an external challenge that relates to the divisiveness of the Indian society. Of course, class divisions are present elsewhere as well. The “Occupy Wall Street” movement has drawn attention to what it sees as the contrast between the very prosperous — the 1 per cent at the top — and the rest of the 99 per cent in the United States. I will not comment here on the veracity of this 1%-99% contrast, as applied to the United States, but relying on a similar division in India would miss the mark by a long margin. There are, of course, many divisions in India — and some apply to newspaper ownership as well — but the division that introduces a generic bias in Indian news coverage, related to the interest of the newspaper reading public, is more like one between a fortunate fifth of the population who are doing just fine on the basis of the economic progress that is taking place in India, and the rest who are being left firmly behind.

There is, in fact, a substantial part of the Indian population — a minority but still very large in absolute numbers — for whom India's economic growth is working well, along with those who were already comparatively privileged. An exaggerated concentration on their lives, which the Indian media tend typically to display, gives an unreal picture of the rosiness of what is happening to Indians in general. There tends to be fulsome coverage in the news media of the lifestyles of the fortunate, and little notice of the concerns of the less fortunate. To refer to three of many unfortunate facts (the list can be quite long): (1) India has the highest percentage of undernourished children in the entire world, measured in terms of the standard criteria; (2) India spends a far lower percentage of its GNP than China on government-provided health care and has a much lower life expectancy; and (3) India's average rank among South Asian countries — India, Pakistan, Bangladesh, Sri Lanka, Nepal, and Bhutan — in the standard social indicators, varying from life expectancy and immunisation to infant mortality and girls' schooling, has dropped over the last twenty years from being second-best to second-worst (even as India has surged ahead in terms of GNP per capita).

The problem here does not, of course, originate in the media, for it is social division that feeds this bias in coverage. But the media can play a more constructive part in keeping the reality of India persistently in the view of the public. The bias in coverage, even though it is by no means unpleasant to the reader, contributes quite heavily to the political apathy about the urgency of remedying the extreme deprivation of the Indian underprivileged. Since the fortunate group includes not only business leaders and the professional classes, but also the bulk of the country's intellectuals, the story of unusual national advancement gets, directly or indirectly, much aired — making an alleged reality out of what is at best a very partial story.

What is probed and what ignored

The group of relatively privileged and increasingly prosperous Indians can easily fall for the temptation to assume that given the high rate of economic growth, there is no particular need for special social efforts to enhance the lives of people. When, for example, the government introduced, as it did recently, its plan of providing subsidised food for the Indian poor, an enormous number of critics pointed immediately to the fiscal problems involved, and some even talked about the sheer “irresponsibility” that is allegedly reflected in the Food Security Bill.

There are indeed many serious problems with the Food Security Bill that has been tabled, and the Bill can be much improved and one hopes it will be. Furthermore, fiscal responsibility is certainly a serious issue and the financing of food subsidies, like other social programmes, demands critical examination. But it is worth asking why there is hardly any media discussion about other revenue-involving problems, such as the exemption of diamond and gold from customs duty, which, according to the Ministry of Finance, involves a loss of a much larger amount of revenue (Rs.50,000 crore per year) than the additional cost involved in the Food Security Bill (Rs.27,000 crore). The total “revenue forgone” under different headings, presented in the Ministry document, an annual publication, is placed at the staggering figure of Rs.511,000 crore per year. This is, of course, a big overestimation of revenue that can be actually obtained (or saved), since many of the revenues allegedly forgone would be difficult to capture — and so I am not accepting that rosy evaluation. And yet it is hard to understand why the cost of the Food Security Bill should be separated out for fiscal gloom without examining other avenues of fiscal soundness. An active media can draw attention to what is being probed and what remains underdiscussed and underexplored.

The impact of India's division between the privileged and the non-privileged can also be seen in the political power of the advocates of continuing — and expanding — subsidies on fuel use, even those that go particularly to the relatively rich (such as petrol for car owners), or of fertilizers, which yield major transfers of a regressive kind, even as they help with agricultural production. It is possible to redesign these fiscal arrangements to introduce more economic rationality, greater environmental awareness, and the demands of equity with efficiency. The political support for tolerating — and defending — the present profligacy in catering to the relatively better off contrasts sharply with the fiscal alarm bells that are sounded whenever proposals for helping the poor, the hungry, the chronically unemployed come up.

If the first problem I referred to, that of accuracy, is one of improving the performance of the news media through better quality control, the second, transcending class bias, concerns the media's role in reporting and discussing the problems of the country in a balanced way. The media can greatly help in the functioning of Indian democracy and the search for a better route to progress including all the people — and not just the more fortunate part of Indian society. What is central to the functioning of the news media in Indian democracy is the combination of accuracy with the avoidance of bias. The two problems, thus, complement each other.

(Amartya Sen, the Thomas W. Lamont University Professor, and Professor of Economics and Philosophy at Harvard University, won the Nobel Prize in Economics in 1998. The Bharat Ratna was conferred on him in 1999.)

Tuesday, 3 January 2012

(US) Physicians Highlight Overlooked Connection Between Social Needs and Health

Link to webpage with full report / story and additional resources. http://www.rwjf.org/vulnerablepopulations/product.jsp?id=73646
This is a story from and about the USA.



Physicians Highlight Overlooked Connection Between Social Needs and Health


National survey indicates physicians believe addressing patients’ social needs is as important as addressing medical conditions.

Four in five physicians say patients’ social needs are as important to address as their medical conditions, according to a new survey conducted by Harris Interactive on behalf of the Robert Wood Johnson Foundation. For physicians serving patients in low-income communities, nine in ten physicians believe this is true.

In this national survey of primary care providers and pediatricians, 85 percent believe that unmet social needs — things like access to nutritious food, reliable transportation and adequate housing — are leading directly to worse health for all Americans. Furthermore, 4 in 5 physicians do not feel confident in their capacity to meet their patients’ social needs, and they believe this impedes their ability to provide quality care.

This is health care’s blind side: Within the current health care system, physicians do not have the time or sufficient staff support to address patients’ social needs.
Physicians surveyed feel so strongly about the connection between social needs and good health that 3 in 4 wish the health care system would pay for the costs associated with connecting patients to services that address their social needs if a physician deems it important for their overall health. Results also revealed that, if physicians had the power to write prescriptions for social needs, they would prescribe fitness programs, nutritional food and transportation assistance. Physicians whose patients are mostly urban and low-income also wish they could write prescriptions for employment assistance, adult education and housing assistance.

We know that our zip code is more powerful than our genetic code when it comes to our health. Indeed, the conditions we face day in, day out, where we live, learn, work and play, have a greater impact on our health and life expectancy than our medical conditions and the health care we receive.

Promising models, such as Health Leads, bridge this gap by empowering health care providers to help remove the social barriers that keep people from taking the actions they need to be healthy. Such models need to continue to be invested in and evaluated. Nevertheless, more can be done. While models that address social needs are a step in the right direction, leadership and commitment from health care decision makers is required to create system-wide and lasting change.