Health Equity: 04/09/12

Monday, April 9, 2012

[EQ] Research and Development to Meet Health Needs in Developing Countries

Research and Development to Meet Health Needs in Developing Countries:
Strengthening Global Financing-Coordination

WHO - Report of the Consultative Expert Working Group –EWG – on:
Research and Development: Financing and Coordination

Available online PDF file [226p.] at: http://bit.ly/HiWC7y

5 April 2012 | Geneva – “…..New sources of funding are needed to stimulate health research specifically for diseases that affect people in developing countries, according to a report published today by an international expert group convened by WHO.

The Consultative Expert Working Group on Research and Development: Financing and Coordination (CEWG) has called for increased global commitment to funding and coordinating health research to meet the specific needs of developing countries. The group proposes a package of changes that includes utilizing open knowledge innovation and prizes as incentives, mandatory government commitments, pooling of funding and an international binding convention on global health research.

Recommendations to improve global financing

· Research outputs that address health needs of developing countries should be in the public domain or made available through open licensing.

· Patent pools should be used to increase sharing of research results.

· Pooled funding mechanisms should coordinate financial resources and some of the funds should be used for capacity building in developing countries including direct grants to companies that can help promote technology transfer.

· WHO should play a central coordinating role in global health research.

· Increased funding is needed from governments and philanthropic sources in the light of market failures of private investments.

· All countries should commit to spend at least 0.01% of gross domestic product on research to develop health technologies for use in developing countries.

Discussion on the recommendations will take place at the 65th World Health Assembly (WHA) in May 2012….”

Content:

Executive summary .

Chapter 1: Introduction

Chapter 2: Setting the scene: the issues

The need for actio

Trends in R&D in the pharmaceutical industry

Research and development relevant to developing countries

Expenditure Estimates and Sources of Funding
Research Outcomes

Research and development and access .

Research and development financing

Research and development coordination

Chapter 3: Review of proposals

Chapter 4: Strengthening global financing of health research and development
Chapter 5: Strengthening global coordination in health research and development
Chapter 6: Implementation: a binding instrument

Annex 1: Inception report

Annex 2: Mapping of EWG and CEWG processes

The EWG‘s grouping of R&D financing and coordination proposals

The first step: creation of an inventory of 109 proposals

The second step: from 109 proposals to 91 proposals

The third step: from 91 to 22 grouped proposals

CEWG grouping of R&D financing and coordination proposals

The inventory of R&D financing and coordination proposals considered by CEWG

The new landscape of proposals: 15 assessments and chapters on financing and coordination

Annex 3: Assessments of proposals . .

Global Framework on Research and Development . .

Removal of data exclusivity . .

Direct grants to companies

Green intellectual property

Health Impact Fund

Orphan drug legislation

Patent pools

Pooled funds

Open approaches to research and development and innovation

Milestone prizes and end prizes

Purchase or procurement agreements

Priority review voucher

Regulatory harmonization

Tax breaks for companies

Transferable intellectual property rights

ANNEX 4: Regional consultation meetings

KMC/2012/HSS
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[EQ] Epidemiology, epigenetics and the 'Gloomy Prospect': embracing randomness in population health research and practice

Epidemiology, epigenetics and the ‘Gloomy Prospect’:
embracing randomness in population health research and practice

George Davey Smith MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, UK
International Journal of Epidemiology doi:10.1093/ije/dyr117

Website: http://bit.ly/HnSQxk

Key Messages:
“….Implications of the ‘gloomy prospect’ for epidemiology, public health and personalized medicine

•A major component of inter-individual differences in risk of disease is accounted for by events that are not epidemiologically tractable, including stochastic events ranging across the sub-cellular and cellular level, to chance biographical events and idiosyncratic gene by environment interactions. These will fall into the ‘non-shared environmental’ component of variance identified in behavioural genetic analyses. Even if their causal contribution could be identified, there would often be no implications for disease prevention, as such events do not generally provide targets for intervention.

•At the level of populations, rather than individuals, a large proportion of cases of disease will often be attributable to modifiable influences that only account for a small proportion of inter-individual variation in risk. These may be elements of ‘the shared environment’ in childhood or the adulthood equivalent of such group-level exposures.

•Epidemiology is a group-level discipline. As Jerry Morris stated in his seminal ‘The Uses of Epidemiology’ over 50 years ago, ‘the unit of study in epidemiology is the population or group, not the individual’.1 Epidemiology relates to incidence rather than particular incidents.

•Ecological studies directly address causes of population disease burden but are subject to many well-known biases, and aetiological hypotheses they support require testing in different study designs. However, the fact that we collect data at the level of the individual does not detract from the fact that in most situations we can only make inferences to groups, and not to individuals.

•Genetic variants are borne by individuals but, like other exposures in an epidemiological context, must usually be analysed at a group level.

•We should not conflate individual- and group-level explanation. In an insightful paper David Coggon and Chris Martyn convincingly present the case for the highly stochastic nature of disease causation. However, they consider that substantial variation between populations in disease rates, or rapid changes in incidence over time, provide an exception to this rule. In fact chance processes at an individual level together with almost entirely explicable group level differences are in no way contradictory, indeed should be expected.

•The substantial stochastic element in disease causation and treatment response suggests that fully personalized medicine is an unlikely scenario. Indeed the move from personalized to stratified medicine reflects the fact that in most situations group-level rather than purely individual data contribute to appropriate treatment decisions, and provide the empirical basis for evidence – based medicine and best practice treatment guidelines.
The tension between more reliable estimates based on larger groups and the essentially individual nature of medical encounters is a long running one, highlighting the importance and difficulty of identifying the smallest coherent groups for which reliable treatment effects can be estimated….”

KMC/2012/HSD
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* * *
This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues. [DD/ KMC Area]
Washington DC USA

Thank you.

[EQ] Epidemiology in Latin America and the Caribbean: current situation and challenges

Epidemiology in Latin America and the Caribbean:
current situation and challenges

Sandhi M Barreto,1* Jaime J Miranda,2,3 J Peter Figueroa,4 Maria Ineˆs Schmidt,5 Sergio Munoz,6 P Pablo Kuri-Morales7 and Jarbas B Silva Jr8

1 Faculdade de Medicina, Universidade Federal de Minas Gerais, Brazil,
2 CRONICAS, Center of Excellence in Chronic Diseases,

3 Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Peru, |
4 University of the West Indies, Mona, Kingston, Jamaica,
5 Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Brazil,
6 Department of Public Health, School of Medicine, Universidad de La Frontera, Chile,
7 Facultad de Medicina, Universidad Nacional Auto´noma de Mexico and

8 Health Surveillance Secretariat, Ministry of Health, Brazil

Oxford University Press on behalf of the International Epidemiological Association

International Journal of Epidemiology 2012;41:557–571doi:10.1093/ije/dys017 March 2012

Website: http://bit.ly/IilkIg

Background

This article analyses the epidemiological research developments in Latin America and the Caribbean (LAC). It integrates the series commissioned by the International Epidemiological Association to all WHO Regions to identify global opportunities to promote the development of epidemiology.

Methods

Health situations of the regions were analysed based on published data on selected mortality, morbidity and risk factors. Epidemiological publication output by country was estimated by Medline bibliometrics. Internet and literature searches and data provided by key informants were used to describe perspectives on epidemiological training, research and funding.

Findings
Despite important advances in recent decades, LAC remains the world’s most unequal region. In 2010, 10% of the LAC’s people still lived in conditions of multidimensional poverty, with huge variation among countries. The region has experienced fast and complex epidemiological changes in past decades, combining increasing rates of non-communicable diseases and injuries, and keeping uncontrolled many existing endemic and emerging diseases.

Overall, epidemiological publications per year increased from 160 articles between 1961 and 1970 to 2492 between 2001 and 2010.
The increase in papers per million inhabitants in the past three decades varied from 57% in Panama to 1339% in Paraguay. Universities are the main epidemiological training providers.

There are at least 34 universities and other institutions in the region that offer postgraduate programmes at the master’s and doctoral levels in epidemiology or public health. Most LAC countries rely largely on external funding and donors to initiate and sustain long-term research efforts. Despite the limited resources, the critical mass of LAC researchers has produced significant scientific contributions.

Future needs
The health research panorama of the region shows enormous regional discrepancies, but great prospects. Improving research and human resources capacity in the region will require establishing research partnerships within and outside the region, between rich and poor countries, promoting collaborations between LAC research institutions and universities to boost postgraduate programmes and aligning research investments and outputs with the current burden of disease.

Thank you.

[EQ] Green Economy - Green Jobs - health risks and benefits - Seminar April 11, 2012

SDE Seminar Series towards Rio+20
Sustainable Development and Environmental Health – SDE - PAHO/WHO

Green Economy/Green Jobs - health risks and benefits

Tenth Seminar:
11 April 2012 – PAHO/WHO Rio+20 - (in English with simultaneous translation to Spanish)

Time: 12:00 pm - 1:00 pm - EDT (Washington, DC USA)
To check local time in WDC against your time zone, see the World Clock

Website PAHO/WHO Rio+20 at: http://bit.ly/oxoRdS

Green Economy/ Green Jobs are viewed as a new activity whose scope in terms of health risks and benefits continue to be an emerging challenge.
However, it seems it can generate very significant co-benefits for preventing infectious diseases, non-communicable diseases and occupational diseases, and even benefit workers’ health promotion.
This seminar intends to show some evidence in different economic sectors, as well as to share successful experiences in the construction sector.

Agenda

12:00 p.m. Welcome and introduction: Dr. Julietta Rodriguez-Guzman, Regional Advisor on Workers’ Health, PAHO/WHO

12:05 p.m. Workers’ Health in the Green Economy and Sustainable Development:

Dr. Ivan Ivanov Dimov, MD, PhD, Team Leader, Occupational Health, WHO

12:20 p.m. Green economy in the construction sector: NIOSH experiences:

Dr. Christine M. Branche, PhD, FACE Associate Principal Director and Director Office of Health and Safety in Construction, NIOSH

12:35 p.m. Commentaries and perspectives from ILO
Dr. Valentina Forastieri, Coordinator of the Health Promotion and Training Unit, International Labor Organization (ILO)

12:45 p.m. Questions and Answers

01:00 p.m. Wrap-up

For further information, see the following links released by the US National Institute of Occupational Safety and Health (NIOSH): http://www.cdc.gov/niosh/construction

How to participate:

In person:
PAHO/WHO
525 23^rd ST NW
Washington DC, 20037 Room 812 – 12h to 13h Eastern Time (WDC)

Online: via Elluminate link:

- Spanish room: www.paho.org/virtual/SeminariosSDE

- English room www.paho.org/virtual/SDESeminars

Background:
SDE Seminar Series towards Rio+20

"Human beings are at the centre of concerns for sustainable development.
They are entitled to a healthy and productive life in harmony with nature" - Principle 1 of the Rio…..” Declaration on Environment and Development, 1992.

The Rio Declaration of 1992 recognizes that healthy populations are central to human progress and sustainable development, and remains equally true today. However, the economic pillar has been prioritized at the expense of the social and environmental pillars of sustainable development over the last few decades, becoming itself a source of volatility and destabilization.

The United Nations Conference on Sustainable Development, Rio+20, now offers an opportunity to re-examine the relationship between health and sustainable development. The proposed SDE Seminar series towards Rio+20 aim at contributing to this important debate by bringing different themes of relevance to sustainable development and health to inform all areas of the Pan American Organization about the themes under discussion in the Rio Conference, but also to inform public health stakeholders and other decision makers in the health sector, to better take part in the debate.

The “Zero Draft of the Outcome Document" [http://bit.ly/zDNKbR] is still under discussion. Health has been poorly positioned in this document and through our weekly discussions, we hope to provide an overview of some of the different aspects of health the context of sustainable development.

The SDE Seminar series will happen every Wednesday from 12 to 1pm (EDT), from February 8 to June 13th.

All Seminars will be live streamed, and open for participation in person at the PAHO/WHO headquarters, or via Elluminate. Some of the Seminars will be in English, others in Spanish.

For those who cannot follow the live seminar, we will have it available later at PAHO Rio+20 Toolkit at: http://bit.ly/oxoRdS

Thank you.