Health Equity

[EQ] Seminar on: Trade and Public Health

2012-01-26T10:57:00.000-08:00

PAHO/WHO

Areas of Sustainable Development and Environmental Health (SDE) and Health Surveillance Disease Prevention and Control (HSD)

Invites you to the Seminar on: Trade and Public Health

Keynote Speaker: Benn McGrady

Tuesday, 31 January 2012

Time: 2:00 pm - 4:00 pm - Eastern Standard Time (Washington DC USA)

To check local time in WDC against your time zone, see the World Clock at:

http://www.timeanddate.com/worldclock/meeting.html

The Problem:

· Trade treaties can affect public health in negative and positive ways depending on how it affects the availability of different products or how they affect labor markets among other factors. A clear case is the increase of chronic non communicable diseases (NCD) due to the higher availability of potentially harmful products, like tobacco, unhealthy food and alcohol. NCD are today the first cause of morbidity and mortality worldwide and tobacco is the main risk factor related to them.

· The most effective interventions in tobacco control, included in the WHO Framework Convention on Tobacco Control (FCTC) contain regulations that will have an effect in trade and businesses and the WHO FCTC is also a legally binding international treaty. Many of the interventions applied to tobacco control will be useful in other areas, like alcohol and junk food regulation, therefore this is a challenge that will grow in the near future.

Challenges: There is a need for an integrated approach from countries recognizing the prevalence of public health over commercial or trade interests.

NCD a public health problem is a priority for WHO/PAHO and also for the entire UN system, that focused its last high level meeting on this subject.

Expected outcomes:

· Increased awareness of the importance of the relationship between trade and public health.

· Country level discussion regarding the prevalence of public health over commercial interests.

To participate in person:

Pan American Health Organization, PAHO/WHO

525 23rd St NW Washington DC 20037 - PAHO HQ Room 1017

To participate online:

To login to the Elluminate session, use the links below and type your name on the sign in page:

ENGLISH: www.paho.org/virtual/SDETobaccoControl

SPANISH: www.paho.org/virtual/SDEControlTabaco

To login type your name on the sign in page

AGENDA

2:00 - 2:15 Introductory remarks:

Dr. Augusto Galvão,Manager, SDE/PAHO

Dr. Marcos Espinal, Manager, HSD/PAHO

2: 15– 2:30 Why International Instruments in Public Health, – WHO Framework Convention on Tobacco Control

Dr. Armando Peruga, WHO/TFI Program Manager

2:30 – 3:20 How Trade Policy affects Public Health:
The Example of Tobacco, Alcohol and Diet and the Burden of Noncommunicable Diseases

Legal debates at WTO: Objections to Australia’s Plain Packaging of Tobacco Products from Countries of the Region

Dr. Benn McGrady, Director of the O’Neill Institute Initiative on Trade, Investment and Health

3:20 – 4:00 Panel:

Dr. Benn McGrady, Director of the O’Neill Institute Initiative on Trade, Investment and Health

Dr. Armando Peruga, WHO/TFI Program Manager

Moderators:

Dr. James Hospedales, Senior Advisor, Prevention and Control of Chronic Diseases, HSD/NC

Dr. Adriana Blanco, Regional Advisor, Tobacco Control, SDE/MH

About Benn McGrady

Benn McGrady is the Director of the O’Neill Institute Initiative on Trade, Investment and Health and an Adjunct Professor at the Georgetown University Law Center, where he teaches International Trade and Health and co-teaches Public Health and International Investment Law.

Dr.McGrady is the author of Trade and Public Health: The WTO, Tobacco, Alcohol and Diet (Cambridge University Press, 2011).

Contact Information
Dr Adriana Blanco, Regional Advisor, Tobacco Control, SDE/MH at: blancoad@paho.org

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[EQ] Health For All: Why equity is crucial

2012-01-26T10:15:00.000-08:00

Health For All: Why equity is crucial

Research Watch - the web TV/magazine of the UNICEF Office of Research - 2012

The Debate: Why is equity in health care crucial for the well being of children?

Cesar Victora, President of the International Epidemiological Association,
Janet Vega, the Director of the Centre for Epidemiology and Public Health policy in Chile, and
Mickey Chopra, UNICEF's Chief of Health.

Watch it at http://bit.ly/wsUmlg

In Look Out For:
Christopher Garimoi Orach from Makerere University School of Public Health, Kampala, gives an insight into research on the unmet needs of new and expectant mothers in displaced populations in Uganda, and Gavin Mooney from the University of Cape Town discusses research on the impact of health care payments on families, and in particular on the well-being of children.
URL: http://bit.ly/wj2TEH

Commentary:
Sofia Gruskin, Director of the Program on Global Health and Human Rights at the Institute for Global Health provides a Commentary on the interplay of
Equity, Human Rights and Health. http://bit.ly/xaPxgD

“……….All too often what has been counted falls back into a traditional paradigm of economic inequity – measuring poorest and richest quintiles – not for lack of interest but for lack of agreement on an appropriate measure, let alone what priority measures should be. While we all recognize the need to go further, tested and validated measures bringing attention to geographic, ethnic, age and gender disparities are few, let alone those which truly measure inequities and inequalities in health and the related availability, accessibility, acceptability and quality of services as mandated under the right to health. But this must be the goal, with important implications for the health and well-being of children. …………”

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[EQ] Social Health Protection: addressing inequities in access to health care

2012-01-26T10:01:00.000-08:00

Social Health Protection: addressing inequities in access to health care

Pre-course e-learning: 20 February - 11 March 2012

Residential phase: 12 - 23 March 2012

Turin, Italy with a study visit to Chambéry, France

International Training Centre of the ILO Social Protection Programme

Flyer: http://bit.ly/z2vcbY

WHO website: http://bit.ly/y3FobN

The course will identify inequities in effective access and main causes, review the importance of universal access to health care in crisis and post crisis situations, issues related to the feasibility of introducing a scheme and planning for implementation; designing the appropriate contribution levels and benefits, monitoring the provision of services and ensuring the sound governance and financing of the scheme.

Objectives

This course enables participants to

• know about main determinants of inequities of social health protection systems

• identify and analyse root causes of those

• assess (dis-)advantages of various financing mechanisms for social health protection through comparative analysis

• evaluate impact and costs of social health insurance and government tax-funded systems

• design and implement policy interventions to reform current schemes

• respond to the specific needs of vulnerable groups to progress towards equity in access to health care

• develop an international perspective on global initiatives on access to health care

Content

Analysis of issues related to gaps in access to health care

• Dimensions of effective access

• Gaps in statutory coverage

• Limitations in the scope of benefits

• Gaps in financial protection

Root causes for inequities in access to health care

• Fragmentation of social protection systems, multiplicity of actors

• Incoherence of policies and strategies

• Links to the socio-economic context

• Impacts of global crises on national policy-making

Developing and implementing responses to achieve universal access to health care

• Extension of social health protection coverage and its impact on poverty reduction

• Progressing towards universal and equitable access to health services

• Main financing mechanisms, collection of funds and creation of fiscal space

• Coordination of different health financing mechanisms for sustainable schemes

• Impact of expenditures and use of resources

• Administration, cost control and good governance of social health protection schemes

• Developing coverage plans and national health budgets

• Affordability and availability of adequate benefits

• Provision of health care benef ts

• National and community-based schemes

• ILO Conventions 102 and 130, Recommendation 69

• Social health protection and international initiatives: Social Protection Floor,
Millennium Development Goals health outcomes, Decent Work Agenda

The multiple dimensions of inequity in effective access to health care for different population groups will be highlighted throughout the programme.

Methodology

Phase I: Pre-course e-learning on the internet-based learning platform – 20 February - 11 March 2012.

• During the initial on-line phase all relevant practical and organisational information about the activity is shared with participants on this platform. A pre-course survey is carried out to assess the specific learning needs and preferences which will be integrated in the face-to-face phase. Through modules and an assignment participants are introduced to the thematic focus of the learning activity.

Phase II: Face-to-Face workshop – two week course, 12 – 23 March 2012 in Turin.

• Participants are expected to attend four sessions daily of 1.5hrs each.

• During the course an action-oriented, highly participative approach is used with particular attention to presenting good practises refl ecting experiences already gained locally and internationally. Training methods will combine lectures and discussions, case studies, open space discussions, group work and individual exercises.

• A visit to a health insurance scheme in Chambéry, France will allow participants on-site questions and answers on operational issues.

• All presentations as well as other relevant information and materials are uploaded on the online platform to facilitate that participants can share with their institutions what they have learned.

Phase III: Post-training on the internet-based learning platform

– following the face to face course.

• During the follow up phase participants upload action plans and discuss their follow-up actions. New resources, expertise and knowledge about the topic of the activity are regularly linked to the platform.

Languages

To foster interregional experience-sharing, the course is offered in English and in French, with simultaneous interpretation. All course materials are provided in both languages.

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[EQ] Scenarios for primary care in 2025 and recommendations for working toward a preferred future

2012-01-26T09:14:00.000-08:00

Scenarios for primary care in 2025 and recommendations for working toward a preferred future

Project of the Institute for Alternative Futures supported by a grant from the Kresge Foundation

Available online at: http://bit.ly/y7qkXi

“………Forecasts by numerous health care experts strongly suggest that primary care is likely to be very different from what we experience today. While the recent health care reform legislation is driving change from a policy level, developments in technology, disease knowledge, health care financing, care protocols and modalities, and other areas are transforming the field of primary care.

As these changes unfold, it will be essential for policy-makers, public health officials, health care providers, and others to understand the alternative paths that 21st century primary care could take…..”

Scenario Workshop Toolkit: In addition to the full report, IAF has developed a scenario toolkit http://bit.ly/yU6n1o and
slides http://bit.ly/yte9SU to help organizations, health care providers, and communities to conduct scenario planning exercises and consider the implications of these Primary Care 2025 Scenarios for their own strategies and operations.

“……Scenarios are different stories describing how the future may unfold. Scenarios force us to consider the systems surrounding our topic and to clarify our assumptions. Given persistent uncertainty, they bound that uncertainty into a limited number of paths. These paths help us think about different probabilities in a larger space of possibilities.

People who work with scenarios find more creative options than those who develop plans based only on the past and present. Strategies, plans, and actions that are created can also be “future tested” against the different scenarios to assure robust initiatives rather than continued efforts based on outdated assumptions. Scenarios are the best method for systematically addressing the uncertain future.

IAF has developed various types of scenarios using the “Aspirational Futures” technique. This technique develops scenarios in three zones:

■ A “zone of conventional expectation” reflecting the extrapolation of known trends, the expectable future;

■ A “zone of growing desperation” which presents a set of plausible challenges that an organization may face, a challenging future; and

■ A “zone of high aspiration,” in which a critical mass of stakeholders pursues visionary strategies and achieves surprising success. (Two scenarios are developed in this zone in order to offer two alternative pathways to surprisingly successful or visionary futures.)………….”

Content:

Introduction

Why Scenarios? 1

Development of the Primary Care 2025 Scenarios

Evolution of Primary Care in the United States

Four Primary Care 2025 Scenarios

SCENARIO 1: “Many Needs, Many Models”

SCENARIO 2: “Lost Decade, Lost Health”

SCENARIO 3: “Primary Care That Works for All”

SCENARIO 4: “I Am My Own Medical Home”

Comparative Matrix

Primary Care 2025 National Workshop

Recommendations and Robust Strategies

Health Professional Education

Individual and Community Capacity and Accountability

Health Information Technology

Population Health

Political and Cultural Change

Conclusion

Appendix 1: Acknowledgements

Appendix 2: Forces Shaping Primary Care

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[EQ] Divided We Stand: Why Inequality Keeps Rising

2012-01-24T13:01:00.000-08:00

Divided We Stand: Why Inequality Keeps Rising

ISBN Number:9789264111639 - December 2011
Organisation for Economic Co-operation and Development (OECD)

Website: bit.ly/shh3fr

In the three decades prior to the recent economic downturn, wage gaps widened and household income inequality increased in a large majority of OECD countries. This occurred even when countries were going through a period of sustained economic and employment growth. This report analyses the major underlying forces behind these developments:

- An Overview of Growing Income Inequalities in OECD Countries

- Special Focus: Inequality in Emerging Economies

- Part I. How Globalisation, Technological Change and Policies Affect Wage and Earnings Inequalities

- Part II. How Inequalities in Labour Earnings Lead to Inequalities in Household Disposable Income

- Part III. How the Roles of Tax and Transfer Systems Have Changed

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[EQ] How can the health equity impact of universal policies be evaluated?

2012-01-24T12:32:00.000-08:00

How can the health equity impact of universal policies be evaluated?

Insights into approaches and next steps

Edited by:

Beth Milton, May Moonan, Margaret Whitehead, David Taylor-Robinson
WHO Collaborating Centre for Policy Research on Social Determinants of Health, University of Liverpool

WHO Regional Office for Europe - 2011

Available online PDF [67p.] at: http://bit.ly/slZJz1

"………Taking population level action on the wider social determinants of health in efforts to reduce health inequities is an international public health imperative. However, an important barrier to action is the perceived lack of evidence about what works to reduce health inequities. This is particularly evident in relation to universal welfare policies, which can have profound effects on health inequities, both positive and negative in nature.

Because universal policies are usually applied to whole populations, and are often complex in nature with long causal chains, this precludes a true experimental design, and other approaches to evaluation are required. This report presents arguments and case studies from an expert group meeting convened to clarify the importance and challenges of evaluating universal policies, and to outline potential approaches to assessing the impact of universal policies on health inequities.

The report also identifies key research and policy questions that need evaluating as a matter of priority, and sets the agenda for partnership working to develop these methods further….."

Content:

Section 1: Introduction

1.1 Background

Section 2: Why is so important to evaluate universal policies" for their impact on health inequities?

2.1 Universal policies are potentially important determinants of health

2.3 The need for evidence to support efficient and effective use of scarce resources

2.4 Piecemeal learning at the local level

2.5 The current erosion of universal policies

2.6 Better evidence for policy--making

Section 3: What are the evaluation challenges and barriers in relation to such policies?

3.1 The issue of controls/comparison groups

3.2 Time--‐lags and long causal chains 􀍴 temporal issues for evaluators

3.3 Linking policy events to outcomes and indicators

3.4 Dealing with complexity

3.5 The 􀍞transferability􀍟 problem and the importance of context

3.6 The mismatch between research and policy time frames

3.7 The difficulty of engaging decision--‐makers from other sectors

3.8 The need to prioritize interventions for evaluation

3.9 The tension between 􀍞robust􀍟 and 􀍞􀅐ood enough􀍟 evidence

Section 4: Current promising approaches to evaluation and gaps/refinements needed

4.1 How might universal policies be evaluated?

Exploiting natural policy experiments

Retrospective analysis: the Inspector Morse/resilience approach

From randomization to case studies

Insights from Complexity Theory

Utilizing logic models and a systems approach

Cross--‐national comparative policy analyses

Assessing differential impacts

Using tracer groups or conditions

Section 5: Burning research questions and policies to evaluate as a matter of priority

5.1 What are the differential effects of national policies to deal with economic recession?

5.2 What are the effects of the 􀍞Choice􀍟 agenda on access to universal services?

5.3 What are the features of an equitable health care service?

5.4 What are the features of evaluations which have led to both reliable and misleading findings, and what are their effects on policy?

5.5 What are the essential elements of an evaluation methodology that capture the equity impact of a universal policy, including the historical context prior to policy implementation and the displacement effects of the implemented policy?

5.6 What lessons can we learn from collaborating with (for example) historians and archaeologists to systematically capture how the historical context of a 􀍞place􀍟 influences the impact (either positive or negative) of an implemented universal policy?

5.7 What lessons can we learn from economists in assessing the equity impact of a universal policy, factoring in the historical context of the 􀍞place􀍟?

An opportunistic tracer group for evaluation 􀍴 children in low--‐income households

5.8 Researching knowledge exchange issues

Section 6: Establishing a longer term partnership

Section 7: Conclusion

Section 8: References and bibliography

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[EQ] User fee removal in the health sector in low-income countries: lessons from recent national initiatives

2012-01-24T10:07:00.000-08:00

User fee removal in the health sector in low-income countries:
lessons from recent national initiatives

Edited by Bruno Meessen, Lucy Gilson and Abdelmajid Tibouti

Health Policy and Planning - Volume 26, Supplement 2 - November 2011

Available free online at: http://bit.ly/zTUg1n

This supplement, sponsored by Unicef, focuses on the challenges related to the design and implementation of user fee removal policies in low-income countries.

"User fees have triggered impassioned discussions in international health over the last two decades. Promoted by a number of international organizations since the late 1980s as a strategy to finance struggling public health facilities in many low-income countries, recent years have seen growing criticism of the impact of fees on access to health services, particularly for the poorest groups.....

In mid-2008, UNICEF approached a group of researchers with the request to document recent experience with user fee removal. While aid actors in the North were still arguing fiercely about the pros and cons of user fees, a growing number of countries had already decided to remove user fees, at least for some priority services.... A consensus was easily reached between UNICEF and the research team led by the Institute of Tropical Medicine, Antwerp: the multi-country review would not (again) focus on evidence against or in favour of user fees, but would instead try to document how countries formulated and implemented user fee removal.

This focus was seen as valuable because it could generate practical lessons for other countries interested in such a step.... the research team judged that the main question of the multi-country review—the challenges related to design and implementation of user fee removal policies—deserved more visibility than just another report....

Our objectives for this supplement were multiple. From the start we decided we would welcome contributions from different regions and fields of expertise, as the supplement had to be useful for researchers, but also for programme officers and policy makers directly involved in health care financing policies in low-income countries. We acknowledged that contributors would adopt different types of methodological approaches to address different questions. We were also keen to get contributions from the different ‘corners’ of the user fee debate. Experts familiar with the controversy can see for themselves that this objective has been achieved; a glance at the list of contributors to this supplement suffices...."

The full supplement is available free online:
Volume 26 suppl 2 November 2011

User fee removal in low-income countries:
sharing knowledge to support managed implementation [Editorial].

Bruno Meessen 1,*, Lucy Gilson 2,3 and Abdelmajid Tibouti 4

1Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium, 2School of Public Health and Family Medicine, University of Cape Town, South Africa, 3Department of Global Health & Development, London School of Hygiene and Tropical Medicine, London, UK and 4UNICEF, New York, USA

http://bit.ly/ytNMUA

“………..As international organizations, development partners have also a major responsibility in terms of knowledge management. It is our firm belief that real efforts must be made at regional level to bring together relevant knowledge—not just formal evidence—to support fee removal and improvements in financial access. A top priority should be to remove the walls between the different ‘niches’ of knowledge: policy makers, scientists, operational actors and aid agencies must learn to develop knowledge together (Meessen et al. 2011). Countries should also better share lessons of experience and good practices. There is, therefore, a need for much better collective learning……….”

Removing user fees for health services in low-income countries: a multi-country review framework for assessing the process of policy change

http://bit.ly/xV1J1H

Removing user fees in the health sector: a review of policy processes in six sub-Saharan African countries

http://bit.ly/wsVwkl

The national subsidy for deliveries and emergency obstetric care in Burkina Faso

http://bit.ly/zZTP8w

Abolition of user fees: the Uganda paradox

http://bit.ly/xKDwF3

Can innovative health financing policies increase access to MDG-related services? Evidence from Rwanda

http://bit.ly/zvlY74

The sudden removal of user fees: the perspective of a frontline manager in Burundi

http://bit.ly/yY6Y50

Abolishing user fees for children and pregnant women trebled uptake of malaria-related interventions in Kangaba, Mali

http://bit.ly/wgAYgw

The national free delivery policy in Nepal: early evidence of its effects on health facilities

http://bit.ly/AfxyHx

Removing user fees for basic health services: a pilot study and national roll-out in Afghanistan

http://bit.ly/xzW0Ye

Removing user fees: learning from international experience to support the process

http://bit.ly/xhTE2W

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[EQ] Modeling causes of death: an integrated approach using CODEm

2012-01-23T12:29:00.000-08:00

Modeling causes of death: an integrated approach using CODEm

Kyle J Foreman; Rafael Lozano, Alan D Lopez, Christopher JL Murray
Institute for Health Metrics and Evaluation, IHME University of Washington, Seattle, WA

School of Population Health, University of Queensland, Australia

Population Health Metrics – January 2012, 10:1 doi:10.1186/1478-7954-10-1

Available online at : http://bit.ly/xYZWgM

“……..Data on causes of death by age and sex are a critical input into health decision-making.
Priority setting in public health should be informed not only by the current magnitude of health problems but by trends in them. However, cause of death data are often not available or are subject to substantial problems of comparability. We propose five general principles for cause of death model development, validation, and reporting.

Methods

We detail a specific implementation of these principles that is embodied in an analytical tool - the Cause of Death Ensemble model (CODEm) - which explores a large variety of possible models to estimate trends in causes of death. Possible models are identified using a covariate selection algorithm that yields many plausible combinations of covariates, which are then run through four model classes.

The model classes include mixed effects linear models and spatial-temporal Gaussian Process Regression models for cause fractions and death rates. All models for each cause of death are then assessed using out-of-sample predictive validity and combined into an ensemble with optimal out-of-sample predictive performance.

Results

Ensemble models for cause of death estimation outperform any single component model in tests of root mean square error, frequency of predicting correct temporal trends, and achieving 95% coverage of the prediction interval.
We present detailed results for CODEm applied to maternal mortality and summary results for several other causes of death, including cardiovascular disease and several cancers.

Conclusions

CODEm produces better estimates of cause of death trends than previous methods and is less susceptible to bias in model specification.
We demonstrate the utility of CODEm for the estimation of several major causes of death…………..”

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[EQ] Health economic assessment tools (HEAT) for walking and cycling -transport infrastructure and policies

2012-01-23T12:01:00.000-08:00

Health economic assessment tools (HEAT) for
walking and cycling -transport infrastructure and policies

Methodology and user guide

Sonja Kahlmeier, University of Zurich, Switzerland

Nick Cavill, Cavill Associates, United Kingdom

Hywell Dinsdale, National Obesity Observatory England, United Kingdom

Harry Rutter, National Obesity Observatory England, United Kingdom

Thomas Götschi, University of Zurich, Switzerland

Charlie Foster, University of Oxford, United Kingdom

Paul Kelly, University of Oxford, United Kingdom

Dushy Clarke, University of Oxford, United Kingdom

Pekka Oja, UKK Institute for Health Promotion Research, Finland

Richard Fordham, University of East Anglia, United Kingdom

Dave Stone, Natural England, United Kingdom

Francesca Racioppi, WHO Regional Office for Europe

WHO Regional Office for Europe.2011

Available online PDF [46p.] at: http://bit.ly/zJVPYm

“…..The promotion of cycling and walking for everyday physical activity not only promotes health but can also have positive effects on the environment.

This booklet summarizes the tools and guidance developed to facilitate this shift: the methodology for the economic assessment of transport infrastructure and policies in relation to the health effects of walking and cycling; systematic reviews of the economic and health literature; and guidance on applying the health economic assessment tools and the principles underlying it.

This methodology and user guide will be of key interest to professionals at both national and local levels: transport planners, traffic engineers, and special interest groups working on transport, walking, cycling or the environment, as well as health economists, physical activity experts and health promotion experts….”

Content

1. Introduction .

2. Methodological guidance on economic appraisal of health effects related to walking and cycling

2.1. Walking and cycling data .

2.2. Time needed to reach full level of walking or cycling

2.3. Interactions between transport-related physical activity, air pollution and road traffic injuries

2.4. Mortality or morbidity?

2.5. The nature of the relationship between physical activity and health

2.6. Age groups .

2.7. Sex

2.8. Time needed for health benefits to build up .

2.9. Activity substitution

2.10. Static vs life tables approach

2.11. Costs applied

2.12. Discounting

2.13. Sensitivity analysis .

3. Reviews of the literature: summary

3.1. Economic literature

3.2. Epidemiological literature

4. The HEAT for walking and for cycling: introduction .

5. HEAT for walking: instructions for users

6. HEAT for cycling: instructions for users

References

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[EQ] Silent Killer, Economic Opportunity: Rethinking Non-Communicable Diseases

2012-01-23T11:50:00.000-08:00

Silent Killer, Economic Opportunity: Rethinking Non-communicable Diseases

Sudeep Chand
The Chatham House Centre on Global Health Security, 2012

Available online at: http://bit.ly/wn1xVx

Summary points

· Non-communicable diseases (NCDs) are the greatest cause of deaths and disability for humans. Usually slowly developing conditions such as heart disease, cancer, asthma, diabetes and depression, some are preventable and others amenable to cost-effective treatment.

· Cumulative losses in global economic output due to NCDs will total $47 trillion, or 5% of GDP, by 2030. Modest investments to prevent and treat NCDs could bring major economic returns and save tens of millions of lives.

· As populations urbanize and grow, tobacco and alcohol use, poor diet and inactive lives will drive up deaths globally by 17% in the next 10 years.

· A coherent response might prioritize tobacco control and child nutrition, focus innovation on efficient community-based models of care, and ensure access to basic off-patent medicines.

· Although the most effective interventions on tobacco, food and alcohol contain fiscal and regulatory threats for individual industries, these merit consideration given the positive economic effects for businesses in general.

· Sustainable, balanced economic policy can consider low rates of NCDs as a measure of success. Where the economic benefits outweigh the costs, civil society has a major role to play in harnessing an effective response to NCDs.

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[EQ] Call for Papers: Public Health Reports Supplement on Applying Social Determinants of Health to Public Health Practice

2012-01-18T08:02:00.000-08:00

Call for submissions of papers for a Public Health Reports special issue

Focused on applying social determinants of health to public health practice

This Call represents the third in a series of special issues published by the U.S. Centers for Disease Control and Prevention focused on public health and social determinants of health (SDH).

The first special issue is focused on:
Addressing Social Determinants of Health in the Prevention and Control of HIV/AIDS, Viral Hepatitis, Sexually Transmitted Infections, and Tuberculosis

Available at: http://bit.ly/zotVLn

The second special issue is focused on:
Data systems and their use in addressing social determinants of health (SDH)
Available at: http://bit.ly/qyxHXD

The third special issue will be published in May/June 2013.
Once published the supplement will be available online with free access to download articles.

Call for Papers

Supplement on Applying Social Determinants of Health to Public Health Practice

Public Health Reports (PHR) is inviting papers for a Supplement on Applying Social Determinants of Health (SDH) to Public Health Practice.

The guest editors for this Supplement are:
Drs. Hazel D. Dean, Deputy Director of the U.S. Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD,TB Prevention (NCHHSTP).
Dr. Kim M. Williams, Behavioral Scientist in the Division of HIV/AIDS Prevention, NCHHSTP, serves as Co-Chair of the NCHHSTP Health Equity Work Group.
Dr. Kevin A. Fenton. Director, NCHHSTP, CDC.

The editors seek manuscripts that advance scientific knowledge and illustrate how public health professionals can address SDH across a range of public health activities that promote health equity among populations most disproportionately impacted by infectious and/or chronic diseases.

Manuscripts may be analytic or descriptive in format and should report on SDH approaches in public health research, surveillance, communication, policy, program, capacity building, or partnership activities.
The goal for the Supplement is to highlight best practices in addressing SDH across a broad range of public health activities.

Manuscripts addressing the following broad range of topics are requested:

· Partnerships, particularly multisectoral, that address SDH and contribute to health equity;

· Design of policies, programs, and interventions to address SDH and contribute to health equity;

· Specific policies and interventions from health or other sectors designed to address SDH and contribute to health equity, with priority placed on those with demonstrated effectiveness;

· Implementation and scale-up of effective interventions that address SDH;

· Measurement, monitoring, and evaluation of the impact (anticipated and unanticipated) of policies, programs, and interventions on SDH and health equity, including development of innovative approaches;

· Capacity building at the program and/or organizational level to address SDH and contribute to health equity; and

· Best practices for communicating about disproportionately impacted populations, populations at high-risk for infectious and/or chronic diseases, health disparities, SDH, or health equity.

Manuscript requirements: Articles in PHR are typically 3,000 words in length. All manuscripts will be reviewed by the PHR Special Editorial Committee (SEC) for this Supplement. The SEC determines which manuscripts are sent for external peer review and which manuscripts will then be published in the Supplement.

Deadline for submission: May 1, 2012. The anticipated publication date for this PHR Supplement is May/June 2013.

Submission of manuscripts: Manuscripts for this Supplement should be e-mailed to manuscripts@publichealthreports.org.
Please include “Applying Social Determinants of Health (SDH) to Public Health Practice” in the subject line of the e-mail.
If you have any questions about this Supplement, please contact Dr. Hazel Dean (404-639-8000; HDean@cdc.gov).
For questions about PHR, please contact the Managing Editor, Julie Keefe (513-232-3190; JKeefe@cdc.gov).

PHR is a peer-reviewed journal of the U.S. Public Health Service and the U.S. Surgeon General. It is published in collaboration with the Association of Schools of Public Health. PHR is the oldest journal of public health in the U.S. and has published since 1878. The journal is widely distributed internationally, and is indexed by MEDLINE/Index Medicus, Current Contents, EMBASE/Excerpta Medica, Pais International, and LexisNexis.

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[EQ] The World Economic Situation and Prospects 2012 (WESP) - UN DESA report

2012-01-17T11:56:00.000-08:00

The World Economic Situation and Prospects 2012 (WESP)

UN Department of Economic and Social Affairs (DESA)– New York, January 17 2012

Available online at: http://bit.ly/wJQQXQ

“…..Countries throughout the world will experience an economic slowdown this year as the sovereign debt crisis in Europe continues to unfold, according to a United Nations report launched today that also warns that governments must urgently address high unemployment rates, particularly among youth.

The report gives a detailed picture on seven geographical regions and forecasts that growth rates for the next two years will slow down in most of them, with the exception of the African continent, which will continue to enjoy growth due to stable commodity prices and foreign investment.

The report points to the European sovereign debt crisis that erupted in Greece last May as a major shock to the global economy, whose multiple negative effects will continue to reverberate around the world.

“Failure of policymakers, especially those in Europe and the United States, to address the jobs crisis and prevent sovereign debt distress and financial sector fragility from escalating poses the most acute risk for the global economy in the outlook for 2012-2013,” the report states.

The report estimates that growth in the European Union (EU) is expected to be only 0.7 per cent in 2012, substantially lower than the 1.6 per cent growth registered last year. In addition, unemployment throughout the continent will remain near 10 per cent in the euro area, having changed very little since September 2009.

Africa is expected to continue to grow, defying the global trend. The continent is forecast to see an increase in its overall growth from 2.7 per cent in 2011 to 5 per cent in 2012 and 5.1 per cent in 2013. This growth will mainly be driven by relatively strong commodity prices, solid external capital inflows and continued demand and investment from Asia.

However, growth will vary greatly among countries in the continent due to military conflicts, corruption, lack of infrastructure and severe drought in certain areas. The report also warns that unemployment and poverty remain major problems and sources of instability, which have already led to political unrest in North Africa.

South Africa is expected to have the strongest economic growth in 2012, supported by growing demand from Asia, continued fiscal stimulus measures and an increase in consumption driven by rising wages.

The economic picture in the Arab World will continue to be subject of high uncertainty due to the political transition and civil protests brought by the Arab Spring. Regional growth is forecast to decline from 6.6 per cent to 3.7 per cent as violent clashes hampered economic activity in several Arab countries. Social unrest also affected trade and tourism revenues, particularly in Lebanon.

However, the report states that generous social spending measures implemented in 2011 by Arab governments such as Saudi Arabia as a way to alleviate popular protests helped boost economic growth and the impact of these measures will continue to be felt throughout 2012.

As with Europe and Africa, unemployment remains a key problem in the region. Despite extremely low female participation rates, unemployment rates in the region are among the highest in the world, especially among the educated youth, and the report warns that leaving unemployment unaddressed represents a major risk to stability in the region.

In East Asia growth is projected to decline to 6.9 per cent in both 2012 and 2013. China, the biggest economy in the region, is also expected to slow down from 9.3 per cent to 8.7 per cent growth in 2012. A major deceleration from China, however, would represent a more pronounced slowdown for the rest of the region.

The South Asian and Latin American and Caribbean regions remain particularly susceptible to the future of developed economies as both the EU and the US are key export markets as well as sources of tourism revenue.

For Latin America, a slowdown in China would also adversely affect the region as it is a major buyer of its commodities and a key investor in South America…..”

“………the report discusses several policy directions which could avoid a double-dip recession, including: optimal design of fiscal policies to stimulate more direct job creation and investment in infrastructure, energy efficiency and sustainable energy supply, and food security; stronger financial safety nets; better coordination between fiscal and monetary policies; and the provision of sufficient support to developing countries in addressing the fallout from the crisis and the coordination of policy measures at the international level…..”

Also available:

Executive Summary available in Arabic, Chinese, English, French, Russian, Spanish

Global press releases: Arabic, Chinese, English, French, Russian, Spanish

Policy Brief 36: Can a protracted slowdown be avoided?

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[EQ] The judgement process in evidence-based medicine and health technology assessment

2012-01-17T09:55:00.000-08:00

The judgment process in evidence-based medicine and health technology assessment

Michael P Kelly a,b and Tessa A Moore c

A The National Institute for Health and Clinical Excellence, (NICE), London, UK.

B General Practice and Primary Care Research Unit, Institute of Public Health, University of Cambridge.

C Head of School Effectiveness, Education, Children's and Cultural Services, London Borough of Richmond upon Thames.

Social Theory & Health (2012) 10, 1–19. doi:10.1057/sth.2011.21; December 2011

Available online at: http://bit.ly/yiBOxB

“….This article describes the judgements used to interpret evidence in evidence-based medicine (EBM) and health technology assessment (HTA).
It outlines the methods and processes of EBM and HTA. Respectively, EBM and HTA are approaches to medical clinical decision making and efficient allocation of scarce health resources.

At the heart of both is a concern to review and synthesise evidence, especially evidence derived from randomised controlled trials (RCTs) of clinical effectiveness. The driver of the approach of both is a desire to eliminate, or at least reduce, bias.

The hierarchy of evidence, which is used as an indicator of the likelihood of bias, features heavily in the process and methods of EBM and HTA. The epistemological underpinnings of EBM and HTA are explored with particular reference to the distinction between rationalism and empiricism, developed by the philosopher David Hume and elaborated by Immanuel Kant in the Critique of Pure Reason.

The importance of Humian and Kantian principles for understanding the projects of EBM and HTA is considered and the ways in which decisions are made in both, within a judgemental framework originally outlined by Kant, are explored…..”

“….The current article adds to that thinking by suggesting that certain philosophical ideas can help to articulate or describe the judgemental and interpretive processes involved.
What this article has not considered, and which remain important areas for consideration, are the discursive and rhetorical devices used by the actors involved, the group dynamics and the way they overlay the decision-making processes…..”

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[EQ] Public-private engagement for diet and health: addressing the governance gap

2012-01-17T09:52:00.000-08:00

Nutrition and Business - How to engage?

United Nations Standing Committee on Nutrition UNSCN, 2011

Available online PDF [107p.] at: http://bit.ly/wVyqnN

CONTENTS

Editorial Denise Costa Coitinho Delmuè

Public-private engagement for diet and health: addressing the governance gap. By Corinna Hawkes & Kent Buse

“…..Core activities of public-private healthy eating initiatives

1. Health promotion and communication campaigns (e.g., information leaflets and post-ers)

2. Diet and nutrition education in formal and informal learning venues (e.g., building cooking skills)

3. Communicating information on food products (e.g., nutrition labelling, and “healthy food” logos )

4. Controlling advertising and marketing of food products (e.g., through advertising codes on marketing)

5. Increasing or decreasing access to food products (e.g., fruits, vegetables, vending ma-chines)

6. Conducting or supporting research (e.g., on development of novel foods)

7. Developing or reformulating food products (e.g., reducing salt)

8. Developing recommendations, guidelines, advice and strategies for governments and industry (e.g., government forum that includes the food industry)

9. Encouraging private sector action in general, such as providing a forum for commit-ments (e.g., “Platforms”)

10. Funding for above activities connected to healthy eating….”

FEATURES

The accountability of public-private partnerships with food, beverage and quick-serve restaurant companies to address global hunger and the double burden of malnutrition.

The potential of public-private-civil society partnerships in humanitarian emergencies: an NGO perspective drawing from emergency programming in
Port-au-Prince, Haiti.

Hybrid public-private delivery of preventative lipid-based nutrient supplement products: key challenges, opportunities and players in an emerging product space.

Private-public partnerships drive one solution to vitamin and mineral deficiencies: Fortify West Africa

Social marketing in public-private partnerships as a tool for scaling up nutrition: a case study from Tanzania.

Governments should govern, and corporations should follow the rules.

Food and beverage transnational corporations and nutrition policy.

RESEARCH REPORT

A qualitative study of UNSCN Steering Committee and Working Group facilitators views on engagement with the private industry

EXAMPLES OF ENGAGEMENT FRAMEWORKS

UNSCN private sector engagement policy

IUNS private sector engagement policy

SLMA Guidelines for health and nutrition related endorsement of branded commercial products
IBFAN’s funding policy .

IAP guidelines on conference organization

Developing more effective UN-business partnerships.

The human right to adequate food: reflections on the engagement with the private sector.

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[EQ] Quality in Qualitative Evaluation: A framework for assessing research evidence

2012-01-12T12:10:00.000-08:00

Quality in Qualitative Evaluation: A framework for assessing research evidence

A Quality Framework

Liz Spencer, Jane Ritchie, Jane Lewis and Lucy Dillon(2003)

National Centre for Social Research
UK Government Chief Social Researcher’s Office, London: Cabinet Office.

Available online at: http://bit.ly/zcNgfz

“……..This document presents a framework for appraising the quality of qualitative evaluations.
It was developed with particular reference to evaluations concerned with the development and implementation of social policy, programmes and practice.

The framework was devised as part of a programme of research conducted on behalf of the Cabinet Office.
The research on which the framework was built involved:

• a comprehensive review of the literature on qualitative research methods relating to standards in qualitative research;

• a review of qualitative research methods used in Government funded evaluation studies;

• a review of existing frameworks for assessing quality in qualitative research;

• exploratory interviews with a range of people who have an interest in quality assessment of qualitative research and/or policy-related evaluations.
These included academics who have written about qualitative research from either a theoretical or empirical perspective; authors of existing frameworks;
research practitioners; commissioners and funders; and policy-makers who have used qualitative research evidence in the development and evaluation
of policies; a workshop, involving the above groups, to refine the framework initially developed;

• a trial application of the framework to a small number of studies.

All these strands of activity have heavily influenced the content of the framework and the premises that surround its operation.

Content:

I Introduction

II Scope of the Framework

III Application of the Framework

IV Content of the Framework

V Further reading

Rapid Evidence Assessment Toolkit at: http://bit.ly/wqiC2A

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[EQ] Why National eHealth Programs Need Dead Philosophers

2012-01-12T11:52:00.000-08:00

Why National eHealth Programs Need Dead Philosophers:
Wittgensteinian Reflections on Policymakers’ Reluctance to Learn from History

Trisha Greenhalgh, Jill Russell, Richard E. Ashcroft, and Wayne Parsons
Queen Mary University of London
The Milbank Quarterly - Volume 89, Number 4, December 2011

Available online at: http://bit.ly/vxvWJ8

Context:
Policymakers seeking to introduce expensive national eHealth programs would be advised to study lessons from elsewhere. But these lessons are unclear, partly because a paradigm war (controlled experiment versus interpretive case study) is raging.

England’s $20.6 billion National Programme for Information Technology (NPfIT) ran from 2003 to 2010, but its overall success was limited. Although case study evaluations were published, policymakers appeared to overlook many of their recommendations and persisted with some of the NPfIT’s most criticized components and implementation methods.

Methods: In this reflective analysis, illustrated by a case fragment from the National Programme for Information Technology NPfIT, we apply ideas from Ludwig Wittgenstein’s postanalytic philosophy to justify the place of the “n of 1” case study and consider why those in charge of national eHealth programs appear reluctant to learn from such studies.

Findings: National eHealth programs unfold as they do partly because no one fully understands what is going on. They fail when this lack of understanding becomes critical to the programs’ mission.

Detailed analyses of the fortunes of individual programs, articulated in such a way as to illuminate the contextualized talk and action (“language games”) of multiple stakeholders, offer unique and important insights. Such accounts, portrayals rather than models, deliver neither statistical generalization (as with experiments) nor theoretical generalization (as with multisite case comparisons or realist evaluations).

But they do provide the facility for heuristic generalization (i.e., to achieve a clearer understanding of what is going on), thereby enabling more productive debate about eHealth programs’ complex, interdependent social practices. A national eHealth program is best conceptualized not as a blueprint and implementation plan for a state-of-the-art technical system but as a series of overlapping, conflicting, and mutually misunderstood language games that combine to produce a situation of ambiguity, paradox, incompleteness, and confusion.

But going beyond technical “solutions” and engaging with these language games would clash with the bounded rationality that policymakers typically employ to make their eHealth programs manageable. This may explain their limited and contained response to the nuanced messages of in-depth case study reports.

Conclusion:
The complexity of contemporary health care, combined with the multiple stakeholders in large technology initiatives, means that national eHealth programs require considerably more thinking through than has sometimes occurred.
We need fewer grand plans and more learning communities. The onus, therefore, is on academics to develop ways of drawing judiciously on the richness of case studies to inform and influence eHealth policy, which necessarily occurs in a simplified decision environment. …”

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[EQ] Advancing the Global Health Agenda

2012-01-12T11:13:00.000-08:00

Advancing the Global Health Agenda

Ilona Kickbusch, Director of the Global Health Programme, Graduate Institute of International and Development Studies, Geneva
UN Chronicle, Vol. XLVIII No. 4, 2011 (30.12.2011)

Available online at: http://bit.ly/wq6hn7

“……In just over two decades, global health has gained a political visibility and status that some authors have called a political revolution. As health related issues have become a centre piece of the global agenda, significant resources in development aid have been made available to address major health problems. Global health has gained this political prominence because three agendas have reinforced one another in a variety of ways:

· a security agenda driven by the fear of global pandemics or the intentional spread of disease, in an era where viruses have the potential to spread from one part of the world to another in a matter of hours;

· an economic agenda, which is concerned not only with the economic impact of poor health on development or of pandemic outbreaks in the global marketplace, but increasingly considers the economic relevance of the health sector, in particular of certain industries, such as tobacco, food, and pharmaceuticals, and the growing global market of goods and services in relation to health;

· a social justice agenda advocating health as a social value and human right, which includes action on the social determinants of health, access to medicines, support for the Millennium Development Goals (MDGs) relating to health, and the active engagement of philanthropies and civil society in a broad range of global health initiatives.

The global health agenda brings together two critical action spheres of our time: managing interdependence and globalization, and addressing the growing inequalities within and between nations through development strategies. It also lies at the intersection of many policy arenas and is subject to a special dynamic…..”

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[EQ] Spanish -- Las residencias m=?iso-8859-1?Q?=E9dicas?= en America L atina

2012-01-10T09:51:00.000-08:00

Las residencias médicas en America Latina

Las residencias médicas en el contexto de las políticas de recursos humanos de salud y de la renovación de la atención primaria de salud

Rosa María Borrell, Charles Godue y Rodolfo Kaufmann

Serie La renovación de la atención primaria de salud en las Américas Nº 60.
Organización Panamericana de la Salud – Área de Sistemas de Salud basados en la Atención Primaria de Salud
OPS/OMS - Washington, DC. USA - 2011

Disponible en texto completo - archivo PDF [140p.] URL : http://bit.ly/ysSNMm

Se entiende como “residencias médicas” al sistema educativo que tiene por objeto completar la formación de los médicos en alguna especialización reconocida por su país de origen, mediante el ejercicio de actos profesionales de complejidad y responsabilidad progresivas, llevados adelante bajo supervisión de tutores en instituciones de servicios de salud y con un programa educativo aprobado para tales fines.

Los sistemas de salud de los países descansan en buena parte en los especialistas y en los médicos residentes, y los ministerios de salud invierten una suma de dinero importante anualmente para cubrir las plazas de los residentes, ya que este es el ámbito desde donde surgen las nuevas generaciones de especialistas.

El presente estudio muestra información cuantitativa y cualitativa de 14 países de América Latina sobre los sistemas y mecanismos de planificación, gestión y formación de los futuros especialistas, además de observaciones puntuales de los encargados de los ministerios de salud y educación acerca de la situación compleja de los sistemas de residencias médicas.
(Argentina, Bolivia, Brasil, Chile, Colombia, Costa Rica, Cuba, El Salvador, Honduras, México, Paraguay, Perú, República Dominicana y Uruguay)

Las conclusiones evidencian la necesidad de reorientar las políticas de recursos humanos en salud, y de la formación de especialistas en particular, ampliando las fronteras de las especialidades básicas y especialmente de la Medicina Familiar. Con recursos humanos especializados en áreas básicas y de alta calidad, los países podrán garantizar la cobertura universal a los sistemas de salud a través de la estrategia de Atención Primaria de la Salud (APS) y de los sistemas integrados de servicios de salud (RISS).

Un importante desafío es consolidar sistemas de planificación y gestión que garanticen la formación y el empleo de especialistas en las provincias y municipios de cada país, por lo que se deberán crear sistemas de incentivos que garanticen su retención en dichos lugares……”

Contenido

Prefacio

Resumen ejecutivo

I. Introducción

II. Análisis de situación de las residencias médicas en 14 países

A. Datos generales

B. Sistema de planificación y gestión

C. Regulación, normas y procedimientos

D. Formación

E. Consideraciones finales sobre los datos ofrecidos por los países

III. Desafíos fundamentales de las residencias médicas

A. Políticas de residencias

B. La gestión y regulación de las residencias

C. La formación en las residencias

V. Conclusiones y recomendaciones

1. Orientar las políticas de las residencias médicas para su contribución al desarrollo de la APS y las RISS

2. Establecer sistemas de planificación de las residencias médicas e invertir en salud familiar

3. Fortalecer la coordinación entre salud y educación para la gestión de las residencias médicas

4. Orientar los programas de residencias por competencias y los ámbitos de aprendizaje en la lógica de las RISS

5. Estructurar los programas de formación con la incorporación de las universidades

6. Impulsar procesos de acreditación de los programas de formación de los especialistas

V. Lineamientos de trabajo

1. Las políticas formación y la planificación a largo plazo

2. Acreditación de los programas de las especialidades básicas

3. Definición de competencias transversales de APS para cada una de las especialidades básicas y de medicina familiar

4. Plan de formación de formadores

Apéndice A: Encuesta

Apéndice B: Primer Taller Regional de Residencias Médicas

Apéndice C: Programa del Seminario Virtual sobre Residencias Médicas en el Campus Virtual de Salud Pública (CVSP)

Apéndice D: Listado por países de especialidades médicas reconocidas

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Tomorrow: Call to Action: A Cholera-Free Hispaniola (Haiti and the Dominican Republic) January 11, 2012, 9 to 9:50 am ET

2012-01-10T08:02:00.000-08:00

Call to Action: A Cholera-Free Hispaniola

(Haiti and the Dominican Republic)

Moving from cholera control to cholera elimination through essential investments in water, sanitation, and hygiene infrastructure

A press briefing in which the governments of Haiti and the Dominican Republic, together with the Pan American Health Organization/World Health Organization (PAHO/WHO), the U.S. Centers for Disease Control and Prevention (CDC), UNICEF, and other key partners, will launch a Call to Action for a Cholera-Free Hispaniola (Haiti and the Dominican Republic).

WHEN: Wednesday, January 11, 2012, 9 to 9:50 a.m. Q&A will follow

WHO: Dr. Mirta Roses, Director, PAHO/WHO

Dr. Kevin De Cock, Director, Center for Global Health, CDC

Sanjay Wijesekera, Chief, Water and Sanitation, UNICEF
H.E. Michel Joseph Martelly, President of the Republic of Haiti (via video)

H.E. Leonel Fernández, President of the Dominican Republic (via video)

CONTEXT:
Haiti is experiencing one of the largest cholera epidemics in modern history. Eliminating cholera from the island of Hispaniola will require dramatic improvements in water and sanitation services. PAHO/WHO, CDC and UNICEF are suggesting four concrete steps to continue saving lives and reducing disease in Haiti and the Dominican Republic.

While the international community has supported the governments of Haiti and the Dominican Republic in implementing cholera prevention and control interventions, major investments in infrastructure and institutional capacity to operate it, are needed to keep cholera from becoming endemic in Haiti.

Even before the earthquake exactly two years ago, population access to improved water and sanitation in Haiti was far below levels in other Latin American and Caribbean countries, and the situation has only grown worse. It is time to act.

WHERE:

In person:
PAHO/WHO, 525 Twenty-third Street, NW, Washington, DC

(Four blocks from Foggy Bottom Metro Station)Simultaneous launches will be held at the Ministry of Health of Haiti, Port-au-Prince, Haiti; and at the National Palace, Santo Domingo, Dominican Republic

Online:

- You can log in remotely and ask questions via Elluminate using the link provided below.

- Also could be viewed on Livestream via the link below (chat available).

Questions may be phoned in or e-mailed to one of the contacts below.

Online via ELLUMINATE:

Room in English: www.paho.org/virtual/PressConference
Room in Spanish: www.paho.org/virtual/ConferenciadePrensa

Room in French: www.paho.org/virtual/ConferencedePresse

NOTE: PLEASE COPY AND PASTE THE LINKS IN A NEW BROWSER

LIVESTREAM: www.livestream.com/paho (floor audio, English)

QUESTIONS BY EMAIL OR SOCIAL MEDIA:

During this press conference, questions can also be sent through:
Facebook: www.facebook.com/pahowho

Twitter: Hashtag: #NoMoreCholera

Or by email: Donna Eberwine-Villagran, eberwind@paho.org, Tel. +1 202 974 3122, Mobile during press conference +1 202 316 5469
PAHO website: http://bit.ly/zxslsW
EQ blog: http://bit.ly/xFDem9

Related Links:

ONE year ONE team 4 Haiti

http://www.youtube.com/user/pahopin?feature=mhee#p/c/35B192E287B9BDAB/26/7241q3gfaLA

The Response to the Cholera outbreak in Haiti
http://www.youtube.com/watch?v=ydqdDeSoozY

ONE year ONE team 4 Haiti
http://www.youtube.com/user/pahopin?feature=mhee#p/c/35B192E287B9BDAB/26/7241q3gfaLA

The Response to the Cholera Outbreak in Haiti
http://www.youtube.com/watch?v=ydqdDeSoozY

Cholera in the Americas

http://www.youtube.com/watch?v=z8NiWwufWkg

The Seventh Epidemic

http://www.youtube.com/watch?v=KikmB33aX0g

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