Pooling health care’s best ideas

Globalization is inescapable. A soda sold in Georgia is available in any country in the world. A farmer in Iowa may travel to India for heart bypass surgery. Companies realize that growth in the next decade is more likely to be grounded in Asia than in America or Europe. The world has undeniably become a much smaller place, and it continues to shrink at an amazing rate. . . .
The Institute of Medicine estimates that there is an 18-year time lag between conception of a new medical practice and implementation of that practice. Between 10 and 17 years can elapse for even the most basic innovative practices to be shared and adopted by the international health community. In the 17 years it took to adopt best practices for infection control now used in hospitals worldwide, for example, countless people needlessly suffered during a course of nearly two decades.

The Myth of ‘Best In The World’

In international comparisons of health care, the infant mortality rate is a crucial indicator of a nation's standing, and the United States' position at No. 28, with seven per 1,000 live births—worse than Portugal, Greece, the Czech Republic, Northern Ireland and 23 other nations not exactly known for cutting-edge medical science—is a tragedy and an embarrassment. Much of the blame for this abysmal showing, however, goes to socioeconomic factors: poor, uninsured women failing to get prenatal care or engaging in behaviors (smoking, using illegal drugs, becoming pregnant as a teen) that put fetuses' and babies' lives at risk. You can look at 28th place and say, yes, it's terrible, but it doesn't apply to my part of the health-care system—the one for the non-poor insured.

Op-Ed on Hunger by Secretary General of the United Nations

The price of food is soaring. The threat of hunger and malnutrition is growing. Millions of the world's most vulnerable people are at risk. An effective and urgent response is needed.
The first of the Millennium Development Goals, set by world leaders at the U.N. summit in 2000, aims to reduce the proportion of hungry people by half by 2015. This was already a major challenge, not least in Africa, where many nations have fallen behind. But we are also facing a perfect storm of new challenges.

Psychotherapy for All: An Experiment

The clinic is at the forefront of a program that has the potential to transform mental health treatment in the developing world. Instead of doctors, the program trains laypeople to identify and treat depression and anxiety and sends them to six community health clinics in Goa, in western India.

Depression and anxiety have long been seen as Western afflictions, diseases of the affluent. But new studies find that they are just as common in poor countries, with rates up to 20 percent in a given year.

Researchers say that even in places with very poor people, the ailments require urgent attention. Severe depression can be as disabling as physical diseases like malaria, the researchers say, and can have serious economic effects. If a subsistence farmer is so depressed that he cannot get out of bed, neither he nor his children are likely to eat.

Health Care: Solutions Without Borders

At a time when most Americans favor an overhaul of the health care system, it's important to look closely at what other countries are getting right. A growing number of health care stakeholders, including policymakers and insurance industry officials, are recommending that we look across the Atlantic to explore the health systems in countries that cover all of their citizens.
The Commonwealth Fund's 2007 International Health Policy Survey released in October—our 10th annual international survey—reveals that, while no one health system provides an ideal model, we have much to learn from the other countries.
Rather than caricature the health systems in other nations, we should evaluate their strengths and shortcomings—and use that knowledge to create a high-performing health system in the United States.

WHO aims to balance drug companies, poor

GENEVA - The U.N. health chief urged countries on Monday to come up with new ways to make medicine for HIV/AIDS and other diseases more affordable in the world's poorest countries, without stifling innovation among pharmaceutical companies.
The World Health Organization's 193 member states are hoping to forge a global strategy on the highly divisive issues of drug development, patenting and pricing by the end of the week.
"People should not be denied access to lifesaving and health-promoting interventions for unfair reasons," said Dr. Margaret Chan, WHO's director-general, in opening the agency's first meeting devoted to the subject since May, when the United States walked out of a negotiating session and dissociated itself from a WHO resolution.
Under rules agreed by the World Trade Organization, countries can issue so-called "compulsory licenses" to disregard patent rights, but only after negotiating with the patent owners and paying them adequate compensation. If they declare a public health emergency, governments can skip the negotiating.
Brazil and Thailand have invoked the procedure to import cheap generic versions of American AIDS drugs, among other medicines, to treat patients who developed resistance to older anti-retrovirals and needed more expensive, second-line drugs.
The moves by Brazil and Thailand were praised by health campaigners but criticized by industry groups. The United States later placed Thailand on a copyright watch list of nations where American companies face problems protecting intellectual property rights. Countries on the list are under extra scrutiny and can face trade sanctions if alleged violations worsen.
The international aid group Oxfam says compulsory licensing almost never occurs because developing countries face pressure from rich governments acting on behalf of their drug companies. Its report last year on drug access cited WHO statistics that 74 percent of AIDS medicines are still under monopoly, and that 77 percent of Africans still lack any access to AIDS treatment.

In China, Brain Surgery Is Pushed on the Mentally Ill

The irreversible brain surgeries performed at No. 454 Hospital, which are all but blacklisted for mental illness in the developed world, are being done across China. They are a symptom of the problems plaguing the nation's health-care system, which has left hospitals with scant public funding and hungry for profit.

U. S. Critics Slam Canada's Health Care System

The birth of identical quadruplet girls to a Canadian woman in Montana last month has ignited debate in the United States with editorial writers and bloggers attacking the Canadian health-care system.
A shortage of neonatal beds in Calgary meant that Karen Jepp and her husband J.P. had to travel to Great Falls, Mont., for the birth of Autumn, Brooke, Calissa and Dahlia on Aug. 12.
The chance of giving birth to identical quadruplets is one in 13 million, so the event attracted widespread international attention and caused many Americans to focus on Canada's universal system of health care.

Abortion in the Philippines: a national secret

The backstreet abortions . . . may become more common as a United States government aid program plans to stop distributing contraceptives in the Philippines in 2008. This will leave birth control up to the government which under the influence of Catholic bishops advocates unreliable natural birth control methods rather than the pill and condoms.

Mentally ill 'suffering neglect'

Mentally ill people in the developing world are being badly neglected, according to a study published in the Lancet medical journal. The authors say mental illness makes up about 14% of global disease, more than cancer or heart disease.
Up to 800,000 people commit suicide each year, mostly in poorer countries. Despite this, the authors say, 90% of sufferers in developing countries receive no care - and in some cases are chained to trees or kept in cages.

Lancet Series (for those of you interested in international mental health)

The Lancet Series on Global Mental Health: Article Collection
Launching a new movement for mental health
“Despite the great attention western countries pay to the mind and human consciousness in philosophy and the arts, disturbances of mental health remain not only neglected but also deeply stigmatised across our societies.”
These are the introductory words of The Lancet's editor Dr Richard Horton, in a comment to introduce the series. He says: “For the most part, these organisations have done far too little, if anything at all?

Families USA Global Health Initiative

"With globalization, the same sea washes all of humankind. We are all in the same boat. There are no safe islands. There is no dividing line between "foreign" and "domestic" infections...There is no them: only us.” –UN Secretary General Kofi Annan