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1. Socio-cultural Factors Influencing the Ebola Virus Disease-related Stigma among African Immigrants in the United States

Author:
Guy-Lucien S. Whembolua, Donaldson Conserve, and Daudet Ilunga Tshiswaka
Publication Date:
12-2017
Content Type:
Research Paper
Institution:
Ìrìnkèrindò: a Journal of African Migration
Abstract:
African immigrants, one of the fastest-growing immigrant populations in the United States (U.S.), face many unique challenges. Since December 2013, the Ebola Virus Disease (EVD) has been claiming lives and altering the societies of origin of West and Central African immigrants. Using the PEN-3 cultural model, a thematic analysis of mainstream U.S. news media was conducted to assess the socio-cultural factors influencing EVD-related stigma experienced by African immigrants. Results of this analysis revealed the perceptions and enabling/nurturing factors that exacerbated or prevented EVD-related stigma. Future interventions designed to address stigma experienced by African immigrants should include EVD-related stigma.
Topic:
Health, Migration, Infectious Diseases, and Ebola
Political Geography:
Africa and United States

2. Antimicrobial Resistance as an Emerging Threat to National Security

Author:
Maxine Builder
Publication Date:
01-2015
Content Type:
Working Paper
Institution:
Atlantic Council
Abstract:
Growing rates of antimicrobial resistance (AMR) pose a threat to public health that could undo many of the medical advances made over the last seventy years, eroding the global medical safety net and posing a significant threat to national security. Diseases once eliminated by a single course of antibiotics show drug resistance, often to several different classes of drugs. Some of the implications of increasing rates of AMR are intuitive, such as longer duration of illness, extended hospital stays, and higher rates of mortality. But other effects of a postantibiotics world are less obvious, such as the inability to perform life-saving operations or the ability for a simple scratch on the arm to kill. Humanity could soon find itself living in a reality in which communicable diseases such as tuberculosis, cholera, pneumonia, and other common infections cannot be controlled. This potentially catastrophic problem still can be abated, and the global health community, including the World Health Organization (WHO), has highlighted AMR as a priority in global health. But all sectors of the international community, not simply those in public health, need to take immediate steps to reverse the current trends and eliminate the systematic misuse of antimicrobial drugs, especially in livestock, and restore the pipeline of new antimicrobial drugs. The significant health and economic costs of AMR are difficult to quantify due to incomplete data that often underreports the extent of the problem, since there are no standard metrics or consensus on methodology to measure rates of AMR. But even the piecemeal statistics that exist paint a bleak picture. In a 2013 report, the US Centers for Disease Control and Prevention (CDC) reports at least two million Americans acquire serious infections to one or more strains of AMR bacteria annually, and at least 23,000 people die of these infections.1 A 2008 study estimated the excess direct costs to the US medical system attributable to AMR infections at $20 billion, with additional estimated productivity losses to be as high as $35 billion.2 With the increase in resistant infections and continuing rise in medical costs, the cost to the American medical system no doubt also has increased. This trend is not a uniquely American problem; it is truly global in scope. The European Union (EU) reports about 25,000 deaths annually due to drug-resistant bacteria, at an overall, combined cost of $2 billion in healthcare costs and productivity losses.3 There were over 14.7 million incidents of moderate-to-severe adverse reactions to antibiotics each year between 2001 and 2005 in China. Of these, 150,000 patients died annually.4 The most recent available data on China estimates that treatment of AMR infections during that same time period cost at least $477 million, with productivity losses of more than $55 million each year.5 A 2005 study of the United Kingdom (UK) found that the real annual gross domestic losses due to AMR were between 0.4 and 1.6 percent.6 Although slightly outdated, this estimate may be a useful guide in assessing the global impact of AMR, and given the trend of increasing resistance, it is likely that the impact will also increase accordingly. That said, it is prudent to repeat that the disparities in the quality of data reporting standards across China, the United States, the United Kingdom, and the European Union make it difficult to directly compare the severity of the impacts AMR has on each entity. The primary cause of AMR globally is antibiotic overuse and misuse, be it from doctors inappropriately prescribing antibiotics to treat viral infections or individuals seeking over-the-counter antibiotics for self-treatment. But another driver, less obvious than overuse in humans, is the use of antimicrobials in livestock, and the ratio of use in animals as compared to humans is astounding. In the United States, about 80 percent of all antibiotics are consumed in either agriculture or aquaculture. Generally, these drugs are administered to livestock as growth promoters and are medically unnecessary. Resistance in livestock quickly spreads to humans, and many community-acquired infections are the result of a contaminated food supply. Although most infections are acquired in the community, most deaths attributed to resistant infections occur in healthcare settings, and healthcare-acquired (or nosocomial) infections are another driver of AMR. At this point, AMR does not pose an immediate and direct threat to national security. Rather, this is a creeping global security crisis. If current trends continue, these drugs upon which the world relies will lose effectiveness. The gains made in fighting infectious diseases will be reversed, and a wide range of routine surgeries and easily treatable infections will become much more dangerous and deadly. This will cause the health of the world's working population to deteriorate, and the economic productivity and social cohesion of the globe to decline. At any time, a “black swan” event—triggered by an outbreak of drug-resistant tuberculosis, cholera, or pneumonia, for example—could prove catastrophic, endangering the fabric of societies and our globalized economy, forcing a stop to international trade and travel to prevent further spread. The issue of AMR is a tragedy of the commons in which individual incentives lead to the overuse and eventual destruction of a shared resource. International cooperation is required to walk back from this ledge and avoid a postantibiotics world, even though it is impossible to completely reverse the damage already done.
Topic:
Health, National Security, Infectious Diseases, and Health Care Policy
Political Geography:
United States, China, United Kingdom, America, and Europe

3. Equatorial Guinea Plays a Leading Role in Combating Malaria

Author:
Mark L. Asquino
Publication Date:
09-2015
Content Type:
Journal Article
Journal:
The Ambassadors Review
Abstract:
In August 2014, I attended a ceremony at the Willard Hotel in Washington, DC that celebrated the tenth anniversary of the Bioko Island Malaria Control Project. Those speaking at the event included senior executives from Marathon Oil Corporation, Noble Energy Inc., and Atlantic Methanol Production Company, which are all US petroleum companies that operate in Equatorial Guinea. Teodoro Obiang Nguema Mbasogo, President of Equatorial Guinea, also delivered remarks. All of the speakers were enthusiastic about a dynamic project that has had a trans­formative effect on the health of generations of Equatoguineans by reducing the morbidity and mortality of malaria infection. What follows is an overview of the project’s history as well as the commitment to US innovation and a shared audacity to tackle one of human­kind’s most endemic and fatal diseases.
Topic:
Development, Health, Human Welfare, Infectious Diseases, and Health Care Policy
Political Geography:
United States and Equatorial Guinea

4. Role of Urbanization, Land-Use Diversity, and Livestock Intensification in Zoonotic Emerging Infectious Diseases

Author:
Jefferson Fox, Duong Nong, Miguel Castrence, James Spencer, Sumeet Saksena, Nguyen Lam, Tran Duc Vien, Michael Epprecht, Chinh Tran, Melissa Finucane, and Bruce Wilco
Publication Date:
10-2014
Content Type:
Working Paper
Institution:
East-West Center
Abstract:
Emerging infectious diseases (EIDs) continue to significantly threaten human and animal health. While there has been some progress in identifying underlying proximal driving forces and causal mechanisms of disease emergence, the role of distal factors is most poorly understood. This article focuses on analyzing the statistical association between highly pathogenic avian influenza (HPAI) H5N1 and urbanization, land-use diversity and poultry intensification. A special form of the urban transition—peri-urbanization—was hypothesized as being associated with 'hot-spots' of disease emergence. Novel metrics were used to characterize these distal risk factors. Our models, which combined these newly proposed risk factors with previously known natural and human risk factors, had a far higher predictive performance compared to published models for the first two epidemiological waves in Viet Nam. We found that when relevant risk factors are taken into account, urbanization is generally not a significant independent risk factor. However, urbanization spatially combines other risk factors leading to peri-urban places being the most likely 'hot-spots'. The work highlights that peri-urban areas have highest levels of chicken density, duck and geese flock size diversity, fraction of land under rice, fraction of land under aquaculture compared to rural and urban areas. Land-use diversity, which has previously never been studied in the context of HPAI H5N1, was found to be a significant risk factor. Places where intensive and extensive forms of poultry production are collocated were found to be at greater risk
Topic:
Health, Infectious Diseases, and Urbanization
Political Geography:
United States and Asia

5. Improving Maternal, Neonatal, and Child Health in Ghana

Author:
Katherine E. Bliss and Cathryn Streifel
Publication Date:
11-2014
Content Type:
Working Paper
Institution:
Center for Strategic and International Studies (CSIS)
Abstract:
In June 2014, a small team from the CSIS Global Health Policy Center traveled to Ghana to examine U.S. bilateral support for maternal, neonatal, and child health (MNCH). The purpose of the trip was to plan a return visit with a delegation of U.S. congressional staff in August 2014. Ghana's mixed progress toward meeting Millennium Development Goals (MDG) 4 and 5 related to maternal and child health; its strong relationship on immunizations with Gavi, the Vaccine Alliance; and its longstanding partnership on health with the United States were all reasons we decided to examine the country's MNCH situation. By late July, the acceleration of the Ebola outbreak in West Africa led us to postpone the trip until emergency preparations are not a major focus of the Ghanaian government, the United States, and other partners. Considering the fruitful meetings we had in June, we have captured here some of our initial impressions, observations, and recommendations.
Topic:
Health, Infectious Diseases, and Foreign Aid
Political Geography:
Africa, United States, and Ghana

6. The Danger of Untreatable Malaria Is Real and Present

Author:
Christopher V. Plowe
Publication Date:
12-2014
Content Type:
Working Paper
Institution:
Center for Strategic and International Studies (CSIS)
Abstract:
The malaria parasite is thought to have killed more people throughout human history than any other single cause. Over the last decade, a large increase in resources for combating malaria — with the lion's share coming from U.S. taxpayers — has resulted in dramatic reductions in malaria cases and deaths in many countries. These successes spurred the Bill Melinda Gates Foundation and the World Health Organization (WHO) to call for global eradication of malaria in 2007.
Topic:
Development, Health, Humanitarian Aid, World Health Organization, and Infectious Diseases
Political Geography:
United States

7. Water and Sanitation in the Time of Cholera: Sustaining Progress on Water, Sanitation, and Health in Haiti

Author:
Katherine E. Bliss and Matt Fisher
Publication Date:
09-2013
Content Type:
Working Paper
Institution:
Center for Strategic and International Studies (CSIS)
Abstract:
In October 2010, just nine months after an earthquake devastated the capital city of Port-au-Prince and displaced an estimated 1.5 million people, Haiti's Ministry of Public Health and Population reported a cholera outbreak in two of the country's most impoverished regions. It was the first time cholera—a diarrheal disease associated with the consumption of food and water contaminated by feces infected with the bacterium vibrio cholerae—had been identified in the country in at least 100 years. Within a month of the initial report, cholera had spread not only to all regions of Haiti but also to the neighboring Dominican Republic. This report considers opportunities for the United States to enhance its support for improving Haiti's water supply and sanitation services and contributing to the elimination of the transmission of cholera and the reduction of diarrheal disease in the country.
Topic:
Development, Humanitarian Aid, Infectious Diseases, and Health Care Policy
Political Geography:
United States, Caribbean, and Haiti

8. The International AIDS Conference Returns to the United States

Author:
Katherine E. Bliss
Publication Date:
03-2012
Content Type:
Working Paper
Institution:
Center for Strategic and International Studies (CSIS)
Abstract:
In 1985, four years after the U.S. Centers for Disease Control and Prevention (CDC) published a notice in the Morbidity and Mortality Weekly Report regarding unusual clusters of disease in young, otherwise healthy, gay men in California and New York, more than 2,000 scientists from around the world assembled at the World Congress Center in Atlanta to exchange research and compare notes on what had come to be known as Acquired Immune Deficiency Syndrome, or AIDS. There have been 18 international AIDS conferences since that initial gathering, in locales ranging from Amsterdam and Florence to Durban and Mexico City. These conferences, which have been organized since 1988 by the International AIDS Society, have evolved from modest- sized meetings of scientists and researchers to multitrack, week-long conventions attracting more than 20,000 delegates, including heads of state, celebrities, philanthropists, researchers, activists, and people living with the human immunodeficiency virus (HIV) and AIDS.
Topic:
HIV/AIDS, Health, International Cooperation, and Infectious Diseases
Political Geography:
United States

9. Pandemic Preemption: A U.S. Strategy for Infectious Disease Control

Author:
William J. Long
Publication Date:
06-2010
Content Type:
Working Paper
Institution:
United States Institute of Peace
Abstract:
The spread of old and new infectious diseases constitutes both a threat to U.S. and global security and peace and an opportunity for the United States to burnish its international image through strengthening foreign capacity in infectious disease surveillance and response. Despite an increase in overall U.S. expenditures on global public health, U.S. policy is not to fully meeting this challenge or capturing this opportunity. Little-known policies implemented by the Centers for Disease Control and Prevention, the United States Agency for International Development, and the Department of Defense offer cost-effective strategies that should be expanded under President Obama's new Global Health Initiative to improve infectious disease control abroad as both a frontline defense against a potential pandemic and a peaceful and positive dimension of U.S. global health diplomacy.
Topic:
Diplomacy, Globalization, Health, and Infectious Diseases
Political Geography:
United States