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11. 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

12. Epidemiological Insurgency: Polio Persistence on the Afghanistan-Pakistan Border

Author:
Rand Quinn
Publication Date:
07-2017
Content Type:
Journal Article
Journal:
Fletcher Security Review
Institution:
The Fletcher School, Tufts University
Abstract:
Despite a profound global impact over the first half of the twentieth century, polio is largely an afterthought throughout the developed world. Vaccines engineered in the late 1950s paved the way for a precipitous drop in global disease burden with the onset of the World Health Organization-led (WHO) Global Polio Eradication Initiative (GPEI) starting in 1988. Recent indicators of the program’s success include a declaration of eradication in India[1] and a teeteringly low infection rate in Nigeria;[2] two of the disease’s last bastions. This progress, however, has been notably stifled by the steady persistence of a wild poliovirus reservoir centered in northern Pakistan along the Afghanistan-Pakistan (Af-Pak) border. Throughout significant portions of recorded history this region’s volatility has been well-documented, including a currently sustained network for the training of terrorist fighters dating back to the period of the 1979 Afghan-Soviet War.[3] These networks serve to both attract fledgling radical jihadist recruits and supply fighters globally, markedly providing many of the transnational fighters taking part in the Syrian Civil War. Their movement in and out of the Af-Pak region has provided a major disease vector for poliovirus. The location of a terrorist network transit hub in by far the world’s largest remaining reservoir of wild poliovirus poses a major challenge for policymakers. Due to several factors, including a decline in healthcare infrastructure throughout the western world, the situation presents a legitimate epidemiological threat. However, the issue is more importantly an exemplar of the morphing nature of multidimensional threats, which are likely to become more prevalent in an era of globalization, failed states, and an inability to effectively address social issues amidst the threat of kinetic warfare...
Topic:
Security, Environment, Health, Terrorism, World Health Organization, Infectious Diseases, and Borders
Political Geography:
Pakistan, Afghanistan, South Asia, Middle East, and United States of America

13. Bird Flu — It’s What’s for Dinner: What Human Population Growth and Climate Change Mean for the Future of Avian Influenza Outbreaks

Author:
Nahid Bhadelia
Publication Date:
07-2017
Content Type:
Journal Article
Journal:
Fletcher Security Review
Institution:
The Fletcher School, Tufts University
Abstract:
China is currently experiencing its fifth epidemic of “bird flu,” or avian influenza H7N9, since 2013 when it was first noted to cause human infections. The virus, which is mainly transmitted from poultry to humans, is also prone to limited human-to-human transmission. To date, there have been 1,258 human cases, with one-third of those cases (460) occurring during this year’s epidemic alone.[1] There are many “subtypes” of avian influenza circulating in birds around the world and most of these viruses cause limited or no human infections. However, two avian influenzas subtypes causing high human mortality have jumped from birds to humans in the last decade, H5N1 and then H7N9. The significant potential of this class of viruses to cause a human pandemic is a global public health concern, particularly because the conditions leading to the rise of these infections are becoming more favorable — for the viruses.
Topic:
Climate Change, Environment, Health, and Infectious Diseases
Political Geography:
China, Asia, and Global Focus

14. Ebola, Liberia, and the “Cult of Bankable Projects”

Author:
Shefa Siegel
Publication Date:
03-2016
Content Type:
Journal Article
Abstract:
Fragile states are unable to cope with additional shocks like Ebola; without passable roads, electricity, and social solidarity there is no viable way to administer basic medical care or prevent minerals from illegally crossing porous borders, much less suddenly contain a runaway virus. Yet instead of addressing core issues of state failure, development aid continues pushing narrowly focused agendas that have little meaning in places where institutions and infrastructure are broken. Why, in response to the disastrous events we saw unfolding in Liberia, were we not calling for public and private investment in the region to be shifted from one bureaucratic budget line to another?
Topic:
Development, Humanitarian Aid, Infectious Diseases, Health Care Policy, and Ebola

15. 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

16. Ebola, Liberia, and the “Cult of Bankable Projects”

Author:
Shefa Siegel
Publication Date:
04-2015
Content Type:
Journal Article
Abstract:
Fragile states are unable to cope with additional shocks like Ebola; without passable roads, electricity, and social solidarity there is no viable way to administer basic medical care or prevent minerals from illegally crossing porous borders, much less suddenly contain a runaway virus. Yet instead of addressing core issues of state failure, development aid continues pushing narrowly focused agendas that have little meaning in places where institutions and infrastructure are broken. Why, in response to the disastrous events we saw unfolding in Liberia, were we not calling for public and private investment in the region to be shifted from one bureaucratic budget line to another?
Topic:
Development, Humanitarian Aid, Infectious Diseases, Health Care Policy, and Ebola

17. 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

18. Preparedness Rather Than Response: A Strategy to Prevent the Next Ebola Crisis

Author:
Andrew Koltun, Brittany Mcnena, and Nawroos Shibli
Publication Date:
07-2015
Content Type:
Policy Brief
Institution:
Centre for International Governance Innovation (CIGI)
Abstract:
The 2013 West African Ebola crisis exposed two weaknesses: the inability of the international community to rapidly mobilize an effective response and a lack of adequate domestic health care systems for epidemic preparedness response. While a number of proposals have addressed gaps in the international response, none have yet addressed the remaining issue of building adequate domestic health systems. Although the World Health Organization’s (WHO’s) 2005 International Health Regulations require that all member countries develop and implement a core set of health system capacities, funding constraints have prevented many low-income countries from meeting these requirements. This brief proposes that the World Bank, in collaboration with the WHO, should develop a Pandemic Prevention Program to assist low-income countries in building strong and robust health systems. This program would assist low-income countries in meeting their international obligations, while ensuring sustainable national ownership in order to prevent the next infectious disease epidemic.
Topic:
Health, Infectious Diseases, and World Bank
Political Geography:
West Africa

19. U.S. Actions Can Help Keep Global Polio Eradication Strategy on Track

Author:
Nellie Bristol
Publication Date:
07-2015
Content Type:
Working Paper
Institution:
Center for Strategic and International Studies (CSIS)
Abstract:
The Global Polio Eradication Initiative (GPEI) in April 2013 unveiled an ambitious six-year strategy aimed at finally ending polio worldwide. The four-pronged approach called for stopping transmission in the remaining polio endemic countries while also eliminating rare but paralyzing vaccine-related polio. It outlined plans to ensure proper laboratory and health facility containment of poliovirus as eradication neared. Lastly, the Polio Eradication & Endgame Strategic Plan 2013–2018 urged countries, donors, and international partners to begin planning for the transition of polio program resources to country heath systems and other health initiatives. The drive to eradicate polio is at a pivotal point. The number of cases is down globally compared to last year. Polio programs in both Nigeria and Pakistan are moving in a positive direction while progress in Afghanistan is holding steady. A successful move to bivalent OPV would greatly reduce the number of polio cases caused by vaccine viruses and set the stage for an eventual worldwide switch to IPV. But extraordinary efforts still are required to reach the endgame strategy’s goals.
Topic:
Infectious Diseases and Health Care Policy

20. Counting the Cost of South Africa's Health Burden

Author:
Sahil Angelo and Richard Downie
Publication Date:
07-2015
Content Type:
Working Paper
Institution:
Center for Strategic and International Studies (CSIS)
Abstract:
South Africa’s health system is approaching a make or break moment. Can it complete a set of complex organizational reforms and place itself on a sustainable financial footing that will enable it to deliver first-rate health care services to patients? Or will a stalled political process, economic stagnation, and the country’s daunting—and expanding—health burden torpedo the reform effort and cause the system to grind to a halt, with dire consequences for the nation’s health? CSIS explored these questions on a recent research trip to South Africa. This report summarizes the findings
Topic:
Infectious Diseases, Health Care Policy, and Reform
Political Geography:
South Africa