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101. Global Oncology in Rwanda

Author:
Darja Djordjevic
Publication Date:
03-2018
Content Type:
Working Paper
Institution:
Weatherhead Center for International Affairs, Harvard University
Abstract:
Last summer, two major pharmaceutical companies, Pfizer and Cipla, reached an agreement to sell sixteen standard chemotherapy drugs at very low cost (purportedly only slightly higher than the manufacturing cost) to six African countries: Rwanda, Uganda, Ethiopia, Kenya, Tanzania, and Nigeria.1 This negotiated deal also included a plan for top American oncologists to simplify cancer treatment protocols, which an IBM team would then make available through an online, open-access tool. This development signaled an important moment in the politics of global health, one of growing awareness and advocacy around cancer in Africa and the Global South. While this particular deal was a positive and overdue development in the battle long-fought by care providers across the world who look after poor people with cancer, we have to wonder for how long such a deal will last, alongside other pressing concerns. Further, how does this initiative fit into the broader political economy of a profit-driven pharmaceutical industry always in search of new markets, with Africa being a potentially massive one?
Topic:
Public Health, Pandemic, and Cancer
Political Geography:
Global South

102. Regulation: The Responsible Control of Drugs

Author:
Global Commission On Drug Policy
Publication Date:
03-2018
Content Type:
Special Report
Institution:
Global Commission On Drug Policy
Abstract:
This new report provides a practical roadmap that tackles the real implications and recognizes the difficulties of transitioning from illegal to legally regulated drug markets. It offers concrete answers regarding the organizational capacity of state institutions to regulate and control a legal market of potentially dangerous products. It highlights the challenges facing impoverished populations that constitute the “working class” of the illegal drug markets. It offers possible ways forward to deal with the risks inherent to the resilience of organized crime. Finally, this report calls for a reform of the prohibition-based international drug control system, which is compromising a universal and holistic approach to the “drug problem.”
Topic:
Crime, Health, War on Drugs, Drugs, and Public Health
Political Geography:
Global Focus

103. History, International Relations, and Public Health - The Case of the Democratic People's Republic of Korea 1953-2015

Author:
John Grundy
Publication Date:
07-2017
Content Type:
Special Report
Institution:
Korea Economic Institute of America (KEI)
Abstract:
The historical legacy of North Korea is characterized by occupation and conflict, and economic rehabilitation and then collapse, with tragic and widespread consequences for population health. From the standpoint of the historical determinants of health, this paper reviews the health system in North Korea between 1953 and 2016. Ideology and political relations have been dominant forces in determining the evolution of the health care system and population health. Despite the development of an extensive primary health care system in the country from the early 1960s following the establishment of the DPRK state in 1948, the public health system experienced a major decline in the 1990s, with catastrophic implications for the health and survival of the population. In recent years, evidence has emerged of some important public health gains, particularly through immunization, women's and children's health, and communicable disease control initiatives. This experience demonstrates that, within the overall policy context dominated by the historical and political determinants of health, there remains the capacity for implementation of public health programs that can yield both tangible health benefits for the population in North Korea, as well as assist the health system to edge closer to a regional standard.
Topic:
International Relations, History, Ideology, and Public Health
Political Geography:
Asia, South Korea, North Korea, and Korea

104. Insight on Syria: Documenting the "Burden of War" on Syrians

Author:
Michelle Nicholasen
Publication Date:
07-2017
Content Type:
Working Paper
Institution:
Weatherhead Center for International Affairs, Harvard University
Abstract:
The war in Syria is remarkable in its cumulative destruction of a society in a short six years. The toll on human life has been heavy; the involvement of multiple states, factions, and terrorist groups undermines resolution; the instigation of forced migration unprecedented; and the unfettered aerial bombardments against civilians—and perhaps most viciously, the deliberate destruction and targeting of health care facilities, health care workers, and patients—have defied all norms of war. Achieving an accurate picture of the human cost of this conflict has been an extraordinary challenge for aid agencies and health officials. In an effort to understand the impact of the war thus far, last winter the British medical journal the Lancet convened a commission of medical professionals to investigate and report on this conflict through the lens of public health. In Lancet parlance, a commission is always anchored at an elite university; in this case the American University of Beirut (AUB). In an early publication to set the stage, The Lancet-AUB Commission on Syria (the Commission) has called Syria “the most dangerous place on earth for health care providers,” and notes that the many reported atrocities “undermine the principles and practice of medical neutrality in armed conflict.” One of the three co-chairs leading the Commission is Weatherhead Center Faculty Associate Jennifer Leaning, François-Xavier Bagnoud Professor of the Practice of Health and Human Rights at the Harvard T.H. Chan School of Public Health, who has studied war and its long-term effects on societies in many parts of the world, including in the Middle East. Her fellow Commission co-chairs are Professor Iman Nuwayhid, Dean of the Faculty of Health Sciences at AUB, and Dr. Samer Jabbour, a cardiologist on the AUB faculty. The Weatherhead Center sat down with Jennifer Leaning to discuss the Commission’s work, its goals, and the scope of the devastation in Syria.
Topic:
Civil War, Displacement, Civilians, Public Health, and Armed Conflict
Political Geography:
Middle East and Syria

105. How is Denver combating mental illness in the homeless population?

Author:
Cat Galley
Publication Date:
11-2017
Content Type:
Working Paper
Institution:
Center on Human Rights Education, University of Denver
Abstract:
As we have seen in the previous weeks, there are many causes to homelessness, substance abuse, trauma, an unstable household, and mental illness. In Denver, 56% of the homeless population have one thing in common, mental illness. Though others are prevalent, post-traumatic stress disorder is seen in many homeless individuals. This is due to the constant sleeping outside, harassment, childhood trauma, and general instability that plagues the life of someone on the streets. Without proper care, many individuals with PTSD turn to drugs or alcohol to cope.
Topic:
Human Rights, Mental Health, Homelessness, and Public Health
Political Geography:
North America, Colorado, and United States of America

106. The World Drug PERCEPTION Problem: Countering Prejudices About People Who Use Drugs

Author:
Global Commission On Drug Policy
Publication Date:
11-2017
Content Type:
Special Report
Institution:
Global Commission On Drug Policy
Abstract:
Drug policy reforms have been difficult to design, legislate or implement because current policies and responses are often based on perceptions and passionate beliefs, and what should be factual discussions leading to effective policies are frequently treated as moral debates. The present report aims to analyze the most common perceptions and fears, contrast them with available evidence on drugs and the people who use them, and provides recommendations on changes that must be enacted to support reforms toward more effective drug policies.
Topic:
Crime, Health, War on Drugs, Drugs, Public Health, and Criminology
Political Geography:
Global Focus

107. Understanding teenage fertility, cohabitation, and marriage: the case of Peru

Author:
Marta Favara, Pablo Lavado, and Alan Sanchez
Publication Date:
09-2016
Content Type:
Working Paper
Institution:
Group for the Analysis of Development (GRADE)
Abstract:
In this study, the authors used data from the Young Lives study, which inves­tigates teenage childbearing, marriage, and cohabitation by tracking a cohort of individuals from the ages of 8 to 19 years. While the present analysis does not intend to establish causality, the longitudi­nal nature of the data allows the researchers to identify the combination of early circumstances and life changes that induce a higher likelihood of these events. The analysis addresses bias due both to reverse causality and to community characteristics that are usually unobserved and fixed over time, a strategy that is quite unique in studies of developing countries. About 1 out of 5 females (and 1 out of 20 males) in our sample had at least one child by the age of 19, and 80 percent of them were married or cohabiting. Early marriage/cohabitation is indeed intrinsically re­lated to early pregnancy and largely predicted by the same factors. For females specifically, girls from poor households with an absent parent for a prolonged period have a higher risk of early childbearing. Similarly, girls whose self-efficacy and educational aspirations decrease over time are more at risk of becoming a mother during adolescence. Conversely, school attendance and better school performance predict a lower risk of early pregnancy; the analysis suggests that this is largely because it postpones the first sexual relationship.
Topic:
Health, Children, Sexuality, Public Health, Young Adults, and Adolescence
Political Geography:
Latin America and Peru

108. Pandemic Declarations of the World Health Organization as an Exercise of International Public Authority: The Possible Legal Answers to Frictions Between Legitimacies

Author:
Pedro A. Villarreal
Publication Date:
06-2016
Content Type:
Journal Article
Journal:
The Goettingen Journal of International Law
Institution:
The Goettingen Journal of International Law
Abstract:
The institutional decisions regarding the 2009–2010 influenza A(H1N1) pandemic displayed how the World Health Organization’s (WHO) role as the international organization in charge of coordinating the pandemic response amounts to an exercise of authority. Notably, the 11 June, 2009 Pandemic Declaration was grounded in the WHO’s guidelines that do not have a binding nature according to international law. However, this is not an obstacle for considering them as an act of authority, since their effects can constrain the decision-making of States. If these non-binding acts have an authoritative nature, then it is necessary to address various legitimacy issues that may be present. This is where the concept of international public authority (IPA) can prove useful, since it enables to combine the non-binding nature of Pandemic Declarations and the respective guidelines with broad legally-oriented figures such as transparency and accountability. The controversies surrounding the 2009 Pandemic Declaration illustrate how the strictly technical-scientific elements that led to such a decision were not necessarily harmonious with other aspects more related to political decision making in general, such as transparency and accountability. This can be considered as an example of how so-called ‘technocratic legitimacy’ sometimes generates friction with lato sensu ‘political legitimacy’. As the 2009–2010 pandemic period unraveled, it became clear that expertise-based legitimacy is not sufficient in itself to consider the act as generally legitimate. On the contrary, the strongest criticisms directed at the decision-making process of the WHO during this event were leveled against deficits of transparency and accountability. This article purports to discuss the issue of how both types of legitimacies, technical-scientific and political, are necessary components for deeming Pandemic Declarations as legitimate enough, since they amount to an exercise of international public authority.
Topic:
International Law, World Health Organization, Public Health, and H1N1
Political Geography:
Global Focus

109. Law as an Antidote? Assessing the Potential of International Health Law Based on the Ebola-Outbreak 2014

Author:
Robert Frau
Publication Date:
11-2016
Content Type:
Working Paper
Institution:
The Goettingen Journal of International Law
Abstract:
The Ebola-Outbreak of 2014 has put international health law in the limelight. This contribution assesses the measures taken by the international community with regard to the outbreak of 2014 with a special focus on the World Health Organization and the UN Security Council. International law provides different actors with means to cooperate in order to fight the outbreak. The list of actors does not include the UN Security Council, which has addressed the outbreak in one resolution under chapter VII without taking any effective legal remedies. In addition, the relevant human right to health has not been addressed by actors, creating leeway in further emergencies.
Topic:
International Cooperation, United Nations, World Health Organization, Ebola, Public Health, and Pandemic
Political Geography:
Global Focus

110. Advancing Drug Policy Reform: a new approach to decriminalization

Author:
Global Commission On Drug Policy
Publication Date:
07-2016
Content Type:
Special Report
Institution:
Global Commission On Drug Policy
Abstract:
Building on current partial decriminalization models that have helped to achieve more effective drug policies and positive outcomes, with a greater emphasis on justice, dignity and human rights, this report advocates ending all penalties – both civil and criminal – on people who use drugs. Detailing the destructive and harmful consequences of punitive drug policies and the need to reconsider them, the report calls for the implementation of alternatives to punishment for all low-level, non-violent actors in the drug trade, and to consider market regulation as the next logical step.
Topic:
Health, War on Drugs, Drugs, Public Health, and Criminology
Political Geography:
Global Focus