Deliberate Extinction: Whether to Destroy the Last Smallpox Virus

The target problem to be examined is smallpox. Specifically, what should we (the United States and the entire world) now do with the last known residual samples of the virus that causes this uniquely horrific disease? The illness itself has virtually disappeared from the catalogue of human afflictions: due to a stunningly imaginative, concerted, and resolute campaign of the World Health Organization (WHO) through the 1970s, no one has contracted this deadly impairment for twenty-five years. Yet the causative element, an insidious scourge known as the variola virus, still remains, housed for now in high-security freezers at the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta, at the comparable Russian facility, denominated Vector, in Siberia, and perhaps at other, clandestine locations as well

Practice and Lived Experience of Menstrual Exiles (Chhaupadi) among Adolescent Girls in Far Western Nepal. December 2018

Background: Menstrual exile, also known as Chhaupadi, is a tradition of “untouchability” in far-western Nepal. Forbidden from touching other people and objects, women and girls are required to live away from the community, typically in a livestock shed, during menstruation. We assessed the lived experiences of Chhaupadi among Nepalese adolescent girls in the far-western Achham district of Nepal, observed the safety and sanitation of their living spaces during Chhaupadi, and assessed the perceptions of local adult stakeholders towards the practice of Chhaupadi. Methods: We collected data from 107 adolescent girls using a self-administered survey in two local schools in Achham. We also conducted a focus group discussion with seven girls, held key informant interviews, and observed the girls’ living spaces during Chhaupadi, using a checklist. Descriptive statistics of the quantitative survey and thematic analyses of qualitative interviews are presented. Results: The majority of the girls (n = 77, 72%) practiced exile, or Chhaupadi, during their menstruation, including 3 (4%) exiled to traditional Chhau sheds, 63 (82%) to livestock sheds, and 11 (14%) to courtyards outside their home. The remaining girls (n = 30, 28%) stayed inside the house, yet practiced some form of menstrual taboos. Of the 77 observed living spaces where the girls stayed during exile, only 30% (n = 23) had a toilet facility. Most exiled girls (97.4%) were restricted from eating dairy products. Participants reported having various psychological problems, including lonliness and difficulty sleeping while practicing Chhaupadi. Three of the girls were physically abused; nine were bitten by a snake. Notably high proportions of the living spaces lacked ventilation/windows (n = 20, 26%), electricity (n = 29, 38%), toilets (n = 54, 70%) and a warm blanket and mattress for sleeping (n = 29, 38%). Our qualitative findings supported our quantitative results. Conclusions: Chhaupadi has been condemned by human rights organizations. While the government has banned the practice, implementation on the ban is proceeding slowly, especially in far-western Nepal. Thus, as a temporary measure, public health professionals must work towards promoting the health and safety of Nepalese women and girls still practicing Chhaupadi

Immunization in developing countries : its political and organizational determinants

The authors use cross-national social, political, economic, and institutional data to explain why some countries have stronger immunization programs than others, as measured by diphtheria-tetanus-pertussis (DTP) and measles vaccine coverage rates and the adoption of the hepatitis B vaccine. After reveiwing the existing literature on demand- and supply-side side factors that affect immunization programs, the authors find that the elements that most affect immunization programs in low- and middle-income countries involve broad changes in the global policy environment and contact with international agencies. Democracies tend to have lower coverage rates than autocracies, perhaps because bureaucratic elites have an affinity for immunization programs and are granted more autonomy in autocracies, althought this effect is not visible in low-income countries. The authors also find that the quality of a nation's institutions and its level of development are strongly related to immunization rate coverage and vaccine adoption, and that coverage rates are in general more a function of supply-side than demand effects. there is no evidence that epidemics or polio eradication campaigns affect immunization rates one way or another, or that average immunization rates increase following outbreaks of diphtheria, pertussis, or measles.Health Monitoring&Evaluation,Disease Control&Prevention,Insurance&Risk Mitigation,Public Health Promotion,Early Child and Children's Health,Health Monitoring&Evaluation,Early Child and Children's Health,Insurance&Risk Mitigation,ICT Policy and Strategies,Health Economics&Finance

The Place of Informed Consent and Community Assent in International Public Health Interventions

What should the role and place of individual informed consent and community assent be in international public health interventions in order to support an intervention, whilst satisfying the appropriate ethical standards? In responding to this research question, the dissertation covers public health interventions and public health ethics in international settings, with particular attention being given to transcultural interventions in developing countries. The example used is of public health interventions targeted towards the threat to public health represented by malaria in Africa. The focus is on research-oriented interventions, although public health practice will also be touched upon. The dissertation does not question the vital role of informed consent in medical and clinical research and practice; the concerns are limited to informed consent and community assent in public health, particularly in developing country contexts. The epistemic position taken is that the relationship between theoretical and empirical work in ethics should be one of a mutually supportive feedback. Therefore the dissertation contains a deductive, theoretical, normative-descriptive tranche, as well as an explorative, exemplary empirical, inductive tranche. To this end, a dissertation Deductive – Inductive Feedback Structure that has been developed. The motivation for adopting this approach is that the research question arose from concerns raised by public health practitioners; therefore an approach was necessary that addresses concrete experiences, as well as the theoretical, normative aspects of consent and assent in public health. This epistemic, methodological structure has stimulated the adoption of a ‘System – Driving Force – Target – Transformation Knowledge’ analytical framework in addressing the research question. Regarding the findings and results, the inductive and deductive tranches fail to result in knowledge being produced that enables the research question to be answered. There are two main reasons for this failure. One is that the ethics of public health is at an early stage of development, especially when compared to the rapid developments in the fields of medical and clinical ethics; therefore no ‘appropriate ethical standards’ are yet available. As long as they do not exist, the research question cannot be answered. The second reason is that there is no clarity on what the relationships between informed consent, community assent, and community participation should be in transcultural public health interventions. However, although the research question remains unanswered, paradoxically the objectives of the dissertation: “to offer a support from the field of ethics for transcultural public health interventions in developing countries, and add to the emerging ethics of public health in developing countries with respect to questions concerning community assent” are tentatively achieved. Public health ethics models and approaches are developed; new processes of informed consent and community assent for use in in public health transcultural interventions in developing countries are suggested. An action plan is proposed that works towards resolving the research question. It is concluded however that the ‘doctrine of informed consent’ often referred to in the medical context needs to be transformed in public health into a maxim of transparent planning, and an approach of being open to combine informed consent, community assent, and community multi-level engagement, all in pursuit of protecting individuals and communities, whilst supporting international public health research and practice

Background paper on the international seafood trade and poverty

(121 p.

Centers for Disease Control and Prevention global health equity strategy 2022-2027

On April 20, 2021, CDC launched an agency-wide health equity science and intervention strategy to holistically reimagine how the agency approaches health equity. CDC commits to: Cultivate comprehensive health equity science, Optimize interventions, Reinforce and expand robust partnerships, and Enhance capacity and workforce engagement (also known as CORE commitments). CDC Director, Dr. Rochelle Walensky, states, \u201cAs America\u2019s public health agency and as a leader of public health globally, CDC is reaffirming our commitment to health for all.\u201dFive pillars guide CDC\u2019s global public health work across the agency: scientific expertise, diverse partnerships, innovation, sustainability, and health equity. CDC works to eliminate health disparities and achieve optimum health through all these pillars, and more specifically by addressing health equity to reach those in greatest need through global programs, research, tools and resources, and leadership.Under CORE, the agency-wide health equity vision is that CDC is a trusted and proven public health leader in advancing health equity. The aim, according to Dr. Leandris Liburd, Director of CDC\u2019s Office of Minority Health and Health Equity, is to \u201cintegrate health equity into the very fabric of all we do as the nation\u2019s leading health agency.\u201dCS331428A August 18, 2022globalhealthequity.pdf20221182

Compliance of Caregivers with polio vaccine Dosages and Timelines in Lagos State Nigeria

Caregivers\u27 compliance with polio vaccine regimens and timely receipt of the recommended 4 doses of polio vaccine are pivotal to eliminating polio. This cross sectional study, conducted in Lagos State, Nigeria, examined polio vaccine compliance and demographic attributes of caregivers\u27 for statistically significant associations. Using an adapted health belief model theoretical framework, 1,200 participants were recruited from well-baby clinics in 8 local government areas in Lagos State. Participants completed a brief demographic survey providing data on caregivers\u27 age, gender, residence (rural or urban), and their level of education as well as records from their children\u27s immunization cards. Data obtained were tested for associations between caregiver\u27s demographic information and their children\u27s receipt of polio doses within specified timelines using chi-square and logistic regression analysis. Fisher\u27s exact analysis were conducted for variables with frequencies less than 5. The only significant association recorded was between the receipt of Polio Dose A and location of caregivers\u27 residence: Rural dwelling caregivers were less likely to receive the first dose of polio. Results showed Polio Dose D to be the dose most likely received in an untimely manner as well as most likely missed of the 4 doses. Logistic regression analysis did not show any variable to be of greater odds in predicting completion of the 4 doses or compliance with timelines of their receipt. Study\u27s results may inspire polio program planners to develop interventions that broaden the immunization coverage for rural dwellers to include nontraditional maternity locations. Positive social change will ensue by the improvement caregivers\u27 compliance with full polio dose receipts with timelines, maximizing immunity

Using Search Queries to Understand Health Information Needs in Africa

The lack of comprehensive, high-quality health data in developing nations creates a roadblock for combating the impacts of disease. One key challenge is understanding the health information needs of people in these nations. Without understanding people's everyday needs, concerns, and misconceptions, health organizations and policymakers lack the ability to effectively target education and programming efforts. In this paper, we propose a bottom-up approach that uses search data from individuals to uncover and gain insight into health information needs in Africa. We analyze Bing searches related to HIV/AIDS, malaria, and tuberculosis from all 54 African nations. For each disease, we automatically derive a set of common search themes or topics, revealing a wide-spread interest in various types of information, including disease symptoms, drugs, concerns about breastfeeding, as well as stigma, beliefs in natural cures, and other topics that may be hard to uncover through traditional surveys. We expose the different patterns that emerge in health information needs by demographic groups (age and sex) and country. We also uncover discrepancies in the quality of content returned by search engines to users by topic. Combined, our results suggest that search data can help illuminate health information needs in Africa and inform discussions on health policy and targeted education efforts both on- and offline.Comment: Extended version of an ICWSM 2019 pape

The Role of Public Administration in Preventing Corruption of State Officials

The main problem with the Indonesian government is the behavior of deviant acts of corruption that harm the nation and state. This research is shown to prevent acts of corruption by implementing the principles of public administration in state officials. The research method used, namely the type of quantitative research is comparative experimental. There are various policies taken by the government to prevent corrupt behavior, namely the application of the principles of public administration in state officials, ethical development and bureaucratic governance through the development of good governance, enforcement and application of public administration law, public awareness, and participation, efforts to improve the system. more effective and efficient public services, and the establishment of an independent institution to prevent corruption. However, this study found irregularities in the efforts to strengthen the KPK institution by re-doing the national insight test on employees