70 Years of Human Rights in Global Health: Drawing on a Contentious Past to Secure a Hopeful Future

The Universal Declaration of Human Rights, adopted on Dec 10, 1948, established a modern human rights foundation that has become a cornerstone of global health, central to public health policies, programmes, and practices. To commemorate the 70th anniversary of this seminal declaration, we trace the evolution of human rights in global health, linking the past, present, and future of health as a human right. This future remains uncertain. As contemporary challenges imperil continuing advancements, threatening both human rights protections and global health governance, the future will depend, as it has in the past, on sustained political engagement to realise human rights in global health

Health Inequalities

The vast health inequalities in the United States and beyond that COVID-19 makes glaringly evident are frequently masked by aggregate statistics, which for years had been showing health improvements. Yet these improvements were inequitably distributed, with benefits disproportionately going to wealthier – and in the United States, white – populations. Globally, vast health inequities also exist among and within countries. The inequalities, which have also helped fuel the rise of populism, extend far beyond health care, including to wealth and income. Disaggregated, granular data is critical to understanding these inequalities. Addressing health inequities must extend far beyond universal access to quality health service to under-funded population-based public health interventions. Meanwhile, as any epidemiologist will tell you, the single biggest predictor of health outcomes is a person’s zip code, indicative of social determinants outside the health sector, including employment, education, housing, and transportation. Without explicit attention to these determinants, and the systematic, structural factors like racism that underlie their inequitable distribution, we can make little progress towards health equity, and will fail to meet the UN Sustainable Development Agenda pledge of leaving no one behind. Equity solutions require dedicated, systematic, systemic, well-resourced plans – health equity programs of action. These would include explicit targets, costed actions, rigorous measurement, and accountability through a comprehensive national effort. The United States could choose to lead, which would be a powerful political commitment to health equity and justice. And an intangible yet powerful benefit would be to restore a sense of dignity for all of society and, in turn, act collectively to elect truthful, compassionate leaders who bring us together as a nation

Land use/land cover change along the Eastern Coast of the UAE and its impact on flooding risk

This study was conducted to investigate the spatiotemporal changes of land use/land cover (LULC) along the eastern coast of the United Arab Emirates (UAE) over a 20-year period using an integration of remote sensing and Geographic Information Systems techniques. The impact of land use change on flooding potential was also investigated through hydrologic model simulations. Landsat images of the years 1996, 2006 and 2016 were processed and analyzed. Change detection was carried out to assess changes in the built-up areas. Furthermore, the impact of urbanization on flooding was assessed using a hydrologic model in two major watersheds of Fujairah Emirate. It was observed that for the period 1996–2006 the vegetation and the built-up areas had increased at a rate of 11.23% and 24.56%, respectively. For the period 2006–2016, this expansion more than doubled in terms of the vegetation class (27.51%) and slightly increased for the built-up class (28.98%). The change detection analysis revealed that urbanization has mostly occurred along the coastal boundary. Hydrologic model simulations quantified the role of urbanization in increasing the flooding potential. The increase depends on watershed characteristics and the rate of change in urbanization and the magnitude of the rainfall event

Community-based malaria control programme in Tigray Region, Northern Ethiopia: Results of a mortality survey of rural under-five children

Abstract: A mortality survey of children under five years of age was undertaken in Tigray Region, in rural areas covered by a community-based malaria control programme. A multistage cluster sampling technique was used to define the sample. Trained Malaria Control Programme personnel conducted interviews in 4660 households. Total under-five population sampled was 7335, in which 190 deaths were reported in one year. Median duration of illness before death was 14 days, mean age at death 1.5 years, and 53% of those who died were male. Forty five percent died without being taken to a Community Health Worker (CHW) or to a health facility before death, and 92% of the deaths occurred at home. Overall, 12% of deaths were reported by families due to fever or malaria. Death rate (age 0-4) was 25.9%. Estimated age specific mortality rate (age 0-4) was 26.3%, underfive mortality rate (U5MR) was 163%, and malaria-specific mortality rate based on lay reporting was 3.3%. Two districts were found to have very high mortality with estimated U5MRs of 372% and 290%. Based on these findings, increased efforts are being made in the Community-Based Malaria Control Programme to educate families about the importance of early diagnosis and treatment and the use of CHW services for ill children. Areas for investigating the determinants of the marked district mortality differentials are discussed. [Ethiop. J. Health Dev. 1998;12(3):203-211

Student and Faculty Preferences Regarding Instructional Modalities at an HBCU Business School as a Result of Covid-19 – A Change Management Approach and Mindset

The COVID-19 pandemic has had a major impact on the higher education community, especially the Historically Black Colleges and Universities (HBCUs). At a micro-level, the HBCU business schools have felt the effects as well, particularly in critical areas such as instructional modalities and the overall classroom experience. Since COVID-19 has changed the educational game, what do key stakeholder groups now prefer regarding instructional modalities in the HBCU business school? This study will answer this question and more while incorporating a change management approach and mindset for leadership and decision-making

Tobacco use among Eritrean health professionals : a final scientific report

The prevalence of smoking among health professionals, especially among male physicians (17%), is a cause for concern given their role as public health leaders. Cessation programmes in the heath care setting and training on cessation techniques was non-existent but the desire to quit among tobacco users was high. Efforts to strengthen tobacco control in Eritrea would include securing the ratification of the WHO Framework Convention on Tobacco Control to guide ongoing efforts to reduce the prevalence of tobacco use and exposure to second hand smoke. Cessation programmes should be incorporated as a key component of the primary heath care setting

Therapeutic efficacy of chloroquine for treatment of Plasmodium vivax malaria cases in Halaba district, South Ethiopia

<p>Abstract</p> <p>Background</p> <p>Chloroquine is an anti-malarial drug being used to treat <it>Plasmodium vivax </it>malaria cases in Ethiopia. However, emergence of chloroquine resistant strains of the parasite has challenged the current efficacy of the drug. Therefore, the aim of this study was to assess the effectiveness of chloroquine against <it>P. vivax </it>strains in one of the malaria endemic areas of Ethiopia, namely Halaba district, located in South Nations and Nationalities Peoples Region (SNNPR) of South Ethiopia</p> <p>Results</p> <p>Among 87 malaria patients enrolled in the study, only 80 of them completed the 28-days follow-up. Seven of them dropped from the study for different reasons. Among those study participants that completed their follow-up, 69 were classified under the category of adequate clinical and parasitological response (ACPR). However, the remaining 11 cases were considered as under treatment failure mainly due to recurrence of parasitemia on day 7 (four patients), day 14 (six patients), and day 21 (one patient). The age of all cases of treatment failures was found to be less than 20 years. The load of parasitemia of patients with treatment failure on day of admission (4709.4/μl) was higher than day of recurrence (372.37/μl). Parasite reduction ratio (PRR) of treatment failure cases was 12.6/μl.</p> <p>Conclusion</p> <p>This report revealed the rise in treatment failure (13% [95% CI = 0.074 - 0.217]) as compared to earlier reports from Ethiopia. It signals the spreading of chloroquine resistant <it>P. vivax </it>(CRPv) strains to malaria endemic areas of Ethiopia. It is recommended that all concerned bodies should act aggressively before further expansion of the current drug resistant malaria.</p

Vulnerability to episodes of extreme weather: Butajira, Ethiopia, 1998–1999

BACKGROUND: During 1999-2000, great parts of Ethiopia experienced a period of famine which was recognised internationally. The aim of this paper is to characterise the epidemiology of mortality of the period, making use of individual, longitudinal population-based data from the Butajira demographic surveillance site and rainfall data from a local site. METHODS: Vital statistics and household data were routinely collected in a cluster sample of 10 sub-communities in the Butajira district in central Ethiopia. These were supplemented by rainfall and agricultural data from the national reporting systems. RESULTS: Rainfall was high in 1998 and well below average in 1999 and 2000. In 1998, heavy rains continued from April into October, in 1999 the small rains failed and the big rains lasted into the harvesting period. For the years 1998-1999, the mortality rate was 24.5 per 1,000 person-years, compared with 10.2 in the remainder of the period 1997-2001. Mortality peaks reflect epidemics of malaria and diarrhoeal disease. During these peaks, mortality was significantly higher among the poorer. CONCLUSIONS: The analyses reveal a serious humanitarian crisis with the Butajira population during 1998-1999, which met the CDC guideline crisis definition of more than one death per 10,000 per day. No substantial humanitarian relief efforts were triggered, though from the results it seems likely that the poorest in the farming communities are as vulnerable as the pastoralists in the North and East of Ethiopia. Food insecurity and reliance on subsistence agriculture continue to be major issues in this and similar rural communities. Epidemics of traditional infectious diseases can still be devastating, given opportunities in nutritionally challenged populations with little access to health care

Using climate information in the health sector

Many infectious and chronic diseases are either directly or indirectly sensitive to the climate. Managing this climate sensitivity more effectively requires new working relationships between the health sector and the providers of climate data and information. In Africa, where communities are particularly vulnerable, Ministries of Health and National Meteorological Services need to collaborate to reduce the burden of climaterelated ill health