The Untapped Power of Soda Taxes: Incentivizing Consumers, Generating Revenue, and Altering Corporate Behavior

Globally, soda taxes are gaining momentum as powerful interventions to discourage sugar consumption and thereby reduce the growing burden of obesity and non-communicable diseases (NCDs). Evidence from early adopters including Mexico and Berkeley, California, confirms that soda taxes can disincentivize consumption through price increases and raise revenue to support government programs. The United Kingdom’s new graduated levy on sweetened beverages is yielding yet another powerful impact: soda manufacturers are reformulating their beverages to significantly reduce the sugar content. Product reformulation – whether incentivized or mandatory – helps reduce overconsumption of sugars at the societal level, moving away from the long-standing notion of individual responsibility in favor of collective strategies to promote health. But as a matter of health equity, soda product reformulation should occur globally, especially in low- and middleincome countries (LMICs), which are increasingly targeted as emerging markets for soda and junk food and are disproportionately impacted by NCDs. As global momentum for sugar reduction increases, governments and public health advocates should harness the power of soda taxes to tackle the economic, social, and informational drivers of soda consumption, driving improvements in food environments and the public’s health

Reframing the Opioid Epidemic as a National Emergency

On August 10, 2017 President Trump announced his intention to declare a national emergency following the recommendation of the White House Commission on Combating Drug Addiction and the Opioid Crisis. Opioid abuse is among the most consequential preventable public health threats facing the nation. More than 600,000 deaths have occurred to date, with 180,000 more predicted by 2020. Of the 20.5 million US residents 12 years or older with substance use disorders in 2015, 2 million were addicted to prescription pain relievers. A national emergency declaration authorizes public health powers, mobilizes resources, and facilitates innovative strategies to curb a rapidly escalating public health crisis

Big Food and Soda Versus Public Health: Industry Litigation Against Local Government Regulations to Promote Healthy Diets

Diets high in fats, sugars, and sodium are contributing to alarming levels of obesity, cardiovascular disease, type 2 diabetes, and certain cancers throughout the United States. Sugary drinks, which include beverages that contain added caloric sweeteners such as flavored milks, fruit drinks, sports drinks, and sodas, are the largest source of added sugar in the American diet and an important causative factor for obesity and other diet-related diseases. City and county governments have emerged as key innovators to promote healthier diets, adopting menu labeling laws to facilitate informed choices and soda taxes, warnings labels, and a soda portion cap to discourage consumption. These measures raise tension between the public health promotion and the food and beverage industry’s interests in maximizing profits. This article analyzes the food and beverage industry’s efforts to undermine local government nutrition promotion measures, including lobbying, funding scientific research, public messaging, and litigation. It examines four case studies (New York City’s soda portion cap, San Francisco’s soda warnings ordinance, and soda taxes in Philadelphia and Cook County), and distills steps that local governments can take to address industry opposition and help ensure the legal viability and political sustainability of key public health interventions

Using COVID-19 to Strengthen the WHO: Promoting Health and Science Above Politics

On April 14, 2020, President Trump announced the suspension of funding for the World Health Organization (WHO) to investigate WHO’s handling of the COVID-19 pandemic—citing WHO’s “disastrous decision” to oppose a travel ban on China, and for being slow and “China-centric.” Certainly, China failed in its international duty to respond rapidly and transparently to the novel coronavirus, and it suppressed truthful information, propelling a localized outbreak into a pandemic now in over 210 countries. Yet close examination of WHO’s COVID-19 response reveals that the Organization acted in line with its authority under the International Health Regulations, and using the available scientific evidence. Still, WHO’s response has been constrained by its limited funding and authority, and its need to maintain diplomacy among member states. We are facing a once-in-a-century health emergency, with WHO under attack as never before. But out of a crisis can come an historic opportunity to strengthen WHO to become the health agency the world desperately needs. What might WHO reform look like if we truly want to empower the Organization, as we should? That reform should address the structural problems that put WHO in the crossfires of geopolitical disputes and force it to appeal to countries’ political interests instead of the best scientific evidence. We propose an emboldened WHO Director-General, sustainable funding, strengthened authority to use unofficial data, and incentives for states’ compliance with global health norms

Risk Tradeoffs and Equitable Decision-Making in the COVID-19 Pandemic

Since the start of the Covid-19 pandemic, societies have faced agonizing decisions about whether to close schools, shutter businesses, delay nonemergency health care, restrict travel, and authorize the use of emergency Covid-19 countermeasures under limited scientific understanding. Measures to control the spread of COVID-19 have disrupted our health, educational, and economic systems, tarnished our mental health, and took away our cherished time with family and friends. Conflicting advice from health agencies on the utility of public health measures left us wondering, was it all worth it? We still do not have all the answers to guide us through difficult risk-risk tradeoff decisions during a health emergency. When both action and inaction can result in significant harm and irreversible damage, decisions surrounding infection control measures become complicated, and there is no single correct answer. Yet ethics can help us think about hard trade-offs that weigh competing values and have deep consequences for society and particularly the most disadvantaged. This essay discusses the challenges of making policy trade-offs amid scientific uncertainty. While there may be no perfect formula for deciding what to do and when, we propose four key considerations for assessing risk-risk trade-offs, involving effectiveness, less-restrictive means, harm identification and amelioration, and equitable distribution. We then and apply those four considerations to the areas of education, economies, health care, travel and migration, social engagement, and medical countermeasures, examining governments’ response to the COVID-19 pandemic, and assessing how responses to the next major outbreak can be improved

How the Biden Administration Can Reinvigorate Global Health Security, Institutions, and Governance

The tragedy of COVID-19 can be fertile soil for deep structural reforms. President Biden can both bolster the immediate responses to COVID-19 and its vast ramifications, and spearhead lasting changes to create a healthier and safer world, from which the United States would richly benefit. The agenda we propose for President Biden is ambitious, yet US. bold leadership on global health will benefit all people, including Americans, and is in the U.S. national interest Along with responding to the COVID-19 domestically, the Biden administration should enhance U.S.-initiatives home, expanding the Global Health Security Agenda and restoring and reinvigorating the PREDICT animal virus identification and tracking project, while ensuring that the U.S. Strategic National Stockpile is fully stocked with critical medical supplies and expanding research and development of antimicrobials. To enable the world to benefit from U.S. science – and to benefit from it – the administration should support the Open Science movement. And the administration should work with Congress to use devote 2% of past and future U.S. domestic COVID-19 spending to the global response, extend a debt moratorium, and enhance debt cancellation. The United States should lead strengthened global governance for health security, beginning with proposing a doubling of mandatory WHO contributions, WHO reform including enhanced civil society participation, and strengthening the International Health Regulations (2005). Meanwhile, along with joining and funding the global vaccine distribution mechanism, COVAX, the Biden administration should propose creating a permanent facility for distributing PPE and other medical supplies and equipment, diagnostics, therapies, and vaccines during epidemics and pandemics. And by supporting use of TRIPS-flexibilities and, going further, supporting suspending intellectual property rights related to COVID-19 technologies, expanding production and increasing access, the administration would enable expanded global production, enhanced access, and lower prices. Finally, the Biden administration should lead a collaborative global effort to ensure that the global health architecture is firmly based in human rights, which would enhance equity and accountability and elevate the voices and priorities of marginalized populations. At its foundation would be the Framework Convention on Global Health, a proposed treaty that, if adopted, would strengthen implementation of the right to health and promote global health equity, while a Right to Health Capacity Fund could support right-to-health advocacy, accountability, and participation mechanisms

Use of Standardized Patient Scenarios to Train Medical Assistants in an Ambulatory Rehabilitation Medicine Clinic

Objectives: To improve the efficiency of our outpatient Rehabilitation Medicine clinic without sacrificing high value/quality patient care. To clarify the responsibilities of the MA and identify areas of redundancy in the rooming process. To demonstrate the utility of in-situ simulation for MA training. To reduce the time it takes for MAs to complete all assigned tasks to 10 minutes or less per encounter in at least 50% of patient encounters within two months from the time of intervention. To potentially highlight other areas in which to improve clinic efficiency and overall patient satisfaction (e.g. front desk registration process, resident and attending physician encounters, clinic and exam room accessibility).https://jdc.jefferson.edu/patientsafetyposters/1051/thumbnail.jp

The Untapped Power of Soda Taxes: Incentivizing Consumers, Generating Revenue, and Altering Corporate Behavior

Globally, soda taxes are gaining momentum as powerful interventions to discourage sugar consumption and thereby reduce the growing burden of obesity and non-communicable diseases (NCDs). Evidence from early adopters including Mexico and Berkeley, California, confirms that soda taxes can disincentivize consumption through price increases and raise revenue to support government programs. The United Kingdom’s new graduated levy on sweetened beverages is yielding yet another powerful impact: soda manufacturers are reformulating their beverages to significantly reduce the sugar content. Product reformulation – whether incentivized or mandatory – helps reduce overconsumption of sugars at the societal level, moving away from the long-standing notion of individual responsibility in favor of collective strategies to promote health. But as a matter of health equity, soda product reformulation should occur globally, especially in low- and middleincome countries (LMICs), which are increasingly targeted as emerging markets for soda and junk food and are disproportionately impacted by NCDs. As global momentum for sugar reduction increases, governments and public health advocates should harness the power of soda taxes to tackle the economic, social, and informational drivers of soda consumption, driving improvements in food environments and the public’s health