HIV/AIDS Part 3: Philanthropy

Photo Credit: famousphilanthropists.com

To mark the 30th anniversary of the first AIDS diagnoses, we’ve been discussing the different groups that came together to improve our understanding of HIV/AIDS and develop new treatments for combating the disease. I’ve written about scientists and advocates in my previous posts for this series, but we’re not done yet! Research needs money and philanthropists were the first to step up to do their part in the fight against AIDS.

Today, the federal government spends over $15 billion every year on HIV/AIDS programs and research. However when AIDS first emerged, the government was not quick to respond. Early donors did not even include foundations, but rather individuals who were personally invested in the epidemic. This probably had a lot to do with the stigma associated with a disease that primarily affected the gay community and intravenous drug users.

Those first donors were really important, because together with advocates, they were able to put a face on the disease. Foundations took notice and realized that HIV/AIDS was a major public health challenge that the federal government was not addressing. In 1986 the Robert Wood Johnson Foundation announced that a significant portion of its annual budget would go towards HIV/AIDS programs and research. They were quickly followed by the Ford Foundation which helped to create the National AIDS Fund (NAF, now AIDS United). New foundations were also created specifically for HIV/AIDS research, like the American Foundation for AIDS Research (amfAR).

Apart from funding research on HIV/AIDS, philanthropists were able to help shift public perception of the disease. They could use their name recognition to funnel funds into community-based programs that would otherwise have been invisible. The resulting public support led to political pressure, which led (finally!) to government investment.

You might think that once big federal dollars are part of the equation, we wouldn’t need HIV/AIDS philanthropy anymore. Actually foundations still play an important role in dealing with this disease, especially in the global health arena. Along with the early champions, newer organizations like the Bill and Melinda Gates Foundation are spending significant resources on fighting the global AIDS epidemic.

Not-at-All-Scary Friday the 13th Round-Up

It was a scary start to the day with Blogger down, but we're back in business and this Friday the 13th isn't too scary at all. In fact, since you didn't get a post yesterday, today's round-up has a few bonus links and a new summer feature to keep you reading until we're back on Monday.

Making the Case for Investment in Research
For those who wonder why it's important to spend NIH money on global health, here's one great reason: a dramatic decrease in infant mortality. For about $208 per life, 97 families are celebrating a new member of their family. Since that doesn't include the value beyond the control of this study, in the end, it will probably cost even less per life saved. Knowledge is power, lasts a lifetime, and can make more lives possible.

Senator Shelby of Alabama is pushing to save NIH from cuts in FY2012.

Advocacy Around the Web
Research shows that people portray their personalities on social networking sites more honestly than anecdotal evidence has us believe. All the more reason to get out there and tell our science stories and defend research while being ourselves.

We're all excited for summer, but remember that with sunny days come summer sunburns. This well-done PSA - Dear 16 year old me - regarding melanoma should be shared with every teenager you know.

The Vatican has spoken out on climate change and made some strong statements about how we should take action now.

News of the Fun
As you might have guessed, kissing is a mood booster.  

Voting is open until the end of the day today on Doodle for Google, a program to encourage young Americans to put in pictures their life's ambition.You can vote once per age group, and there are many fun doodles to choose from. Also, for a country that's falling behind in math and science, it's interesting just how many of the finalists have science themes.

New Features
As New Voices begins its third summer, we now have enough content to feature historical posts from New Voices. The new segment will appear in round-ups, and if you like it and want it to be an even more regular feature, let us know. Without further ado....

On this day in  New Voices:
2010 - Sarah wrote about Failures in U.S. Chemical Regulation
2009 - FlyGal wrote about U.S. Competitiveness and Innovation

First Stop: NIH

Image courtesy of USAID

When I arrived in DC a couple of weeks ago, I was excited to see many famous places for the first time: the White House, Washington Monument, Lincoln Memorial and others. Which major attraction did I see first? The NIH campus.

Alright, it might not be every tourist’s top choice, but the NIH campus in Bethesda, MD is a place I’ve heard and read about for years. So when Heather asked me to attend a lecture there by Dr. Rajiv Shah, the current USAID (US Agency for International Development) administrator, I was more than happy to visit.

It turned out, however, that I wasn’t the only one having my “first time” on the NIH campus. NIH Director Dr. Francis Collins introduced Shah and noted that this was the first time a sitting USAID administrator had addressed the NIH. It was a bit a surprising: two closely related – and physically close – government agencies never having that kind of interaction.

As Shah soon described, the bond between USAID and the NIH certainly has plenty of room to grow. He first brought up a few cases in which the NIH has already contributed to USAID work: An NIH-funded study called First Breath has led to the development of a program against newborn asphyxia. An NIH study that discovered circumcision can reduce HIV transmission has brought on a circumcision campaign in Swaziland. And NIH studies on antiretrovirals and gel microbicides have USAID looking further into those HIV prevention strategies.

There remain plenty of areas, however, where the NIH’s potential for discovery and development can yield great benefits for USAID. In the fight against malaria, for example, Shah said, “we must invent new solutions:” faster methods of diagnosis, safer insecticides, cheaper medicines, and – the biggest potential coup – a cheap, effective vaccine. The two agencies share many of the same targets – malaria, HIV/AIDS, tuberculosis – and by working together, they can shorten “the distance between bench and bush.”

It was Shah’s first address to the NIH, and he immediately gave both agencies plenty to think about in the years ahead as their efforts become more unified. “This collaboration is the most powerful building tool we have,” Shah said, adding that “When we have this massive engine focused […] it will be a huge win for the world.”

My hope now is that everyone involved in promoting health – whether health care providers, researchers, or their supporters – recognize that this “massive engine” should be interacting, working together, and, of course, visiting one another. The majority of people might not have the opportunity to visit the NIH, like I did, but together we can bring its discoveries and its benefits to their doorstep.

Meet Peter Hotez, PhD, MD, Molecular Parasitologist and Pediatrician

Today we're profiling Peter Hotez, PhD, MD, of George Washington University Medical Center. He is also President of the Sabin Vaccine Institute and Editor-in-Chief of Public Library of Science Neglected Tropical Diseases magazine.

1. What do you do?

I’m a pediatrician, a researcher and an advocate for the health of people around the world. This includes leading a team to develop vaccines for neglected tropical diseases (NTDs) through the Human Hookworm Vaccine Initiative and the Schistosomiasis Vaccine Initiative. I also helped start the Global Network for Neglected Tropical Diseases, an advocacy initiative of the Sabin Vaccine Institute, where I serve as President. Additionally I do a lot of biomedical research, publish scientific papers and teach at The George Washington University Medical School where I chair the Department of Microbiology, Immunology, and Tropical Disease.

2. What motivates you to do advocacy?

It all started when I began visiting places in the world where neglected tropical diseases are most visible. I was struck by the devastating pathology I saw and knew something had to be done as soon as possible. I also knew that while vaccines are the long term solution, developing one takes many years and something had to be done right away. Many of these diseases are completely preventable and treatable with only a few cents. It was really just a matter of letting the global community know about it. So I started talking about the diseases that you don’t hear about as often, but are just as much to blame for trapping people in the cycle of poverty.

3. What limits your ability to do advocacy?

For me, it’s about balancing my roles and responsibilities. At Sabin, we like to say “We’re scientists. We’re researchers. And we’re advocates for a world free of needless human suffering.” There are certainly times when I wish I could do more direct advocacy because I think it’s important to speak on behalf of patients who can’t. This is why I helped create the Global Network. But I know it’s also important to keep one foot grounded in the sciences and invest in long-term solutions. I think spending time in the lab makes me more effective as an advocate because it gives me a unique perspective.

4. Do your colleagues do advocacy and outreach? Why or why not?

To be a scientist in the United States today doesn’t just mean developing vaccines. You also have to ensure your work is funded. As a result I need to spend a lot of time writing and submitting grants. There isn’t a lot of time left for advocacy so I know that many of my colleagues don’t have capacity to advocate outside of the lab.

5. Do you think outreach and advocacy is a responsibility of scientists? Should it be required?

Some scientists just aren’t made out to be advocates. But we need scientists who have the capacity to be advocates to serve as a public voice to educate people, and be able to raise awareness and impact of pressing global health issues.

6. In what ways do you reach out?

I spend a fair amount of time engaging press for interviews, profiles and op-eds. I am also the editor-in-chief of a peer-reviewed scientific journal called Public Library of Science Neglected Tropical Diseases (PLoS NTDs). So mainly [I reach out] through my writing. I engage in public speaking opportunities, speaking to both lay and scientific audiences. Finally, living in Washington, D.C. allows me to take advocacy into the political arena. I frequently visit Capitol Hill and several regulatory agencies to talk about NTDs and how the U.S. government can play a bigger role in helping control and eliminate NTDs around the world.

Me: Wow. You’re everywhere.

Dr. Hotez: No, not everywhere. We try to be strategic in how we develop vaccines and maximize access to treatments to help the world’s poorest people.


Thank you to Dr. Hotez for giving us his time via phone so we could learn more about him and his career.

This is part of the ongoing Profiling New Voices series.

Child Nutrition is a Global Concern

April is Global Child Nutrition Month. This is the perfect time to give the globe a “check-up” for developments, efforts, and general information on children’s nutrition in a few regions of our planet. Let's start our journey here at home in the United States.

According to the National Alliance for Nutrition and Activity, two-thirds of premature deaths in the U.S. are due to poor nutrition, physical inactivity and tobacco use. Nutrition is a key ingredient to a healthy life-style. It should be on everyone’s agenda, especially those in a position of responsibility to children.

Within the United States there are initiatives taking place to battle childhood obesity. The First Lady, Michelle Obama, and former president Bill Clinton have undertaken stamping out this problem as their personal platform.

A group of retired military officers going by the name “Mission: Readiness” are calling school lunches a national security threat. These officers are looking at it from a recruitment perspective. A large portion (9 million to be exact) of 17-24 year old are too overweight to join the military. Even those who wish to make that most noble commitment cannot because they do not meet basic regulations to be successful airmen.

The Healthy, Hunger-Free Kids Act that just passed the House Agriculture Committee gives power to the Secretary of Agriculture to set forth new standards for school lunches, breakfasts and all foods sold on school grounds. With efforts from the First Lady, “Mission: Readiness”, and many other public health groups child nutrition and combating childhood obesity has been brought to the forefront of policy in the United States.

The U.S. is not the only country with a childhood obesity problem. Mexico’s childhood obesity rate is second only to the United States. A health ministry report released in January noted that school children in Mexico have an average of five opportunities to eat in the average school day. This is quite astounding considering the school day only lasts four hours. School lunches and food sold on school grounds is a target amongst Mexican policymakers. North America is not the only region focusing on nutrition issues. Though, the picture in other nations is on the opposite end of the nutrition spectrum.

North America has plenty of food for its children. Children need only to make healthy decisions and have healthy options available to them. South-east Asian nations are plagued by a lack of food rather than poor quality. Organizations are engaging in grassroots efforts to develop new food options through farming, herding, and fishing.

To curb this problem World Vision introduced vegetable crops such as potatoes, carrots, and cabbage into children’s diet in East Timor, a south-east Asian nation. Also, farming techniques and goat, chicken, and fish farming is developing for new sources of food.

Cost of food and the heavy effect of weather are serious problems in most of Africa and organizations are working to counteract that fact.

Concern Worldwide hosts supplementary feeding programs for malnourished children. The UN World Food Program is also providing supplementary rations to children under the age of five, pregnant women and nursing mothers.

Babysitters, parents, school officials, and policymakers should be concerned with the food being distributed to the children of all nations. There are basic guidelines for nutrition and how much of which foods we are supposed to consume each day.

With this information in mind we should educate children on proper eating habits. Also, we should support organizations that provide nutritious meals or meal supplements to children in parts of the globe that do not have access to sufficient food sources. No child should go hungry, ever.

HIV/AIDS: From Death Sentence to Chronic Disease?

Yesterday, we talked about the childhood obesity epidemic in America, but as I stated at the beginning of this series, we have largely forgotten the problem of HIV and AIDS in America. Over time, it has become less popular to talk about HIV/AIDS, most likely because it is no longer considered a death sentence. During the beginning stages of the HIV epidemic in the late 70’s and early 80’s, there was little that clinicians could do to help HIV/AIDS patients, because no one knew what the mysterious illness was and people died within 16 months of exposure.

In 1983, we finally knew what the mysterious virus was that was causing so many people to get sick. Five years after identifying the actual virus we call HIV, the first anti-retroviral licensed as an effective treatment for HIV, AZT hit the market. This was a major breakthrough, significantly altering the course of HIV illness and helping destroy the notion that HIV/AIDS was an instant death sentence. Almost immediately, people were able to live longer with the virus. Basic science research helped to close the gap in time between identification of a virus and an effective treatment due to years of analyzing viruses and retroviruses, like HIV. Now there are over 20 different anti-retrovirals on the market.

While medical research has worked to find treatments and cures, the public health community has worked to prevent people from acquiring the virus. HIV testing has become widely available in health departments, clinics and doctor’s offices all over the country. Safe sex education has been paramount in limiting the spread of HIV. Public health has worked to make sure people use condoms during sexual activity and converse with their partners about knowing their HIV status.

The cutting edge research on HIV/AIDS bridges treatment and prevention by testing the effectiveness of pre-exposure prophyaxis, or PrEP. PrEP involves using anti-retrovirals as a prevention tool as opposed to treatment tool, to protect HIV-negative people from HIV infection. The theory behind this research is that if people take ARVs before they are exposed to HIV, they will lower their risk of infection if or when they do come in contact with the virus. If proven effective, PrEP would provide a safety net for anyone who is at risk of HIV infection.

Although PrEP is an exciting bridge between medical treatments and prevention, it is important to remember that we still must go forward in finding a cure or an effective vaccine against this illness. Worldwide, there are 33 million people living with HIV/AIDS. Medical research and public health must continue to work together, because there is much work yet to be done.

This is Part 4 of 5 in our Intersection of Medical Research and Public Health series.
Part 1 - The Intersection of Medical Research and Public Health
Part 2 - Research and Public Health Tackle the Flu Together
Part 3 - Today's Epidemic: Childhood Obesity
Part 4 - HIV/AIDS: From Death Sentence to Chronic Disease?
Part 5 - Advocating for the Intersection

World Tuberculosis Day 2010

Tuberculosis, or TB for short is not something most people will think about today. But we should, which is why public health advocate Karen Goraleski is guest posting today to give us a little history about TB.

***

More than 125 years after the discovery of the cause of TB we are still fighting this ancient killer. Even more incredible, we are using drugs and treatments developed nearly a half-century ago. The major burden of TB is found in developing countries, where 98% of TB deaths occur. In addition to killing people, it wields a double hit by draining $12 billion annually from the world’s poorest communities, where families caring for a loved one with TB spend eight to 20% of their income on treatment. Businesses and local economies must also cope with the absence of employees with TB, who will lose three to four months of work on average.

We don’t think about TB here in the U.S., but we need to. In the 1980s and under a false sense of security, America relaxed its monitoring of TB. As a result, TB returned with a vengeance in the 1990s. Flash forward another ten plus years to 2007 and we have more than 13,000 TB cases reported.

An increased investment in research to develop new tools to diagnose and treat TB is essential to prevent the needless suffering caused by TB and its often fatal drug resistant strains. Without this, TB can quickly overpower the current inadequate response to this long-standing but beatable disease.

In this world where disease is just a plane ride away for all of us, where business and commerce are expanding globally, where students and youth groups routinely travel to distant places, it is critical for the U.S. to invest in global health research to develop better prevention and treatment for TB, and to find a definitive cure.


Karen Goraleski is the vice president of public health partnerships at Research!America.

For more on tuberculosis, check out this fact sheet.

Advocating Outside the Box (Or Outhouse?)

Photo Credit: NRDC

Think back to a time that you were so concerned about an issue that you took action. What did you do to make your opinion heard?

As a kid, I always felt the word advocate carried a connotation that made it only applicable to people who took significant action to fight for a cause, like Martin Luther King Jr., for civil rights, or Rachel Carson, for the environment. However, I now understand that advocacy is simply taking action to promote change no matter how simple the action may seem.

Advocacy includes a wide range of actions from the classics - such as lobbying, protests, and civil disobedience - to newer actions that are developing alongside technology. As the internet became a fixture of everyday life, we saw a rise of electronic advocacy, which can include spreading news on social-networking sites or using the internet to organize collective actions like email campaigns.

Increasingly, events are being organized through viral marketing, which takes advantage our tendency to post information to sites like Twitter to disperse information through a self-replicating process similar to how viruses spread.

A recent example of viral marketing includes mass actions organized for World Water Day. March 22^nd was designated in 1992 by the United Nations as an international day to raise awareness about the world’s water crisis.

This year, a large number of people celebrated World Water Day as advocates by participating in a global mass action. Thousands of people in over 72 countries stood up for clean water and sanitation by lining up behind a toilet. The purpose of this event, aptly called the World’s Longest Toilet Queue, was to bring people together to voice their support for international government action to fight the water crisis.

This international event was organized promoted using social sites like Facebook and Twitter. A queue was even formed near New Voices neighborhood today, on Capitol Hill in Washington, DC!

More pictures across the globe can be seen at the World’s Longest Toilet Queue’s Flickr page.

The Toilet Queue wasn’t the only event held for World Water Day. Did any of you, our readers, participate in events? We’d love to hear about it!

February News Round-Up

As we quickly approach the end of the shortest month of the year, here's some of the interesting stuff the New Voices bloggers are reading.

Reactions on Biomedical Research Funding
As you recall, earlier this month, the President's budget was released and requested $32.1 billion for NIH. This was an increase over the previous year's budget, but a decrease if you consider the financial bump from American Recovery and Reinvestment Act they have received for the past two fiscal years.

This past weekend the annual meeting for the American Association for the Advancement of Sciences was held in San Diego. One of the distinguished guests was Dr. Francis Collins, the director of the National Institutes of Health. During a press conference, Dr. Collins shared his thoughts on funding outlooks for biomedical research. In response to the 2-year stimulus money, Collins emphasized that major scientific progress can't be supported by short-term funding increases. One of the approaches the NIH is considering to compensate for the lower budget is by investing the funds that they do have into more high-risk projects, hoping it will enable larger breakthroughs to occur. Collins said, "If you’re not supporting research that fails sometimes, then you’re probably not doing a good job of encouraging the most groundbreaking ideas."
By: Sarah

New Hopes on the Fight against HIV/AIDS
During the annual meeting for the American Association for the Advancement of Sciences, Brian Williams, a research fellow at the South African Centre for Epidemiological Modeling and Analysis, said that global public health officials could eliminate HIV/AIDS in 40 years, and stop HIV infections in as soon as five years. Epidemiologists are now looking to use anti-retroviral (ARV) medications to curb the spread of HIV/AIDS. Since ARV treatment can result in a reduction of the HIV virus by twenty-five times, epidemiologists are hoping that if more people with HIV are treated earlier, there would be fewer new cases of the disease. If the program is introduced, it would be expensive – between $3 billion to $4 billion per year. However, Williams states that the plan would show savings immediately, reducing hospitalizations and lost years of life from youth passing away from the virus.
By: Kimberly

Reacting to Advancing Technology
Research inevitably leads to new advances. However, it can be a challenge for people to incorporate technologies or knowledge into their lives - be they computers, vaccines, or safety procedures. Over at Slate, Vaughan Bell gives us a history of "new" technology and how society has responded through the years. You might be surprised to find that even writing was once considered to be "too much" of an advancement for society.
By: Heather

Contribute to Global Health

Photo credit: Eduardo Munoz, Reuters

We've been spending this week looking at ways you can give back to your community both next Monday during the National Day of Service and throughout the year. In lieu of today's planned post on ways to contribute locally, I'd like to refer everyone to the dire health needs of those suffering in the Caribbean - particularly in Haiti.

By now, I'm sure you've heard about the devastating 7.0 earthquake that has demolished Port-au-Prince and taken thousands of lives. Over at The Big Picture, you can see some of these scenes through the lens of photojournalists on the ground.

A friend of mine works at USAID and expressly said that monetary donations are the most effective at this time (clothes and food are difficult to transport in while the priority is medical supplies).

The Daily Beast* has a pretty comprehensive list of ways to help Haiti. The fastest way to get involved for most of you is also simple: send a text message that results in a donation (it will appear on your phone bill).

Text HAITI to 90999 ($10 to Red Cross)
Text YELE to 501501 ($5 to Yéle, Wyclef Jean’s development organization.)

*Hat tip to Clifford for the link.

Adventures in Cuba

I was excited about the opportunity to go to Cuba since so few Americans get the chance. However, getting there is not easy, and although the U.S. and Cuba are less than 100 miles apart the distance between the two countries is almost immeasurable.

Our adventure - I was traveling with Karen Goraleski, who leads our Paul G. Rogers Society for Global Health Research - began in Miami, where there was mass confusion about checking-in and our charter left over an hour late. We would soon learn that this was pretty much par for the course on this trip. After 12 hours of traveling, including about an hour standing in a sea of blue plastic-wrapped bags (to prevent pilfering) waiting for our luggage, we made it to the hotel to find that it was overbooked. The hotel eventually came up with a solution, but this was not the way we wanted to start our trip.

We made our way to the Palacio de Convenciones the next morning for our meeting on tracking resources for health research. The Global Forum for Health Research officially started that evening with an opening ceremony planned by our Cuban hosts.

Cuba's Minister of Public Health, Jose Ramon Balaguer Cabrera (right) and Vice President Jose Ramon Fernandez Alvarez (center) both addressed the Forum. Together they spoke for more than an hour and a half about the Revolution and their health system. Interesting at first and then very, very tedious. Cuba does produce a large number of doctors and have some very good stats on measures such as infant mortality and vaccination rates, but their public health message is watered-down when the toilets in the convention center didn't have seats and then you were lucky to find soap in the bathroom (I don't usually rely on hand sanitizer, but I was really happy to have a small bottle in my purse!).

Although we spent most of our time at the Global Forum, we had a free afternoon to explore Havana. We opted to take a guided tour since our time was so limited. It, like most things in Cuba, started very late.

Our first stop on the tour was Plaza de la Revolucion where many political rallies take place and many government offices are located. The Ministry of Interior building features the image of Che Guevara, with the slogan "Hasta la Victoria Siempre" or "Forever Onwards Towards Victory." Guevara was a major figure in the Cuban Revolution and the first Minister of the Interior appointed by Fidel Castro.

This billboard commemorating the 50th anniversary of the Revolution when Fidel Castro claimed control of Cuba was on the perimeter of Plaza de la Revolucion - just one of many examples of propaganda supporting the regime that we saw.

Our next stop was a cigar shop, but we took the opportunity to look around the area rather than risk being stopped in the Miami airport. This photo captures a lot of what we saw in what seemed to be a neighborhood where average Habaneros live, work and go to school.

The tour made its way to El Capitolio, where the Cuba legislature met from the 1930s-1950s. Today, it houses the Cuban Academy of Sciences. This stop provided some of the starkest contrasts for us. The beautiful El Capitolio building and surrounding parks were on one side of the street.
While this building was directly opposite on the other side of the street. As evidenced by the laundry hanging from the balconies, people live in this building. We could tell that it was once very beautiful, but years of neglect and hurricanes have taken their toll.

However, Cuba, with the help of UNESCO, slowly has been restoring La Habana Vieja or Old Havana. The Castillo de la Real Fuerza borders the Plaza de Armas. The sculpture on the watchtower is called La Giraldilla and is the symbol of the city of Havana.
The ceiba tree in the picture above marks where Havana, then called Villa de San Cristobal, was founded on November 16, 1519. We were in Havana on the 490th anniversary, although we did not get to see the annual gathering where residents walk around the tree three times, dropping coins in the hope that their wishes will come true.


The Hotel Santa Isobel is a great example of one of the restored buildings in La Habana Vieja.

As the sun began to set, we stopped at some of Ernest Hemingway's haunts, including La Bodeguita del Medio and the Hotel Ambos Mundos. I used the last few moments of daylight to capture the photo above from the roof of the hotel.

Overall, my trip to Havana was fascinating, and I really enjoyed meeting many Cubans who were very friendly and always willing to chat. It will be an experience to remember that gave me a tremendous appreciation for so many things that as an American I took for granted before my trip.

Our Woman in Havana

Presenting at the Global Forum for Health Research held at the Palacio de Convenciones in Havana, Cuba.

So I'm not a spy, but I did have what will likely be a once in a lifetime opportunity to go to Havana, Cuba. I recently attended the Global Forum for Health Research, which I was able to do as a U.S. citizen under a general license to attend a professional meeting organized by an international organization.

Because of the work that Research!America does tracking the U.S. investment in health research, we were invited to participate in a day-long meeting that brought together other experts in the field of tracking resources for health research. I have been studying the U.S. investment in health research for more than five years now, so it was interesting to meet others from around the world doing similar work. The participants came from a variety of backgrounds with a range of perspectives about tracking health research resources. Some—like Research!America—focused on country-level spending, others looked at disease-specific research and still others took a more global view.

I think one thing that all of the meeting attendees could agree on is that tracking investments in health research, and specifically research for global health, is a challenge and that more information about what is being spent on research for health around the world is needed. As is often the case in meetings like this, more questions than answers were generated. Some of the key questions include:

• What is the definition of research? Should infrastructure, salaries, capital investments and other research enabling activities be included?
• Is there a difference between “health research” and “research for health?”
• Which countries/organizations are tracking health research investments?
• How can we establish guidelines for cross-country comparisons of their investments in health research?
• How can this data be most effectively used for advocacy?
• Should methodology differ when the data will be used in advocacy?
  

In addition to this meeting, I also had the opportunity to participate in a panel discussion titled “Who’s Investing and Who Cares?” that was moderated by New England Journal of Medicine Editor-in-Chief, Jeffrey Drazen, MD. I shared our data on the U.S. investments in health research and global health research, some of our public opinion polling that shows that Americans do care about the issue and information about Research!America’s Paul G. Rogers Society for Global Health Research.

Attending the Global Forum for Health Research also allowed me to meet an interesting array of people from around the world, all working in some way on global health, and to learn more about topics outside the realm of my day-to-day work, such as product development partnerships, incentives for global health research and the Cuban health system. Much more to come in my post tomorrow about the travel experience, Cuba and photos from a brief tour of Havana.

Understanding Alzheimer's

Photo credit: Reader's Digest

Today some of us from New Voices are helping out at a briefing on the Hill. One of the focuses of the briefing is Alzheimer’s disease. Because Alzheimer’s is an important health issue and World Alzheimer’s Day was this past Monday, I thought it would be an appropriate topic for this post.

Alzheimer’s is a major health concern because it affects significant numbers of people across the US and throughout the world. Currently, an estimated 5.3 million people throughout the United States have Alzheimer’s; 35 million people across the globe are living with Alzheimer’s and dementia. These numbers will only increase with time: according to a recent report by Alzheimer’s Disease International, more than 115 million people across the globe will suffer from dementia by 2050. And in addition to the influence the disease has on the lives of patients and caregivers, it also has a huge economic impact: Alzheimer’s and other dementias cost Medicare, Medicaid and businesses more than $148 billion each year.

Although many have been directly impacted by Alzheimer's, there is a concerning lack of awareness about the disease in low and middle income countries and even in developed countries. The signs of the disease are not always recognized, and people are often hesitant to report symptoms. According to the World Alzheimer’s Report, in the UK:

• The average length of time people wait before reporting symptoms is three years
• 70% of caregivers report being unaware of the symptoms of dementia before diagnosis and 58% believe the symptoms to be a normal part of aging
• Only 31% of primary care doctors believe that they have adequate training to diagnose and manage dementia

Fortunately, important strides are being made toward understanding and finding treatment for Alzheimer’s. At the beginning of this month, teams of researchers from the UK and France reported having found potentially key genes linked to the development of Alzheimer’s disease, the first time in 16 years that such gene clues have been discovered. In July, another team reported that an immune therapy given to cancer patients could help reduce the risk of Alzheimer's.

Recognizing the importance of the disease, Alzheimer’s Disease International has made several recommendations to the global community. It has suggested that the disease be made a global and national health priority, that appropriate services for diagnosing the disease be created and made accessible, called for greater collaboration, and more research regarding the causes of “Alzheimer’s disease and other dementias, pharmacological and psychosocial treatments, the prevalence and impact of dementia, and the prevention of dementia.”

So what can you do? Here are a few suggestions:

• Learn more about the symptoms, diagnosis, and treatments to gain a better understanding of the disease.
• Participate in the Memory Walk to help raise research funding.
• Get involved by finding out about services and support groups in your community.
• If you have been affected by Alzheimer’s, tell others about your experience to raise awareness and support for research and treatment.

Silence is the Enemy

Men and women from across the blogosphere have been writing in support of the Silence is the Enemy campaign started by Sheril Kirschenbaum over at The Intersection.

Silence is most assuredly the enemy when it comes to violence. Some quick facts*:

• 1.6 million people worldwide die each year from violence. More than 51,000 are Americans.
• Violence is the leading cause of death among people aged 15-29.
• The U.S. saved $14.8 billion on heath care, police response, lost productivity and death in the first five years of the Violence Against Women Act. In comparison, the investment in the program to prevent violence against women was $1.6 billion over the same time period.

According to a 2008 Research!America survey**, 98% of Americans think that the U.S. should work to prevent violence in the U.S. and 61% think the U.S. should work to prevent violence globally. Either way, that's a lot of Americans who want to stop the violence before it starts.

How will you stand up and make your voice heard so that silence is no longer the enemy?

*Facts from the Investment in research saves lives and money fact sheet on Global Violence.
**See slides 12 & 13

Experiences with H1N1 in China

Chronicles of a Science Policy Intern
Shortly before starting my summer in Washington DC, I traveled to the People’s Republic of China for 2 weeks to complete a course in international entrepreneurship. All in all, it was a great trip. I learned a lot and would highly recommend a visit to China for anyone interested in learning more about this developing country.

Arriving in China by plane revealed the first of the unexpected experiences. The H1N1 virus (swine flu) is still a very real concern in China. Upon landing in Shanghai, the entire plane was considered to be “in quarantine.” Chinese health officials boarded the plane wearing complete biohazard suits including goggles and respirators. Each passenger was individually screened for fever or other signs of the H1N1 virus. The Chinese health officials walked up and down each row and took the temperature of every passenger by holding a thermal imaging scanner to our foreheads. This went one-by-one in an A330 with almost 300 people on board. Someone several rows behind me apparently did not pass the quarantine exam, because all the health officials gathered around this unfortunate soul. Soon, several seats in the near vicinity had large red stickers on them and those people didn’t get off the plane when the rest of the passengers were allowed to deplane over 60 minutes later. Luckily, no one in my group was quarantined.

While this was an interesting experience, it raised a larger question: is this really the most effective way to prevent a public health crisis? Considering the fact that there is rarely antibacterial soap in any restroom in China, hand sanitizer is not provided in public areas, and many Chinese citizens readily spit in public, I question whether the resources spent to screen an entire plane could be spent more wisely on public health initiatives to prevent the spread of disease. Before I arrived in China there had only been a few documented cases of H1N1, so apparently the Chinese method of keeping H1N1 from entering the country has been effective so far. This seemed like a “wall” approach. If the country could keep H1N1 out, there wouldn’t be a problem. But what happens if the “wall” develops a crack? Without the internal infrastructure (antibacterial soap, hand sanitizer, hygiene) in place, China is taking a huge gamble with the health of its citizens. I’d argue that in addition to keeping H1N1 out of China, the government should also work to develop internal measures to prevent the spread of the virus in the event that H1N1 or a mutated form does enter the country.

I’m curious about the differences in public health initiatives between the United States, China, and the rest of the world. What experiences with public health and H1N1 have you had? Does anyone have experiences with the public health responses of other countries to H1N1?

World Malaria Day

Photo credit: JCI (Junior Chamber International, Inc.)

Yesterday's post about the potential impact of climate change on malaria incidence details why paying attention to the disease is so important. We’ve made significant advances in malaria control with the money invested so far, but more research for malaria still needs to be done. In honor of World Malaria Day, we've complied a short list of resources, interesting projects, and some great people working in the field.

Resources

• The CDC and NIH both provide extensive information regarding malaria.
• UNICEF provides this fact sheet and the Global Malaria Action Plan is particularly interesting for more in depth information.
  

Innovative Collaborations

• Artemisinin Project — is a collaboration between the Gates Foundation, Sanofi Aventis, Amyris Biotechnologies, a researcher at University of California, & the first nonprofit drug developer in the U.S.—to develop lower cost, semi-synthetic artimisinin.
• GlaxoSmithKline's Patent Pool — Glaxo recently donated 800 of its patents related to neglected tropical diseases to a patent pool. These diseases are considered largely unprofitable ventures, since they mostly affect people in poor countries. Glaxo is trying to encourage global collaboration for research to find better treatments.
• We know a lot of you out there are jealous of Luke's lightsaber. Well soon, you can have your own mosquito zapping laser gun!
  

To put a face on the exciting malaria research that is being done, check out some of our Global Health Ambassadors:

• Ambassador Barry Beaty runs a program called Casa Segura (Safe House), which uses interventions-such as insecticide treated bed nets- to prevent vector transmission in homes.
• Ambassador Jim Kazura has been studying malaria in children, and those that acquire immunity to the disease, to learn more about the relationship between their responses to the disease and their immunity.
• Ambassador Frank Collins has been helping to sequence or map the Anopheles gambiae, the mosquito that is the primary transmitter of malaria parasites in sub-Saharan Africa.

Random Fun Fact

• Last week, Ashton Kutcher and CNN got in a race to see who get get the most "followers" on Twitter... with a goal of reaching 1 million. Ashton won, and is donating $100,000 (10,000 bednets) to fight malaria in Africa, using Twitter as a social tool to raise awareness for World Malaria Day.