A comment on International accountability for essential medicines.

There are many times when there are grey areas in human rights. For instance, what does the constitution of the United States REALLY say about gun laws, abortion, gay marriage, not any of these things are covered in detail as to how our current political setting should be addressed. However, some human rights, like access to essential medicines, which is denied by at least the 10 million people who die annually from preventable disease, is well defined by many international agreements while also not being followed due to international capitalism and neoliberal economic ideas that apply a price on the essential human right of healthcare.

When we talk about global health and access to medicines, everyone indisputably looks to the World Health Organization for answers as to how to handle things. Interestingly, they have released a small article highlighting multiple legal, international documents that put forth international law stating that Access to Essential Medicines is a human right!

Starting from the earliest, we have the very constitution of the World Health Organization adopted in 1946 and since signed upon by the 193 member countries (in 2010). The specific section worth mentioning is the "right to health" which reads "The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition."

The next is in the Declaration of Human Rights in 1948 which states in Article 25, Section 1 "(1) Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control."

There are of course more international agreements that state these things, including a general comment 14 issued in 2000 that details accessibility, quality, and appropriateness to goods and services deemed essential, including essential medicines as defined by WHO.

With all of these international, legally binding documents of which most nations including the United States have signed, how is it that the bottom billion people in the world, in terms of financial gain, still do not have access to most of the essential medications these terms have been talking about since 1946?

I would wager that it is due to our shift globally from individual economies based sometimes on public good, to an over-rampant consumerism. Someone along the way figured out we could make money off of the medications people desperately need, and our governments and regulatory agencies have agreed with them, after signing these types of declarations. My biggest question is, where do developed nations stand if they cannot even heed to the agreements they set forward and signed?

-Justin

Free Course on Health for all through Primary Care

Take a free online course taught by John's Hopkins faculty about health care. This should be really interesting, I know many of our bloggers will be checking out this opportunity.

If you are a student, activist, healthcare professional, or even just a human being, this is a super important topic to look at. Feel free to check it out at this link: https://www.coursera.org/course/healthforall

UAEM meets Tuesdays at 7, in Anspach

UAEM is starting off the semester with lots of cool things going on behind the scenes. We're talking with a few big key players at the University level about getting global access policies in place at CMU. We're also hosting the documentary Escape Fire, which is about the broken healthcare system in the US. We're hosting speakers from the Thirst Project, a group working on providing drinking water to communities worldwide. We're also doing fundraisers and passing a resolution supporting global access policies from the CMU Student Government Association. These are exciting times to get involved, and I encourage all of you to do so!

JOIN US: NEXT TUESDAY at 7pm in Anspach 151!!!

NTDs Education!: Kala-Azar (Visceral Leishmaniasis.

Visceral Leishmaniasis exists in Southern Europe, India, and Eastern Africa. The video talks about there being nearly 1.5 billion diseases, and talks a lot about the costs of treatment. Truly Great. The WHO lists both paromycin (mentioned in video) and liposomal amphotericin B as essential medicines for the disease.


For even more information, check out One World Health on Youtube or at their website.

This is the first of weekly posts dedicated to making education about NTDs simple and easy!

BRCA Gene Case: Ethics Vs. Profits

Hello Everyone,

This case has been going on for as long as I've been involved with UAEM, and it is slowly gaining more and more public appeal. Recently Ethan Guillen (former UAEM Executive Director) sent a link to the chapters email listserv with a blog that has been following the case intently and has lots of updates. Here is a short summary (I do regret that I have not read a lot of the blogposts).

Myriad (biotech) bought the rights of the discovery of the BRCA1 and BRCA2 breast cancer genes, and patented their own test for their presence. The test is highly conclusive and can give physicians an insight into breast cancer cases extremely early on. The problem: they hold exclusive rights over the test AND the genes. This means that only Myriad can perform the tests (and there have been people sued for trying to duplicate it) and only Myriad can develop new tests, since they literally own the gene. Now, there have been cases that have reached the supreme court in which discoveries similar to these genes have been deemed unpatentable (unfortunately my mind is slipping on the name of the case).

Basically to make the story short, the case is very much active. It seemed that courts were really ruling in the direction of ethics, deeming the patents not valid, until it reached an upper level appeals court, which deemed them valid under patent law. The hope is that the supreme court will see the case and rule on the side of humanity over profits, but we'll all have to watch.

Meanwhile, here's the link to the blog:
http://keionline.org/node/1464

-Justin

If you were unable to attend the Sujal Parikh Memorial Symposium on Health and Social Justice, or loved it so much you would like to watch the presentations again, you are in luck. The presentations from the symposium have been made available at http://sujalsymposium.org/blog-and-news/. Please feel free to share the videos with anyone you feel would enjoy them!

Just a little opinion of mine...

Gandhi’s Public Health Proposal: Children After an inspirational, educational, and motivational conference this past weekend, I wanted to further explore the utility of public health research, when it should be conducted, and whom should be the focus. We have a vast sea of knowledge on certain pandemics, but are sickly deprived in other important areas. Research must be purposeful towards improving the health of individuals. How do we do that...? "If we are to teach real peace in this world, and if we are to carry on a real war against war, we shall have to begin with the children" -- Mohandas Gandhi. Who is going to argue with one of the most influential men of our time and his infallible statement? However, this aphorism, although accepted by many, is implemented by few. Specifically in the field of public health, campaigns are often targeted towards children, but the research exploring the roots of these causes is often an inadequate amount. Academic research relating to health behaviors of children in much of the world is not at a caliber conducive for adequate policy change and program development to improve public health. How can we fix a problem if we do not understand it? Wars against non-communicable diseases, substance abuse, and other public health fights related to health behaviors must begin with understanding the causes of the causes: why are children motivated towards certain actions which put them at risk for certain diseases? When this is understood, progress in public health can be made. A prime example of where further research of children’s health behaviors could be beneficial--the diabetes pandemic of Belize. As the leading cause of death in Belize, diabetes is a major public health concern (The Epidemiology Unit, 2009). The overall national prevalence for this non-communicable disease is 13.1% (Gough E et al., 2008). However, the incidence of diabetes is increasing (The Epidemiology Unit, 2008; The Epidemiology Unit, 2009): from 2000-2030, the region of Latin America and the Caribbean is expected to see a 40% increase of people with diabetes in their total population (Wild et al., 2004). In a study conducted by the Ministry of Health, Belize and PAHO/WHO, statistically significant associations were found between diabetes mellitus and age, hypertension, BMI, total cholesterol, LDL, HDL, triglyceride, and waist circumference (Gough E et al., 2008). Conclusions of the study stated that these findings provide justification for the development of national policies and programs to address these public health issues and furthermore, a need to emphasis diabetes prevention (Gough E et al., 2008). But what comprise beneficial prevention strategies? Gandhi might suggest focusing on children. Behind Gandhi’s aphorism, several studies have supported that investments in early childhood development are powerful means to reduce the escalating chronic disease burden in adults, reduce costs for judicial and prison systems, and enable more children to become healthy adults who can positively contribute to society, socially and economically (ECDKN, 2007a; Engle et al., 2007; Schweinhart, Barnes & Weikart, 1993; Schweinhart, 2004; Lynch, 2004). This is because many challenges in adult society have their roots in the early years of life, including major public health problems such as obesity, heart disease, and mental health problems (CDSH, 2008). Therefore, exploring these roots could lead to answers that could develop policies that could potentially prevent future generations from the predicted prevalence of 32,959,000 cases (Wild et al., 2004) of diabetes in Latin American and the Caribbean by the year 2030. The causes of the causes should be explored: What causes certain health behaviors, which subsequently cause certain diseases? Researchers in Europe have already signed onto to Gandhi’s public health proposal. The Health Behaviors of School-Aged Children (HBSC) is an ongoing international study carried out in collaboration with WHO/EURO investigating ‘causes of the causes’. The perspective of the study is one in which adolescent health related behavior is seen as part of young people’s broader lifestyle, viewing health in a social context. With developments in scientific management and theoretical perspectives, HBSC has made a substantial contribution to the area of youth health (Currie et al, 2009). Unfortunately, the HBSC study has been limited to Europe and North America. However, evidenced by its success, international health could be greatly improved by its expansion. Similar studies should be conducted in Latin America, the Caribbean, Asia, Central America…around the globe! What could happen if Gandhi’s public health proposal was adopted in Belize? What if we better understood what was motivating children towards certain health behaviors, specifically when it came to food consumption? The onset of diabetes mellitus is largely influenced by diet, and such habits are largely developed in childhood (CDSH, 2008). During childhood, a significant amount of time is spent at school. Children are exposed to various factors influencing health behaviors during the school day, including personal factors such as peer-pressure, and environmental factors such as what food is available for purchase at the school store and what is served for lunch (if the school serves lunch). Therefore, similar to studies conducted by the HBSC should be conducted in the Latin America and Caribbean region, exploring the ‘causes of the causes’ in order to further understand the complex situation of health behaviors and lead to improved prevention strategies. What impact would Gandhi’s public health proposal have in Sub-Saharan Africa? The Appalachia region of the United States? Southeast Asia? We must further explore and understand before we can make sustainable improvements in public health. And we can begin with children... -Rebeccah