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‘Reshaping global health’ – a radical proposal for global health?

What is it with shapes and global development? Seems a week doesn’t go by without someone proposing a new one. I wish I worked in sustainable development – they get food-inspired shapes like doughnuts. In public health you just get triangles. At least you used to. Now we have a proposal to consider from three well-known global health scholars: Mark Dybul, Peter Piot and Julio Frenk. They want to re-shape global health. They think it’s a radical proposal. Here’s what I think. Read more

Who’s funding WHO?

Michael Day posed this question as the title to a piece he wrote in the BMJ five years ago.  Then, Day was reporting on a relatively modest sum of money ($10,000) finding its way to the World Health Organisation (WHO) from the pharmaceutical company GlaxoSmithKline (GSK) via a third party charity. I pose it now not because I have a new scandal to report, but to draw your attention to two documents circulated as background reading for the just-concluded World Health Assembly – documents enticingly titled A65/29 Add.1 and A65/30.  These documents tell you how much money the WHO received during 2010-2011, and from whom. They were also the subject of a bit of a spat last year in the magazine Foreign Affairs between Sonia Shah and  Christy Feig. So, I approach a summary of the data with some caution. As Susan Strange once warned: Cave! Hic dragones!  Read more

Are health statisticians the new post-modernists?

By which I don’t mean: are they edgy and cool? Rather, I mean do they deliberately write a load of impenetrable made-up gobbledygook that makes them sound clever to the layperson?  For your delectation, I compare two statistics papers that were published this week, one in PLOS Medicine, the other in The Lancet.  Read more

Chinese doctors under threat: who will repair the broken windows?

This is a guest post by Yina Xiao, a Researcher here at Bocconi University, about an under-reported (suppressed?) challenge currently facing the medical profession in China…

Last Friday, April 13th, a serial killer attacked the chief of the E.N.T. department in Peking University’s 2nd affiliated hospital (Renming Hospital) and a resident working in the emergency department of the No. 711 hospital Read more

Times they are a climate-changin

In an editorial last year, the BMJ’s editor Fiona Godlee described climate change as “the greatest risk to human health”; more of a risk than either communicable or non-communicable disease. I agree but would add that a) climate change threatens human survival, not just our health; and b) that threat is not limited to humans but extends to all life on our planet.

Two books to bring you up to speed on the essential facts of climate change are Mark Lynas’ Six Degrees and Gwynne Dyer’s Climate Wars. Two Reports just published are UNEP’s ‘21 Issues for the 21st Century‘ (aka the Foresight Report) (summarised by John Vidal here) and the UN’s optimistically titled ‘Resilient People, Resilient Planet‘. There are other essential reads more directly focused on global health (see here, here and here). 

The most important conclusion I draw from these studies is that whatever is going to happen to the planet (for good or ill) is going to happen in my lifetime. If I do nothing, and feedback loops precipitate irreversible global warming, I will share personal responsibility for the consequences of my inaction. The second conclusion, slightly more urgent than the first, is that it is what I do now that matters. And by ‘now’ I mean in the next 5-10 years. 

What needs to be done?

Mark Lynas is unambiguous about this:

The lesson is as clear as it is daunting: if we are to be confident about saving humanity and the planet from what could be the worst mass extinction of all time…we must stop at 2 degrees

The window of opportunity

I like the implicit assumption in this metaphor. The ‘window of opportunity’ has to be at ground level: any higher and the only opportunity it will likely afford is the opportunity to fall out and hurt yourself. At this level we might want to call it the ‘window of potential danger’.  Go higher still, say higher than the 1st floor, and you’re more accurately looking at a ‘window of certain death’. 

Mark Lynas again: 

Every year that we allow CO2 levels to go on rising, the odds of overshooting 2 degrees go on shortening. As CO2 concentrations climb to 400ppm (they stood at 382 in 2007 and rise at about 2ppm per year), our room for manoeuvre will have narrowed considerably”

The real millennium development goal

The development world is focused on 2015 for all the wrong reasons. The MDG ‘deadline’ is an arbitrary, politically inspired, moment in time for assessing policy makers’ lack of imagination. Climate change gives us a reason for taking 2015 much more seriously.  According to Lynas’ maths, if CO2 concentrations continue to rise at 2ppm per year, then 2015 will be the year that we reach the 400ppm watershed. That’s three years away!

So far, so good…?

There’s a famous opening line in Kassovitz’s film La Haine:

Hubert: “Heard about the guy who fell off a skyscraper? On his way down past each floor, he kept saying to reassure himself: So far so good… so far so good… so far so good. How you fall doesn’t matter. It’s how you land!” 

Global health people – you, me, them – are in denial about the fact that we are falling. We all need to take climate change seriously and stop fiddling at the margins while Rome burns. There is nothing more important than this. If you are spending your grant pounds/dollars/euros/yen researching anything else, then – frankly – you are wasting your time, effort, and money.


Corporate (anti) social responsibility

Corporate Social Responsibility (CSR) is in the news quite a bit this week. But is it a duck or a rabbit? Or, to be less vague, are the number of ‘anomalies’ stacking up against CSR (the ‘duck’) so persuasive that we can’t really say it’s a duck any more; that we have to conclude that, really, CSR is actually Corporate Anti-Social Responsibility (CASR) and, as such, a rabbit? Read more

Which global health journal do you recommend…?

I’m often asked by students and colleagues to suggest a suitable global health journal for their work. A while back, I compiled this table of journals that publish research on global health. It’s not bang up to date and you will need to check the journal website for the latest on their impact factors, terms and conditions etc. Hopefully, you will find amongst these the perfect home for your next eminent contribution to global health.

Read more

Welcome to Portswood!

Southampton Medics’ Review have been making some great videos over the years to raise money for charity. The proceeds from their latest show are to be split between The Cardiomyopathy Association – a leading cause of death in young people, and a local charity – The Soceity of St James – homelessness service. This time around they are hoping to raise in excess of £5000. To do that, they’ve produced this fabulous video – a take on Jay Z’s classic ‘Empire State of Mind’. For those of you who don’t know, Portswood is a suburb of Southampton and, according to the Medics Review, “one of the world’s darkest, dingiest places”. So, not like New York then.

If you like the video as much as I did, I hope you will consider a donation to one or both of their chosen charities, innit.


Our leadership is dire, so why shouldn’t we despise government?

A couple of weeks ago Jeffrey Sachs wrote an opinion piece in the Guardian: ‘Western politicians are dire, but we mustn’t despise government’. There’s no denying Sachs is a persuasive writer, but in this case he writes himself into a corner. The examples he marshals together as evidence for why we should despise governments are so compelling that his final assertion that we should nevertheless still trust them falls flat on its face.

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Improving the lives of ‘half the sky’

What non-health factors contribute to good maternal and child health in developing countries? Good question. In a chapter to a new book edited by researchers at the London School of Hygiene and Tropical Medicine ‘ Good Health at Low Cost: 25 years on‘ I synthesise evidence from five country studies in an effort to find some answers. Read more

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