Climate training for health professionals

We kicked off the second annual Summer Institute this week. Twelve public-health professionals and climate scientists from ten countries are visiting the Lamont campus, where the International Research Institute for Climate and Society is based, to learn how to use climate information to make better decisions for planning and disease prevention.

It is essential for the health community to better understand the role climate plays in determining the fundamentals of health – air, water and food – as well as its role as a driver of specific outcomes related to infectious disease, says Madeleine Thomson, who runs both the health and Africa programs at the IRI and is one of the brains behind the two-week training course.

“After all, health is fundamental to the way we understand human well-being, and a key indicator of sustainable development. Here, we like to think of climate as both a challenge and a resource,” she says.

Extreme weather events or prolonged droughts are often associated with negative outcomes, Thomson says, but by understanding climate and its associated impacts and potential predictability, decision makers can start responding proactively to climate challenges. In some situations, they can even get ahead of the game, she says. At IRI, we call it climate risk management.

Read more about the Summer Institute on Climate Information for Public Health here.

Politics makes for strange bug-fellows

Rather than “royally” waste money funding infectious disease research for geopolitical reasons, developed nations must instead establish well-funded, well – connected consortia to help countries with the greatest chance of success, world health experts said today.

The recommendation comes exactly one week before the Bush-sponsored Global Fund to Fight AIDS, Tuberculosis and Malaria doles out its first set of grants.

“We must move away from dispensing aid for geopolitical reasons, because such aid is usually royally wasted,” said Olusoj Adeyi, a senior health specialist at the World Bank. Speaking at a forum on emerging infections sponsored by the US National Academies of Sciences (NAS), the goal, he added, is to transform national entities “to a unified epidemiological system.”

Resources should instead be channeled into “countries that have the best ability to make progress, or make policies,” said William Steiger, of the US Department of Health and Human Services.

The Global Fund has thus far collected $2 billion in pledges from both public and private sectors. But combating infectious diseases is estimated to require tens of billions of dollars annually, according to the World Health Organization.

Because much of the money required will come from the private sector and philanthropic organizations ultimately, Steiger says, making the fund, and its operation, credible to the private sector is critical to its success.

At the same time, organizations cannot simply use corporate strategies in addressing emerging infections, cautioned Roy Widdus, of the Initiative for Public -Private Partnerships for Health. “We cannot adopt approach of business everywhere in international public health.”

While funding must be performance-based, Widdus added, “we need to make sure that it doesn’t divert our attention in thinking about how to help people who have been failed by their governments.”

As a consequence of globalization, disease burdens in the developing world are affecting the developed world, notes Adeyi. To combat infectious diseases around the world, developed nations must deploy their advanced disease-control capabilities and resources in should be deployed in developing ones.

Ensuring the effectiveness of these partnerships is going to require a lot of money, a long -term commitment, and the right reasons for helping developing countries, he added.

Several speakers also emphasized the importance of developing long-term programs in countries of need, rather than dumping enormous sums of money for the short term.

“Soft funding leads to squishy results,” said the Fogarty International Center’s Eric Mintz. Funding human resources does just as much “global good” as funding the development of products like vaccine, medicines, and new diagnostic technology, Mintz said, referring to his agency’s newly established program on funding US-trained foreign scholars to establish labs in their home countries.

Funding product development in the absence of personnel who can appreciate and properly utilize it, he added, is only taking care of half the job.

Unmet need in infectious disease research: social science

Despite nearly a decade’s consensus that numerous social factors contribute to the global spread of infectious diseases, the field still suffers from a dearth of important social-science information, according to a researcher speaking at a meeting of the US National Academies of Sciences (NAS) today.

“We need to look at population movements, organization, behaviors, and culture,” said Jonathan Mayer, a geographer at the University of Washington. At the NAS Institute of Medicine’s forum on emerging infections, Mayer spoke on how the dynamics of vector-borne diseases are changing with increased globalization. Understanding these dynamics means we must unify vector and human ecology, he said.

In 1992, an IOM workshop in which Mayer participated identified numerous social factors, such as land use, civil unrest, and demographics, as contributing to microbial threats to health. Since then, little has been done to show how these factors influence emerging infectious diseases, he contends.

“Social and behavioral sciences are just starting to pay attention to this suite of issues,” agreed Deborah Balk, a researcher at Columbia University’s Center for International Earth Science Information Network whose work focuses on how climate change affects public health in developing countries. (Balk was not present at the meeting.) “Much of the dialogue has been too narrowly focused on how a particular climate anomaly may affect a particular disease vector, without sufficient regard paid to climate variation and intervening factors like migration or land use adaptations,” she told BioMedNet News.

Population movement was a recurring theme among many forum participants today. Between the mid-1970s and 1990s, considering migrant workers, refugees, and internally displaced populations, the volume of human movement in the world has increased fourfold, said speaker Martin Cetron of the US Centers for Disease Control and Prevention. Because it now takes less than 36 hours to circumnavigate the globe, Cetron added, the incubation periods of many diseases are now shorter than the time it takes to move from one place to another.

Therefore, he said, “disease is going to emerge in the clinics and communities of the points of destination, not during travel.” However, he suggested, it may become necessary to reintroduce “vector spraying” on international flights.

Increasing population movements, coupled with the rapid increase in the urbanization of the developing world, will yield conditions ripe for outbreaks, warned Harvard professor of population and international health Mary Wilson. “These areas are typically poor, warm, and surrounded by large slums and shanty towns that lack infrastructure and resources,” Wilson said.

Urbanization is also a factor that needs to be considered, she added. Outbreaks in cities of the developing world may be globalized more readily because, unlike their counterparts in the developed world, these cities tend to be linked both to rural areas (from poor people seeking work) and to the larger world community, via international airports, she said.

Migrational activity is much more continuous in developing urban areas, said Balk, and this may lead to people moving around with various disease “burdens.” But while there are studies that show migration indeed has an impact on disease, it’s much harder to show the more complex picture of how seasonal migration affects the sending and receiving communities, she said.

“People know that migration matters, it’s just hard to quantify,” she said.