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  • Anthropology in public health emergencies:what is anthropology good for?

    Stellmach, D; Beshar, I; Bedford, J; du Cros, P; Stringer, B (BMJ Publishing Group, 2018-03-25)
    Recent outbreaks of Ebola virus disease (2013-2016) and Zika virus (2015-2016) bring renewed recognition of the need to understand social pathways of disease transmission and barriers to care. Social scientists, anthropologists in particular, have been recognised as important players in disease outbreak response because of their ability to assess social, economic and political factors in local contexts. However, in emergency public health response, as with any interdisciplinary setting, different professions may disagree over methods, ethics and the nature of evidence itself. A disease outbreak is no place to begin to negotiate disciplinary differences. Given increasing demand for anthropologists to work alongside epidemiologists, clinicians and public health professionals in health crises, this paper gives a basic introduction to anthropological methods and seeks to bridge the gap in disciplinary expectations within emergencies. It asks: 'What can anthropologists do in a public health crisis and how do they do it?' It argues for an interdisciplinary conception of emergency and the recognition that social, psychological and institutional factors influence all aspects of care.
  • Clinical bacteriology in low-resource settings: today's solutions

    Ombelet, S; Ronat, JB; Walsh, T; Yansouni, CP; Cox, J; Vlieghe, E; Martiny, D; Semret, M; Vandenberg, O; Jacobs, J (Elsevier, 2018-03-05)
    Low-resource settings are disproportionately burdened by infectious diseases and antimicrobial resistance. Good quality clinical bacteriology through a well functioning reference laboratory network is necessary for effective resistance control, but low-resource settings face infrastructural, technical, and behavioural challenges in the implementation of clinical bacteriology. In this Personal View, we explore what constitutes successful implementation of clinical bacteriology in low-resource settings and describe a framework for implementation that is suitable for general referral hospitals in low-income and middle-income countries with a moderate infrastructure. Most microbiological techniques and equipment are not developed for the specific needs of such settings. Pending the arrival of a new generation diagnostics for these settings, we suggest focus on improving, adapting, and implementing conventional, culture-based techniques. Priorities in low-resource settings include harmonised, quality assured, and tropicalised equipment, consumables, and techniques, and rationalised bacterial identification and testing for antimicrobial resistance. Diagnostics should be integrated into clinical care and patient management; clinically relevant specimens must be appropriately selected and prioritised. Open-access training materials and information management tools should be developed. Also important is the need for onsite validation and field adoption of diagnostics in low-resource settings, with considerable shortening of the time between development and implementation of diagnostics. We argue that the implementation of clinical bacteriology in low-resource settings improves patient management, provides valuable surveillance for local antibiotic treatment guidelines and national policies, and supports containment of antimicrobial resistance and the prevention and control of hospital-acquired infections.
  • What's coming for health science and policy in 2018? Global experts look ahead in their field

    Swaminathan, S; Room, RS; Ivers, LC; Hillis, G; Grais, RF; Bhutta, ZA; Byass, P (Public Library of Science, 2018-01-30)
    In PLOS Medicine's first editorial of 2018, editorial board members and other leading researchers share their hopes, pleas, concerns, and expectations for this year in health research and policy.
  • The rite of passage of becoming a humanitarian health worker: experiences of retention in Sweden

    Albuquerque, S; Eriksson, A; Alvesson, HM (Taylor & Francis Open, 2018-01-15)
    Low retention of humanitarian workers poses constraints on humanitarian organisations' capacity to respond effectively to disasters. Research has focused on reasons for humanitarian workers leaving the sector, but little is known about the factors that can elucidate long-term commitment.
  • Survivors' Perceptions of Public Health Messages During an Ebola Crisis in Liberia and Sierra Leone: An Exploratory Study

    Schwerdtle, P; De Clerck, V; Plummer, V (Wiley-Blackwell, 2017-09-20)
    The outbreak of Ebola virus disease in Guinea, Liberia, and Sierra Leone was the largest epidemic of Ebola ever recorded. The healthcare workforce was diminished and exhausted as the region emerged from civil war. Few qualitative, descriptive studies have been conducted to date that concentrate on the voices of Ebola survivors and their perceptions of health messages. In this study, we employed an interpretive, qualitative design to explore participant experiences. Twenty five survivors who had recovered from Ebola were recruited from three villages in Liberia and Sierra Leone in August 2015. Data were collected using semistructured interviews. Data analysis revealed four themes: (i) degrees of mistrust; (ii) messages conflicting with life and culture; (iii) seeing is believing; and (iv) recovery inspires hope. The findings were explored in the context of the relevant literature. The themes highlight the need to develop culturally-appropriate messages, underpinned by a sound understanding of the community and a willingness to work with the culture and trusted leaders.
  • The 'Indirect Costs' of Underfunding Foreign Partners in Global Health Research: A Case Study

    Crane, J; Andia B; Fouad, T; Boum, Y; R Bangsberg, D (Taylor & Francis, 2017-09-16)
    This study of a global health research partnership assesses how U.S. fiscal administrative policies impact capacity building at foreign partner institutions. We conducted a case study of a research collaboration between Mbarara University of Science and Technology (MUST) in Mbarara, Uganda, and originally the University of California San Francisco (UCSF), but now Massachusetts General Hospital (MGH). Our case study is based on three of the authors' experiences directing and working with this partnership from its inception in 2003 through 2015. The collaboration established an independent Ugandan non-profit to act as a local fiscal agent and grants administrator and to assure compliance with the Ugandan labour and tax law. This structure, combined with low indirect cost reimbursements from U.S. federal grants, failed to strengthen institutional capacity at MUST. In response to problems with this model, the collaboration established a contracts and grants office at MUST. This office has built administrative capacity at MUST but has also generated new risks and expenses for MGH. We argue that U.S. fiscal administrative practices may drain rather than build capacity at African universities by underfunding the administrative costs of global health research, circumventing host country institutions, and externalising legal and financial risks associated with international work.
  • Educating Nurses in Resource-Poor Areas

    Defranciscis, J (Australian Nursing and Midwifery Federation, 2017-07)
    Jai Defranciscis is an Australian nurse with a passion for paediatrics and education in resource-poor settings. Last year she joined the international medical aid organisation M decins Sans Fronti res (MSF) - also known as Doctors Without Borders - heading to South Sudan for a year, working with refugees fleeing fighting between armed groups. This is her account.
  • Medicine Is Still a Victim of War: We Desperately Need New Ideas

    Sheather, J; Pérache, A (BMJ Publishing Group, 2017-06-14)
    What we are witnessing is war without restraint. But what do we do to stop it?
  • What is a Hotspot Anyway?

    Lessler, J; Azman, A; McKay, H; Moore, S (American Society of Tropical Medicine and Hygiene, 2017-06)
    AbstractThe importance of spatial clusters, or "hotspots," in infectious disease epidemiology has been increasingly recognized, and targeting hotspots is often seen as an important component of disease-control strategies. However, the precise meaning of "hotspot" varies widely in current research and policy documents. Hotspots have been variously described as areas of elevated incidence or prevalence, higher transmission efficiency or risk, or higher probability of disease emergence. This ambiguity has led to confusion and may result in mistaken inferences regarding the best way to target interventions. We surveyed the literature on epidemiologic hotspots, examining the multitude of ways in which the term is used; and highlight the difference in the geographic scale of hotspots and the properties they are supposed to have. In response to the diversity in the term's usage, we advocate the use of more precise terms, such as "burden hotspot," "transmission hotspot," and "emergence hotspot," as well as explicit specification of the spatiotemporal scale of interest. Increased precision in terminology is needed to ensure clear and effective policies for disease control.
  • An Open Source Pharma Roadmap

    Balasegaram, M; Kolb, P; McKew, J; Menon, J; Olliaro, P; Sablinski, T; Thomas, Z; Todd, MH; Torreele, E; Wilbanks, J (Public Library of Science, 2017-04-18)
    In an Essay, Matthew Todd and colleagues discuss an open source approach to drug development.
  • Ten Tips to Improve the Visibility and Dissemination of Research for Policy Makers and Practitioners

    Tripathy, J; Bhatnagar, A; Shewade, H; Kumar, A; Zachariah, R; Harries, A (International Union Against Tuberculosis and Lung Disease, 2017-03-21)
    Effective dissemination of evidence is important in bridging the gap between research and policy. In this paper, we list 10 approaches for improving the visibility of research findings, which in turn will hopefully contribute towards changes in policy. Current approaches include using social media (Facebook, Twitter, LinkedIn); sharing podcasts and other research outputs such as conference papers, posters, presentations, reports, protocols, preprint copy and research data (figshare, Zenodo, Slideshare, Scribd); and using personal blogs and unique author identifiers (ORCID, ResearcherID). Researchers and funders could consider drawing up a systematic plan for dissemination of research during the stage of protocol development.
  • Dilemmas in Access to Medicines: a Humanitarian Perspective

    Smith, J; Aloudat, T (Elsevier, 2017-03-11)
  • Medicine Under Fire

    Sheather, J; Hawkins, V (BMJ Publishing Group, 2016-12-14)
  • On Complicity and Compromise: A Reply

    Lepora, C; Goodin, RE (BMJ Publishing Group, 2016-12-14)
  • Global Health Education in Germany: An Analysis of Current Capacity, Needs and Barriers

    Kaffes, I; Moser, F; Pham, M; Oetjen, A; Fehling, M (BioMed Central, 2016-11-25)
    In times of increasing global challenges to health, it is crucial to create a workforce capable of tackling these complex issues. Even though a lack of GHE in Germany is perceived by multiple stakeholders, no systematic analysis of the current landscape exists. The aim of this study is to provide an analysis of the global health education (GHE) capacity in Germany as well as to identify gaps, barriers and future strategies.
  • Fighting Poor-Quality Medicines in Low- And Middle-Income Countries: The Importance of Advocacy and Pedagogy

    Ravinetto, R; Vandenbergh, D; Macé, C; Pouget, C; Renchon, B; Rigal, J; Schiavetti, B; Caudron, JM (BioMed Central, 2016-11-10)
    The globalization of pharmaceutical production has not been accompanied by a strengthening and harmonization of the regulatory systems worldwide. Thus, the global market is characterized today by a situation of multiple standards, and patients in low- and middle-income countries are exposed to the risk of receiving poor-quality medicines. Among those who first raised the alarm on this problem, there were pioneering humanitarian groups, who were in a privileged position to witness the gap in quality of medicines between high-income countries and low- and middle-income countries. Despite an increasing awareness of the problem and the launch of some positive initiatives, the divide in pharmaceutical quality between the North and the South remains important, and insufficiently addressed. More advocacy is needed for universal access to quality-assured medicines. It should target all those who are strongly "involved" with medicines: regulators, international organizations, journalists, purchasers, prescribers, program managers, policy makers, public health actors and the patients. Advocacy should be based on evidence from research and monitoring programs, and technical concepts should be translated in lay language through communication tools that address all the stakeholders. The fight to ensure universal access to quality medicines needs the participation of all, and can only be successful if grounded in common understanding.
  • Avoiding Catastrophes: Seeking Synergies Among the Public Health, Environmental Protection, and Human Security Sectors

    Stoett, P; Daszak, P; Romanelli, C; Machalaba, C; Behringer, R; Chalk, F; Cornish, S; Dalby, S; de Souza Dias, BF; Iqbal, Z; Koch, T; Krampe, F; Lo, M; Martin, K; Matthews, K; Nickerson, JW; Orbinski, J; Price-Smith, A; Prieur-Richard, AH; Raja, A; Secko, DM; Suazo, A; Swain, A (Elsevier, 2016-10-04)
  • A Medecins Sans Frontieres Ethics Framework for Humanitarian Innovation Plus Worked Case Studies

    Sheather, J; Jobanputra, K; Schopper, D; Pringle, J; Venis, S; Wong, S; Vincent-Smith, R (2016-10)

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