Emerging diseases are “infections that have newly appeared in a population or have existed but are rapidly increasing in incidence or geographic range”. Human emerging diseases include previously unobserved diseases like SARS, disease agents that have acquired new properties like MDR Mycobacterium tuberculosis and E. coli, and diseases that are increasing in prevalence and range like Lyme disease and West Nile virus. The dangerous outcomes of emerging infectious diseases prove to be more dangerous than ever now due to globalization.
In his presentation, Laegreid included a chart of international travel from 1950 to 2010. Up until 1960, there were less than 100 million international tourist arrivals per year. It has grown exponentially since and in 2010, international tourist arrivals reached 1000 million per year. International travel has such a significant impact with the spread of infectious disease now that there are computer systems that calculate flight paths to predict where certain infectious diseases originated and would show up next. For example, with the SARS epidemic, it was determined that it originated from Hong Kong and then predicted to China, US, Australia, Canada, the UK, and Germany quickest, in under 6 weeks. From there, these systems can use probability to predict where the virus would end up next based on flight paths so that the respective countries can prepare ahead of time for the epidemic.
It has been almost a decade since the SARS epidemic and tourist rates are still on the rise, meaning the chances of new emerging diseases spreading even quicker is very high. Using creative systems like this allows nations to plan ahead and becomes an essential factor in reaching adequate public health measures for an infectious disease outbreak.
Thursday, November 17, 2011
Saturday, November 12, 2011
Policies, Barriers, and Incentives for Skilled Labor Migration
On Wednesday, November 9th, I attended the workshop “Policies, Barriers, and Incentives for Skilled Labor Migration and Immigration: Healthcare as a Special Case”. Many notable individuals coming from universities and institutes around the country came together to discuss the case of skilled worker immigration in healthcare. In this specific workshop, the individuals are considering the issues, barriers, challenges, opportunities, and ethical considerations for recruiting and retaining immigrant health care workers. One of the biggest debates throughout this workshop was the importance of skilled health care worker migration vs. immigration.
The speaker that touched greatly on worker migration vs. immigration was Diana Vellos Coker. She discussed the possibilities of migration for doctors and nurses and visa limitations. Most of the visas that are available to nurses are in the form of temporary visas. The process to get a green card, however, is a very long, drawn out process. There is initially a visa screening process to ensure that the nurse’s credentials are appropriate. First, they must have a visa that is valid for 5 years and this must stay current. They also must pass and English requirement, and finally be able to prove that they have a certain skill set to bring into the US. Then, depending on the country of origin, many nurses must wait 8-15 years to receive their green card. However, during this time, they are recommended not to leave the US because then their visa status can get reevaluated which would not qualify them for the green card anymore. The barrier to leave the US can prove to be very difficult if they have other family members in their country of origin, but if went against it, they would lose their chance of immigrating. In the past, this green card process has taken only 3 months, so much has changed throughout the years.
Another argument that was brought forward regarding immigration practices is the necessity of these immigrant health care workers. Currently, it is not a shortage of nurses that cause the problem of health care within the US, but rather a geographic misdistribution. There is a severe lack of health care workers in medically underserved areas, or rural areas, and also in long term care facilities. This is due to poor work environments, high turnover rates, and a lack of faculty to prepare nurses. If immigration laws were to provide a green card incentive for working in such areas, then it is likely that this health care issue can be mended. Otherwise, many of these immigrant nurses are just going into areas that don’t necessarily need the extra work force. Unfortunately, putting in place any sort of immigration incentive is a very abstract idea and is not likely to pass, so immigrants will still have to withstand long immigration processes and their immigration will not be used to solve the health care maldistribution issue.
The speaker that touched greatly on worker migration vs. immigration was Diana Vellos Coker. She discussed the possibilities of migration for doctors and nurses and visa limitations. Most of the visas that are available to nurses are in the form of temporary visas. The process to get a green card, however, is a very long, drawn out process. There is initially a visa screening process to ensure that the nurse’s credentials are appropriate. First, they must have a visa that is valid for 5 years and this must stay current. They also must pass and English requirement, and finally be able to prove that they have a certain skill set to bring into the US. Then, depending on the country of origin, many nurses must wait 8-15 years to receive their green card. However, during this time, they are recommended not to leave the US because then their visa status can get reevaluated which would not qualify them for the green card anymore. The barrier to leave the US can prove to be very difficult if they have other family members in their country of origin, but if went against it, they would lose their chance of immigrating. In the past, this green card process has taken only 3 months, so much has changed throughout the years.
Another argument that was brought forward regarding immigration practices is the necessity of these immigrant health care workers. Currently, it is not a shortage of nurses that cause the problem of health care within the US, but rather a geographic misdistribution. There is a severe lack of health care workers in medically underserved areas, or rural areas, and also in long term care facilities. This is due to poor work environments, high turnover rates, and a lack of faculty to prepare nurses. If immigration laws were to provide a green card incentive for working in such areas, then it is likely that this health care issue can be mended. Otherwise, many of these immigrant nurses are just going into areas that don’t necessarily need the extra work force. Unfortunately, putting in place any sort of immigration incentive is a very abstract idea and is not likely to pass, so immigrants will still have to withstand long immigration processes and their immigration will not be used to solve the health care maldistribution issue.
Saturday, November 5, 2011
Global health fund uncovers $20 million more in losses through corruption in new probes
The Global Fund to Fight AIDS, Tuberculosis, and Malaria, the international financing organization founded by Bill Gates, has now uncovered over $73 million in losses due to corruption across several countries. Three recent cases, in Nigeria, India, and Mauritania, has raised overwhelming concern about the accounting practices exercised by the countries that have been receiving grants. For example, in the case of corruption of India, at least $872,000 of the Global Fund grants have been transferred to another corporation and used to rent and renovate an official’s home.
The Global Fund is a highly reputable organization that has saved 7.7 million lives. Since its creation in 2002, governments globally have pledged $28.3 billion. Unfortunately, when a high proportion of the money is sent directly to countries with corrupt governments, the amount of corruption with the funds that has been found is not too much of a surprise.
Unfortunately, with the findings of the millions of dollars that has been lost through corruption, many governments have or considered withholding their pledges to the Global Fund. Germany had initially withheld their pledge of $285.7 million. Without those funds, the Global Fund calculated that to lead to the deaths of 43,000 people. The European Commission and Denmark have still withheld their pledges. Spain, Italy, Japan, and Ireland are also conflicted with a decision about their pledge, and have withheld a proportion of it.
With such a high amount of funds being lost to corruption every year, these countries have every reason to doubt their pledge to the Global Fund as their funds are not being distributed as intended. However, without such funds, many individuals will die due to the treatment that this organization is able to bring to individuals. It is clear that monitoring policies need to be enforced more, directly where the funds are being sent; otherwise an essential financial component of international health will be missing and many lives will be lost to preventable diseases. Unfortunately, such a large change of monitoring policies can be very difficult to instate since the funds are distributed across all different regions across the world.
The article can be found here: http://www.washingtonpost.com/world/europe/global-health-fund-uncovers-20-million-more-in-losses-through-corruption-in-new-probes/2011/11/01/gIQA0NW7cM_story.html
The Global Fund is a highly reputable organization that has saved 7.7 million lives. Since its creation in 2002, governments globally have pledged $28.3 billion. Unfortunately, when a high proportion of the money is sent directly to countries with corrupt governments, the amount of corruption with the funds that has been found is not too much of a surprise.
Unfortunately, with the findings of the millions of dollars that has been lost through corruption, many governments have or considered withholding their pledges to the Global Fund. Germany had initially withheld their pledge of $285.7 million. Without those funds, the Global Fund calculated that to lead to the deaths of 43,000 people. The European Commission and Denmark have still withheld their pledges. Spain, Italy, Japan, and Ireland are also conflicted with a decision about their pledge, and have withheld a proportion of it.
With such a high amount of funds being lost to corruption every year, these countries have every reason to doubt their pledge to the Global Fund as their funds are not being distributed as intended. However, without such funds, many individuals will die due to the treatment that this organization is able to bring to individuals. It is clear that monitoring policies need to be enforced more, directly where the funds are being sent; otherwise an essential financial component of international health will be missing and many lives will be lost to preventable diseases. Unfortunately, such a large change of monitoring policies can be very difficult to instate since the funds are distributed across all different regions across the world.
The article can be found here: http://www.washingtonpost.com/world/europe/global-health-fund-uncovers-20-million-more-in-losses-through-corruption-in-new-probes/2011/11/01/gIQA0NW7cM_story.html
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