DOCSLIB.ORG

Constructing International Health: the Communicable Disease Center, Field Epidemiologists and the Politics of Foreign Assistance (1948-1972)

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Constructing International Health: the Communicable Disease Center, Field Epidemiologists and the Politics of Foreign Assistance (1948-1972) 1 Constructing International Health: The Communicable Disease Center, Field Epidemiologists and the Politics of Foreign Assistance (1948-1972) Etienne Gosselin Department of History, Faculty of Arts McGill University, Montreal December, 2011 A thesis submitted to McGill University in partial fulfillment of the requirements of the degree of Doctorate of Philosophy in History ©Etienne Gosselin, 2011 2 Abstract Following World War II, new institutions were created to manage international health issues and assist developing nations in addressing their public health problems. Bilateral aid agencies and multilateral organizations designed, promoted, financed and implemented various programs to alleviate the burden of disease in the Third World, but also pursued political goals. In this dissertation, I analyze the development of international health activities of the Communicable Disease Center (CDC) from 1948 to 1972, from the first overseas assignment of a CDC officer until the end of major global public health campaigns at the beginning of the 1970s. My focus is on the role and motivations of CDC leaders and field epidemiologists who aimed and worked to transform the public health agency from a marginal international player into an important actor in the institutional constellation. In extending activities from the U.S. to the international arena, the CDC, as a national health agency, faced legal and political obstacles which limited its access to foreign localities where international health programs were being implemented. I argue that if expertise in field epidemiology existed in Atlanta and CDC leaders expressed a desire to see their agency take a more prominent role, the deployment of CDC personnel overseas remained problematic. To circumvent these obstacles, the CDC utilized development agencies, public health technologies and multilateral health organization as conduits to get access to foreign environments, procure international field experience to its epidemiologists and make an impact on the control of infectious diseases. As I show, it was especially during the 1960s that these three trajectories coalesced to ensure CDC’s place as a public health actor of international reach and contributed in establishing its credibility. The exploration of the CDC’s relationships with these international health actors and technologies also demonstrates the tensions deriving from the arrival of a new actor of 3 international health, the limits of expertise when opposed by political considerations and the various tactics employed to secure a role in the design, implementation and management of public health programs abroad. Key words: Communicable Disease Center; Centers for Disease Control; international health; bilateral assistance; field epidemiology; malaria; smallpox; surveillance; history of public health; history of U.S. foreign relations. 4 Résumé Après la Deuxième guerre mondiale, de nouvelles institutions sont créées afin de gérer les dossiers de la santé internationale et d’assister les nations en voie de développement dans la prise en charge de leurs problèmes de santé publique. Les agences d’aide bilatérale et les organisations multilatérales ont imaginé, promu, financé et implanté plusieurs programmes dans le but d’alléger le poids des maladies dans le Tiers monde, mais aussi à des fins de politique étrangère. Dans cette thèse, j’analyse la construction des activités de santé internationale du Communicable Disease Center (CDC) de 1948 à 1972, période correspondant à sa première mission outremer jusqu’à la fin d’importants programmes de santé internationale au début des années 1970. Je me concentre sur le rôle et les motivations des dirigeants du CDC et des épidémiologistes de terrain, qui visaient à transformer leur agence de santé publique, d’abord un acteur marginal, en un joueur important dans la constellation institutionnelle de la santé internationale. Dans l’expansion de leurs activités de la scène nationale à l’échelle internationale, le CDC, en tant qu’agence de santé nationale, a été confronté à des obstacles légaux et politiques limitant leur accès aux territoires étrangers où les programmes de santé internationale sont implantés. Je démontre que si le CDC disposait d’une expertise en épidémiologie de terrain et même si leurs dirigeants désiraient jouer un rôle international important, le déploiement des officiers du CDC à l’étranger demeurait problématique. Afin de contourner ces obstacles, le CDC utilisa les agences de développement international, les technologies de santé publique ainsi que les organisations multilatérales comme conduits afin d’accéder aux territoires d’outremer, donner une expérience internationale à ses épidémiologistes de terrain et modifier profondément les conventions sur le contrôle des maladies infectieuses. Tel que je le démontre, 5 ces trois trajectoires fusionnent dans les années 1960 afin de confirmer le statut du CDC en tant qu’acteur de la santé internationale et contribuent à établir la crédibilité de l’institution. L’exploration des relations du CDC avec ces institutions et les technologies de santé publique permettent également de mettre en relief plusieurs éléments : les tensions découlant de l’arrivée d’un nouvel acteur institutionnel de la santé internationale, les limites de l’expertise qui est parfois en opposition avec des considérations politiques et les diverses tactiques utilisées pour s’assurer une place dans la mise sur pied, l’implantation et l’administration des programmes de santé publique à l’étranger. Mots clés : Communicable Disease Center; Centers for Disease Control; santé internationale, aide bilatérale; épidémiologie de terrain; malaria; variole; veille sanitaire; histoire de la santé publique; histoire des relations étrangères américaine 6 Dedication To my father (1951-2008) and my children: my links to the past and the future 7 Acknowledgements My first words of thanks go my family and friends who supported me through this long process. Their patience and understanding were invaluable. Tania pushed me and comforted me in times of doubt. Without her, this dissertation would never have seen the light of day and I would not have escaped with my sanity intact. To Florent and Charles Vincent: the time spent playing with them was my daily reward. Frédéric Jean remained interested in learning about my research and rekindled my flame about my own work. Igor, Jean-Frédéric, and Jonathan offered much needed breaks and showed me it was possible to be done. Very special thanks to Melissa for the hospitality and to Mireille who really came through at the last minute. My father passed away as I was starting my dissertation but he was an inspiration in doing good work. To my mother: she never questioned my choice and encouraged me in going as far as I can. Guy and Diane believed in me and were sources of motivation. Their help with everything cannot be overstated. My supervisor Thomas Schlich was always there for all kinds of support and gave me the freedom to explore this fascinating subject. He was unwavering in his belief that this could be done even during difficult times. His patience and comments were ingredients that allowed me to sit down and get to work. I wish every graduate student to find as good a supervisor as Thomas was to me. I would also like to thank George Weisz who first believed in this project and offered precious advice to further my research. Andrea Tone and Lorenz Lüthi were always there in case of need and contributed greatly in expanding my knowledge in new directions. George Dehner and Randall Packard graciously provided me with documents and comments to improve the quality of my work. Thank you to Gilberto Hochman, 8 Ted Brown Bob Reinhardt, Michael Bresalier for taking the time to read parts of this dissertation and generously offering their insights. This work would not have been possible without the financial support of the Social Sciences and Humanities Research Council of Canada, the Fonds de recherche du Québec - Société et culture, the Tomlinson Fellowship and other grants from McGill University. I received much help from archivists and librarians in finding documents. Rob Richards at the NARA facilities in Morrow, Georgia and Tab Lewis in College Park went out of their way to find boxes and obscure documents and offered continual support throughout the years. Mary Hilpertshauser and Joel Hewett assisted in finding and assembling sources from the David J. Sencer Museum at the CDC. Thanks to Jessica Murphy of the Countway Library of Medicine, Marjorie Kehoe of the Alan Mason Chesney Medical Archives, Doug Atkins of the National Library of Medicine, Charles Florey and Eman Hamman of the International Epidemiological Association, and Romain Ledauphin of the UN Archives. This extends to the staff of the Health Sciences and Osler Libraries at McGill University, especially Christopher Lyons who was available to answer my many questions. My research has greatly benefited from participation of former CDC members who graciously accepted to be interviewed: Teeb Al-Samarrai, Philip S. Brachman, William H. Foege, Donald A. Henderson, Joan Millar, Robert G. Scholtens and an anonymous informant. A very special thanks to Don Millar, who accepted to read and comment part of this work and accepted to share some of his personal papers, and to David J. Sencer (1924-2011) who was very generous with his time and also provided me with documents from his collection. 9 Finally my thanks go to friends, faculty, professors and staff who assisted me in
Load more

Recommended publications
  • J. Michael Mcginnis, Md, Ma, Mpp
    J. MICHAEL MCGINNIS, MD, MA, MPP National Academy of Medicine, the National Academies, 500 Fifth Street NW, Washington DC 20001, (202) 334-3963, [email protected] Highlights: Michael McGinnis is a physician and epidemiologist who lives and works in Washington DC. Through his writing, government service, and work in philanthropy, he has been a long-time contributor to national and international field leadership in health, health care, and health policy. He currently serves at the National Academy of Medicine (NAM), where he is the Leonard D. Schaeffer Executive Officer, Senior Scholar, and Executive Director of the NAM’s Leadership Consortium for public and private collaboration on behalf of a continuously learning health system. Previously, he served as founding Director, respectively, of the Robert Wood Johnson Foundation’s (RWJF) Health Group, the World Health Organization’s Office for Health Reconstruction in Bosnia, the federal Office of Research Integrity (interim), and the federal Office of Disease Prevention and Health Promotion. In a tenure unusual for political and policy posts, he held continuous appointment through the Carter, Reagan, Bush and Clinton Administrations at the Department of Health and Human Services, with policy responsibilities for disease prevention and health promotion (1977-1995). Programs and policies conceived and launched at his initiative include the Healthy People process establishing national health goals and objectives (1979-present), the U.S. Preventive Services Task Force (1984-present), the Dietary Guidelines for Americans (with USDA, 1980- present), the multi-level Public Health Functions Steering Group and the Ten Essential Services of Public Health (1994-present), the RWJF Active Living family of programs (2000-present), the RWJF Young Epidemiology Scholars Program (2001-2012), the RWJF Health and Society Scholars Program (2002-2017), and the current Learning Health System initiative of the NAM.
    [Show full text]
  • THE SURGEON GENERAL and the BULLY PULPIT Michael Stobbe a Dissertation Submitted to the Faculty of the University of North Carol
    THE SURGEON GENERAL AND THE BULLY PULPIT Michael Stobbe A dissertation submitted to the faculty of the University of North Carolina at Chapel Hill in partial fulfillment of the requirements for the degree of Doctor of Public Health in the Department of Health Policy and Administration, School of Public Health Chapel Hill 2008 Approved by: Ned Brooks Jonathan Oberlander Tom Ricketts Karl Stark Bryan Weiner ABSTRACT MIKE STOBBE: The Surgeon General and the Bully Pulpit (Under the direction of Ned Brooks) This project looks at the role of the U.S. Surgeon General in influencing public opinion and public health policy. I examined historical changes in the administrative powers of the Surgeon General, to explain what factors affect how a Surgeon General utilizes the office’s “bully pulpit,” and assess changes in the political environment and in who oversees the Surgeon General that may affect the Surgeon General’s future ability to influence public opinion and health. This research involved collecting and analyzing the opinions of journalists and key informants such as current and former government health officials. I also studied public documents, transcripts of earlier interviews and other materials. ii TABLE OF CONTENTS LIST OF TABLES.................................................................................................................v Chapter 1. INTRODUCTION ...............................................................................................1 Background/Overview .........................................................................................1
    [Show full text]
  • THE SURGEON GENERAL and the BULLY PULPIT Michael Stobbe a Dissertation Submitted to the Faculty of the University of North Carol
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Carolina Digital Repository THE SURGEON GENERAL AND THE BULLY PULPIT Michael Stobbe A dissertation submitted to the faculty of the University of North Carolina at Chapel Hill in partial fulfillment of the requirements for the degree of Doctor of Public Health in the Department of Health Policy and Administration, School of Public Health Chapel Hill 2008 Approved by: Ned Brooks Jonathan Oberlander Tom Ricketts Karl Stark Bryan Weiner ABSTRACT MIKE STOBBE: The Surgeon General and the Bully Pulpit (Under the direction of Ned Brooks) This project looks at the role of the U.S. Surgeon General in influencing public opinion and public health policy. I examined historical changes in the administrative powers of the Surgeon General, to explain what factors affect how a Surgeon General utilizes the office’s “bully pulpit,” and assess changes in the political environment and in who oversees the Surgeon General that may affect the Surgeon General’s future ability to influence public opinion and health. This research involved collecting and analyzing the opinions of journalists and key informants such as current and former government health officials. I also studied public documents, transcripts of earlier interviews and other materials. ii TABLE OF CONTENTS LIST OF TABLES.................................................................................................................v Chapter 1. INTRODUCTION ...............................................................................................1
    [Show full text]
  • Distribution Agreement in Presenting This Thesis Or Dissertation As A
    Distribution Agreement In presenting this thesis or dissertation as a partial fulfillment of the requirements for an advanced degree from Emory University, I hereby grant to Emory University and its agents the non-exclusive license to archive, make accessible, and display my thesis or dissertation in whole or in part in all forms of media, now or hereafter known, including display on the world wide web. I understand that I may select some access restrictions as part of the online submission of this thesis or dissertation. I retain all ownership rights to the copyright of the thesis or dissertation. I also retain the right to use in future works (such as articles or books) all or part of this thesis or dissertation. Signature: _____________________________ ______________ Anita L. Renahan-White Date Faith and the Public's Health By Anita L. Renahan-White Master of Divinity Candler School of Theology ___________________________________________ [Thesis Advisor's signature] Dr. John Blevins Committee Chair ___________________________________________ [Member's signature] Dr. Steven J. Kraftchick Director of General and Advanced Studies ___________________________________________ [Member's signature] Dr. Emmanuel Lartey Committee Member Faith and the Public's Health By Anita L. Renahan-White MPH Emory University 1993 Thesis Committee Chair: John Blevins, ThD An abstract of A thesis submitted to the Faculty of the Candler School of Theology in partial fulfillment of the requirements for the degree of Master of Divinity 2012 Abstract Faith and the Public's Health By Anita L. Renahan-White In the following thesis "Faith and the Public's Health," I detail findings from research and interviews I conducted from March 2011 through February 2012.
    [Show full text]
  • The Peace Corps' Contributions to the Global Smallpox Eradication Program
    The Peace Corps’ Contributions to the Global Smallpox Eradication Program About the Office of Strategic Information, Research, and Planning (OSIRP) It is the mission of OSIRP to advance evidence-based management at the Peace Corps by guiding agency strategic planning; monitoring and evaluating agency-level performance and programs; conducting research to generate new insights in the fields of international development, cultural exchange, and Volunteer service; enhancing the stewardship and governance of agency data; and helping to shape agency engagement on high-level, governmentwide initiatives. Front Cover: Peace Corps Volunteers Robert Steinglass and Doug Arbuckle administering the smallpox vaccine in Mille, Ethiopia, in 1974. Photo: Steinglass, personal collection. ii Dedication This report is dedicated to the memory of Dr. Donald Ainslie “D. A.” Henderson (September 7, 1928—August 19, 2016), a seminal figure in the field of smallpox eradication. The Peace Corps is deeply appreciative of having had the opportunity to correspond with Dr. Henderson about the contributions of Peace Corps Volunteers and returned Volunteers within the context of the global eradication program. His charismatic leadership, tireless energy, and unflagging devotion to this program inspired countless public health workers around the world, including many of the returned Peace Corps Volunteers interviewed for this report. iii Acknowledgments In 1806, approximately 10 years after Dr. Edward Jenner conducted the first documented experiment with smallpox vaccination, laying the foundations of modern medicine, President Thomas Jefferson wrote to the English physician and scientist. Jefferson acknowledged the importance of this discovery, extending “a portion of the tribute of gratitude due to you from the whole human family.
    [Show full text]
  • Seamus Heaney Exhibit Is Tribute to Friend of Emory Emory Photo Video
    Welcome to spring semester SPECIAL ISSUE Online all the time at news.emory.edu JANUARY 21, 2014 ATHLETICS BEARDEN EXHIBIT Oxford’s organic farm 2 Eagle teams ‘Black Odyssey’ return strong draws scholars, Spring break alternatives 5 for 2014. faculty and local Calendar highlights 6-7 Page 3 celebrities. Page 12 Founders Week 11 University Course expands 11 Seamus Heaney exhibit is tribute to friend of Emory Emory Photo Video Nobel Prize-winning poet Seamus Heaney had a long relationship with Emory, having presented the inaugural Richard Ellmann Lectures. By MAUREEN MCGAVIN beginning at 6 p.m. with W. Ronald Schuchard, Emory profes- were part of an old bench from Carysfort College in Dublin, sor emeritus of English, as toastmaster. where Heaney taught in the 1970s. “Seamus Heaney: The Music of What Happens,” opening Geraldine Higgins, director of Emory’s Irish studies pro- There will also be a custom-built media space where people Saturday, Feb. 22, will be Emory’s first major exhibition cel- gram, curated the exhibition, choosing the title from a line can listen to recordings of Heaney and other distinguished writ- ebrating the life of the late Irish poet and Nobel Prize winner. in the Heaney poem “Song:” “The finest music of all is the ers, artists and well-known figures, including Irish actor Liam Heaney had a special connection to Emory beginning music of what happens.” Neeson and novelist Sir Salman Rushdie, reading his poems. with his first reading in March 1981. He delivered the inau- The exhibition will showcase Heaney’s poems and drafts A large kite will be at the center of the exhibition, suspended gural Richard Ellmann Lectures in Modern Literature in showing his handwritten revisions, rare publications, and over the spiral staircase in the gallery that descends to the lower 1988, donated his lecture notes to Emory’s Manuscript, artists’ books containing his poetry.
    [Show full text]
  • Proquest Dissertations
    'RANDOM MURDER BY TECHNOLOGY': THE ROLE OF SCIENTIFIC AND BIOMEDICAL EXPERTS IN THE ANTI-NUCLEAR MOVEMENT, 1969 - 1992 LISA A. RUMIEL A DISSERTATION SUBMITTED TO THE FACULTY OF GRADUATE STUDIES IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY GRADUATE PROGRAM IN HISTORY YORK UNIVERSITY, TORONTO, ONTARIO AUGUST 2009 Library and Archives Bibliotheque et 1*1 Canada Archives Canada Published Heritage Direction du Branch Patrimoine de I'edition 395 Wellington Street 395, rue Wellington OttawaONK1A0N4 Ottawa ON K1A 0N4 Canada Canada Your file Votre reference ISBN: 978-0-494-54104-3 Our file Notre r6f6rence ISBN: 978-0-494-54104-3 NOTICE: AVIS: The author has granted a non­ L'auteur a accorde une licence non exclusive exclusive license allowing Library and permettant a la Bibliotheque et Archives Archives Canada to reproduce, Canada de reproduire, publier, archiver, publish, archive, preserve, conserve, sauvegarder, conserver, transmettre au public communicate to the public by par telecommunication ou par I'lnternet, preter, telecommunication or on the Internet, distribuer et vendre des theses partout dans le loan, distribute and sell theses monde, a des fins commerciales ou autres, sur worldwide, for commercial or non­ support microforme, papier, electronique et/ou commercial purposes, in microform, autres formats. paper, electronic and/or any other formats. The author retains copyright L'auteur conserve la propriete du droit d'auteur ownership and moral rights in this et des droits moraux qui protege cette these. Ni thesis. Neither the thesis nor la these ni des extraits substantiels de celle-ci substantial extracts from it may be ne doivent etre imprimes ou autrement printed or otherwise reproduced reproduits sans son autorisation.
    [Show full text]
  • Controlling Onchocerciasis (River Blindness) in Sub-Saharan Africa
    Case 7 Controlling Onchocerciasis (River Blindness) in Sub-Saharan Africa Geographic area: Sub-Saharan Africa Health condition: In west African countries in 974, nearly 2 million of the area’s 20 million inhabit- ants were infected with onchocerciasis, and approximately 200,000 were blind. Global importance of the health condition: Onchocerciasis, or river blindness, afflicts approximately 42 mil- lion people worldwide, with well over 99 percent of its victims in sub-Saharan Africa. An estimated 600,000 people are blind, and an additional .5 million Africans are visually impaired due to onchocerciasis. Intervention or program: The Onchocerciasis Control Program (OCP) was launched in 974 in west African countries. Weekly aerial spraying with environmentally safe insecticides helped control the dis- ease vector—blackflies that bred in fast-moving waterways, thereby halting transmission of the disease. In 995, a second program, the African Programme for Onchocerciasis Control (APOC), was established to control the disease in 9 central, east, and southern African countries. Through a broad international partnership and the participation of 5,000 remote, rural communities, APOC and OCP distributed a drug donated by Merck & Co., Inc., Mectizan (ivermectin), to more than 45 million people in sub-Saharan Africa in 2005. The drug prevents and alleviates the symptoms of the disease with one annual dose. Cost-effectiveness: OCP operated with an annual cost of less than $ per protected person. Commit- ments from 27 donors during the 28-year project totaled $600 million. The annual return on investment was calculated to be about 20 percent, primarily attributable to increased agricultural output; about $3.7 billion will be generated from improved labor and agricultural productivity.
    [Show full text]
  • Disease Strategy Debated
    MONDAY, MARCH 20, 2006 To Conquer, or Control? Disease Strategy Debated By DONALD G. McNEIL Jr and CELIA W. DUGGER Other Likely Candidates for Eradication There is a heroic allure to ridding the planet of a horrible disease forever. DISEASE EST. CASES TRANSMISSION BREAKING THE CYCLE Louis Pasteur is famous as the inventor of the vaccine. Jonas Salk is synonymous Guinea worm 12,000 Worm larvae in water Filter or treat pond water. with the one he created to combat polio. fleas swallowed by Dig deep wells so they do In the medical community, doctors like humans. Worms can not get contaminated. Donald A. Henderson and William Foege grow three feet long. are honored as the conquerors of smallpox. Lymphatic 120 million Mosquitoes carry juvenile Deworming pills kill Though the dream of eradication filariasis (1996) worms. Adult worm nests juvenile worms, but victims continues to animate scientists, doctors swell legs and scrotums, must be treated annually and public health officials, the history crippling victims. for 6 years. is at best rocky. In the past century, erad- ication efforts failed against hookworm, yellow fever and malaria. Today the struggling drive against polio has raised new questions about whether eradication of any disease is achievable, and, if so, whether the cost in terms of effort and dollars would be worth it, given all the A woman with other diseases that need attention. lymphatic filariasis The latest push began in 1993, when in Haiti. the International Task Force for Disease Eric S. Lesser for The New York Times Eradication, a panel of experts, was convened in Atlanta by the Centers for Measles 30 million Virus spread by Vaccine delivered Disease Control and Prevention, Emory annual cases; coughing, sneezing by injection.
    [Show full text]
  • Worldwide Smallpox Eradication, 1957–67
    Med. Hist. (2020), vol. 64(1), pp. 71–93. c The Authors 2019. Published by Cambridge University Press 2019 This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. doi:10.1017/mdh.2019.77 Re-assessing the Foundations: Worldwide Smallpox Eradication, 1957–67 SANJOY BHATTACHARYA 1* and CARLOS EDUARDO D’AVILA PEREIRA CAMPANI 2 1Centre for Global Health Histories, Department of History, University of York, York YO10 5DD, UK 2Department of Health Sciences, University of York, York YO10 5DD, UK Abstract: An expansive, worldwide smallpox eradication programme (SEP) was announced by the World Health Assembly in 1958, leading this decision-making body to instruct the World Health Organization Headquarters in Geneva to work with WHO regional offices to engage and draw in national governments to ensure success. Tabled by the Soviet Union’s representative and passed by a majority vote by member states, the announcement was subject to intense diplomatic negotiations. This led to the formation, expansion and reshaping of an ambitious and complex campaign that cut across continents and countries. This article examines these inter-twining international, regional and national processes, and challenges long-standing historiographical assumptions about the fight against smallpox only gathering strength from the mid-1960s onwards, after the start of a US-supported programme in western Africa. The evidence presented here suggests a far more complex picture. It shows that although the SEP’s structures grew slowly between 1958 and 1967, a worldwide eradication programme resulted from international negotiations made possible through gains during this period.
    [Show full text]
  • SPRING 2014 Issue 5.01 Consequentialist Epidemiology Big Push Initiatives in Global Health Nyc's New Health Commissioner
    consequentialist epidemiology big push initiatives in global health nyc’s new health commissioner issue 5.01 FROM THE DEPARTMENT OF EPIDEMIOLOGY SPRING 2014 MAILMAN SCHOOL OF PUBLIC HEALTH – COLUMBIA UNIVERSITY Sandro Galea, MD, DrPH Gelman Professor and Chair Department of Epidemiology EDITOR Barbara Aaron Administrative Director EDITOR / WRITER Elaine Meyer Associate Director of Communications CONTRIBUTING WRITERS Rachel Kitchenoff Tim Paul ASSOCIATE DESIGNER Kristen Byers Web Developer / Graphic Designer DESIGNER Jon Kalish ON THE COVER: A graphic reduction of John Snow’s mapping of the 1854 London cholera outbreak. The map has been reduced to the representation of deaths—marked by rectangular bars set perpendicular to streets. The bars are colored red for emphasis. Featured in Bringing ‘consequentialism’ back to epidemiology on page 10. CONTENTS 3 Publication highlights FEATURES 8 Bringing ‘consequentialism’ back to epidemiology 14 Big push initiatives in global health 21 How cities affect urban health 25 Epidemiology role models: Trainees draw lessons from NYC’s new health commissioner 29 Symposium report: Explanation and prediction in population health 30 In the news 32 Faculty publications DEPARTMENT OF EPIDEMIOLOGY 1 chair’s message Colleagues, 2x2 has a new look. Our spring 2014 issue has been redesigned to accommodate more in-depth articles about epidemiology, and to draw on and better synchronize with our online presence on the2x2project.org This move reflects our growing focus on communicating our findings to better inform and influence the epidemiologic conversation. Our ultimate goal is to translate our science into policy and action that improves population health. We see communicating the science of epidemiology with the broadest possible audience as a step in that direction.
    [Show full text]
  • Fifth Meeting of the WHO Advisory Group on the EVD Response WHO HQ 14:00 – 15:30, 15 January 2015
    Fifth Meeting of the WHO Advisory Group on the EVD Response WHO HQ 14:00 – 15:30, 15 January 2015 Participants: Members Co-chair: Dr Sam Zaramba, former Director-General of Health (Uganda) Co-chair: Professor David Heymann, Senior Fellow, Centre on Global Health Security, Chatham House, UK (USA) Dr William Foege, former Director, Centers for Disease Control and Prevention (USA) Professor Cheikh Ibrahima Niang, Cheikh Anta Diop University (Senegal) Professor Peter Piot, Director, London School of Hygiene and Tropical Medicine, and Chair, WHO consultation on the science of EVD (Belgium) Dr Mike Ryan, Consultant and former WHO Director of Outbreak Alert and Response (Ireland) Dr Viroj Tangcharoensathien, Senior Adviser, Ministry of Public Health (Thailand) WHO/UN WHO: DG, DDG, Bruce Aylward, Keiji Fukuda, Alex Gasasira, Sylvie Briand, Cathy Roth, Xing Jun, Munjoo Park, Caroline Barrett UN: David Nabarro, Chadia Wannous Summary of discussion and recommendations: Dr Zaramba (Chair of the meeting) introduced topics for this meeting: 1) Community-level surveillance and contact tracing and 2) Preparedness for future public health emergencies. He asked the WHO Secretariat to first provide an update on these two subjects. Dr Briand outlined the role of contact tracing as part of a package of interventions to respond to EVD as well as a key intervention for Phase II to get to zero cases. One way to measure performance on contact tracing is to look at the percentage of new cases that were part of a contact list. The proportion of new cases among known contacts is approximately 25% in Liberia, and 50% in Guinea.
    [Show full text]