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  • Author: Melinda K. Abrams, Reginald D. Williams II, Katharine Fields, Roosa Tikkanen
  • Publication Date: 05-2021
  • Content Type: Special Report
  • Institution: Commonwealth Fund
  • Abstract: About one-quarter of U.S. adults report having a mental health diagnosis such as anxiety or depression or experiencing emotional distress. This is one of the highest rates among 11 high-income countries. While U.S. adults are among the most willing to seek professional help for emotional distress, they are among the most likely to report access or affordability issues. Emotional distress is associated with social and economic needs in all countries. Nearly half of U.S. adults who experience emotional distress report such worries, a higher share than seen in other countries. The United States has some of the worst mental health–related outcomes, including the highest suicide rate and second-highest drug-related death rate. The U.S. has a relatively low supply of mental health workers, particularly psychologists and psychiatrists. Just one-third of U.S. primary care practices have mental health professionals on their team, compared to more than 90 percent in the Netherlands and Sweden.
  • Topic: Health, Health Care Policy, Mental Health, Drugs, Substance Abuse
  • Political Geography: United States, Europe, Global Focus
  • Author: Laurie Zephyrin, Molly FitzGerald, Munira Z. Gunja, Roosa Tikkanen
  • Publication Date: 11-2020
  • Content Type: Policy Brief
  • Institution: Commonwealth Fund
  • Abstract: The U.S. has the highest maternal mortality rate among developed countries. Obstetrician-gynecologists (ob-gyns) are overrepresented in its maternity care workforce relative to midwives, and there is an overall shortage of maternity care providers (both ob-gyns and midwives) relative to births. In most other countries, midwives outnumber ob-gyns by severalfold, and primary care plays a central role in the health system. Although a large share of its maternal deaths occur postbirth, the U.S. is the only country not to guarantee access to provider home visits or paid parental leave in the postpartum period.
  • Topic: Health, Health Care Policy, Women, Reproductive Health
  • Political Geography: United States, Global Focus
  • Author: Michelle M. Doty, Eric C. Schneider, Roosa Tikkanen, Arnav Shah, Reginald D. Williams II
  • Publication Date: 08-2020
  • Content Type: Special Report
  • Institution: Commonwealth Fund
  • Abstract: With more than 4 million confirmed cases and 150,000 deaths as of August, the United States is failing to control the COVID-19 pandemic. At a time when many nations are reopening their economies and societies, the U.S. is struggling in its attempts to do the same. To examine the early impact of the pandemic on the well-being of adults in the U.S. and abroad, the Commonwealth Fund joined the survey research firm SSRS to interview 8,259 adults age 18 and older between March and May 2020. It is the latest in the Commonwealth Fund’s series of cross-national comparisons featuring the United States and nine other high-income countries that participate in the Fund’s annual International Health Policy Survey. The following exhibits illustrate COVID-19’s effects on people’s mental health and economic security and compare levels of public trust in national leaders in responding to the pandemic.
  • Topic: Health, Health Care Policy, Mental Health, Public Health
  • Political Geography: United States, Europe, Global Focus
  • Author: Meredith B. Rosenthal, Paul F. van Gils, Caroline A. Baan, Eline F. de Vries, Jeroen Struijs
  • Publication Date: 04-2020
  • Content Type: Special Report
  • Institution: Commonwealth Fund
  • Abstract: We identified 23 initiatives in eight countries that have implemented bundled-payment models, focusing on procedures such as total joint replacements and cardiac surgery, as well as chronic conditions like diabetes and breast cancer. Of the 35 studies retrieved, 32 reported effects on quality of care and 32 reported effects on medical spending. Twenty of 32 studies reported modest savings or a modest reduction in spending growth, while two studies (both based on the same initiative) demonstrated increased spending in the early years of the bundled-payment model’s implementation. Eighteen of 32 studies reported quality improvements for most evaluated measures, while other studies showed no difference in measured quality. Our study provides evidence that bundled-payment models have the potential to reduce medical spending growth while having either a positive impact or no impact on quality of care.
  • Topic: Economics, Health, Health Care Policy, Income Inequality, Macroeconomics, Coronavirus, COVID-19
  • Political Geography: United States, Global Focus
  • Author: Roosa Tikkanen, Melinda K. Abrams
  • Publication Date: 01-2020
  • Content Type: Special Report
  • Institution: Commonwealth Fund
  • Abstract: A 2015 Commonwealth Fund brief showed that — before the major provisions of the Affordable Care Act were introduced — the United States had worse outcomes and spent more on health care, largely because of greater use of medical technology and higher prices, compared to other high-income countries. By benchmarking the performance of the U.S. health care system against other countries — and updating with new data as they become available — we can gain important insights into our strengths and weaknesses and help policymakers and delivery system leaders identify areas for improvement. This analysis is the latest in a series of Commonwealth Fund cross-national comparisons that uses health data from the Organisation for Economic Co-operation and Development (OECD) to assess U.S. health care system spending, outcomes, risk factors and prevention, utilization, and quality, relative to 10 other high-income countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom. We also compare U.S. performance to that of the OECD average, comprising 36 high-income member countries.
  • Topic: Health, Health Care Policy
  • Political Geography: United States, Europe, Global Focus
  • Author: Maxim Ananyev, Michael Poyker, Yuan Tian
  • Publication Date: 03-2020
  • Content Type: Working Paper
  • Institution: Nottingham Interdisciplinary Centre for Economic and Political Research (NICEP)
  • Abstract: We document a causal effect of conservative Fox News Channel in the United States on physical distancing during COVID-19 pandemic. We measure county-level mobility covering all U.S. states and District of Columbia produced by GPS pings to 15-17 million smartphones and zip-code-level mobility using Facebook location data. Then, using the historical position of Fox News Channel in the cable lineup as the source of exogenous variation, we show that increased exposure to Fox News led to a smaller reduction in distance traveled and smaller increase in the probability to stay home after the national emergency declaration in the United States. Our results show that slanted media can have a harmful effect on containment efforts during a pandemic by affecting people’s behaviour.
  • Topic: Health, Media, Journalism, Public Health, Data, COVID-19
  • Political Geography: United States
  • Author: Martin Gaynor, Nirav Mehta, Seth Richards-Shubik
  • Publication Date: 05-2020
  • Content Type: Working Paper
  • Institution: Centre for Human Capital and Productivity (CHCP), Western University
  • Abstract: We study physician agency and optimal payment policy in the context of an expensive medication used in dialysis care. Using Medicare claims data we estimate a structural model of treatment decisions, in which physicians differ in their altruism and marginal costs, and this heterogeneity is unobservable to the government. In a novel application of nonlinear pricing methods, we theoretically characterize the optimal unrestricted contract in this screening environment with multidimensional heterogeneity. We combine these results with the estimated model to construct the optimal contract and simulate counterfactual outcomes. The optimal contract is a flexible fee-for-service contract, which pays for reported treatments but uses variable marginal payments instead of constant reimbursement rates, resulting in substantial health improvements and reductions in costs. Our structural approach also yields important qualitative findings, such as rejecting the optimality of any linear contract, and may be employed more broadly to analyze a variety of applications.
  • Topic: Economics, Government, Health, Health Care Policy, Human Capital, Productivity, Medicare
  • Political Geography: United States
  • Author: Shannon Monnat
  • Publication Date: 02-2019
  • Content Type: Working Paper
  • Institution: Institute for New Economic Thinking (INET)
  • Abstract: Over the past two decades deaths from opioids and other drugs have grown to be a major U.S. population health problem, but the magnitude of the crisis varies across the U.S., and explanations for widespread geographic variation in the severity of the drug crisis are limited. An emerging debate is whether geographic differences in drug mortality rates are driven mostly by opioid supply factors or socioeconomic distress. To explore this topic, I examined relationships between county-level non-Hispanic white drug mortality rates for 2000-02 and 2014-16 and several socioeconomic and opioid supply measures across the urban-rural continuum and within different rural labor markets. Net of county demographic composition, average non-Hispanic white drug mortality rates are highest and increased the most in large metro counties. In 2014-16, the most rural counties had an average of 6.2 fewer deaths per 100,000 population than large metro counties. Economic distress, family distress, persistent population loss, and opioid supply factors (exposure to prescription opioids and fentanyl) are all associated with significantly higher drug mortality rates. However, the magnitude of associations varies across the urban-rural continuum and across different types of rural labor markets. In rural counties, economic distress appears to be a stronger predictor than opioid supply measures of drug mortality rates, but in urban counties, opioid supply factors are more strongly associated with drug mortality rates than is economic distress. Ultimately, the highest drug mortality rates are disproportionately concentrated in economically distressed mining and service sector dependent counties with high exposure to prescription opioids and fentanyl.
  • Topic: Economics, Health, Inequality, Macroeconomics, Drugs
  • Political Geography: United States
  • Author: Sandra E. Black, Jesse Rothstein
  • Publication Date: 01-2019
  • Content Type: Policy Brief
  • Institution: Economics for Inclusive Prosperity (EfIP)
  • Abstract: While private provision of goods often yields the efficient outcome, there are a number of goods that are not efficiently provided in the private market. Here, we outline two such situations: investments in child care and education, and insurance against risks created by business cycles, poor health, and old age. Because private markets work poorly for these goods, and the costs of market failure are large, standard economic reasoning implies a significant role for government provision. The reduction in economic insecurity that this would bring could help to improve political stability as well, by reducing the stakes that people perceive in discussions of trade, immigration, technological change, and countercyclical policy (Inglehart and Norris, 2016). Many observers (e.g, Hacker, 2018) have pointed to economic anxiety as a potential contributor to populist reactions in the U.S. and many European countries; a public sector that acts to reduce the risk that households face could ameliorate this, generating political spillovers and improving the state of the country more broadly.
  • Topic: Economics, Education, Health, Health Care Policy, Children, Economic Policy, Economic Theory
  • Political Geography: United States, Europe
  • Author: Ilyana Kuziemko
  • Publication Date: 07-2019
  • Content Type: Policy Brief
  • Institution: Economics for Inclusive Prosperity (EfIP)
  • Abstract: My read of the evidence (and my own social welfare weights, which place great weight on the un- and under-insured as well as middle-class workers who are implicitly taxed via expensive health plans) lead me to conclude that Medicare for All would increase welfare in the US. However, I also want to highlight what I consider the biggest risks of such a policy.
  • Topic: Economics, Health, Health Care Policy, Economic Policy
  • Political Geography: United States
  • Author: David P. Adams, Meriem Doucette, Justin Tucker
  • Publication Date: 06-2019
  • Content Type: Journal Article
  • Journal: California Journal of Politics and Policy
  • Institution: Institute of Governmental Studies, UC Berkeley
  • Abstract: This paper explores the engagement and mobilization of an affluent community in relation to a known environmental hazard. It extends our understanding of individual responses to environmental risk and provides at least one response to the long-unanswered question: how would affluent communities respond to hazardous sites? Despite the contention that these resource-rich communities will respond differently than the less affluent communities that traditionally have these environmental hazards, we find no meaningful difference in their mobilization and engagement. Despite their perception of risk associated with the Ascon landfill in Huntington Beach and relatively little trust in government to clean up the site, the community is largely unwilling to engage in activities related to site cleanup. This is an important contribution to our understanding of what generates individual action for environmental hazards and compels us to re-examine our understanding of what (if any) role socio-economic status plays in an individual’s response.
  • Topic: Environment, Health, Public Health
  • Political Geography: United States, California
  • Author: Marie L. Mallet, Lisa Garcia Bedolla
  • Publication Date: 06-2019
  • Content Type: Journal Article
  • Journal: California Journal of Politics and Policy
  • Institution: Institute of Governmental Studies, UC Berkeley
  • Abstract: This paper examines the effects of the rescission announcement of the DACA program on the health outcomes of Latino DACA recipients in California. Research shows that undocumented immigrants face poorer health outcomes than their documented counterparts and U.S. citizens, and that being offered legal status (e.g. DACA) considerably improves their health outcomes. Even though studies have examined the impact of shifting legal status on incorporation, to our knowledge no studies have considered the effects of announcing the rescission of the DACA program on its recipients. However, this is important because it may have implications on their health outcomes. This study addresses this gap by using in-depth interviews with 43 Latino DACA recipients living in the California San Francisco Bay Area in 2017 and 2018. Our findings suggest that rescission announcement of DACA has led to worsening health outcomes for DACA recipients. Specifically, we find that it created what we call a state of transitory legality among the 1.5 generation, which causes DACA recipients to experience health outcomes that are worse than those before DACA. Our results are important in the field of sociology, public policy and heath care because they show the negative effects of reversing inclusionary immigration policies on the health outcomes of undocumented Latino immigrants.
  • Topic: Health, Immigration, Citizenship, Immigrants, Public Health
  • Political Geography: United States, California
  • Author: Moises Rendon, Mark L Schneider
  • Publication Date: 03-2018
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: The Issue Venezuela has been subjected to an unprecedented man-made humanitarian crisis, including extreme food and medicine shortages, thousands of children dying of malnutrition, and malnourished people contracting formerly eradicated diseases. While Venezuela’s dictatorial regime has repeatedly rejected humanitarian aid from the outside, the country’s humanitarian, economic, social, and institutional collapse, along with fierce political repression, have caused 1.2 million Venezuelans to flee the country over the past two years, with hundreds of thousands more and possibly millions expected to flee in the future. Our Recommendations Encourage the United States and other like-minded countries to provide leadership on the diplomatic and assistance fronts to help respond to this crisis. Work to build consensus within the international community on the urgency of the Venezuelan humanitarian crisis and to agree on steps to address the crisis, including convening a high-level task force. Develop a comprehensive policy response that includes immediate relief efforts on Venezuela’s border with Colombia and within Venezuela using innovative mechanisms due to the current limited humanitarian access. Provide immediate technical assistance to help estimate the level of need and identify available resources. Support and engage civil society and local actors, including nongovernmental organizations (NGOs), the private sector, and entrepreneurs, as well as the Venezuelan diaspora community, to help limit the suffering of the Venezuelan people. Encourage host countries to grant temporary protected status to Venezuelans and create a broader burden-sharing arrangement in the region for processing those seeking refuge, following the recent guidelines by the UN High Commissioner for Refugees (UNHCR). Support the use of innovative technology tools, such as blockchain and digital currencies, to facilitate distribution of aid within and beyond Venezuela.
  • Topic: Health, Poverty, United Nations, Food, Humanitarian Crisis
  • Political Geography: United States, South America, Venezuela
  • Author: Sevgi BALKAN-ŞAHİN
  • Publication Date: 10-2018
  • Content Type: Journal Article
  • Journal: Alternative Politics
  • Institution: Department of International Relations, Abant Izzet Baysal University, Turkey
  • Abstract: The Doha Ministerial Declaration on the Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement and Public Health adopted in November 2001 clarified the right to use the TRIPS flexibilities to promote public health. Examining the hegemonic struggle of opposing social forces from a neo-Gramscian perspective, the paper attributes this outcome to the strategy of trasformismo used by market-oriented social forces to legitimize the policies of the World Trade Organization (WTO) and prevent resistance against the market-driven TRIPS Agreement. It argues that although non-governmental organizations (NGOs) such as Medecins Sans Frontieres, Third World Network, and Oxfam worked as a counter-hegemonic force to ensure the access of least developed countries to generic versions of patented drugs, flexibilities confirmed by the Doha Declaration can be seen more as a strategy of trasformismo to absorb counter-hegemonic ideas than the counter-hegemonic groups’ successful incorporation of the right to ensure public health into the TRIPS Agreement.
  • Topic: Health, World Trade Organization, Hegemony, Health Care Policy, NGOs, Public Health
  • Political Geography: United States, Europe, Asia, North America
  • Author: Susie Kilshaw
  • Publication Date: 01-2018
  • Content Type: Book
  • Institution: Berghahn Books
  • Abstract: Gulf began to surface. This mysterious illness was given the name “Gulf War Syndrome” (GWS). This book is an investigation into this recently emergent illness, particularly relevant given ongoing UK deployments to Iraq, describing how the illness became a potent symbol for a plethora of issues, anxieties, and concerns. At present, the debate about GWS is polarized along two lines: there are those who think it is a unique, organic condition caused by Gulf War toxins and those who argue that it is probably a psychological condition that can be seen as part of a larger group of illnesses. Using the methods and perspective of anthropology, with its focus on nuances and subtleties, the author provides a new approach to understanding GWS, one that makes sense of the cultural circumstances, specific and general, which gave rise to the illness.
  • Topic: Health, Gulf War, Masculinity , PTSD
  • Political Geography: United States, Iraq, United Kingdom, Europe, Middle East
  • Author: Sara R. Collins, Shanoor Seervai, Roosa Tikkanen, Munira Z. Gunja
  • Publication Date: 12-2018
  • Content Type: Special Report
  • Institution: Commonwealth Fund
  • Abstract: Women in the United States have long lagged behind their counterparts in other high-income countries in terms of access to health care and health status. This brief compares U.S. women’s health status, affordability of health plans, and ability to access and utilize care with women in 10 other high-income countries by using international data.
  • Topic: Health, Health Care Policy, Women, Reproductive Health
  • Political Geography: United States, Global Focus
  • Author: Amanda Michaud, David Wiczer
  • Publication Date: 12-2018
  • Content Type: Working Paper
  • Institution: Centre for Human Capital and Productivity (CHCP), Western University
  • Abstract: We evaluate the contribution of changing macroeconomic conditions and demographics to the increase in Social Security Disability Insurance (SSDI) over recent decades. Within our quantitative framework, multiple sectors differentially expose workers to health and economic risks, both of which affect individuals’ decisions to apply for SSDI. Over the transition, falling wages at the bottom of the distribution increased awards by 27% in the 1980s and 90s and aging demographics rose in importance thereafter. The model also implies two-thirds of the decline in working-age male employment from 1985 to 2013, three-fourths of which eventually goes on SSDI.
  • Topic: Economics, Government, Health, Disability, Human Capital, Social Security, Insurance , Productivity, Health Insurance
  • Political Geography: United States
  • Author: Guy-Lucien S. Whembolua, Donaldson Conserve, Daudet Ilunga Tshiswaka
  • Publication Date: 12-2017
  • Content Type: Research Paper
  • Institution: Ìrìnkèrindò: a Journal of African Migration
  • Abstract: African immigrants, one of the fastest-growing immigrant populations in the United States (U.S.), face many unique challenges. Since December 2013, the Ebola Virus Disease (EVD) has been claiming lives and altering the societies of origin of West and Central African immigrants. Using the PEN-3 cultural model, a thematic analysis of mainstream U.S. news media was conducted to assess the socio-cultural factors influencing EVD-related stigma experienced by African immigrants. Results of this analysis revealed the perceptions and enabling/nurturing factors that exacerbated or prevented EVD-related stigma. Future interventions designed to address stigma experienced by African immigrants should include EVD-related stigma.
  • Topic: Health, Migration, Infectious Diseases, Ebola
  • Political Geography: Africa, United States
  • Author: Shawn Bishop, David Squires, Dana O. Sarnak
  • Publication Date: 10-2017
  • Content Type: Special Report
  • Institution: Commonwealth Fund
  • Abstract: arious factors contribute to high per capita drug spending in the U.S. While drug utilization appears to be similar in the U.S. and the nine other countries considered, the prices at which drugs are sold in the U.S. are substantially higher. These price differences appear to at least partly explain current and historical disparities in spending on pharmaceutical drugs. U.S. consumers face particularly high out-of-pocket costs, both because the U.S. has a large uninsured population and because cost-sharing requirements for those with coverage are more burdensome than in other countries. Most Americans support reducing pharmaceutical costs. International experience demonstrates that policies like universal health coverage, insurance benefit design that restricts out-of-pocket spending, and certain price control strategies, like centralized price negotiations, can be effective.
  • Topic: Health, Health Care Policy, Drugs
  • Political Geography: United States, Europe, Global Focus
  • Publication Date: 09-2017
  • Content Type: Special Report
  • Institution: Commonwealth Fund
  • Abstract: Health care costs are heavily concentrated among people with multiple health problems. Often, these are older adults living with frailty, advanced illness, or other complex conditions. In 2014, the New York–based Commonwealth Fund, a private, independent foundation, established the International Experts Working Group on Patients with Complex Needs through a grant to the London School of Economics and Political Science. The group’s purpose was to outline the prerequisites of a high-performing health care system for “high-need, high-cost” patients and to identify promising international innovations in health care delivery for meeting needs of these patients. Drawing on international experience, quantitative and qualitative evidence, and its members’ collective expertise in policy and program design, implementation, and evaluation, the international working group sought to articulate the principles that underpin high performance for this complex population in health systems around the world.
  • Topic: Health, Health Care Policy
  • Political Geography: United States, Global Focus
  • Author: Michelle M. Doty, Arnav Shah, David Squires, Dana O. Sarnak, Eric C. Schneider
  • Publication Date: 07-2017
  • Content Type: Special Report
  • Institution: Commonwealth Fund
  • Abstract: The U.S. ranked last on performance overall, and ranked last or near last on the Access, Administrative Efficiency, Equity, and Health Care Outcomes domains. The top-ranked countries overall were the U.K., Australia, and the Netherlands. Based on a broad range of indicators, the U.S. health system is an outlier, spending far more but falling short of the performance achieved by other high-income countries. The results suggest the U.S. health care system should look at other countries’ approaches if it wants to achieve an affordable high-performing health care system that serves all Americans.
  • Topic: Health, Health Care Policy
  • Political Geography: United States, Global Focus
  • Author: Elias Mossialos, Ana Djordjevic, Robin Osborn, Dana O. Sarnak
  • Publication Date: 05-2017
  • Content Type: Special Report
  • Institution: Commonwealth Fund
  • Abstract: This publication presents overviews of the health care systems of Australia, Canada, China, Denmark, England, France, Germany, India, Israel, Italy, Japan, the Netherlands, New Zealand, Norway, Singapore, Sweden, Switzerland, Taiwan, and the United States. Each overview covers health insurance, public and private financing, health system organization and governance, health care quality and coordination, disparities, efficiency and integration, use of information technology and evidence-based practice, cost containment, and recent reforms and innovations. In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilization, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views.
  • Topic: Health, Health Care Policy
  • Political Geography: United States, Global Focus
  • Author: Dana O. Sarnak, Jamie Ryan
  • Publication Date: 01-2016
  • Content Type: Special Report
  • Institution: Commonwealth Fund
  • Abstract: U.S. health care costs are disproportionately concentrated among older adults with multiple chronic conditions or functional limitations—a population often referred to as “high-need” patients. This analysis uses data from the Commonwealth Fund 2014 International Health Policy Survey of Older Adults to investigate health care use, quality, and experiences among high-need patients in nine countries compared with other older adults. High-need patients use a greater amount of health care services and also experience more coordination problems and financial barriers to care compared with other older adults. Disparities are particularly pronounced in the United States. The comparative success of other countries, particularly in reducing financial barriers to care, may be a product of policies that specifically target high-need patients. Similarly focusing on these populations in the U.S. and effectively managing their care may improve their health status while reducing overall costs.
  • Topic: Health, Health Care Policy
  • Political Geography: United States, Global Focus
  • Author: Maxine Builder
  • Publication Date: 01-2015
  • Content Type: Working Paper
  • Institution: Atlantic Council
  • Abstract: Growing rates of antimicrobial resistance (AMR) pose a threat to public health that could undo many of the medical advances made over the last seventy years, eroding the global medical safety net and posing a significant threat to national security. Diseases once eliminated by a single course of antibiotics show drug resistance, often to several different classes of drugs. Some of the implications of increasing rates of AMR are intuitive, such as longer duration of illness, extended hospital stays, and higher rates of mortality. But other effects of a postantibiotics world are less obvious, such as the inability to perform life-saving operations or the ability for a simple scratch on the arm to kill. Humanity could soon find itself living in a reality in which communicable diseases such as tuberculosis, cholera, pneumonia, and other common infections cannot be controlled. This potentially catastrophic problem still can be abated, and the global health community, including the World Health Organization (WHO), has highlighted AMR as a priority in global health. But all sectors of the international community, not simply those in public health, need to take immediate steps to reverse the current trends and eliminate the systematic misuse of antimicrobial drugs, especially in livestock, and restore the pipeline of new antimicrobial drugs. The significant health and economic costs of AMR are difficult to quantify due to incomplete data that often underreports the extent of the problem, since there are no standard metrics or consensus on methodology to measure rates of AMR. But even the piecemeal statistics that exist paint a bleak picture. In a 2013 report, the US Centers for Disease Control and Prevention (CDC) reports at least two million Americans acquire serious infections to one or more strains of AMR bacteria annually, and at least 23,000 people die of these infections.1 A 2008 study estimated the excess direct costs to the US medical system attributable to AMR infections at $20 billion, with additional estimated productivity losses to be as high as $35 billion.2 With the increase in resistant infections and continuing rise in medical costs, the cost to the American medical system no doubt also has increased. This trend is not a uniquely American problem; it is truly global in scope. The European Union (EU) reports about 25,000 deaths annually due to drug-resistant bacteria, at an overall, combined cost of $2 billion in healthcare costs and productivity losses.3 There were over 14.7 million incidents of moderate-to-severe adverse reactions to antibiotics each year between 2001 and 2005 in China. Of these, 150,000 patients died annually.4 The most recent available data on China estimates that treatment of AMR infections during that same time period cost at least $477 million, with productivity losses of more than $55 million each year.5 A 2005 study of the United Kingdom (UK) found that the real annual gross domestic losses due to AMR were between 0.4 and 1.6 percent.6 Although slightly outdated, this estimate may be a useful guide in assessing the global impact of AMR, and given the trend of increasing resistance, it is likely that the impact will also increase accordingly. That said, it is prudent to repeat that the disparities in the quality of data reporting standards across China, the United States, the United Kingdom, and the European Union make it difficult to directly compare the severity of the impacts AMR has on each entity. The primary cause of AMR globally is antibiotic overuse and misuse, be it from doctors inappropriately prescribing antibiotics to treat viral infections or individuals seeking over-the-counter antibiotics for self-treatment. But another driver, less obvious than overuse in humans, is the use of antimicrobials in livestock, and the ratio of use in animals as compared to humans is astounding. In the United States, about 80 percent of all antibiotics are consumed in either agriculture or aquaculture. Generally, these drugs are administered to livestock as growth promoters and are medically unnecessary. Resistance in livestock quickly spreads to humans, and many community-acquired infections are the result of a contaminated food supply. Although most infections are acquired in the community, most deaths attributed to resistant infections occur in healthcare settings, and healthcare-acquired (or nosocomial) infections are another driver of AMR. At this point, AMR does not pose an immediate and direct threat to national security. Rather, this is a creeping global security crisis. If current trends continue, these drugs upon which the world relies will lose effectiveness. The gains made in fighting infectious diseases will be reversed, and a wide range of routine surgeries and easily treatable infections will become much more dangerous and deadly. This will cause the health of the world's working population to deteriorate, and the economic productivity and social cohesion of the globe to decline. At any time, a “black swan” event—triggered by an outbreak of drug-resistant tuberculosis, cholera, or pneumonia, for example—could prove catastrophic, endangering the fabric of societies and our globalized economy, forcing a stop to international trade and travel to prevent further spread. The issue of AMR is a tragedy of the commons in which individual incentives lead to the overuse and eventual destruction of a shared resource. International cooperation is required to walk back from this ledge and avoid a postantibiotics world, even though it is impossible to completely reverse the damage already done.
  • Topic: Health, National Security, Infectious Diseases, Health Care Policy
  • Political Geography: United States, China, United Kingdom, America, Europe
  • Author: Judyth L. Twigg
  • Publication Date: 03-2014
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: Over the last few years, Russia's relationship with the United States has traveled a swift and seemingly deliberate arc from partner to pariah. The current turmoil in Ukraine and near-certain resulting isolation of Russia culminate several years' worth of deteriorating ties. The Edward Snowden mess, disagreements over Syria and Iran, dismay over the eroding human rights environment in Russia, and now Russian annexation of Crimea have led the previously heralded "reset" to an unceremonious end. What are the implications of these and related developments for U.S.-Russia collaboration in medicine and public health? Should avenues of partnership remain open, even in such a frosty political context? Should the international community support Russia's health sector when ample resources exist within Russia itself? Is it even possible anymore?
  • Topic: Development, Diplomacy, Economics, Health, Human Rights, Human Welfare, Bilateral Relations
  • Political Geography: Russia, United States, North America
  • Author: Janet Fleischman, Alisha Kramer
  • Publication Date: 04-2014
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: For decades, the United States has been the global leader in supporting voluntary family planning services around the world. The benefits of family planning are numerous, not only for women's health, but also for increasing child survival, nutrition, education, and economic development, as well as preventing mother-to-child transmission of HIV. For these reasons, family planning is a core component of sustainable development.
  • Topic: Health, Foreign Aid, Health Care Policy
  • Political Geography: Africa, United States
  • Author: Katherine E. Bliss
  • Publication Date: 04-2014
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: Toward the end of 2014, the Global Alliance for Vaccines and Immunisation (GAVI) will host a pledging conference to generate funds for activities to be carried out during 2016–2020.
  • Topic: Diplomacy, Health, Foreign Aid
  • Political Geography: United States
  • Author: Katherine E. Bliss, Cathryn Streifel
  • Publication Date: 11-2014
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: In June 2014, a small team from the CSIS Global Health Policy Center traveled to Ghana to examine U.S. bilateral support for maternal, neonatal, and child health (MNCH). The purpose of the trip was to plan a return visit with a delegation of U.S. congressional staff in August 2014. Ghana's mixed progress toward meeting Millennium Development Goals (MDG) 4 and 5 related to maternal and child health; its strong relationship on immunizations with Gavi, the Vaccine Alliance; and its longstanding partnership on health with the United States were all reasons we decided to examine the country's MNCH situation. By late July, the acceleration of the Ebola outbreak in West Africa led us to postpone the trip until emergency preparations are not a major focus of the Ghanaian government, the United States, and other partners. Considering the fruitful meetings we had in June, we have captured here some of our initial impressions, observations, and recommendations.
  • Topic: Health, Infectious Diseases, Foreign Aid
  • Political Geography: Africa, United States, Ghana
  • Author: Mark Fukuda, Tom Cullison
  • Publication Date: 12-2014
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: In the Greater Mekong Subregion (GMS), militaries remain essential to any effort to control and eliminate artemisinin-resistant malaria. Stretching back to World War II and the Vietnam War, the U.S. Department of Defense (DoD) has a long and distinguished history researching and developing new tools for malaria control, in partnership with both military and civilian host government experts. Since the mid-1990s, DoD has significantly expanded its global surveillance, training, and capacity - building investments. As Southeast Asian countries have mobilized in recent years against artemisinin-resistance with the ultimate aim of malaria elimination, DoD and regional militaries have actively joined the effort, initiating promising pilot approaches in Southeast Asia. To strengthen DoD's contribution, it is proposed that the United States launch a Defense Malaria Elimination Program that will significantly enhance partner militaries' capacities, advance the goal of elimination, including the threat of resistance, and accelerate the development of drugs and vaccines.
  • Topic: Defense Policy, Health, Humanitarian Aid
  • Political Geography: United States, Vietnam, Southeast Asia
  • Author: Christopher V. Plowe
  • Publication Date: 12-2014
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: The malaria parasite is thought to have killed more people throughout human history than any other single cause. Over the last decade, a large increase in resources for combating malaria — with the lion's share coming from U.S. taxpayers — has resulted in dramatic reductions in malaria cases and deaths in many countries. These successes spurred the Bill Melinda Gates Foundation and the World Health Organization (WHO) to call for global eradication of malaria in 2007.
  • Topic: Development, Health, Humanitarian Aid, World Health Organization, Infectious Diseases
  • Political Geography: United States
  • Author: William Savedoff, Victoria Fan
  • Publication Date: 03-2014
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Almost every country exhibits two important health financing trends: health spending per person rises and the share of out-of-pocket spending on health services declines. We describe these trends as a "health financing transition" to provide a conceptual framework for understanding health markets and public policy. Using data over 1995-2009 from 126 countries, we examine the various explanations for changes in health spending and its composition with regressions in levels and first differences. We estimate that the income elasticity of health spending is about 0.7, consistent with recent comparable studies. Our analysis also shows a significant trend in health spending - rising about 1 percent annually - which is associated with a combination of changing technology and medical practices, cost pressures and institutions that finance and manage healthcare. The out-of-pocket share of total health spending is not related to income, but is influenced by a country's capacity to raise general revenues. These results support the existence of a health financing transition and characterize how public policy influences these trends.
  • Topic: Development, Economics, Health, Governance
  • Political Geography: United States
  • Author: Jefferson Fox, Duong Nong, Miguel Castrence, James Spencer, Sumeet Saksena, Nguyen Lam, Tran Duc Vien, Michael Epprecht, Chinh Tran, Melissa Finucane, Bruce Wilco
  • Publication Date: 10-2014
  • Content Type: Working Paper
  • Institution: East-West Center
  • Abstract: Emerging infectious diseases (EIDs) continue to significantly threaten human and animal health. While there has been some progress in identifying underlying proximal driving forces and causal mechanisms of disease emergence, the role of distal factors is most poorly understood. This article focuses on analyzing the statistical association between highly pathogenic avian influenza (HPAI) H5N1 and urbanization, land-use diversity and poultry intensification. A special form of the urban transition—peri-urbanization—was hypothesized as being associated with 'hot-spots' of disease emergence. Novel metrics were used to characterize these distal risk factors. Our models, which combined these newly proposed risk factors with previously known natural and human risk factors, had a far higher predictive performance compared to published models for the first two epidemiological waves in Viet Nam. We found that when relevant risk factors are taken into account, urbanization is generally not a significant independent risk factor. However, urbanization spatially combines other risk factors leading to peri-urban places being the most likely 'hot-spots'. The work highlights that peri-urban areas have highest levels of chicken density, duck and geese flock size diversity, fraction of land under rice, fraction of land under aquaculture compared to rural and urban areas. Land-use diversity, which has previously never been studied in the context of HPAI H5N1, was found to be a significant risk factor. Places where intensive and extensive forms of poultry production are collocated were found to be at greater risk
  • Topic: Health, Infectious Diseases, Urbanization
  • Political Geography: United States, Asia
  • Author: Jonathan Weigel, Paul Farmer
  • Publication Date: 03-2014
  • Content Type: Journal Article
  • Journal: Americas Quarterly
  • Institution: Council of the Americas
  • Abstract: Haiti is currently battling the world's largest cholera epidemic in half a century. An integrated, comprehensive response—including case-finding and rapid treatment, water and sanitation efforts, and vaccination—could bring cholera to heel on Hispaniola and help prevent its spread elsewhere in the region.1 But the local and international response has, to date, fallen short. Tens of thousands of cases and hundreds of deaths were reported in May and June of this year.2 If the disease had appeared in the United States or elsewhere in the developed world, all available control tools would have been deployed. But the safe, effective and inexpensive cholera vaccine has only recently become available in Haiti. In April, the Haitian Ministry of Health and two healthcare nonprofits began delivering vaccines to about 91,000 people in rural and urban Haiti.
  • Topic: Development, Health
  • Political Geography: United States, Latin America
  • Author: Leighton Ku, Brian Bruen
  • Publication Date: 02-2013
  • Content Type: Working Paper
  • Institution: The Cato Institute
  • Abstract: Claims are sometimes made that immigrants use public benefits, such as Medicaid, the Supplemental Nutrition Assistance Program, or the Temporary Assistance for Needy Families programs, more often than those who are born in the United States. This report provides analyses, using the most recent data from the Census Bureau, that counter these claims. In reality, low-income non-citizen immigrants, including adults and children, are generally less likely to receive public benefits than those who are native-born. Moreover, when non-citizen immigrants receive benefits, the value of benefits they receive is usually lower than the value of benefits received by those born in the United States. The combination of lower average utilization and smaller average benefits indicates that the overall cost of public benefits is substantially less for low-income non-citizen immigrants than for comparable native-born adults and children. The report also explains that the lower use of public benefits by non-citizen immigrants is not surprising, since federal rules restrict immigrants' eligibility for these public benefit programs.
  • Topic: Economics, Health, Humanitarian Aid, Markets, Immigration
  • Political Geography: United States
  • Author: Katherine E. Bliss
  • Publication Date: 05-2013
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: Hopes are high for a successful outcome of the 2013 replenishment process, through which the Global Fund to Fight AIDS, Tuberculosis and Malaria seeks pledges of $15 billion to support planned activities for 2014-2016. Yet at a time when some experts argue it is finally possible to “turn the tide” on HIV/AIDS, malaria, and tuberculosis, it is unclear whether countries and other donors will pledge adequate funding to meet the revitalized Fund's replenishment goal. The United States has an essential leadership role to play in helping ensure a successful 2013 replenishment outcome. In the short term it must come through with a strong pledge of its own and engage diplomatically with a range of donor and beneficiary countries to demonstrate support for the organization. In the longer term the U.S. will need to work with the Fund and other governments to identify new ways for public and private-sector entities, as well as individuals, to support the Global Fund's work.
  • Topic: Diplomacy, Health, Humanitarian Aid, Foreign Aid, Health Care Policy
  • Political Geography: United States
  • Author: Janet Fleischman, Alisha Kramer
  • Publication Date: 05-2013
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: U.S. policymakers and private-sector partners increasingly appreciate the importance of targeted U.S. investments in women's health to achieve global health outcomes, especially in sub-Saharan Africa.With budgetary constraints worsening, progress in women's health will require maximizing investments by engaging new partners, identifying program synergies, and aligning with countries' national priorities to meet women's needs. Such strategic coordination—involving maternal newborn and child health, voluntary family planning, and HIV and AIDS services—presents new opportunities to expand the impact of U.S. investments.
  • Topic: Gender Issues, Health, Humanitarian Aid, Foreign Aid, Health Care Policy
  • Political Geography: Africa, United States
  • Author: Katherine Bliss (ed), Victor D. Cha
  • Publication Date: 05-2013
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: In the fall of 2012 the Center for Strategic and International Studies (CSIS) Global Health Policy Center organized a working group to analyze progress on diplomatic outreach to advance global health during the first four years of the Barack Obama administration. Over three sessions the working group members, who included health policy researchers, former diplomats, and an ex- officio group of current government officials, met to discuss emerging trends related to global health diplomacy and to develop a set of recommendations to enhance U.S. diplomatic outreach on global health for the next four years. Much of the working group's effort focused on the important role played by the secretary of state in raising the visibility of global health challenges on the world stage and on the Department of State's potential to promote greater coherence and integration of U.S. overseas health programs in the next presidential term.
  • Topic: Foreign Policy, Diplomacy, Emerging Markets, Globalization, Health, Health Care Policy
  • Political Geography: United States
  • Author: J. Stephen Morrison, Sharon Stash, Todd Summers
  • Publication Date: 03-2013
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: South Africa has the highest burden of HIV/AIDS in the world, with 5.6 million people living with the virus and over 400,000 newly infected annually. Since 2004, the U.S. government has committed more than $4 billion to combating HIV/AIDS in South Africa—the largest U.S. investment in HIV/AIDS worldwide. Continued progress in controlling HIV/AIDS in South Africa, the epicenter of the pandemic, is pivotal to sustained progress against the disease worldwide.
  • Topic: Foreign Policy, Health, International Cooperation, Bilateral Relations, Health Care Policy
  • Political Geography: Africa, United States, South Africa
  • Author: Conor M. Savoy
  • Publication Date: 12-2013
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: Foreign aid donors face a changed development landscape that necessitates a new approach to programming resources. In the last 20 years, countries across the developing world demo cratized, began to improve their governance, and experienced substantial economic growth. Yet, significant challenges remain that must be tackled, many of which fall within the governance and growth nexus. These issues—government effectiveness, rule of law, regulatory policies related to the business and investment climate, and barriers to entry to the formal economy—are the preeminent challenges to expanding broad- based economic growth and continuing to reduce global poverty. The United States needs to shift its focus away from meeting basic human needs toward broader institutional development if it is to increase support for the governance and growth nexus. U.S. foreign aid is overwhelmingly directed toward global health and the delivery of other public goods. This must change.
  • Topic: Security, Development, Education, Emerging Markets, Health, Poverty, Foreign Aid
  • Political Geography: United States, United Kingdom
  • Author: David Nusbaum
  • Publication Date: 10-2013
  • Content Type: Policy Brief
  • Institution: Belfer Center for Science and International Affairs, Harvard University
  • Abstract: Nuclear research reactors are used in many countries for many different purposes. Most of the reactors are used for research (mainly in physics), training for nuclear operators and engineers, materials testing in radiation conditions, or the production of radioiso¬topes for medicine and industry. Some countries, like Iran, are building new reactors ostensibly to fill these needs. Many of these reactors operate with highly enriched uranium (HEU) nuclear fuel — in most cases, enriched to around 90 percent, the same as fuel for nuclear weapons. The production and fabrication of HEU fuel, and the handling, transport, and storage of both fresh and spent fuel containing HEU entails considerable proliferation, security, and safety risks as well as very high costs. The global stockpile of highly enriched uranium was about 1500 tons in 2012, which was enough for more than 60,000 simple, first gen¬eration implosion weapons. About 98 percent of this material is held by the nuclear weapon states, with the largest HEU stockpiles in Russia and the United States.
  • Topic: Security, Education, Energy Policy, Health, Nuclear Power
  • Political Geography: Russia, United States, Iran
  • Author: Arnold A. Chacon
  • Publication Date: 04-2013
  • Content Type: Journal Article
  • Institution: Council of American Ambassadors
  • Abstract: From the United Nations Security Council (UNSC) and the Organization of American States (OAS) to regional law enforcement and counternarcotics cooperation, Guatemala is emerging as a key actor. It is a willing partner with the United States in six US presidential priority initiatives: improving food security, preventing HIV/AIDS, mitigating the impact of climate change, and promoting health, citizen security, and educational exchanges.
  • Topic: Security, Climate Change, Health
  • Political Geography: United States, America
  • Author: John L. Kokulis
  • Publication Date: 10-2013
  • Content Type: Working Paper
  • Institution: American Enterprise Institute for Public Policy Research
  • Abstract: The rise in military health care spending has been a primary driver of the large growth in military personnel compensation over the past decade. Left unchecked, these costs will impact the ability of the DoD's Military Health System (MHS) to support its three critical missions: 1. Readiness for deployment: Maintaining an agile, fully deployable medical force and a health care delivery system so they are capable of providing state-of-the-art health services anytime, anywhere; 2. Readiness of the fighting force: Helping commanders create and sustain the most healthy and medically prepared fighting forces anywhere; and 3. The benefits mission: Providing long-term health coaching and health care for 9.7 million DoD beneficiaries.
  • Topic: Defense Policy, Economics, Health, Governance
  • Political Geography: United States
  • Author: Tetsuji Yamada, Chia-Ching Chen, Chie Hanaoka, Seiritsu Ogura
  • Publication Date: 08-2013
  • Content Type: Working Paper
  • Institution: Walter H. Shorenstein Asia-Pacific Research Center
  • Abstract: Background: For the past two decades, more and more women in certain European countries, Japan, and the United States are giving birth to their first child at a considerably later age than ever before. It remains unclear as to what extent this age-related general fertility decline is affected by changing social and cultural norms. Method: The Global Centers of Excellence Survey was conducted by Osaka University in Japan (n=5313) in 2009. Multivariate regression analyses were conducted to examine the impact of psychosocial norms, cultural differences, and economic conditions on the perception of childbearing. Results: The findings suggest that a subjective measure of happiness has a significant influence on childbearing. A society with income inequalities between classes discourages childbearing. It is observed that women's higher labor force participation generates a negative impact on motherchild relations which causes discouragement of childbearing. A higher female labor force participation stemmed from a transition of a traditional society into a modern and marketoriented society discourages childbearing. Conclusions/implications: A woman's decision to delay childbearing is based on her perception of psychosocial norms with surrounding economic environment and her own value of opportunity in the market oriented society. Childbearing also imposes psycho-economic burdens on the working population under mix of a traditional, patriarchal society, and a modern market oriented framework. Childbearing incentives could be a strategic policy to encourage positive attitudes of childbearing in general and proper welfare policy, labor law(s), employment conditions, and social security system for a working mother with a child or children.
  • Topic: Economics, Gender Issues, Health, Poverty, Social Stratification, Labor Issues
  • Political Geography: United States, Japan, Europe, Israel, Asia
  • Publication Date: 09-2013
  • Content Type: Working Paper
  • Institution: Aspen Institute
  • Abstract: In many respects, the U.S. health care system is breathtakingly innovative. It produces new technology, medical procedures, and scientific knowledge at a dazzling speed, enabling patients to recover from diseases and injuries once thought incurable or untreatable. As a consequence, the U.S. has one of the highest survival rates for cancers, excels at acute and trauma care, and has produced half of the world's Nobel laureates.
  • Topic: Economics, Health, Social Stratification, Governance
  • Political Geography: United States
  • Author: Jagadeesh Gokhale
  • Publication Date: 11-2012
  • Content Type: Working Paper
  • Institution: The Cato Institute
  • Abstract: Official federal budget accounts are constructed exclusively in terms of current cash flows – receipts from taxes and fees and outlays on purchases and transfers. But cash-flows do not reveal economically relevant information about who benefits and who loses from government policies. Cash flows also do not reveal how changes in government's policies redistribute resources within and across generations, including reducing the tax burden on today's generations and increasing it on future ones. Because most government transact ions are targeted by age and gender, the federal government can bring about large resource transfers across generations. Intergenerational resource transfers will grow larger as the composition of budget receipts and expenditures changes with relatively faster growth of age-and-gender-related social insurance program. Intergenerational redistributions across generations through federal government operations could substantially affect different generations' economic expectations and choices and exert powerful long-term effects on economic outcomes.
  • Topic: Economics, Government, Health, Human Welfare, Markets, Monetary Policy
  • Political Geography: United States
  • Author: Katherine E. Bliss
  • Publication Date: 03-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: In 1985, four years after the U.S. Centers for Disease Control and Prevention (CDC) published a notice in the Morbidity and Mortality Weekly Report regarding unusual clusters of disease in young, otherwise healthy, gay men in California and New York, more than 2,000 scientists from around the world assembled at the World Congress Center in Atlanta to exchange research and compare notes on what had come to be known as Acquired Immune Deficiency Syndrome, or AIDS. There have been 18 international AIDS conferences since that initial gathering, in locales ranging from Amsterdam and Florence to Durban and Mexico City. These conferences, which have been organized since 1988 by the International AIDS Society, have evolved from modest- sized meetings of scientists and researchers to multitrack, week-long conventions attracting more than 20,000 delegates, including heads of state, celebrities, philanthropists, researchers, activists, and people living with the human immunodeficiency virus (HIV) and AIDS.
  • Topic: HIV/AIDS, Health, International Cooperation, Infectious Diseases
  • Political Geography: United States
  • Author: Janet Fleischman
  • Publication Date: 07-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: The dual global epidemics of HIV/AIDS and gender - based violence (GBV) exert a destructive and disproportionate impact on women and girls, especially in high HIV - prevalence countries in Africa. Yet despite bipartisan political consensus on the intersection between HIV and GBV, efforts to address this area have not attracted the attention or resources necessary to drive the program innovation that could demonstrate progress. However, new momentum is now being brought to this agenda with the U.S. President ' s Emergency Plan for AIDS Relief ' s (PEPFAR) GBV initiative. Although still early in implementation and facing many challenges, the GBV initiative has the potential to yield important lessons about synergies and cost - effectiveness in reducing GBV and HIV, with clear implications for U.S. global health investments.
  • Topic: Gender Issues, Globalization, Health
  • Political Geography: United States
  • Author: Janet Fleischman
  • Publication Date: 06-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: Each day, nearly 800 women die around the world from complications in pregnancy or childbirth. That's one woman losing her life, every 100 seconds, every day. And while, from 1990 to 2010, global maternal mortality rates declined by roughly 47%, from about 546,000 to 287,000, the regional disparities are enormous: 85% of all maternal deaths occur in sub-Saharan Africa and South Asia—and more than half of these occur in sub-Saharan Africa. These deaths are largely preventable with interventions and training to address complications such as hemorrhage, infection, and obstructed labor, and more broadly with increased access to reproductive health services.
  • Topic: Foreign Policy, Health, International Affairs, Foreign Aid, Health Care Policy
  • Political Geography: Africa, United States, South Asia
  • Author: Pieter Fourie
  • Publication Date: 06-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: When the Group of Eight (G-8) industrialized countries decided at their 2001 meeting in Genoa to establish the Global Fund to Fight AIDS, Tuberculosis, and Malaria to increase international funding for interventions against the three diseases, the United States was a leading supporter. The fund was a public-private partnership set up in 2002 with formal status as a foundation under Swiss law. In the fund's first two years, the United States accounted for nearly half the total amount pledged and challenged other donors to increase their contributions. By 2008 the Global Fund had committed $15.6 billion to AIDS activities in 140 country.
  • Topic: Foreign Policy, Government, Health, Health Care Policy
  • Political Geography: United States, South Africa
  • Author: Katherine E. Bliss, Paulo Buss, Felix Rosenberg
  • Publication Date: 09-2012
  • Content Type: Working Paper
  • Institution: Center for Strategic and International Studies
  • Abstract: On November 7, 2011, the Global Health Policy Center of the Center for Strategic and International Studies (CSIS) in Washington, D.C., in partnership with the Fiocruz Center for Global Health (CRIS) in Rio de Janeiro, Brazil, hosted a seminar entitled “New Approaches to Global Health Cooperation.” The event, which took place in Rio de Janeiro, assembled health policy researchers and practitioners from Brazil, Europe, the United States, and sub - Saharan Africa to examine emerging practices in global health co operation. Issues considered included the factors driving greater international engagement on public health challenges, the growing trend of trilateral cooperation, and the role of the BRICS (Brazil, Russia, India, China, and South Africa) and South - South activities in expanding international cooperation on global health. Over the course of the day - long meeting, speakers and audience members examined the reasons for the overall expansion of funding and programming for overseas global health activities durin g the past decade; considered the factors that underpin Brazil's increasing focus on global health as an area of bilateral and multilateral outreach; reviewed the characteristics of successful trilateral cooperation efforts; and debated the future of multi country engagement on health.
  • Topic: Development, Emerging Markets, Health, Health Care Policy
  • Political Geography: Africa, Russia, United States, China, Europe, Washington, India, South Africa, Brazil, Latin America