Archive for One World Health

The world is changing – will your PhD matter?

At the dawn of the Sustainable Development Goals (SDGs) – which ushers in 17 new goals in a global agenda to “end poverty, protect the planet, and ensure prosperity for all”, most countries will be realigning their national development goals to be in tune with these global goals to realize specific targets over the next 15 years. As a researcher, one thing will soon become obvious in the midst of this global effort to bring about change – that is future research grants will be awarded primarily around these 17 SDG goals. An important question – “how your research fits in this global agenda?” arises for you and other PhD researchers who will soon be applying for these grants to drive your respective fields forward with whatever piece of the bigger science puzzle you will be solving.

It will not be an easy task to find one’s footing in the fast changing terrain of global goals and priorities, and Dr Liz Grant of the Global Health Academy at Edinburgh University is not shy to point this out. But, thankfully, not without some pointers to a way forward. Dr Grant has had extensive research experience at the level of Global Health with her many years of research in palliative care around the globe. In her talk on the ‘Impact of PhD Researchers on Global Health’ which she delivered at the Global Health PhD Network event in October 2015, she had a lot to share.

In a talk that was neatly supplemented with real life examples of her own research, Dr Grant carefully led the thoughts of the PhD researchers in the room on a number of issues, which in her opinion will soon become important in their researching career in the light of the new SDGs.

Top of her list was the need for PhD researchers to start thinking of where to find other pieces of evidence for their research. “What matters in your PhD”, she said, “is pulling materials from connected disciplines and connected areas and making sure you draw them in – use the materials out there…network pieces of information together”. In truth, that is how science works in our day through extensive bridge building across multiple disciplines and you probably have come across this a number of times already in your field. The rewards of this approach is long term and may not be immediate which in the little time space of a PhD makes it appear impractical. But in Dr Grant’s view, your research questions are still questions because there have not been enough conversations around them for others before you to have answered them. This is a brilliant way to look at things because in a way it challenges you to start expanding the discourse around your research to span more than just the area of your interest, to generate interest in other relevant fields.

But what good might all that knowledge you obtain as a result be, if not for the good of mankind. “Knowledge for knowledge sake is wonderful”, she says, “but knowledge to make a difference is why you are here and why I am here and why the university is here”. The message here is pretty simple – don’t let your PhD be only just another addition to the vast collection of information sitting on shelves around the world and only collecting dust. But it should be one that works and makes a difference. And she thinks you can achieve this by starting to think about your PhD research in terms of who the constituents are (i.e. those directly affected by what you are doing), how you will engage the public on important issues like the burden of the problem you are dealing with or trying to help solve, and also the economics involved and equally importantly why your research needs to be prioritised in the face of other competing research.

Huge task, but is it beyond you? Of course not. A big step forward in making any of the impact that would make your PhD research matter is through advocacy. Because the impact is kind of often seen through advocacy, she said, in doing things like, writing blogs, getting local workshops, and communicating what you are studying to people who have the connections to make things work. “People built systems and people can take it down,” she says in reference to the perpetual ‘brick walls’ of resistance that bureaucracies will mount on your path. Keep talking to as many people as possible and never ever underestimate the power of networking because you can change things in partnerships.

In bringing all this home, Dr Grant urges PhD researchers to think once again about their PhD and ask themselves what are the core components of what they are doing. For instance in her own research in palliative care then this would be about the core components of a health care system. Ask yourself if your research is around the core components. If not, what can you do to create the conditions necessary for change? Are you getting the right materials at the right time to create these conditions? And will these conditions support a sustainable system? Also what is the national architecture like in your country that will mean your piece of research can fit in. Answers to these questions and a lot more which couldn’t fit in this piece are what in Dr Grant’s expert opinion would make your PhD make an impact.

“Never forget why we research, you and I – it’s our communities, it’s our families, it’s people.” Dr Liz Grant

Dr Grant’s talk was preceded by a lively PhD poster session that saw four PhD students from the University of Edinburgh present their research work from four different regions around the globe. The first poster by Sara Valencia looked at vaccine trials in Southern and Central America (Colombia, Brazil and Mexico). A second poster that looked at the prevalence of Non-communicable Diseases and the entitlement to and the use of health services in the Gaza strip was presented by Majdi Ashour. Mkululi Wami presented the findings of a research work he carried out in Sub Saharan Africa in Zimbabwe which used antibody responses based on parasite egg counts to estimate infection prevalence of schistosomiasis in young children. The last poster was presented by Ai Oishi on a research that sort to identify patients for palliative care approach in primary care settings in Japan.

The Global Health PhD Network started, in October 2014, as a student-driven interest group within the Global Health Society, University of Edinburgh, with the express aim of bringing together like-minded postgraduate researchers from the three colleges in the university for research sharing, knowledge and skills exchange, networking and shared global health career development. The Network has hosted a series of events during the past year to bring together PhD researchers in the university to listen to and to share thoughts on important issues surrounding global health. And their most recent event (the one I just described) was yet another opportunity for the Network to reiterate its vision of creating an environment that supports and promotes cross-disciplinary networking by inviting PhD poster presenters from all three colleges of the university.

Again, looking back at some of the key points in Liz’s talk on the importance of networking and advocacy for PhD researchers, you realise that the Global Health PhD Network has its priorities well placed, doing things right as it should be and is already on the right bus into the future.


Richard F Oppong, Institute of Evolutionary Biology, University of Edinburgh

Calling for a stronger climate and health nexus within the UNFCCC

From 1-11th June I was part of the International Federation of Medical Students Association’s (IFMSA) delegation at the UNFCCC intersessional’s in Bonn. The IFMSA has been engaging diligently in the UNFCCC process for over 5 years working to reinforce the climate and health nexus within the negotiating text. Our efforts have been greatly appreciated by delegates and the global climate policy community, as there is a relatively small health community engaging with the UNFCCC, despite the recognition that climate change is the “greatest threat to global health of the 21st century” (1). Last December, our work was rewarded in the Lima Call for Action where health was placed firmly in the preamble of the text (2). We entered these intersessionals with positive spirits, due to recent successes of the World Health Assembly, which took place in Geneva the previous week. This resulted in a resolution on the public health dangers of air pollution and the need to phase out fossil fuels in order to both tackle ill-health from pollution and reap co-health benefits of climate change mitigation (3). However, as we head towards COP21 in Paris, which aims to produce a legally binding global agreement, there is concern that the need to dramatically shorten the text will force certain issues into the side-lines. Our aim from now until Paris is to use the contacts we have made at these intersessionals and previous COPs to coordinate a larger coalition of countries that will provide a strong position on health in the new global agreement.

This was my first experience as a delegate at the UNFCCC, and despite not having particularly high expectations, I must admit that the pace of the talks was even slower than I had expected. Negotiations hardly got further than discussing commas and brackets and how these could be used to shorten the text from its former 96 pages to something more manageable. However, after day 6 they had only managed to cut this down to 86 pages, and nothing of the substance of the text had even begun to be discussed. This was frustrating for many of the organisations who had come to lobby delegates on a breadth of issues which need to be included within the text such as human rights, intergenerational equity, gender and health. Being part of the youth constituency, I found there were many barriers to prevent our voices being fully considered. From informing us of interventions less than hour before, not providing adequate translation services, giving us interventions only at the end of sessions and forcing our creative actions to be within strict rules and regulations; our opportunity to represent young people, who are going to be most impacted by the decisions, was severely restricted. The lack of representation of the Global South also made me question the legitimacy of the process. How are we supposed to go about constructing effective policy solutions when those suffering the most from climate change are not represented? Of course, this is not an issue unique to climate change policy, but to witness this stark injustice in reality was a powerful reminder of the need for change.

After spending the past year being involved with local and national action on climate change and health, the pace and level of engagement at these high level negotiations was at best disheartening. It is clear we cannot wait upon the UN to ensure effective solutions to the impending and already tangible impacts of climate change. Whilst the IFMSA and others will continue to be at the forefront of ensuring a legally binding and successful agreement that will protect and promote global health, we rely upon a forward thinking global health community to implement solutions in their own communities. This needs to go beyond acknowledging the intersections between ecology and health towards being part of the structural change needed to ensure a sustainable and healthy future.

This is a critical year for climate action and the implications of inaction on our health and our future is unprecedented. I hope to continue to work within the UNFCCC, but also to bridge the gap between this process and community action which is a key part to building climate resilience. Through attending several side events during the conference I also found that public health provided an important and coherent narrative in which to address a wide range of climate change issues from food and water scarcity, air pollution, occupational and community health surround fossil fuel extraction, transitions towards sustainable active transport and rising infectious diseases in crops, livestock and people. It was clear that health is a powerful tool to provide an anchor of agreement in the UNFCCC, as well as provide a lens to engage a breadth of people with climate change. I look forward to tracking the progress of the UNFCCC and hope that an agreement in Paris will be reached that will mobilise the diverse and collaborative movement needed to save human and ecological life on this planet.


References

Costello (2009) Managing the health effects of climate change. The Lancet [pdf] https://www.ucl.ac.uk/global-health/project-pages/lancet1/ucl-lancet-climate-change.pdf

Lima Call for Action: http://unfccc.int/files/meetings/lima_dec_2014/application/pdf/auv_cop20_lima_call_for_climate_action.pdf

World Health Organisation (2015) World Health Assembly closes, passing resolutions on air pollution and epilepsy [online] Available at: http://www.who.int/mediacentre/news/releases/2015/wha-26-may-2015/en/


ADP2.9: Last Updates from the IFMSA Delegation

ADP2.9: Updates from the ADP 2.9 United Nations Climate Change Conference

ADP2.9 – Meet the IFMSA Delegation!


 

Eleanor Dow – Medical student at the University of Edinburgh and coordinator of Healthy Planet UK, a network of students raising awareness of the links between climate change and health.

http://www.healthyplanetuk.org/

 

Zoonotic diseases neglected for decades.

As part of a study to analyse changes in global health priorities at the global level of the resolutions adopted at the World Health Assembly – the decision making body of the WHO – the relative neglect of endemic zoonotic diseases has been highlighted. This work has recently been published in PLOS NTDs, and has received widespread media attention.

The eight diseases of interest (anthrax, bovine tuberculosis, brucellosis, cysticercosis, echinococcosis, human African trypanosomiasis (HAT), leishmaniasis, rabies) are part of the group termed Neglected Zoonotic Diseases (NZDs) at an international meeting in 2005, so called as they are “not adequately addressed” at national and international levels. Zoonotic diseases are defined as diseases that are transmissible between humans and animals.

In the last decade, the Neglected Tropical Diseases (NTDs) have received increased global attention, and recent events celebrated the increased advocacy and control that has occurred. The research highlighted that these diseases have received relatively little attention at the global policy level, living up to their neglected title. In developing countries where these diseases remain endemic and resources are limited, the control of these diseases is limited as other high profile diseases are prioritised.

Some of the diseases have high fatality and cause a high number of deaths globally each year. For example, rabies causes an estimated 60,000 deaths worldwide, yet this disease remains neglected despite evidence that the disease can be effectively controlled through dog vaccination.

Neurocysticercosis is the greatest cause of preventable epilepsy worldwide, causing an estimated 30% of the 17 million cases of epilepsy in areas where the causative parasite is endemic. This disease can be controlled through sanitation and improved pig husbandry, and improved diagnosis of human infection, requiring a multi-sector approach.

Following the London Declaration on NTDs, there has been increased focus on NTD control. Of the NZDs, only leishmaniasis and HAT are included in the ten diseases which are the focus of the declaration, meaning that the other diseases are not benefitting from the increased Research and Development and drug donations that the other NTDs are experiencing as a result of the declaration. This study highlighted three diseases in particular that are not included in the WHO NTDs. Anthrax, brucellosis and bovine tuberculosis have therefore not received the increased attention that the other NTDs have seen. Upon the inception of the WHO in 1948, around twenty zoonotic diseases were determined to be diseases of priority in the WHO, including bovine tuberculosis and brucellosis. Despite this, there have not been any resolutions adopted for these diseases since 1950.  For these diseases, effective and simple control methods exist, meaning that they are no longer endemic in many developed countries. It is therefore astonishing to many that they remain neglected.

It seems that these diseases are particularly neglected due to the complexities of controlling diseases that affect both humans and animals, and the required communication and collaboration between human and animal health sectors, both at community and ministerial levels, that is sometimes lacking. This despite the dual benefits that would be received by both human and animal health sectors upon increased effective control methods.

The international attention that has been received following the publication of this research may be indicative that the neglect of these diseases – some of which are well known and well controlled in some countries – may be something which is surprising, but that there is desire to reduce this neglect and therefore the deaths that occur as a result. In order to reduce this neglect, we must see increased cooperation and communication between human and animal sectors at all levels, and efforts to increase the advocacy for the control of these diseases.

 

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Ms Hayley Mableson is in the final stages of completing a PhD from the University of Edinburgh.  Her research to date has focussed on global health advocacy and its application, with particular emphasis on the neglected tropical and zoonotic diseases.