Global Health Conversations – Détails, épisodes et analyse

A Storytime:

The story of Cholera in London in the 1800s and how John Snow’s famous experiments revolutionised epidemiology and public health as we know it in modern, western history has always been a favourite for me.

I was reminded of this story strolling through Soho past the John Snow pub recently and past the famous Broad Street pump. This podcast episode is a public health bedtime story; one of science and pioneering innovation. It’s a story we know, but one that ignited something in me, and I like to listen to things.

I hope you enjoy the story. :)

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A walkthrough. The Pandemic Accord is a proposed global agreement aimed at strengthening pandemic prevention, preparedness, and response. Emerging in the aftermath of COVID-19, the accord aims to address gaps in international coordination, surveillance, and equitable access to medical countermeasures, globally.

This episode takes a high level overview of the Pandemic Accord, it’s purpose and a walkthrough of some of its most pertinent Articles

GHC Newsletter: PANDEMIC ACCORD - Negotiations stall. Failure to reach agreement (focus on PABS) - May 2024

GHC Newsletter: Pandemic Agreement Round-up as INB 11 Concludes - September 2024

Current draft: Pandemic Accord 

Timestamps: 

Intro: 00:00 
Background: 01:15 
How it works & the role of WHO: 04:51
Articles 1 - 3: 07:50
Articles 4 & 5 - Prevention & One Health: 08:34
Articles 6 & 7: 11:05
Article 9 - Research & Development: 12:17
Article 10 - Local Manufacturing: 14:28
Article 11 - Tech Transfer & 'know-how': 14:50
Article 12 - Pathogen Access & Benefit Sharing - PABS: 17:36
Articles 13 & 13bis - Supply Chain & Logistics & Procurement & Distribution : 21:00
Alignment with other agreements: 23:18 
Article 14 - Regulation & Strengthening: 24:14
End: 24:54

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In this episode we discussed oral health as a public health issue. Discussing system challenges, incentivisation and disincentivasation, dental caries as the most common infectious disease, bacteria and the use of antibiotics.

Ema is a doctor of dental medicine from Croatia, currently undertaking her specialization in orthodontics and facial orthopedics in Barcelona, Spain. She  started her professional career as a dentist in the UK after completing her MSc in International Health Management  at Imperial College Business School and has continued working in the UK  in several dental practices as an NHS and private practitioner.

Watch the cheeky behind the scenes video as I remote recorded this episode with Dr Ema Prohic. https://www.youtube.com/watch?v=lYtwPcdP-2w&list=PLuMBJBscY0rlz0UzeigxHVA3bfRMnzz7i&index=2

The Podcast episode will be available on Global Health Conversations wherever you listen on Sunday 31 March.

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In this episode, in recognition of International Women's Day, we talk about cervical cancer and discuss its significance as a symbol of global health disparities and gender inequality. Cervical cancer incidence is exacerbated by socio-economic factors and disproportionately affects women in poverty. 

We discuss the importance of HPV vaccination, regular screening, and innovative prevention strategies like diagnostic tools to enable self-sampling. And the incredible toll of the devastating disease.

Resources:

Subscribe to the newsletter - https://globalhealthconversations.substack.com

1. Podcast Episode: Cancer in Africa: The dual burden of disease  

2. HPV self-sampling for cervical cancer screening: a systematic review of values and preferences: https://pubmed.ncbi.nlm.nih.gov/34011537/

3. Cancer in sub-Saharan Africa in 2020: a review of current estimates of the national burden, data gaps, and future needs: https://www.sciencedirect.com/science/article/abs/pii/S1470204522002704

4. Podcast Episode: The Role of Storytelling in Women's Health

5. World Bank: New Data Show Massive, Wider-than-Expected Global Gender Gap

6. No equality for working women in any country in the world, study reveals

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In this week’s solocast we discussed the cost of medical care. Particularly, I attempted to answer the question: Why do Americans pay (so much) more for healthcare? With my health economist hat on - I looked into transparency, drug prices and administrative costs. But are these only reasons that the US has the world’s third highest out of pocket health expenditure? And, moreover, how does this affect patients and patient outcomes?

Resources:

1. Why are American Healthcare costs so high - Vlogbrothers
2. Vox: The true story of America’s sky-high prescription drug prices

Get in touch with me here: Christiana@globalhealthwriter.com

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This is the official last episode of Season 1! The Global Health Conversations Newsletter continues throughout the holidays until we're back after the Christmas holidays. Click here to Sign up to the free Global Health Conversations fortnightly newsletter. It is packed with the latest news in global health with themes each fortnight. You will also be notified when the next exciting interview is up!

Today's episode focussed on sustainability in the Pharma and biotech industries - redefining what sustainability means in the field. Our special guest, Elisabetta Marani, or Eli, as I call her is a sustainability expert with almost a decade of experience working gin sustainability, CSR, continuous improvement & supply chain in the Pharma, Biotech and Medical devices industries; including at Biotech, Catalent and Amplifion. She has a wealth of knowledge and a dear friend of mine having completed our MScs together in Drug Discovery & Pharma Management at the UCL School of Pharmacy. She is also the founder of The Young Sustainability Network - providing guidance and solutions for young professionals with an interest in working in sustainability.

We talked about many topics including circular economy, greenwashing, net zero carbon emissions goals and the role of sustainability in Pharma, practical solutions, access to medicines as a key objective of the industry alongside furthering environmental sustainability aims and if you are a young professional interested in this area - be sure to listen to the end as Eli provides her expert advice in this area. If you are not a young professional, be sure to listen to the very end for Eli's advice as to how we can all make a difference in our personal spheres of work.

About Today's Guest:

Elisabetta Marani graduated in Biochemistry at the University of Sheffield, pursued a masters at UCL in drug discovery & pharma management, and later on an Msc in environmental management at the Open University.

She worked in the pharma & biotech industry for 6+ years, first focusing on environmental impact of pharma production sites and progressively moving to corporate roles of ESG reporting, wider corporate social responsibility programs management. She recently moved over to the medical device/hearing care industry and is now in the function of procurement, focusing on building sustainable supply chain and sourcing programs .

She is a Certified Auditor ISO14001, Sustainability Practitioner (IEMA) and Lean Six Sigma Green Belt. She is also founder of The Young Sustainability Network (TYSN), an online global community aimed to support and empower young professionals as they embark in sustainability careers.

Disclaimer provided by guest:
Views expressed are personal opinions of the guest speaker and do not represent the views of the companies she has worked or currently works for in any way.

If you are interested in a career in sustainability and would like to get in touch with Eli's initiative, reach out to The Young Sustainability Network (link).

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*****If you or a friend or loved one has been affected by the issues raised in this episode, I strongly encourage you to 1. Click here to find a domestic violence hotline or helpline near you in your country please speak to someone who will understand your situation and help. 2. Delete your search history and stay safe. *****

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These are the ways in which women disproportionately die prematurely because of being women. Throughout this episode, you will hear me use this phrase as I walk through the ways that gender based violence impacts the right to long and healthy life; as well as the real life stories of survivors. Fortunate to have lived but with life long scars - physical and emotional - to carry.
*********

- Listen to Episode 10: The Role of Storytelling in Women's Health (ft. Loredana Marta)
- Ross Kemp Human trafficker interview (TW)

Sources of clips used:
- https://www.youtube.com/watch?v=-hI9p_PhbKQ
- https://www.youtube.com/watch?v=2Num0P3H7lU&t=415s
- https://www.youtube.com/shorts/QG4iyS0MYUw
- https://www.youtube.com/watch?v=4I_o0l5jdOg
- https://www.youtube.com/watch?v=U1XvFSoUhWI&t=191s
- https://www.youtube.com/watch?v=77vz3r7OmZA
- https://www.youtube.com/watch?v=IU1i2IlkLbU

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(Note: I was unfortunately unable to add the supplementary slides to the show notes. However, the image described in question 8 is in this week's Newsletter. Thanks for understanding and I hope you enjoyed the episode! If so, it really helps me if you leave me a kind, cheeky little five star rating ;) Thank you, Friend, for being part of the Conversation.)

This week's episode delves into the fundamentals of global health. A beginners guide to the most basic concepts.

The first part focussed on this overview: 04:00

The second part is a fun Global Health Quiz: 18:35

Each of the 8 questions is designed to illustrate an important concept in global health. The questions are below. And so are the answers.

Global Health General Knowledge Quiz Questions

 1.  What percentage of the world lives in extreme poverty today? 
2. Average Life Expectancy at birth globally is 73 (2020). Which country has a lower life expectancy than the global average?
3. How many babies are born per woman in Sri Lanka (fertility rate)? 
4. What is the global average adult literacy rate (female)? 
5. What is the immunisation coverage for measles and DPT in Zimbabwe? 
6. Maternal mortality (per 100 000 live births) ranges from 2 – 1150 globally. What is the global average?   
7. What percentage of the world’s population live in cities? 
8.The world average for out-of-pocket expenditure is 18% of total health expenditure. Which country has the highest OOP %? 

_______

 Mentioned in the episode:

1. The End of An Era: 2015 Millennium Development goals round-up (2016)

2. The Lancet Global Health (2023): A call to action: the global failure to effectively tackle maternal mortality rates

_______
 
Quiz Answers: 

1. D 
2. C  
3. A 
4. B 
5. D 
6.  B
7. D 
8. A 

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Timestamps:
Intro & Update: 01:36
Health Systems strengthening: 5:07
Local manufacturing: 19:19

Read the Newsletter here

Summary:
This week’s episode provides a high level summary of important pillars in health systems strengthening and provides background on the move to manufacture vaccines and biologics regionally in Africa and beyond.

Listen to Part 1 here:  Universal Health Coverage: No-one Left Behind & Financial Protection (Part 1)

Resources: 

• Tracking universal health coverage: 2023 global monitoring report
• Brookings Op-ed: Africa must produce its own vaccines
• The Guardian: South Africa launches ‘unprecedented’ investigation of Johnson & Johnson over TB drug prices 
• Health Systems Strengthening points: 

1. Health Service Delivery

2. Health Workforce Development - health workforce has been a cornerstone of discussions 

3. Health Infrastructure and Equipment:

4. Health Information Systems:

5. Health Financing:

• Develop sustainable and equitable financing mechanisms, such as taxation, health insurance, and social health protection schemes, to ensure that healthcare services are affordable and accessible to all, regardless of income.
•  Reduce out-of-pocket expenses for healthcare, which can lead to financial hardship.

6. Governance and Leadership:

• Strengthen the governance and leadership of health systems by improving policies, regulations, and management structures.
•  Enhance transparency and accountability to prevent corruption and mismanagement.

7. Community Engagement and Empowerment:

• Involve communities in decision-making processes and encourage them to actively participate in their own health care.
•  Promote health education and awareness to empower individuals to make informed health choices.

8. Collaboration across sectors:

• Recognize that health outcomes are influenced by factors beyond the healthcare sector, such as education, sanitation, nutrition, and economic conditions.
•  Foster collaboration with other sectors to address these social determinants of health.

9. Research and Innovation:

• Encourage research and innovation to continuously improve the effectiveness and efficiency of healthcare services.
•  Promote the adoption of evidence-based practices and technologies.

10. Emergency Preparedness and Response:

• Strengthen the health system's ability to respond to public health emergencies and disasters, ensuring that it can provide essential services even during crises.

11. Equity and Inclusivity:

• Ensure that vulnerable and marginalized populations, including those in remote or conflict-affected areas, have equitable access to healthcare services.

12. Monitoring and Evaluation:

• Establish mechanisms to regularly monitor and evaluate the performance of the health system in achieving UHC goals and make necessary adjustments.

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We discussed the role and impact of storytelling on women’s health and explored inequities that exist in this area. We also discussed health tech and the many persisting shortcomings that impact women’s health, treatment and lives. 

Loredana Marta pens a newsletter under the name Vulvarina about how sexism interferes with our lives in unseen ways, in areas ranging from medical care, to industrial design and social dynamics. Her storytelling is stats- and fact-based, letting her legal background shine through, jazzed up with approachable anecdotes of mundane London life. She spent the last two years in the startup scene, where along with her two cofounders, she built OPEN social, bringing genuine conversations back to social media by matching people based on their moods. Writer and tech gal/lady (?) is currently exploring female health and digitalisation, as well as a gender and ethnicity personalised approach to medical research and care.
Click here to read and subscribe to Vulvarina. Loredana's hard hitting newsletter.

Resources from this week's episode:
1. The leadership gap in healthcare: https://www.oliverwyman.com/our-expertise/perspectives/health/2019/jan/women-in-healthcare-make-80--of-purchasing-decisions--yet-13--of.html
2. Female founders in the US Venture Capital ecosystem: https://pitchbook.com/news/reports/2022-all-in-female-founders-in-the-us-vc-ecosystem
3. Health system tracker - health expenditures: https://www.healthsystemtracker.org/chart-collection/health-expenditures-vary-across-population/#Average%20individual%20health%20spending,%202019%C2%A0
4. Discussion of the research and funding gap in women's health:
https://medcitynews.com/2022/12/womens-health-is-suffering-due-to-lack-of-research-and-funding-experts-say/
5. Commentary piece on the profitability of women's health - Why we're betting big on women's health
6. Research Funding for Women's Health: A Modeling Study of Societal Impact: Findings for Alzheimer's Disease and Alzheimer's Disease Related Dementia Model (Free to access)
7. Medical textbooks: https://www.sciencedaily.com/releases/2008/10/081015132108.htm
8. Time: 'Women Die From Heart Attacks More Often Than Men': https://time.com/5499872/women-heart-disease/
9. Principles of Sex-based Differences in Physiology: https://www.sciencedirect.com/bookseries/advances-in-molecular-and-cell-biology/vol/34/suppl/C
10. Guardian commentary on study: 'Women 32% more likely to die after operation by male surgeon' 

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