Sebelius announces $42.5 million for public health improvement programs through the Affordable Care Act

$399,836 to Georgia State Department of Community Health

U.S. Department of Health and Human Services Secretary Kathleen Sebelius today (September 20) announced that the Centers for Disease Control and Prevention (CDC) has awarded funding for 94 projects totaling $42.5 million to state, tribal, local and territorial health departments to improve their ability to provide public health services. This funding, made possible through the new Prevention and Public Health Fund created by the Affordable Care Act, will be distributed through cooperative agreements to 49 states, eight federally recognized tribes, Washington, D.C., nine large local health departments, five territories, and three Affiliated Pacific Island jurisdictions to maximize public health efforts.

“These funds will help health departments around the country to improve the quality and effectiveness of the critical health services that millions of Americans rely on every day,” said Secretary Sebelius. “Strengthening our public health system through better coordination and collaboration will help to deliver higher quality health care more efficiently.”

This new 5-year cooperative agreement program entitled, Strengthening Public Health Infrastructure for Improved Health Outcomes, will provide health departments with needed resources to make fundamental changes in their organizations and practices, so that they can improve the delivery of public health services including:

- Building and implementing capacity within health departments for evaluating the effectiveness of their organizations, practices, partnerships, programs and use of resources through performance management

- Expansion and training of public health staff and community leaders to conduct policy activities in key areas and to facilitate improvements in system efficiency

-Maximizing the public health system to improve networking, coordination, and cross-jurisdictional cooperation for the delivery of public health services to address resource sharing and improve health indicators

-Disseminating, implementing and evaluating public health’s best and most promising practices

- Building a national network of performance improvement managers that share best practices for improving the public health system.

“Investing in public health builds a foundation for a strong and healthy society and contributes to lowering the cost of health care. Investing in proven preventive services and strong policies helps us to avoid unnecessary costs later,” said CDC Director Thomas R. Frieden, M.D., M.P.H.

“These funds are a down payment on improving public health services across the nation,” said Dr. Judith A. Monroe, CDC’s deputy director for state, tribal, local and territorial support. “With these funds, we will help our nation’s public health departments work more effectively and efficiently to detect and respond to public health problems. This program will strengthen the nation’s public health system and our ability to improve the health and well being of all Americans.”

In response to the CDC’s original funding announcement Public Health Systems and Infrastructure projects in July 2010, CDC received more than 140 applications from health departments seeking funds through this cooperative agreement. For more information, please visit http://www.cdc.gov/ostlts

-----
Community News You Can Use
www.fayettefrontpage.com
Fayette Front Page
www.georgiafrontpage.com
Georgia Front Page
Follow us on Twitter:  @GAFrontPage

Sebelius Announces New $250 Million Investment to Lay Foundation for Prevention and Public Health

U.S. Department of Health and Human Services Secretary Kathleen Sebelius on June 18 announced $250 million in new Affordable Care Act investments to support prevention activities and develop the nation’s public health infrastructure.

Chronic diseases, such as heart disease, cancer, stroke, and diabetes, are responsible for 7 of 10 deaths each year among Americans, and account for 75 percent of the nation’s health spending. Many Americans engage in behaviors such as tobacco use, poor diet, physical inactivity, and alcohol abuse, which harm their health.

“Investing in prevention and public health builds the foundation for improving the health and well-being of Americans, and for lowering costs in the health care system,” said Secretary Sebelius. “Investing in proven preventive services will help patients get the care they need early, avoiding costly and unnecessary care later. This prevention-focused approach is better for doctors, patients, and our national balance sheet.”

The investments announced today in prevention and public health are the second allocation for fiscal year 2010 from the new $500 million Prevention and Public Health fund created by the Affordable Care Act.

The $250 million investment in prevention and public health will go to:

* Community and Clinical Prevention: $126 million will support federal, state and community prevention initiatives; the integration of primary care services into publicly funded community-based behavioral health settings; obesity prevention and fitness; and tobacco cessation.
* Public Health Infrastructure: $70 million will support state, local, and tribal public health infrastructure and build state and local capacity to prevent, detect, and respond to infectious disease outbreaks.
* Research and Tracking: $31 million for data collection and analysis; to strengthen CDC’s Community Guide by supporting the Task Force on Community Preventive Services; and to improve transparency and public involvement in the Clinical Preventive Services Task Force.
* Public Health Training: $23 million to expand CDC’s public health workforce programs and public health training centers.

“With these investments, we are tackling the underlying causes of chronic diseases as well as strengthening our ability to meet the public health challenges of the 21st century,” said Surgeon General Regina M. Benjamin. “This moves America in the direction of becoming a fit and healthy nation.”

Earlier this week, Secretary Sebelius announced the allocation of the first half of the Prevention and Public Health fund to increase the number of clinicians and strengthen the primary care workforce. Building on the earlier investments made by the American Recovery and Reinvestment Act of 2009 and the Affordable Care Act, particularly for the National Health Service Corps, the investments will support the training and development of more than 16,000 new primary care providers over the next five years.

With these investments and others, the Affordable Care Act is continuing the Obama Administration’s historic work to promote wellness and reduce chronic disease. The new law also calls for a national strategy to improve the nation’s health, eliminates co-pays for key preventive services like cancer screenings, and provides new support for employer wellness programs.

-----
www.fayettefrontpage.com
Fayette Front Page
www.georgiafrontpage.com
Georgia Front Page
Follow us on Twitter:  @GAFrontPage

HHS Secretary Sebelius Announces Cornerstone Funding of the $650 Million Recovery Act Community Prevention and Wellness Initiative

Creating ways for healthful lifestyle habits to be the natural first choice for Americans is the goal of a $650 million initiative of the U.S. Department of Health and Human Services (HHS). The funds from the American Recovery and Reinvestment Act will be used to increase physical
activity, improve nutrition, decrease obesity, and decrease smoking in U.S. communities.

HHS Secretary Kathleen Sebelius today announced a funding opportunity for communities and tribes to apply for $373 million in cooperative agreements for the comprehensive public health initiative, Communities Putting Prevention to Work, to be led by the Centers for Disease Control
and Prevention (CDC).

"This initiative will make disease prevention and health promotion top priorities in states and communities across the country," Secretary Sebelius said. "Preventing disease is vital as a strategy to improve our nation's health and reduce health care costs."

Communities Putting Prevention to Work will change systems and environments-for example, improving access to healthy foods and opportunities for physical activity-and putting into place policies, such as clean-indoor-air laws, that will promote the health of populations. Funded entities will have two years to complete their work.

The $373 million in cooperative agreements will be awarded to communities through a competitive selection process. The cooperative agreements will support evidence-based prevention strategies for youth and adults and will promote partnerships across communities and sectors.

The remainder of the funds for this initiative will be made available in the coming weeks to states, territories, and organizations to support, extend and evaluate the reach and impact of the community projects.

Funded projects will emphasize high-impact, broad-reaching policy, environmental, and systems changes in schools (K-12) and communities. For example, communities will work to make high-fat snack foods and sugar-sweetened beverages less available in schools and other community sites and to use media to promote healthy choices. In addition, funded communities will be encouraged to provide quality physical education in the nation's schools and enact comprehensive smoking bans.

"The CDC is excited to have this opportunity to help states and communities do more to deliver proven prevention strategies, in ways that reach whole communities and populations," said CDC Director, Thomas Frieden, M.D., M.P.H. "Chronic diseases linked to obesity, poor nutrition, physical inactivity, and tobacco use are the leading causes of death and disability in our nation. These additional resources will improve the quality of life for millions of Americans."

Communities interested in applying for Communities Putting Prevention to Work grants can find more information at www.grants.gov. The application deadline for the community projects is Dec. 1, 2009. Deadlines for state, territory, and other prevention projects that are part of the
Communities Putting Prevention to Work initiative will be announced soon.

-----
www.fayettefrontpage.com
Fayette Front Page
www.georgiafrontpage.com
Georgia Front Page

Obama Administration Calls on Nation to Begin Planning and Preparing for Fall Flu Season & the New H1N1 Virus

The Obama Administration sent a strong message to the nation today that it is time to start planning and preparing for the fall flu season and the ongoing H1N1 flu outbreak and that the federal government is prepared to commit resources, training, and new tools to help state and
local governments and America's families get ready.

White House Homeland Security Advisor John Brennan, Secretary of Health and Human Services Kathleen Sebelius, Secretary of Homeland Security Janet Napolitano, Secretary of Education Arne Duncan joined with delegations from 54 states, tribes and territories today at the H1N1 Influenza Preparedness Summit at the National Institutes of Health in Bethesda, Md., to kick-off the government's nation-wide fall flu preparedness efforts.

"The President and the administration are actively engaged in mitigating the effects of the H1N1 flu virus and developing a national response framework and action plan that builds on the efforts and lessons learned from this spring's initial onset to prepare for the possibility of a
more serious fall outbreak of the virus," said White House Homeland Security Advisor Brennan in his address to summit participants.

"Over the course of coming weeks and months, we will move aggressively to prepare the nation for the possibility of a more severe outbreak of the H1N1 virus," said HHS Secretary Sebelius. "We ask the American people to become actively engaged with their own preparation and
prevention. It's a responsibility we all share."

"The federal government is working together with its federal, state, local and tribal partners to develop a nation-wide plan to combat the H1N1 flu that incorporates the lessons we learned this spring," said Homeland Security Secretary Napolitano. "The H1N1 Summit will allow us to continue this aggressive preparation for all possible H1N1 virus outbreak scenarios to ensure that we are doing everything possible to keep our country safe and healthy."

"Effectively dealing with a potential H1N1 outbreak requires all of us -- parents, educators, health providers, and local, state and federal governments -- working together on our emergency management plan," said Education Secretary Duncan. "Today's Flu Summit is an important step in that direction. Our primary goals at the Department of Education are the health and well being of students, faculty and staff, and ensuring that, in the event of any school closures, the learning process will continue."

Maryland Governor Martin O'Malley moderated a Governors panel with participation via videolink from Governor Jim Douglas of Vermont, Governor Jim Doyle of Wisconsin, Governor Mark Parkinson of Kansas, Governor John Baldacci of Maine and Governor Jodi Rell of Connecticut.

"When responding to a national pandemic or a national recession, the basic principles of smart government remain the same -- to increase efficiency, openness, and transparency in everything we do. Today's summit illustrates our collective commitment to that goal," said Maryland Governor Martin O'Malley. "The experience in the spring taught us that while earlier pandemic flu planning efforts were effective, there are also areas for improvement. Effective response requires accurate and timely information that is as close to real time as possible. We share the commitment of the Obama Administration to constantly monitor, evaluate and improve these processes as we continue to lead the world in emergency preparedness."

Throughout the one-day summit, Administration officials laid out specific ways that states and local governments could start their planning and preparation efforts and announced new programs and resources to help state and local governments, the medical community and every day America prepare for H1N1 and the fall flu season.

First, HHS will make available preparedness grants worth a total of $350 million. These grants were funded by Congress in the latest supplemental appropriations bill and they will give state and local public health offices and health care systems valuable resources to step up their
preparedness efforts.

Second, the federal government will centralize communications about H1N1 and seasonal flu on the federal government's new Web site www.flu.gov. This one-stop comprehensive site brings together flu-related information from across HHS and other federal agencies. The expanded site builds on the pandemic planning information long presented on www.pandemicflu.gov, and incorporates information about the novel H1N1 flu as well as the seasonal flu.

Finally, HHS is launching a new PSA campaign contest to encourage more Americans to get involved in the nation's flu preparedness efforts by making a 15-second or 30-second PSA. Officials at the summit stressed the idea of "shared responsibility" when it comes to combating the flu and the goal of the new HHS PSA campaign contest is to tap into the nation's creativity to help educate Americans about how to plan for and prevent the spread of H1NI influenza. HHS will evaluate submissions and will present the best PSAs back to the public so everyone can vote on their favorite submission. The winning PSA will receive $2,500 in cash and will appear on national television. Contest details as well more information about the larger effort to plan and prepare for the flu season are available at www.flu.gov.

-----
www.fayettefrontpage.com
Fayette Front Page
www.georgiafrontpage.com
Georgia Front Page

CDC Launches New Environmental Public Health Tracking Network

The Centers for Disease Control and Prevention announced today the launch of the Web-based Environmental Public Health Tracking Network, a surveillance tool that scientists, health professionals, and -- for the first time -- members of the public can use to track environmental exposures and chronic health conditions.

"The ability to examine many data sets together for the first time has already resulted in faster responses to environmental health issues. We believe the Tracking Network holds the potential to shed new light on some of our biggest environmental health questions," said Howard Frumkin, M.D., M.P.H., DrPh., director, of CDC's National Center for Environmental Health.

The web-based tool unites vital environmental information from across the country, including air and water pollutants and information for some chronic conditions, including asthma, cancer, childhood lead poisoning and heart disease into one resource.

While scientists know exposures such as air particle pollution and lead contribute to illnesses, many environmental and health connections remain unproven since detailed health and environmental data existed in separate silos until now.

"The Tracking Network is the foundation we need to make better environmental health decisions and help prevent chronic illnesses, such as asthma, cancer, and heart disease," said Michael McGeehin, Ph.D., director, Division of Environmental Hazard and Health Effects of CDC's National Center for Environmental Health.

CDC funds projects in California, Connecticut, Florida, Maine, Maryland, Massachusetts, Missouri, New Hampshire, New Jersey, New Mexico, New York, Oregon, Pennsylvania, Utah, Washington, Wisconsin, and New York City.

To date, their projects have led to 73 public health actions to control potential illnesses from environmental exposures. For example, the Utah Department of Health received a call from a citizen concerned about cases of cancer in his neighborhood. In the past, a similar call would have prompted a study that would have taken up to a year to complete, with most of that time spent waiting for data. In less than a day, the Utah Tracking Program was able to let this resident know that the likelihood of cancer in his area was no greater than in the state as a whole.

Massachusetts ranks third in the United States for prevalence of asthma. When Massachusetts Tracking staff conducted asthma surveillance and indoor quality assessments in schools, a significant association between mold/moisture and the prevalence of asthma was found. Based on tracking data, Massachusetts staff are working with school officials to correct mold/moisture problems and to enact policy changes for reducing mold and moisture in schools.

In March 2009, CDC received additional funding from Congress to expand environmental public health tracking to five more locations. Awards will be made and announced later this summer. Over time, CDC hopes to expand the Tracking Network across all 50 states, and track additional environmental hazards and health conditions to build a more complete picture of environmental public health.

CDC's Tracking Network is the result of collaboration with 17 local and state health departments; federal partners, including the National Aeronautics and Space Administration, the National Cancer Institute, the U.S. Environmental Protection Agency and the U.S. Geological Survey; and organizations including the American Public Health Association, Association of State and Territorial Health Officials, Council of State and Territorial Epidemiologists, National Association of County and City Health Officials, National Environmental Health Association, National Association of Health Data Organizations and the National Association for Public Health Statistics and Information Systems.

-----
www.fayettefrontpage.com
Fayette Front Page
www.georgiafrontpage.com
Georgia Front Page

Public Health Laboratories To Assume Primary Responsibility for Confirmatory Testing of Swine Flu

/PRNewswire / -- Approximately sixty-five state and local public health laboratories around the United States will assume primary responsibility for confirmatory testing of Human Influenza A H1N1 of Swine Origin, or "Swine Flu," within the next week. Previously, all swine flu specimens had to be sent to CDC laboratories in Atlanta for final confirmatory testing, which identifies specimens to the strain level.

The rRT-PCR swine flu panel diagnostic test kits are being shipped this week from the Centers for Disease Control and Prevention (CDC), which developed the assay. Public health laboratories are slated to begin testing late next week following on-site validation of the test.

Deployment of the test was made possible via an emergency use authorization (EUA) issued by the U.S. Food and Drug Administration (FDA) on April 27 in response to a request from CDC.

"Testing will now proceed more rapidly, because we will have sites around the country that can fully characterize the virus, rather than only one at CDC in Atlanta," said Frances Pouch Downes, DrPH, APHL president, and director, Michigan Public Health Laboratory, Michigan Department of Community Health. "Public health labs are receiving considerable attention in connection with the deployment of the swine flu test, but this is really business as usual for us. We're there in the community, ready to protect the public's health as the situation warrants."

Each year state and local public health laboratories conduct routine surveillance to monitor circulating strains of influenza. Their findings are used to develop the influenza vaccine for the following season and to control the spread of the disease in the current year. Additionally, public health laboratories subtype influenza specimens received from clinical and hospital labs. Test results support decisions regarding patient treatment and measures to control the spread of disease.

Yet even though influenza surveillance and diagnostics are routine functions at public health laboratories, this year's outbreak poses particular challenges. "Lab folks are resilient, but even they have limits in how long they can manage to do more with less," said APHL Executive Director Scott Becker. "The economic downturn has really taken a toll on state and local health departments. I am seriously concerned about staff burnout if this outbreak continues more than a couple of months."

Results of a first quarter 2009 APHL survey indicate that the public health laboratory workforce, which numbers only 6500 nationwide, has been reduced by at least 500. These reductions apply to administrative and IT support as well as to laboratory staff. Survey results also show deep cuts to laboratory budgets -- sometimes requiring the elimination of entire public health programs, mandatory furloughs and reductions in funding for essential equipment and supplies. More cuts and staff reductions are anticipated in coming months based on initial responses to APHL's second quarter survey on the impact of the economic downturn.

-----
www.fayettefrontpage.com
Fayette Front Page
www.georgiafrontpage.com
Georgia Front Page
Twitter @GAFrontPage

FDA Authorizes Emergency Use of Influenza Medicines, Diagnostic Test in Response to Swine Flu Outbreak in Humans

The U.S. Food and Drug Administration, in response to requests from the U.S. Centers for Disease Control and Prevention, has issued Emergency Use Authorizations (EUAs) to make available to public health and medical personnel important diagnostic and therapeutic tools to identify and respond to the swine flu virus under certain circumstances. The agency issued these EUAs for the use of certain Relenza and Tamiflu antiviral products, and for the rRT-PCR Swine Flu Panel diagnostic test.

The EUA authority allows the FDA, based on the evaluation of available data, to authorize the use of unapproved or uncleared medical products or unapproved or uncleared uses of approved or cleared medical products following a determination and declaration of emergency, provided certain criteria are met. The authorization will end when the declaration of emergency is terminated or the authorization revoked by the agency.

Currently, Relenza is approved to treat acute uncomplicated illnesses due to influenza in adults and children 7 years and older who have been symptomatic for less than two days, and for the prevention of influenza in adults and children 5 years and older. Tamiflu is approved for the treatment and prevention of influenza in patients 1 year and older.

The EUAs allow for Tamiflu also to be used to treat and prevent influenza in children under 1 year, and to provide alternate dosing recommendations for children older than 1 year. In addition, under the EUAs, both medications may be distributed to large segments of the population without complying with the label requirements otherwise applicable to dispensed drugs, and accompanied by written information pertaining to the emergency use. They may also be distributed by a broader range of health care workers, including some public health officials and volunteers, in accordance with applicable state and local laws and/or public health emergency responses.

In authorizing an EUA for the rRT-PCR Swine Flu Panel diagnostic test, the FDA has determined that it may be effective in testing samples from individuals diagnosed with influenza A infections, whose virus subtypes cannot be identified by currently available tests. This EUA allows the CDC to distribute the swine flu test to public health and other qualified laboratories that have the needed equipment and the personnel who are trained to perform and interpret the results.

The test amplifies the viral genetic material from a nasal or nasopharyngeal swab. A positive result indicates that the patient is presumptively infected with swine flu virus but not the stage of infection. However, a negative result does not, by itself, exclude the possibility of swine flu virus infection.

The EUA authority is part of Project BioShield, which became law in July 2004.

-----
www.fayettefrontpage.com
Fayette Front Page
www.georgiafrontpage.com
Georgia Front Page
Follow us on Twitter: @GAFrontPage

HHS Declares Public Health Emergency for Swine Flu

The Department of Health and Human Services yesterday issued a nationwide public health emergency declaration in response to recent human infections with a newly discovered swine influenza A (swine flu) virus.

The formal declaration of a Public Health Emergency (PHE) is a tool that facilitates HHS’ preparation and mobilization for disasters and emergencies. For example, PHEs were recently declared for flooding in North Dakota, the Inauguration, and several 2008 hurricanes.

Yesterday’s declaration, made under section 319 of the Public Health Service Act, will help HHS prepare for prevention and mitigation activities by enabling Food and Drug Administration (FDA) emergency use authorizations of drugs, devices, or medical tests under certain circumstances.

Specifically, the PHE will enable the FDA to review and issue emergency use authorizations (EUAs) for the use of certain laboratory tests to help detect the newly discovered strain of influenza and for the emergency use of certain antivirals.

“HHS is taking these steps today to be proactive in responding to this new influenza virus by offering national tools in support of community-led preparedness and response efforts,” Acting HHS Secretary Charles Johnson said. “The declaration allows us the flexibility, while we learn more about the virus and its impact in the United States, to take additional steps to fully mobilize our prevention, treatment and mitigation capabilities should those actions become necessary.”

In addition to the declaration, HHS leaders are working together across operating divisions to coordinate response to the swine flu outbreak. For example, the FDA, the National Institutes of Health, and the Centers for Disease Control and Prevention are working together to develop a vaccine precursor that could be used to develop a vaccine for this swine flu virus.

To date, there have been 20 confirmed cases of swine Influenza A (swH1N1) in California, Texas, Kansas, New York, and Ohio. No deaths in the U.S. have been reported due to the illness. Additional cases of the virus have been confirmed in Mexico and Canada.

Swine flu is a respiratory disease of pigs caused by type A influenza that regularly causes outbreaks of influenza among pigs. Swine flu viruses do not normally infect humans; however, human infections with swine flu do occur, and cases of human-to-human spread of swine flu viruses have been documented.

-----
www.fayettefrontpage.com
Fayette Front Page
www.georgiafrontpage.com
Georgia Front Page
Follow us on Twitter: @GAFrontPage

FDA Alerts Public about Danger of Skin Numbing Products

The U.S. Food and Drug Administration today issued a Public Health Advisory to alert consumers, patients, health care professionals, and caregivers about potentially serious and life-threatening side effects from the improper use of skin numbing products. The products, also known as topical anesthetics, are available in over-the-counter (OTC) and prescription forms.

Skin numbing products are used to desensitize nerve endings that lie near the surface of the skin, causing a numbness of the skin. These topical anesthetics contain anesthetic drugs such as lidocaine, tetracaine, benzocaine, and prilocaine in a cream, ointment, or gel. When applied to the skin surface, they can be absorbed into the blood stream and, if used improperly, may cause life-threatening side effects, such as irregular heartbeat, seizures, breathing difficulties, coma, or even death. FDA has received reports of adverse events and deaths of two women who used topical anesthetics before laser hair removal. In February 2007, the FDA issued a Public Health Advisory - “Life-Threatening Side Effects with the Use of Skin Products containing Numbing Ingredients for Cosmetic Procedures,” to warn consumers about these products.

Patients for whom an over-the-counter or prescription topical anesthetic is recommended should consider using a topical anesthetic that contains the lowest amount possible of medication that will relieve your pain. Also, health care professionals should determine whether adequate pain relief can be safely achieved with a topical anesthetic, or whether a different treatment would be more appropriate.

The FDA strongly advises consumers not to:

* make heavy application of topical anesthetic products over large areas of skin;
* use formulations that are stronger or more concentrated than necessary;
* apply these products to irritated or broken skin;
* wrap the treated skin with plastic wrap or other dressings; and
* apply heat from a heating pad to skin treated with these products.

When skin temperature increases, the amount of anesthetic reaching the blood stream is unpredictable and the risk of life-threatening side effects increases with greater amounts of lidocaine in the blood.

A recently published study in Radiology looked at women taking acetaminophen and ibuprofen by mouth versus applying lidocaine gel, a topical anesthetic, to the skin to decrease discomfort during mammography. The lidocaine gel was applied to a wide skin surface area and then covered with plastic wrap. There were no serious or life-threatening side effects reported in the study, nor were any reported when FDA discussed the results with the doctor who performed the study. The study results favored the use of lidocaine as there was significantly less discomfort than with the plain gel or oral acetaminophen or ibuprofen. However, given the life-threatening side effects associated with the use of topical anesthetics during laser hair removal, FDA is concerned that similar side effects could occur when topical anesthetics are used during mammography. Further, the study was small and it is possible that a larger study might show different findings.
Patients should talk with their health care professional if they are considering using a topical anesthetic before a mammogram. The following summarizes advice for patients if a topical anesthetic is recommended for their use:

* use a topical anesthetic that contains the lowest strength, and amount, of medication that will relieve the pain;
* apply the topical anesthetic sparingly and only to the area where pain exists or is expected to occur;
* do not apply the topical anesthetic to broken or irritated skin;
* ask their healthcare professional what side effects are possible and how to lower their chance of having life-threatening side effects from anesthetic drugs; and
* be aware that wrapping or covering the skin treated with topical anesthetics with any type of material or dressing can increase the chance of serious side effects, as can applying heat to the treated area while the medication is still present.

-----
www.fayettefrontpage.com
Fayette Front Page
www.georgiafrontpage.com
Georgia Front Page

Completely Predictable: Cholera in Zimbabwe

Zimbabwe’s cholera crisis, which has caused more than 1,900 deaths, is a “manmade disaster” caused by President Robert Mugabe’s government, according to a January 13 report by Physicians for Human Rights (PHR), co-authored by Johns Hopkins Bloomberg School of Public Health researcher Chris Beyrer, MD, MPH ’90.

The report, which presents qualitative data derived from interviews with health care workers, engineers, school teachers, NGO and UN representatives, and other officials in the country, attributes the epidemic to Mugabe’s intentional neglect of water treatment and sanitation services, which have fallen into severe disrepair since he was accused of electoral fraud and political violence during run-off elections this summer.

Beyrer, director of the Johns Hopkins Center for Public Health and Human Rights, gathered data in Zimbabwe with three other PHR physicians during a covert five-day visit to the country in mid-December. Escorted by a group of Zimbabwean doctors, Beyrer and colleagues, in-country on tourist visas, toured four provinces, in both rural and urban locations. The general hospitals were “bolted closed,” said Beyrer, the cholera hospitals were under tight surveillance, and the mission hospitals were stretched beyond the point of being able to deliver medical supplies or even running water.

“Zimbabwe offers a classic lesson in public health,” said Beyrer. “When government neglects its basic functions, citizens die. The cholera epidemic in Zimbabwe is completely predictable and preventable. It’s the outcome of the collapse of the most basic water and sanitation measures.”

The health care infrastructure in Zimbabwe has been deteriorating since 2000, when Mugabe began a “land reform” program that undermined the nation’s agriculture industry and crippled the economy. After the disputed polls this summer and a UN order to share power with his political rival in September, Mugabe became proactive in his punishment of Zimbabweans. According to Beyrer, professor of Epidemiology, Mugabe created an extreme breakdown of the health care system.

“You can’t mistake the stench of the sewage,” said Beyrer. In all provinces visited, he and his colleagues observed ruptured sewage pipes and garbage that lines the dirt roads alongside ditches. “There’s open sewage,” said Beyrer. “In some towns, citizens have built walls of garbage—the garbage hasn’t been collected in months.”

The outlook for cholera in the country is grim. The monsoon rains are just beginning in Zimbabwe now, after five months of a cholera crisis, and Beyrer expects the epidemic to worsen.

As a stopgap measure, said Beyrer, aid groups can provide medicine and food. But the crisis may intensify to a degree that the international community would intervene in Zimbabwe against Mugabe’s wishes, acting on a controversial concept known as Responsibility to Protect (a UN-endorsed concept that obligates the international community to respect, protect and fulfill nations’ rights to sovereignty).

A telling footnote to the cholera story, said Beyrer, is the prevalence they observed, among Zimbabweans, of pellagra, a vitamin deficiency disease precipitated by a carbohydrates-only diet. Health officials in Zimbabwe are not allowed to report malnutrition, because no one is supposed to be starving in Zimbabwe, the nation formerly known as “the breadbasket of the world.”

“All of this is evidence of why good government is so central to public health,” said Beyrer. “The basic functions of public health really are state functions. When a state ceases in that, public health fails.” — Christine Grillo

Read In Zimbabwe, a Cancer Called Mugabe, by Chris Beyrer and Frank Donaghue, in the Washington Post.

-----
www.fayettefrontpage.com
Fayette Front Page
www.georgiafrontpage.com
Georgia Front Page