HIV/AIDS
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Larry Diamond
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From a humanitarian perspective, few international policy proposals appear more compelling than debt relief for the world's poor. The poorest countries have seen their external debts spiral to the point where interest payments are crowding out desperately needed investments in roads, schools, sanitation, health care, and other social services. The majority of their people live below the poverty line, struggling to survive on a dollar or two a day. Average life expectancy is well below 60 years and declining in many countries because of AIDS. Lacking access to safe drinking water, preventive medicine, and basic education, as well as to markets, credit, and justice, people live needlessly short and degrading lives.

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One of the world's greatest ethical challenges is the inequities in global health. Life expectancy in the United States is about 80 years and rising, while in many parts of the developing world, particularly in Africa as a result of HIV/AIDS, it is 40 years and falling. On the "bright side," the globalization of life sciences is key force to improve health in the developing world. For example, the rise of the Indian biotechnology industry has improved availability of vaccines and programs like the Grand Challenges in Global Health Initiative funded by the Bill and Melinda Gates Foundation provide hope for upstream discovery science against global health problems. However, on the "dark side," the globalization of life sciences poses risks to global biosecurity including bioterrorism by non-state actors.

This lecture will explore how to optimize the benefits of the "bright side," and mitigate the risks of the "dark side," of the globalization of life sciences. Dr. Singer will argue that the biological case is different from the nuclear case and demands a different approach, and explore the potential role of the United Nations in enhancing global biosecurity.

Peter A. Singer is senior scientist at the McLaughlin Rotman Centre, University Health Network; professor of medicine, University of Toronto; co-director of the Canadian Program in Genomics and Global Health; and a distinguished investigator of the Canadian Institutes of Health Research. He studied internal medicine at the University of Toronto, medical ethics at the University of Chicago, public health at Yale University, and management at Harvard Business School. Between 1995 and 2006, Singer was Sun Life Financial Chair in Bioethics, director of the University of Toronto Joint Centre for Bioethics, and director of the World Health Organization Collaborating Centre for Bioethics at the University of Toronto.

History Corner, Building 200, Room 002

Peter A. Singer Senior Scientist, McLaughlin Rotman Centre, University Health Network, and Professor of Medicine Speaker University of Toronto
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This issue of CHP/PCOR's Quarterly Update covers news from the Winter 2007 quarter and includes articles about:

  • two Veterans Affairs-related items -- this year's recipient of the Under Secretary's Award for Health Science Research, and the Health Services Research & Development Annual meeting;
  • the importance of proper HIV resource allocation: What method of allocation is best to ensure that HIV prevention and treatment program funds are being used effectively? One study looks at this issue from an aggregate-level analysis;
  • the use of functional magnetic resonance imaging technology to examine how financial decisions are made. Researchers were able to identify specific areas of the brain that are activated prior to when individuals actually make purchasing decisions;
  • the report series concerning the quality gap, as identified by the Institute of Medicine. Two recently-released reports about the quality gap in asthma care and healthcare-associated infections are covered;
  • CHP/PCOR research activities and updates, including a year-in-review of the Patient Safety Research Group that examines the notion of safety culture;
  • a Research in Brief selection that highlights recently-published CHP/PCOR research. This piece examines the public-private partnerships model used to improve health and welfare systems.
The newsletter also contains various other news items that may be of interest to our readers. Note to the reader: The newsletter is fully-navigational. Any text that is surrounded by a dashed box is clickable and will allow the reader to navigate the newsletter more efficiently. The end of each article contains a special symbol (§) that, when clicked, will take the reader back to the table of contents. Please feel free to contact Amber Hsiao with any questions.
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Suicide bombings targeting Israeli civilians were once the favored tactic of Palestinian terrorists. Israeli deaths from suicide bombings peaked in the spring of 2002, but Israeli countermeasures dramatically lowered the number of successful suicide bombings since then. This talk will assess the impact of various countermeasures on suicide bombing rates with an eye towards understanding the decline in successful suicide bombings in Israel.

Edward H. Kaplan is the William N. and Marie A. Beach Professor of Management Sciences at the Yale School of Management, a professor of public health at the Yale School of Medicine, and professor of engineering in the Yale Faculty of Engineering. An elected member of the National Academy of Engineering and the Institute of Medicine, Kaplan uses operations research and statistical methods to study problems in public policy and management. His earlier work was devoted to evaluating HIV prevention programs, while his more recent studies focus on counterterror topics such as the tactical prevention of suicide bombings and response logistics in the event of a bioterror attack. He has also dabbled in predicting the outcomes of presidential elections and NCAA basketball tournaments. His efforts have been recognized with several awards in the fields of operations research and public health.

Reuben W. Hills Conference Room

Edward Kaplan William N. and Marie A. Beach Professor of Management Sciences, Professor of Public Health, and Professor of Engineering Speaker Yale University
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Despite predictions of their eradication in the 1960s, infectious diseases remain a significant cause of global health, economic, and social problems. There has been a renewed focus on the background "matrix" of infections that occur around the globe, as well as on emerging, re-emerging, and deliberately emerging (i.e. bioterror) agents. This talk will provide a global health perspective on infectious diseases in 2007, and highlight the lessons that can be learned from three conditions (HIV/AIDS, influenza, and SARS).

Daniel Libraty is an associate professor of medicine at the University of Massachusetts Medical School. He is a member of the Center for Infectious Disease and Vaccine Research (CIDVR), and the Division of Infectious Diseases/Department of Medicine. He received his MD degree from the University of California, San Diego. He completed his post-graduate residency in internal medicine at the University of California, San Francisco, and obtained subspecialty training in infectious diseases at the University of California, Los Angeles. His research focuses on understanding the protective and pathogenic human immune responses to emerging and re-emerging viral diseases such as dengue, hantavirus, SARS, and influenza. He has lived and traveled extensively throughout Southeast Asia and other parts of the world in the course of working on these infectious diseases.

Reuben W. Hills Conference Room

Daniel Libraty Associate Professor, Department of Medicine Speaker University of Massachusetts
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Dr. Karen Eggleston will join the Shorenstein Asia-Pacific Research Center as a center fellow on July 1, 2007. Dr. Eggleston will lead the center's program on comparative health care in East Asia.

Dr. Eggleston's research focuses on comparative healthcare systems and their link to broader social protection policies during economic development and transition from central planning to market-based economies; payment incentives and their impact on healthcare insurer and provider behavior; the market structure of healthcare, including competition, integration, ownership, and healthcare productivity; and incentives surrounding health behaviors such as the spread of HIV/AIDS, overuse of antibiotics, and smoking. She studied in China for two years and was a Fulbright scholar in Korea.

Eggleston earned her Ph.D. in public policy from Harvard University in 1999. She has an M.A. in economics and another in Asian studies from the University of Hawaii, Economics (August 1995 and May 1992, respectively.) She is currently an assistant professor of economics at Tufts University in Boston. Dr. Eggleston joined the faculty at Tufts in 1999.

Currently, Dr. Eggleston is a research associate at the Kennedy School of Government at Harvard University and an academic program coordinator at the Kennedy School Health Care Delivery Policy Program also at Harvard. Dr. Eggleson has been a research associate at the China Academy of Health Policy (CAHP) at Peking University, Beijing, China since 2003 and in the summer of 2004 she was a consultant to the World Bank on their project on health service delivery and the rural health sector.

"Karen will be a great addition to the center," says director of the center, Gi-Wook Shin.

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Executive Director of UNAIDS since its creation in 1995 and Under Secretary-General of the United Nations, Dr. Peter Piot comes from a distinguished academic and scientific career focusing on AIDS and women's health in the developing world.

Drawing on his skills as a scientist, manager, and activist, Dr. Piot has challenged world leaders to view AIDS in the context of social and economic development as well as security.

Under his leadership, UNAIDS has become the chief advocate of worldwide action against AIDS. It has brought together ten organizations of the United Nations system around a common agenda on AIDS, spearheading UN reform.

Dr. Piot earned a medical degree from the University of Ghent, a PhD in Microbiology from the University of Antwerp, Belgium and was a Senior Fellow at the University of Washington in Seattle. After graduating from medical school, Dr. Piot co-discovered the Ebola virus in Zaire in 1976.

In the 1980s, Dr. Piot launched and expanded a series of collaborative projects in Burundi, Côte d'Ivoire, Kenya, Tanzania, and Zaire. Projet SIDA (Project AIDS) in Kinshasa, Zaire, was the first international project on AIDS in Africa and is widely acknowledged as having provided the foundations of our understanding of HIV infection in Africa. He was a professor of microbiology, and of public health at the Institute of Tropical Medicine, in Antwerp, and the Universities of Nairobi, Brussels, and Lausanne.

In 1992, Dr. Piot joined the Global Programme on AIDS of the World Health Organization, in Geneva, as Associate Director.

Born in 1949 in Belgium, Dr. Piot is fluent in three languages and is the author of 16 books and more than 500 scientific articles. He has received numerous awards for scientific and societal achievement, and was made a Baron by King Albert II of Belgium in 1995. He is a member of the Institute of Medicine of the National Academy of Sciences of the United States and the Royal Academy of Medicine of Belgium, and is a Fellow of the Royal College of Physicians of London, UK.

For more information about Dr. Piot, read "The Life of a Virus Hunter" from Newsweek's special edition of May 15, 2006, AIDS at 25.

Kresge Auditorium

Dr. Peter Piot Executive Director, UNAIDS and Under Secretary-General, United Nations Speaker
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Dr. David Heymann is the Assistant Director-General for Communicable Diseases and Representative of the Director-General for Polio Eradication. From July 1998 until July 2003, he was Executive Director of the WHO Communicable Diseases Cluster. Dr. Heymann was Director of the WHO Programme on Emerging and other Communicable Diseases from October 1995 to July 1998, and prior to that was the Chief of research activities in the WHO Global Programme on AIDS. Before joining WHO, Dr. Heymann worked for thirteen years as a medical epidemiologist in sub-Saharan Africa on assignment from the US Centers for Disease Control and Prevention (CDC). He also worked for two years in India as a medical epidemiologist in the WHO Smallpox Eradication Programme.

Dr. Heymann holds a B.A. from the Pennsylvania State University, an M.D. from Wake Forest University, a Diploma in Tropical Medicine and Hygiene from the London School of Hygiene and Tropical Medicine, and has completed practical epidemiology training in the two-year Epidemic Intelligence Service of CDC. In 2004, he received the American Public Health Association Award for Excellence and was named to the United States Institute of Medicine. In 2005, he was awarded a Welling Professorship at the George Washington University School of Public Health and the 2005 Donald Mackay medal by the American Society of Tropical Medicine and Hygiene.

Bechtel Conference Center

David L. Heymann Assistant Director-General for Communicable Diseases and Representative of the Director-General for Polio Eradication, World Health Organization Speaker
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