Global Health
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Carolina for Kibera (CFK) inspires and nurtures youth leaders in the slum of Kibera, Kenya through a unique model of participatory development.  CFK recognizes the youth of Kibera as resilient, wise, innovative, and eager to lift their community above the poverty and violence that plagues it.  CFK's long-term initiatives provide youth opportunities to learn and serve while addressing a wide range of community needs including healthcare, education, waste recycling and reduction, HIV/AIDS testing and counseling, and girls' empowerment.  CFK's model of participatory to fight abject poverty, and prevent ethnic, gender and religious violence has been internationally recognized, earning awards as a Time Magazine and Gates Foundation "Hero of Global Health" and the 2008 Oklahoma City National Memorial Foundation's Reflections of Hope Award.  CFK is a major affiliated entity of UNC based at the Center for Global Initiatives.


Salim Mohamed Salim Mohamed co-founded and served as the Executive Director of Carolina for Kibera for eight years. At the age of 16, he was involved in the development of MYSA - the largest youth sports program in Africa based in the Mathare slum of Nairobi.  Salim has helped launch community based sports and development programs in Ghana, Gambia, and Nigeria and presented at the International AIDS Conference. He serves as a director for Shoe 4 Africa, an advisor to Global Education Fund and a YES! facilitator.  A TED Africa Fellow, he is currently pursuing a master's degree at the University of Manchester.

Rye Barcott  While an undergraduate on an NROTC scholarship at UNC-Chapel Hill in 2001, Barcott founded CFK with the late nurse Tabitha Atieno Festo and community organizer Salim Mohamed. Barcott served five years in the Marine Corps before earning a combined MBA and MPA at Harvard as a Reynolds Social Entrepreneurship Fellow and a member of the Harvard Endowment's Advisory Committee on Shareholder Responsibility.  In 2006, he was named an ABC World News Person of the Year.  A TED Fellow and member of the UNC Chancellor's Innovation Circle, Barcott is writing a book that juxtaposes community organizing and counter-insurgency (under contract, Bloomsbury Publishing).

Oksenberg Conference Room

Rye Barcott Founder (l) Speaker Carolina for Kibera (CFK)
Salim Mohamed Co-Founder (r) Speaker Carolina for Kibera (CFK)
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Megan Smith, Vice President, New Business Development and General Manager, Google.org., argued that greater interconnectedness achieved by information technology is a major liberating force in the world. Whether it is aiding the coordination of protests or increasing transparency of governments, the exchange of information has huge benefits. This is not a new phenomenon. In places where people have been able to exchange information easily, social progress has followed. Megan cited the example of Seneca Falls, New York where the canal system allowed for extensive communication; it became significant in both the women's rights and abolition movements.

While a large proportion of the world is benefiting from greater interconnectedness, Africa still lacks the infrastructure to take full advantage. Submarine fiber optic cables are necessary for quick and cheap internet cables and many African countries, particularly in the east, are not connected to these, relying instead on satellites. This is likely to change over the next few years, bringing great potential for further development.

The mission of Google.org is to use technology to drive solutions to global challenges such as climate change, pandemic disease and poverty. The organization was set up as part of a commitment to devote approximately one percent of Google's equity plus one percent of annual profits to philanthropy, along with employee time.  Google.org now places its strategic focus on those projects that can leverage the resources of Google staff, particularly its engineers.

Current projects that harness the power of information include:

  • Google Flu Trends: This uses aggregated Google search data to estimate flu activity up to two weeks earlier than traditional methods. This system has almost 90% accuracy in real time flu prediction and is therefore an extremely useful tool for health delivery agencies. It is now being used in 30 countries. Google is also starting to work in Cambodia to collect data around SARS.
  • Google Power Meter provides a system for consumers to understand their in-home energy use and to take steps to reducing this. The Meter receives information from utility smart meters and in-home energy management devices and visualizes this information on iGoogle (a personalized Google homepage).The premise underlying this project is that greater information is going to be crucial to tackling climate change and consumers ought to be able to be empowered to make informed decisions about their energy use.
  • Disaster relief: In response to the Haitian earthquake, a team of engineers worked with the U.S. Department of State to create an online People Finder gadget so that people can submit information about missing persons and to search the database. Google Earth satellite images have also been used to document the extent of damage.
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BACKGROUND: The optimal community-level approach to control pandemic influenza is unknown. METHODS: We estimated the health outcomes and costs of combinations of 4 social distancing strategies and 2 antiviral medication strategies to mitigate an influenza pandemic for a demographically typical US community. We used a social network, agent-based model to estimate strategy effectiveness and an economic model to estimate health resource use and costs. We used data from the literature to estimate clinical outcomes and health care utilization. RESULTS: At 1% influenza mortality, moderate infectivity (R(o) of 2.1 or greater), and 60% population compliance, the preferred strategy is adult and child social distancing, school closure, and antiviral treatment and prophylaxis. This strategy reduces the prevalence of cases in the population from 35% to 10%, averts 2480 cases per 10,000 population, costs $2700 per case averted, and costs $31,300 per quality-adjusted life-year gained, compared with the same strategy without school closure. The addition of school closure to adult and child social distancing and antiviral treatment and prophylaxis, if available, is not cost-effective for viral strains with low infectivity (R(o) of 1.6 and below) and low case fatality rates (below 1%). High population compliance lowers costs to society substantially when the pandemic strain is severe (R(o) of 2.1 or greater). CONCLUSIONS: Multilayered mitigation strategies that include adult and child social distancing, use of antivirals, and school closure are cost-effective for a moderate to severe pandemic. Choice of strategy should be driven by the severity of the pandemic, as defined by the case fatality rate and infectivity.

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Clinical Infectious Diseases
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Douglas K. Owens
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Abstract
One of the biggest themes of the 21st century is interconnection -- specifically, the interconnection of people and data.  These interconnections can change everything about how we see the world, how the world sees us, and how we work together.  Where some people might see "big brother," I see empowerment -- empowerment of groups and individuals to improve quality of life and reduce our impact on the planet. 

Megan Smith oversees teams that manage early-stage partnerships, explorations and technology licensing. She also leads the Google.org team, guiding strategy and developing new partnerships and internal projects with Google's engineering and product teams. She joined Google in 2003 and has led several of the company's acquisitions, including Keyhole (Google Earth), Where2Tech (Google Maps), and Picasa. She also co-led the company's early work with publishers for Google Book Search. Previously, Megan was the CEO and, earlier, COO of PlanetOut, the leading gay, lesbian, bisexual and transgender online community. Under her leadership, PlanetOut grew tenfold in reach and revenue. Prior to that, Megan was at General Magic for six years working on handheld communications products and partnerships. She also worked in multimedia at Apple Japan in Tokyo.

Over the years, Megan has contributed to a wide range of engineering projects, such as designing an award-winning bicycle lock; working on a space station construction research project that eventually flew on the U.S. space shuttle; and running a field-research study on solar cookstoves in South America. She was also a member of the MIT-Solectria student team that designed, built, and raced a solar car in the first cross-continental solar car race, covering 2000 miles of the Australian outback. She was selected as one of the 100 World Economic Forum technology pioneers for 2001 and 2002.

Megan holds a bachelor's degree and a master's degree in mechanical engineering from MIT, where she now serves on the board. She completed her master's thesis work at the MIT Media Lab.

Summary of the Seminar
Megan Smith, Vice President, New Business Development and General Manager, Google.org., argued that greater interconnectedness achieved by information technology is a major liberating force in the world. Whether it is aiding the coordination of protests or increasing transparency of governments, the exchange of information has huge benefits. This is not a new phenomenon. In places where people have been able to exchange information easily, social progress has followed. Megan cited the example of Seneca Falls, New York where the canal system allowed for extensive communication; it became significant in both the women's rights and abolition movements.

While a large proportion of the world is benefiting from greater interconnectedness, Africa still lacks the infrastructure to take full advantage. Submarine fiber optic cables are necessary for quick and cheap internet cables and many African countries, particularly in the east, are not connected to these, relying instead on satellites. This is likely to change over the next few years, bringing great potential for further development.

The mission of Google.org is to use technology to drive solutions to global challenges such as climate change, pandemic disease and poverty. The organization was set up as part of a commitment to devote approximately one percent of Google's equity plus one percent of annual profits to philanthropy, along with employee time.  Google.org now places its strategic focus on those projects that can leverage the resources of Google staff, particularly its engineers.

Current projects that harness the power of information include:

  • Google Flu Trends: This uses aggregated Google search data to estimate flu activity up to two weeks earlier than traditional methods. This system has almost 90% accuracy in real time flu prediction and is therefore an extremely useful tool for health delivery agencies. It is now being used in 30 countries. Google is also starting to work in Cambodia to collect data around SARS.
  • Google Power Meter provides a system for consumers to understand their in-home energy use and to take steps to reducing this. The Meter receives information from utility smart meters and in-home energy management devices and visualizes this information on iGoogle (a personalized Google homepage).The premise underlying this project is that greater information is going to be crucial to tackling climate change and consumers ought to be able to be empowered to make informed decisions about their energy use.
  • Disaster relief: In response to the Haitian earthquake, a team of engineers worked with the U.S. Department of State to create an online People Finder gadget so that people can submit information about missing persons and to search the database. Google Earth satellite images have also been used to document the extent of damage.

Wallenberg Theater

Megan Smith Vice President, New Business Development, and General Manager Speaker Google.org
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The world of genomics is transforming medicine, and is likely to influence the future development of new drugs, diagnostics, and vaccines. To date, the greater focus of genomics and medicine has been on conditions affecting resourcewealthy settings, primarily involving scientists and companies in those settings. However, we believe that it is possible to expand genomics into a more global technology that can also focus on diseases of resource-limited settings. This goal can be achieved if genomics is made a global priority. We feel one way to move in this direction is through a comprehensive approach to infectious diseases-i.e., an Infectious Disease Genomics Project-that would mirror the Human Genome Project. Without an active, unified effort specifically focused on allowing actors at any level to participate in the genomics revolution, infectious diseases that primarily affect the poor will likely not achieve the same level of scientifici advancement as diseases affecting the wealthy.

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Public Library of Science – Biology
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Authors
Karen Eggleston
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In December 2009, the Asia Health Policy Program celebrates the first anniversary of the launch of the AHPP working paper series on health and demographic change in the Asia-Pacific. The series showcases research by AHPP’s own affiliated faculty, postdoctoral fellows, and visiting scholars, as well as selected works by other scholars from the region.

To date AHPP has released eleven research papers in the series, by authors from China, South Korea, Thailand, Taiwan, Pakistan, and the US, with more on the way from Japan and Vietnam. Topics range from “The Effect of Informal Caregiving on Labor Market Outcomes in South Korea” and “Comparing Public and Private Hospitals in China,” to “Pandemic Influenza and the Globalization of Public Health.”  The working papers are available at the Asia Health Policy website.

AHPP considers quality research papers from leading research universities and think tanks across the Asia-Pacific region for inclusion in the working paper series. If interested, please contact Karen Eggleston.

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Background: Decisions on the timing and extent of vaccination against pandemic (H1N1) 2009 virus are complex.

Objective: To estimate the effectiveness and cost-effectiveness of pandemic influenza (H1N1) vaccination under different scenarios in October or November 2009.

Design: Compartmental epidemic model in conjunction with a Markov model of disease progression.

Data Sources: Literature and expert opinion.

Target Population: Residents of a major U.S. metropolitan city with a population of 8.3 million.

Time Horizon: Lifetime.

Perspective: Societal.

Interventions: Vaccination in mid-October or mid-November 2009.

Outcome Measures: Infections and deaths averted, costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness.

Results of Base-Case Analysis: Assuming each primary infection causes 1.5 secondary infections, vaccinating 40% of the population in October or November would be cost-saving. Vaccination in October would avert 2051 deaths, gain 69 679 QALYs, and save $469 million compared with no vaccination; vaccination in November would avert 1468 deaths, gain 49 422 QALYs, and save $302 million.

Results of Sensitivity Analysis: Vaccination is even more cost-saving if longer incubation periods, lower rates of infectiousness, or increased implementation of nonpharmaceutical interventions delay time to the peak of the pandemic. Vaccination saves fewer lives and is less cost-effective if the epidemic peaks earlier than mid-October.

Limitations: The model assumed homogenous mixing of case-patients and contacts; heterogeneous mixing would result in faster initial spread, followed by slower spread. Additional costs and savings not included in the model would make vaccination more cost-saving.

Conclusion: Earlier vaccination against pandemic (H1N1) 2009 prevents more deaths and is more cost-saving. Complete population coverage is not necessary to reduce the viral reproductive rate sufficiently to help shorten the pandemic.

Primary Funding Source: Agency for Healthcare Research and Quality and National Institute on Drug Abuse.

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Journal Publisher
Annals of Internal Medicine
Authors
Douglas K. Owens
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