*** Aboriginal and Torres Strait Islander readers are advised this column mentions and includes images of persons who have passed away ***
The column this week covers diverse topics, from the world’s most neglected displacement crises, to the environmental destruction wrought by Big Tech, the latest on avian influenza, and some intersections between our unhealthy food and media systems.
Also covered are a NSW inquiry’s recommendations for improving mental health and healthcare, and calls for truth-telling about the ongoing impacts of colonisation.
Italian public health leader Professor Walter Ricciardi writes that: “Historians, economists and sociologists are unanimous in saying that there have never been, in the history of humanity, such numerous and complex challenges simultaneously as in the current world.”
He cites the Pope as saying “this is not an epoch of change, but a change of epoch”.
The quotable?
Countering anti-scientific attacks requires new approaches to science communication and public engagement. Particularly in the biomedical sciences we need a new generation of scientists who are committed to defending science in public places and, sometimes, defending colleagues from attacks by politicians, the media and pseudo-intellectuals.
In other words, courageous public health professionals.”
Global health
For the second year in a row Burkina Faso is the world’s most neglected displacement crisis, according to a new report from the Norwegian Refugee Council (NRC). The normalisation of neglect is exacerbating needs and deepening despair.
The annual list of neglected displacement crises is based on three criteria: lack of humanitarian funding, lack of media attention, and a lack of international political and diplomatic initiatives compared to the number of people in need. The crisis in Cameroon is listed second, having featured on the list every year since 2018.
The Democratic Republic of Congo, Mali, and Niger follow in this grim ranking, meaning that for the first time all three countries in the central Sahel are among the top five most neglected crises.
“The utter neglect of displaced people has become the new normal,” said Jan Egeland, Secretary General of NRC. “The local political and military elites disregard the suffering they cause, and the world is neither shocked nor compelled to act by stories of desperation and record-breaking statistics. We need a global reboot of solidarity and a refocus on where needs are greatest.”
Norwegian Refugee Council: Once again, Burkina Faso is the world’s most neglected crisis
WHO Avian Influenza A (H5N2) – Mexico
On 23 May 2024, Mexico reported to the Pan American Health Organization/World Health Organization a confirmed fatal case of human infection with avian influenza A(H5N2) virus detected in a resident of the State of Mexico who was hospitalised in Mexico City.
The person who died was 59-years-old, with no history of exposure to poultry or other animals, and multiple underlying medical conditions.
This is the first laboratory-confirmed human case of infection with an influenza A(H5N2) virus reported globally and the first avian H5 virus infection in a person reported in Mexico. Although the source of exposure to the virus in this case is currently unknown, A(H5N2) viruses have been reported in poultry in Mexico.
Nature: The pandemic treaty: a grand global social bargain
Regarding ongoing efforts to develop a global pandemic treaty, Professor Laurence Gostin writes: “A grand social bargain is within reach that would make everyone safer and the world fairer.
“But it will require political will and a willingness to compromise. Failure to reach an historic agreement could actually make the world more vulnerable by eviscerating trust and international cooperation.
“The Global North wants open scientific exchange. That is a global public good. But I do not think rich countries understand the depth of anger in low- and middle-income countries over unconscionable and ongoing inequalities. Science, combined with justice, is a powerful force if only political leaders would seize this once-in-a-lifetime opportunity.”
BMJ: Covid-19: South African disclosures reveal secretive world of nations’ vaccine contracts
The BMJ reports that documents detailing negotiations between COVID vaccine manufacturers and the South African government show how drug companies pressured low and middle income nations into accepting high prices and unusually harsh terms, say public health activists who secured the documents’ release from South Africa’s Supreme Court.
Fatima Hassan, director of the Health Justice Initiative, which reviewed the papers with help from the US advocacy group Public Citizen and other analysts, said that the documents revealed “attempts to extract one sided terms, especially by pharma giants Moderna and Pfizer, all while they profiteered from a global health emergency”.
The contracts that South Africa signed – with Pfizer, with Johnson and Johnson’s subsidiary Janssen, with the international vaccine alliance Gavi, and with the Serum Institute of India, maker of the AstraZeneca vaccine – are still the only vaccine contracts signed by a national government during the pandemic to see the light of day, the report says.
The Lancet: Calls for a focus on health risks in EU election
Italian public health leader Professor Walter Ricciardi writes that: “Historians, economists and sociologists are unanimous in saying that there have never been, in the history of humanity, such numerous and complex challenges simultaneously as in the current world.
“Pandemics, economic recession, climate change, the collapse of biodiversity, not to mention wars involving more than 2 billion people, including millions of Europeans who thought they had removed this problem forever, are formidable challenges that threaten the very survival of mankind.”
He cites the Pope as saying ‘this is not an epoch of change, but a change of epoch’ and that pretending nothing has happened will lead to immediate unhappiness.
“Since silence is not neutral,” writes Ricciardi, “scientists should get involved and participate more assiduously in public debates and should not be afraid to make their voices heard loud and clear when the debate falls within their fields of experience.
“Countering anti-scientific attacks requires new approaches to science communication and public engagement. Particularly in the biomedical sciences we need a new generation of scientists who are committed to defending science in public places and, sometimes, defending colleagues from attacks by politicians, the media and pseudo-intellectuals. In other words, courageous public health professionals.”
The Guardian: The ugly truth behind ChatGPT: AI is guzzling resources at planet-eating rates
Mariana Mazzucato, Professor in the Economics of Innovation and Public Value at University College London, describes how the tech industry’s infrastructure – the physical datacentres housed in business parks and city outskirts – consume massive amounts of energy.
Despite its name, the infrastructure used by the “cloud” accounts for more global greenhouse emissions than commercial flights. In 2018, for instance, the 5bn YouTube hits for the viral song Despacito used the same amount of energy it would take to heat 40,000 US homes annually.
Large language models such as ChatGPT are some of the most energy-guzzling technologies of all. Research suggests, for instance, that about 700,000 litres of water could have been used to cool the machines that trained ChatGPT-3 at Microsoft’s data facilities.
She argues for a systematic, comprehensive approach to address Big Tech’s destructive environmental footprint.
Public health
Inside our Food and Beverage Manufacturers Australia 2024: Assessing company policies and practices for supporting healthier food environments and improving population nutrition
New research shows kids are targeted with alcohol, gambling and junk food ads online
The Guardian: News outlets producing ‘covert marketing’ for McDonald’s, KFC and Domino’s, study finds
Australian and New Zealand Journal of Public Health: Covert marketing of quick-service restaurants via news media in Australia: A content analysis
This study involved a content analysis of press releases made between July 2021 and June 2022 by the five largest quick-service restaurant brands in Australia by brand share, and a content analysis of news media coverage related to the press releases.
Among 52 press releases, new food products (27% of press releases; all unhealthy foods) and corporate social responsibility activities (25%) were the most promoted subjects.
For 62% of press releases, at least one news media item was identified. Among the 86 identified news media items, most related to press releases promoting new food products (45% of news media items) or corporate social responsibility activities (21%). News media items overwhelmingly had a slant favourable to the relevant brand (93%).
Conclusion: “Press releases by top-selling quick-service restaurant brands in Australia commonly generate news media coverage that promotes such brands and their predominantly unhealthy products.”
Implications for public health: “Policies restricting unhealthy food marketing should consider brand-generated news media coverage.”
BMJ: Tobacco funded research: how even journals with bans find it hard to stem the tide of publications
Research funded by the tobacco industry is still appearing in highly cited medical journals, despite attempts by some to cut ties altogether, an investigation by The Investigative Desk and The BMJ has found.
Although the tobacco industry has a long history of subverting science, most of the leading medical journals don’t have policies that ban research wholly or partly funded by the industry. Even when publishers, authors, and universities are willing to restrict ties to the industry, evidence indicates that they struggle to identify funding sources, because tobacco companies have funded front groups and have diversified into pharmaceutical and health technology.
World No Tobacco Day
Paying tribute, and First Nations news
ABC News: Aunty Fay Carter remembered for work improving the lives of Indigenous Victorians
The story behind the FIRST pandemic network logo design
Listen to the podcast
Listen to the interview with Dr Summer May Finlay
#AusPol
National Indigenous Times: Terms of reference for Truth-telling and Healing inquiry to shine light on Queensland’s past and present
Queensland Government: Truth-telling and healing
Read the OPCAT report here.
The NSW Legislative Council report, Equity, accessibility and appropriate delivery of outpatient and community mental health care in New South Wales, made 39 recommendations.
It does not mention prisons and aged care as important settings for mental healthcare and intervention; nor does it mention racism as a cause of so much mental harm. There is no explicit mention of poverty although the first recommendation urges the NSW Government to undertake a whole of government reform approach that addresses the social and environmental determinants of health: housing, cost of living, transport, education, employment, climate change, natural disasters.
Recommendations include riority investment in community-based mental health services, and that existing mental health service directories are widely publicised, updated every three months, and search engine optimised, as appropriate for the type of directory, and that NSW Health enhance service and referral pathways and information sharing between State and Commonwealth Government agencies, non-government and community-managed organisations, and private healthcare services to facilitate better access, affordability, and navigation of services, and to look to expand the employment of peer navigators to strengthen service navigation.
It also recommends that the NSW Government provide fee free TAFE courses and qualifications in mental healthcare, and facilitate relocation and housing for mental healthcare workers in the public system and address social and cultural barriers to relocation.
It says the NSW Government should explore opportunities for integration between primary care and mental health services including embedding mental health clinicians within general practice, and look for ways to integrate peer workers into the broader mental health workforce, including emergency departments, and determine clear role definitions, framework and qualifications, and funding additional scholarship places for the Certificate IV qualification in Mental Health Peer Work.
Australian Health Review: Beyond Budget increases, transformative reforms needed in health sector
According to an Australian Health Review statement, many in the health sector still feel we could receive more value out of this vast expenditure.
‘For critical areas of the health system such as primary care and rural and regional health care, which face enormous pressures, this Budget has a way to go in reassuring Australians they will have a sustainable health system for the future,’ says Dr Sonĵ Hall, Editor in Chief of the Australian Health Review, of which the June 2024 issue was released today.
‘As Professor Claire Jackson AM discusses in her Perspective piece in this issue, five national reviews have supported the need for primary care reform, yet action on these vital reforms has been slow.’
‘We can’t solve these problems with just more of the same funding. However, we can work towards a sustainable primary care system for all Australians by implementing targeted initiatives such as payment reform, improving equity in pay and conditions for the primary care workforce, and promoting increased collaboration between the federal and state governments,’ continues Dr Hall.
‘Rural and regional health care is much in need of long-term investment and reform. While the majority of our population is based in urban centres, those living in regional and remote areas will likely have a higher burden of disease, lower life expectancy and increased expenses and distances to travel in order to access basic healthcare.’
‘Maximising the value of investments in regional and remote healthcare should be a priority. This could involve finding ways to provide cardiac rehabilitation services to people with heart disease in remote areas through improved models of care led by co-design or using under-utilised rural hospitals to reduce surgical waiting lists for certain outpatient surgeries. This issue of the Australian Health Review also explores lessons learned from a health service merger, as discussed by Emeritus Professor Stephen Duckett AM.’
In this case study, Professor Duckett follows the merger of four hospitals in western Victoria, as it aimed to address the issues of inequitable health outcomes for the Wimmera region, low and declining access to local health services, under and over-utilised resources across the region and workforce gaps. This case study highlights the importance of adequate resourcing, funding, expertise, communication, and time in driving successful mergers in the healthcare sector.
‘We must continue to invest in our healthcare system’s foremost asset, its workforce. The Budget did deliver some valuable workforce programs such as the new Commonwealth Prac Payment, to help elevate ‘placement poverty’ in trainee nurses during practical placements, but further research is needed to develop strong training foundations and to promote transformational leadership within our workforce, and ensure staff can provide care that is culturally safe,’ says Dr Hall.
ABC News: Canberra hospitals bring back compulsory masks and limit visitors as COVID-19 and other winter illnesses increase
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