Public health commitment

Letter from Roy Widdus to Commission on Intellectual Property Rights, Innovation and Public Health (Hopefully) clarifying the discussion on advanced purchase commitments, advanced market mechanisms for early stage vaccines, and the IFFlm (May 10, 2005). 

Annex 2C (1) articulates one overarching principle - that the parties to the agreement are "committed to facilitating high quality health care and continued improvements in public health for their nationals" (AGDFAT 2005). It then mentions four subsidiary principles which emphasize, in that public health context, the importance of innovation, and research and development. 

In reality, decisions about public health are often made on the basis of politics rather than science. If this were not so, more resources would be committed to controlling food poisoning relating to micro-organisms and less to relatively minor health hazards such as pesticides and environmental contaminants. Political decision-making needs to balance the needs of public health against legitimate consumer expectations. 

Poisoning in the geriatric population is an ongoing public health concern. In the majority of patients older than 64 years of age, accidental poisoning due to dementia and confusion, improper use or storage of a product, and therapeutic errors is the rule. However, approximately one in 10 is intentional with suicidal intent. Interestingly, elderly females are approximately three times more likely to commit suicide with drugs than males (who prefer carbon monoxide). 

To researchers, one of the glories of Rahway is the collection of brainpower and facilities all in one place— from production lines to chemistry labs to animal testing. You can tell from the campus that there s a large commitment to research. says David Perlin, scientific director of the Public Health Research Institute in Newark, who has worked on a couple of antifungal projects for Merck. 

Ethically, the restriction of movement of a potentially infectious person is highly problematic. It violates the core of the ANA Code of Ethics, respect for the inherent dignity of individuals—the nurse s primary commitment to the patient (ANA, 2001). In the event of a public health emergency, a nurse may have a corresponding obligation to the community. The nurse should work to resolve the dilemma in such a way to ensure patient safety, guard the patient s best interests and preserve the professional integrity of the nurse (ANA, 2001, p. 10). 

Regardless of how one views the threat of chemical or biological terrorism, it seems clear that the modern public health profession demands thorough knowledge and thoughtful approaches to the problem. Both past experience and current events suggest that, once thus committed, little can stop a determined terrorist from... 

Depression in the elderly is a major public health problem. Many elderly depressed patients are often inadequately treated, or depression is missed or mistaken for another disorder, such as dementia. In the elderly, depressed mood, the typical signature symptom of depression, may be less prominent than other depressive symptoms such as loss of appetite, cognitive impairment, sleeplessness, anergia, and loss of interest in and enjoyment of the normal pursuits of life. Somatic (physical) complaints are quite frequently the presenting symptoms in elderly depressed patients. The increased suicidal attempts present in the depressed elderly may be due to access to firearms, diminished cognitive functions, sleep disruptions, poor social interactions, and inattention among primary caregivers. Approximately every 95 minutes an elderly person commits suicide. ... 

As the world realized that IDD has become a major public health threat to millions of people, and that a person s mental ability directly affects his or her contribution to society and a nation s development, the Chinese government made a great commitment to the world in 1991 to eliminate IDD in China by 2000. The National Advocacy Meeting to Eliminate IDD by the Year 2000 in China, hosted by the state council in September 1993, was the catalyst for the National IDD Elimination Program. The key national IDD elimination strategies include ... 

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