Dynamic linkage of public proteomics data in Ensembl using TrackHubs
International Networks in Public Health & the linkage with National Networks
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Transcript of International Networks in Public Health & the linkage with National Networks
International Networks in Public Health & the linkage with National
Networks
Dr Maureen BirminghamWHO representative to Thailand
This presentation
• Definition of a network
• Roles of a public health network
• Examples - CDs, NCDs, surveillance
• What makes a good network?
What is a Network?
“an interconnected system of things or people”
“an association of individuals having a common interest, formed to provide mutual assistance, helpful information, or the like”
Role of Public Health Networks
• “Sharing” to strengthen capacity or inform those who need to know (on a specific issue)– Experiences– Knowledge– Expertise– Methods/tools– Information/data
• Collaborate on a specific issue or problem(e.g. research network)
• Advocate for needed actions/resources
Some examples
NCDnet
Global Network to combat Non-Communicable Diseases
NCDnet
Mission: Help implement the global Strategy Action Plan
Raise awareness Increase resource availability
Catalyze country-level implementation
10 million
15 million
20 million
25 million
High-income countries
Upper middle-income
Lower middle-income
Low-income countries
0.6M
0.5M
3.3M
2.3M
10.2M10.2M
3.3 M3.3 M3.0M
3.0M3.0M
3.0M
5.9M5.9M
2.3M
6.8 M6.8 M
3.7M
13.6M13.6M
1.1M0.9M
Low-income countriesGroup III - InjuriesGroup II – Other deaths from noncommunicable diseasesGroup II – Premature deaths from noncommunicable diseases (below the age of 60), which are preventableGroup I – Communicable diseases, maternal, perinatal and nutritional conditions
Growing importance of Non-Communicable Diseases (NCDs)
Cause of deaths in the world
So
urce
:
Disease/risk factor
Intervention Cost of implementation
(Low = < I$1 per capita
High = > I$2 per capita)
Health impact
(DALYs per 1m popn) (Small = < 100
Large = > 1,000)
Cost-effectiveness
(I$ per DALY averted)(Very = < GDP per capita
Quite = 1-3 * GDP per capita)
Ris
k facto
rs
Tobacco use Excise tax on tobacco products Low Large Very cost-effective
Smoke-free workplaces Low Modest Quite cost-effective
Packaging, labelling and awareness countermeasures
Low Modest Very cost-effective
Comprehensive ad bans Low Modest Very cost-effective
Harmful use of alcohol Excise tax on alcoholic beverages Low Modest Very cost-effective
Unhealthy diet and physical inactivity
Reduce salt intake Low Large Very cost-effective
Food taxes (fat) and subsidies (fruit and vegetables)
Low Modest Very cost-effective
Intensive counselling Very high Large Quite cost-effective
NC
Ds
Diabetes Glycaemia control High Large Quite cost-effective
Cardiovascular diseases
Hypertension drug treatment Low Large Very cost-effective
Cancer Treatment of 1st stage breast cancer
Low Modest Very cost-effective
Cervical cancer screening (PAP smear) and treatment
Low Modest Very cost-effective
Respiratory disorders Inhaled corticoid-steroids for asthma
Low Small Quite cost-effective
Advocacy to promote action: There are low cost interventions to prevent NCDs…
World Economic Forum: Global Risk 2010 Report
Oil spikes
Retrenching from globalization
Asset price collapse
Food price volatility
Financial crisis
NCDs
Infectious diseases
Advocacy to create new perspectives on NCDs and investments to control them
2010
Communicating a clear global vision on how to move forward
2000
2003
2004
2008
Global Strategy for the Prevention and Control of Noncommunicable Diseases
WHO Framework Convention on Tobacco Control
Global Strategy on Diet,Physical Activity
and Health
Action Plan on the Global Strategy for the Prevention and Control of Noncommunicable Diseases
6 objectives:
1. Raise priority of NCDs; integrate NCDs control into all public policies
2. Strengthen national policies and programmes
3. Address risk factors
4. Prioritize research
5. Strengthen partnerships
6. Monitor NCD trends
Roadmap for implementation in countries
SEANET-NCD
Objectives• Contribute to the global efforts• Facilitate national NCD networks • Share experience, expertise, resources• Collaborate in research• Advocate & mobilize resources• Strengthen national NCD policies and strategies• Support capacity building
What is INFOSAN?
A global network of national food safety authorities, established in 2004 to:
Promote information exchange of important food safety issues
Respond to food safety emergencies
Help countries strengthen their capacity to manage food safety risks
As of today, there are 177 country members of INFOSAN
INFOSAN SecretariatInternational Food Safety Authorities Network
INFOSAN Focal point
in Agriculture
Sector
INFOSAN Focal point
in HealthSector
INFOSAN Emergency
ContactPoint
INFOSAN Focal point
in Food Safety
Authority
Counterparts across the farm to table continuum
Structure of INFOSAN
INFOSAN Focal point
in other Sectors
INFOSAN Focal point
in TradeSector
Advisory Group
WHO surveillance & response systems
ExampleMelamine Contamination of Infant Formula
• Melamine added in the primary production
sector (milk collection centres) to disguise
the dilution of milk with water
• 22 of 79 Chinese producers of powdered infant formula
were affected
• Products from affected producers exported
to 5 countries
• Levels detected range from <0.1 – 2600 mg/kg
>294,000 children ill
>50,000 hospitalized
6 deaths
Other products contaminated
• milk (powder), yoghurt, biscuits, instant & liquid
coffee preparations
• egg powder, fresh eggs, animal feed
• Sodium bicarbonate (raising agent)
• Exports reported all over the world
Measures Taken by INFOSAN
• Secured websitesINFOSAN provided regular updates of information to its emergency network
– Close collaboration with Chinese MOH
– Collaboration with affected countries to verify information and provide alerts
– Assistance to countries on laboratory information, analytical methods, safety limits etc.
• Public Websites
Special websites set up to provide continuous updates to the public
The global polio eradication initiative
Global Laboratory Network for Polio EradicationN = 145 laboratories
The designation employed and the presentation of material on this map do not imply the expression of any opinion whatsoever on the part of the secretariat of the World Health Organisation concerning the legal status of any country,territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement.
Specialised Reference Laboratory
Regional Reference LaboratoryNational/ Sub-national Laboratory
Training
QC
Isolates
Data
Isolates
DataTraining
QCNational Labs
N = 123Serves host country
Isolates & types viruses
Regional Reference LabsN = 15
Serves > 1 country
Isolates & types viruses Differentiates (ITD) wild & Sabin-like polio viruses
Distributes supplies as needed
GlobalSpecialized Labs
N = 7 Isolates & types viruses
Performs ITD & sequencing Prepares & distributes reagents
Prepares & distributes PT testResearch
Lia
ises
wit
h i
mm
un
iza
tio
n &
su
rvei
lla
nce
p
ers
on
ne
l
Structure of the polio laboratory networkEvery country need not have the same capacity: “networking” provides access to services
ACTMalaria FoundationArmed Forces Research Institute of Medical Sciences (AFRIMS)
American Refugee Committee (ARC)Asian Development Bank (ADB)
Bill & Melinda Gates Foundation (BMGF)CDC MOH Thailand (TUC)
Center for Disease Control (CDC) AtlantaFamily Health International (FHI)
Health Unlimited (HU)Institute Pasteur Cambodia
Institute of Tropical Medicine (ITM) Antwerp, Belgium International Office for Migrations (IOM)
INTERPOLJapanese Ministry of HealthKenan Institute Asia (Kenan)
Mahidol-Oxford-Wellcome-trust Research Unit (MORU)Malaria Consortium
Management Sciences for Health (MSH/RPM+)MEASURE / evaluation
Medecins Sans Frontieres (MSF)Medicine for Malaria Venture (MMV)
MEKONG COUNTRIES(MOH)National academies / Research Institutions
Partners for Development (PFD)Population Services International (PSI)
SEAMEO TROPMEDSOKHLO Malaria Research Unit (SMRU)
Tropical Diseases Research (TDR)University Research Co (URC)
US Pharmacopeia / DQIUSAID-RDM-Asia
World Food Programme (WFP)WHO Collaborating Centers
WHO
Mekong Malaria Programme networking
Technical Networking Workshop every 2-3 years since 1999
Last technical consultation in Phuket, Thailand in September 2007
Build evidence of malaria drug resistance, Prepare a multi-country response
Proportion of positive cases on day 3 (2001-2007)
Qinghaosu - Artemisinins
Rapid action, broad stage specificity, safe, gametocytocidal
More study sites of the intensified TES (Therapeutic Efficacy Studies) network to better understand malaria
drug resistance
x xx
x
xx
x
x xx
xxxx
xx
x
xxx
x
Artemisinin resistance, the doom scenario
EWGLINET
• European surveillance scheme for travel-associated legionnaires' disease network
• aims – reduce incidence of travel associated legionellosis– provide an early warning system
• objectives – maintain a European surveillance – detect a common source – inform all those need to know about travel-associated Legionellosis– inform the public
Strengthening Global Networksfor Health Security
Strengthening Global Networksfor Health Security
1st Millenium
Epidemics and Pandemics have Epidemics and Pandemics have shaped our history…shaped our history…
Middle Ages
20th Century
WHO has detected & assessed > 2,800 events during 2001 to 2009
They continue to threaten us..
Modeling EID events: Relative risk of an EID
Hot Spots: global distribution of relative risk of an EID event caused by zoonotic pathogens from wildlife, (Jones Nature, 2008).
The Global Outbreak Alert and Response Network (GOARN)
• Assist countries with disease control efforts
• Investigate events and assess risks of rapidly emerging epidemic disease threats
• Support national outbreak preparedness
GOARN includes > 190 technical institutions and networks coordinating actions and resources to respond
to public health events of international concern.
GOARN partners have provided experts for > 104 operations in 75 countries for 197 missions.
Disease #outbreaks
# Deployments
Ebola 10 286Avian Influenza 21 206Marburg 2 122SARS 5 81Yellow Fever 8 58Cholera 3 52Rift Valley Fever 5 42Tsunami 3 40Meningitis 2 14Other 17 168Total 76 1007
GOARN deployments (as of April 2009)
GOARN – direct technical assistance and field support
• Materials
• Expertsepidemiology, public health, infection control, case management, risk communication, crisis management, logistics, laboratory, contingency planning
• Teamsmulti-disciplinary experts
• Funding
GOARN and Specialist Networks
GOARNGOARN
EDPLN(BSL4 laboratories)
COMBI(Health education)
Clinical
What makes a good network
• Clear purpose• Mutual benefits for all involved• Ownership• Clear roles & deliverables• Complementary and efficient division of labor• Sufficient resources• Accountability• Spirit of ‘comradery’ & ‘togetherness’
Conclusion
• Networks exist usually to share something or solve something of shared interest
• Networks can help provide access to information, expertise, methods, tools
• Networks can be more efficient and effective than working alone
Thank you