Tag Archives: global health

Addressing the Global Challenge of Ebola and Infectious Disease Outbreaks

On Wednesday, July 17th, 2019, the World Health Organization (WHO) Emergency Committee released a statement declaring the Ebola outbreak in the Democratic Republic of the Congo (DRC) an international emergency. The statement announced that, on average, 80 new cases are reported each week along the northeastern border of the DRC. Because thousands cross this border to Rwanda daily, the national and regional risk is very high. Furthermore, the US Department of State now considers the North Kivu and Ituri Provinces in the DRC a “Level 4: Do Not Travel” zone due to the threats to safety caused by local conflicts and the Ebola outbreak. Preexisting unstable political conditions, poor security and limited infection control practices add to the complexity of the situation. Two community health workers were murdered last week, contributing to the unrest. Now the disease has reached Goma, a city with nearly two million people and an international airport, leading WHO to take action.

According to WHO, the virus continues to spread geographically, despite improvements in outbreak surveillance and decreases in virus transmissions. Additional resources, local community involvement, increased security measures, and efforts across multiple sectors are still necessary to control this outbreak. Our reports explore recent Ebola outbreaks, infectious disease control and prevention, and global health policy, and provide guidance for decision-making. All reports are free to read or download.


Integrating Clinical Research into Epidemic Response: The Ebola Experience

The 2014–2015 Ebola epidemic in western Africa was the longest and most deadly Ebola epidemic in history, resulting in 28,616 cases and 11,310 deaths in Guinea, Liberia, and Sierra Leone. The Ebola virus has been known since 1976, when two …


Global Health and the Future Role of the United States

While much progress has been made on achieving the Millenium Development Goals over the last decade, the number and complexity of global health challenges has persisted. Growing forces for globalization have increased the interconnectedness of …


The Neglected Dimension of Global Security: A Framework to Counter Infectious Disease Crises

Since the 2014 Ebola outbreak many public- and private-sector leaders have seen a need for improved management of global public health emergencies. The effects of the Ebola epidemic go well beyond the three hardest-hit countries and beyond the …


The Global HIV/AIDS Crisis: Resources to Inform Decision Making

In 2008, more than 33 million people across the globe had HIV/AIDS, 67 percent of whom were in Africa. In addition, more than 90 percent of the 2.7 million new infections reported that year occurred in Africa, and only half of Africans who should have received antiretroviral therapy (ART) according to World Health Organization guidelines then in place were treated. By 2020, the number of infected people in Africa is estimated to grow to over 30 million, with just 7 million of the approximately 12 million who should be treated under current guidelines likely able to receive ART, according to a new report released by the Institute of Medicine.

Preparing for the Future of HIV/AIDS in Africa: A Shared Responsibility says that the number of people infected with HIV/AIDS in sub-Saharan Africa is projected to far outstrip available resources for treatment by the end of the decade, forcing African nations to make difficult choices about how to allocate inadequate supplies of lifesaving ART. The report calls for a renewed emphasis on reducing the rate of new infections, promoting more efficient models of care, and encouraging shared responsibility between African nations and the U.S. for treatment and prevention efforts, which could greatly improve prospects for the future.

The global AIDS pandemic calls for action beyond Africa, too. There are many countries in Eastern Europe, the Commonwealth of Independent States, and Asia where the sharing of contaminated injecting equipment is the primary mode of HIV transmission. In some cases, HIV is spreading rapidly from injecting drug users to their partners through sexual transmission, and from injecting drug users and their partners to newborns. Preventing HIV Infection among Injecting Drug Users in High Risk Countries: An Assessment of the Evidence finds that several key approaches can reduce HIV related risk behavior among injecting drug users. The report urges high-risk transitional and developing countries to take immediate steps to make these techniques widely available.

These reports and others from the Institute of Medicine can inform and guide discussion of the HIV/AIDS crisis both internationally and here in the United States, where according to the Centers for Disease Control there were 56,000 newly infected Americans and 15,000 AIDS-related deaths in 2008.

Preparing for the Future of HIV/AIDS in Africa Preparing for the Future of HIV/AIDS in Africa: A Shared Responsibility

HIV/AIDS is a catastrophe globally but nowhere more so than in sub-Saharan Africa, which in 2008 accounted for 67 percent of cases worldwide and 91 percent of new infections. The IOM recommends that the United States and African nations move toward a strategy…

Preventing HIV Infection among Injecting Drug Users in High Risk Countries Preventing HIV Infection among Injecting Drug Users in High Risk Countries: An Assessment of the Evidence


The U.S. Commitment to Global Health The U.S. Commitment to Global Health: Recommendations for the Public and Private Sectors

Health is a highly valued, visible, and concrete investment that has the power to both save lives and enhance the credibility of the United States in the eyes of the world. While the United States has made a major commitment to global health, there remains a…

HIV and Disability HIV and Disability: Updating the Social Security Listings

The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus qualify for disability benefits. In this report, the Institute of…

HIV Screening and Access to Care HIV Screening and Access to Care: Exploring Barriers and Facilitators to Expanded HIV Testing

More than 200,000 people in the United States living with HIV/AIDS do not know they are infected. The Institute of Medicine’s Committee on HIV Screening and Access to Care held a workshop and reviewed literature to explore barriers and facilitators to more…

PEPFAR Implementation PEPFAR Implementation: Progress and Promise

In 2003 Congress passed the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act, which established a 5-year, $15 billion initiative to help countries around the world respond to their AIDS epidemics. The initiative is generally referred to…

Healers Abroad Healers Abroad: Americans Responding to the Human Resource Crisis in HIV/AIDS

Healers Abroad: Americans Responding to the Human Resource Crisis in HIV/AIDS calls for the federal government to create and fund the United States Global Health Service (GHS) to mobilize the nations best health care professionals and other…

Public Financing and Delivery of HIV/AIDS Care Public Financing and Delivery of HIV/AIDS Care: Securing the Legacy of Ryan White

Each year it is estimated that approximately 40,000 people in the U.S. are newly infected with HIV. In the late 1990s, the number of deaths from AIDS dropped 43% as a result of highly active antiretroviral therapy. Unfortunately, the complex system…

Nine new books: emergency care, obesity prevention, engineering innovation, and more

Nine new publications—both pre-publications and final versions—hit the website last week, and as usual, we’re rounding them up here. Stay tuned to Notes From NAP. In the next few weeks, we’ll be writing about some of our most popular publications in addition to these weekly lists of what’s new.

Featured Publication

Regionalizing Emergency Care: Workshop Summary (prepublication)

During medical emergencies, hospital staff and emergency medical services (EMS) providers, can face barriers in delivering the fastest and best possible care. Overcrowded emergency rooms cannot care for patients as quickly as necessary, and some may divert ambulances and turn away new patients outright. In many states, ambulance staff lacks the means to determine which hospitals can provide the best care to a patient. Given this absence of knowledge, they bring patients to the closest hospital. In addition, because emergency service providers from different companies compete with each other for patients, and emergency care legislation varies from state to state, it is difficult to establish the necessary local, interstate, and national communication and collaboration to create a more efficient system.

In 2006, the IOM recommended that the federal government implement a regionalized emergency care system to improve cooperation and overcome these challenges. In a regionalized system, local hospitals and EMS providers would coordinate their efforts so that patients would be brought to hospitals based on the hospitals’ capacity and expertise to best meet patients’ needs. In September 2009, three years after making these recommendations, the IOM held a workshop sponsored by the federal Emergency Care Coordination Center to assess the nation’s progress toward regionalizing emergency care. The workshop brought together policymakers and stakeholders, including nurses, EMS personnel, hospital administrators, and others involved in emergency care. Participants identified successes and shortcomings in previous regionalization efforts; examined the many factors involved in successfully implementing regionalization; and discussed future challenges to regionalizing emergency care. This document summarizes the workshop.

See the rest of this week’s new publications