Bill Frist, Vandy Professors Hold Ebola Discussion
by Jen Todd, [email protected]
Doctors, professors and former Senate Majority Leader Bill Frist invite the public to discuss the base of worldwide fear: Ebola.
"Ebola is a modern plague, which sorely tests U.S. leadership at multiple points," said J. Stephen Morrison of the Center for Strategic and International Studies in a statement. "It requires grappling with considerable unknowns, and preserving the confidence, trust and support of the American people."
The two along with William Schaffner, professor of Preventive Medicine in the Department of Health Policy at Vanderbilt University School of Medicine, and Sten H. Vermund, director of the Vanderbilt Institute for Global Health, will begin the conversation, addressing four points.
These subjects are: the U.S. approach to cases entering the United States, the mobilization in Liberia, the growth of the epidemic in West Africa and how to stop transmission, and efforts to develop new vaccines and treatments.
Then, Muktar Aliyu, associate director for research for the Vanderbilt Institute for Global Health, and James E. Crowe, Jr., director of the Vanderbilt Vaccine Center, will jump in to consider what changes need to be made in the U.S. approaches, both short and long-term.
The free event is open to the public and begins at 10 a.m. Nov. 21 at Vanderbilt University Medical Center, Light Hall Room 208, 2215 Garland Ave.
The Case for Foreign Aid: There Is No 'Them' Only 'Us'
By Bill Frist and Jenny Eaton Dyer Nov. 5, 2014, 6:20 p.m.
With the advent of the few Ebola cases that have emerged in the U.S., Americans and the global community can and should turn their attention to the plight of fragile health care infrastructure in poor countries. This outbreak is a stark reminder that our own health and prosperity is directly linked to that of the developing world. Foreign aid is a catalyst for building healthier families and communities — and in turn, helping our own.
Too often, health systems in poor countries are ill equipped to handle public health crises, or even provide basic primary health care services including, immunizations for children; the treatment and prevention of infectious diseases such as HIV, tuberculosis and malaria; and other life-saving interventions such as access to contraceptives.
The Ebola crisis is showing us once again how critical it is to invest in functioning public health systems in developing nations, so they are able to increase access to the information and tools people need to protect their own health and the health of their loved ones. Importantly, these systems must be designed to reach and meet the needs of women and girls.
Two years ago, leaders from around the world came together to commit to an ambitious goal: By 2020, 120 million more women and girls in the world's poorest countries would have access to the information and tools they need to make the best decisions, harmonious with their values and beliefs, in planning their families.
We are already seeing results. Today, Family Planning 2020 — the movement that carries this global effort forward — launched its second annual report on progress made toward this goal.
In 2013, more than 8.4 million additional women and girls had access to contraceptives compared to 2012, across 69 of the world's poorest countries. Access to contraceptives averted an estimated 77 million unintended pregnancies. And the lives of more than 125,000 women and girls were saved from complications related to unintended pregnancies.
Hope Through Healing Hands partnered with the Bill & Melinda Gates Foundation one year ago to champion a spectrum of issues related to maternal, newborn and child health, with a special emphasis on healthy timing and spacing of pregnancies, or international family planning. If women have access to an array of contraceptive methods, including fertility awareness, we can save and improve the lives of millions.
Nearly 1 in 39 women die in Africa from complications related to pregnancy and childbirth, making it a leading cause of preventable death. Yet if women can better time their pregnancies between the ages of 18 and 24, they can exponentially affect their chances of survival. For instance, women who give birth between the ages of 20 and 24 are 10 to 14 times more likely to survive than those who have babies when they are younger. And by giving women the means to space the births of their children by at least three years, newborns would be twice as likely to survive their first year. We could drastically reduce maternal and infant mortality with better access to information and services for healthy timing and spacing of pregnancies.
With a focus on the mother-child orbit of health, we cut to the nexus of global health challenges to address extreme poverty, access to education, gender equality and infectious disease. Economically, healthy timing and spacing of pregnancies, and access to contraceptives, is one of the best investments a country can make in its future. Contraceptives are cost-effective and deliver big savings in health care costs and social programs. For each U.S. dollar spent on helping women plan their families, governments can save up to $6 on health, housing, water, and other public services.
The Ebola outbreak is a tragedy and has already claimed the lives of thousands. It will take serious intervention to stop its further spread and interrupt transmission. As we consider how best to respond, let's also consider how best to strengthen the infrastructure of health systems in poor countries, and how to provide simple interventions, like family planning, to save the lives of millions of mothers and children around the world.
Bill Frist, M.D., is a former senator from Tennessee. Jenny Eaton Dyer, Ph.D., is the executive director of Hope Through Healing Hands.
Ebola Turning Point: Realities And Ideals For On-The-Ground Testing
Forbes | November 1, 2014
By Bill Frist
Imagine waking up with a fever and nausea in West Africa. You would probably be equal parts curious about the cause of your symptoms, and terrified that it might be fatal. Ebola is actually the least likely cause of your fever, unless of course you had been exposed to a known Ebola case. Malaria is a much more likely cause of your fever, and now that the summer months are approaching, Lassa Fever, another type of Viral Hemorrhagic Fever, is becoming more prevalent.
You go to the local "clinic" and healthcare workers there isolate you. They draw blood and send it to a nearby city for testing. It will take days for the results to come back. You are considered Ebola positive until proven otherwise. Until then, you are put in containment with other febrile patients–some probably with Ebola. There is no space. You are crammed in with other sick patients and isolated from your family. You may feel O.K. compared to these patients, some of whom are potentially deathly ill. If you do not have Ebola now, will you have it by the time your waiting period is done?
Now imagine an alternative reality.
You wake up with the same fever and nausea. You go to a designated diagnostic site, likely the same clinic, and your finger is pricked or a small vial of blood is drawn by a trained healthcare worker. You are asked to wait in a holding room for up to three hours, but no more. Everyone in the room with you is about as sick as you are and waiting quietly and calmly. In a few hours, you have an answer: You have Lassa or Malaria or another febrile illness, or you have Ebola. From there you are triaged appropriately to the best treatment, maybe released with anti-malarial medications or other treatment.
In West Africa today, a rapid diagnostic test (RDT) would be a complete game changer. Identifying infected individuals quickly means the best use of resources, quick institution of appropriate treatment, reduced risk for spread of infection, and decrease in public panic and fear.
On October 25 the FDA approved two tests from BioFire Defense that can produce a diagnosis in two hours compared with current polymerase chain reaction (PCR) methods that generally take four hours. The new tests use patented "FilmArray" technology to identify the virus quickly.
While this is definitely a step in the right direction, it is still not the ideal solution. First, BioFire's FilmArray tests still require someone to draw an entire tube of blood and inactivate the virus, which is dangerous. Second, the testing instrument can only process one sample at a time. One machine can process 24 tests a day, while PCR tests can run up to 70 tests a day even though they take four hours. Third, the cost is almost prohibitive. The new test instrument costs $39,000 and each test is $189 dollars. Considering multiple devices are needed, and that PCR is relatively cheap, the cost benefit analysis needs to be considered.
This is not to say I am not encouraged by the possible impact of the BioFire technology. I am especially pleased the FDA accelerated approval. But we cannot stop here.
The ideal RDT would be a quick, field-ready test, with results available within hours at a very low cost. It would not require large blood samples, would have a high sensitivity and specificity, and may even be able to detect viral RNA before a patient becomes symptomatic—at very low concentrations—to avoid lengthy quarantines.
Several groups have reached out to me to let me know that they are working to develop such a test. Promising development it happening! When these criteria are met, it will be possible to test in a maximally effective, decentralized, and distributed way.
Until then the wisest course is a coordinated containment strategy for real exposures. The only people that have contracted Ebola in the U.S. have been healthcare workers exposed to the bodily secretions of infected patients late in the disease progression. Our focus should be on people who are truly likely to have been infected. And the treatment strategy should leverage the specific hospitals that are trained in managing diseases like Ebola.
It is hubris to think just anyone in healthcare can take care of Ebola patients and properly contain it. We have to respect the virus. But that does not mean mass hysteria, wide spread travel bans or even airport quarantines. We have to remember the science behind Ebola. It is infectious but not very contagious. It requires that bodily secretions contact mucous membranes.
While mistakes have been made in identifying and containing this outbreak, we must recognize we are fighting a disease and not each other. What we learn as we contain Ebola can be applied to infectious disease challenges in the future—both globally and at home. Today, one out of every 25 people admitted to the hospital in the U.S. acquires an infection and more than 5,000 people die of those infections each month. Early detection of infections in the hospital setting can reduce spread and save lives.
Doing thing right on Ebola will become the standard for how in the future we treat all infectious diseases. We need to keep working to get it right—to make the ideal a reality.
FGHL Blog: Yi He - Routine in Munsieville
Yi He
Not too many things happened during this time period, I continued reading literature regarding baseline survey of early child development in developing countries, talked with people in the community, identify key issue which I need to add into the survey; attended monthly hub meetings, tried to understand their responsibilities for supporting our core mission: promoting overall health status of vulnerable children in Munsieville.
HTHH, CSIS, and VIGH Host Panel Discussion on U.S. Leadership on Ebola
Don't miss this special event coming up at Vanderbilt on Friday, November 21.
Senator Bill Frist, M.D., Global Health Experts Lead Community Conversation at Vanderbilt University on U.S. Leadership on Ebola in West Africa and at Home
Melany Ethridge, (972) 267-1111, [email protected]
NASHVILLE, TENNESSEE, Oct. 27, 2014 – On November 21, former Senate Majority Leader Bill Frist, M.D., founder of Hope Through Healing Hands; J. Stephen Morrison, Ph.D., Senior Vice President at the Center for Strategic and International Studies; William Schaffner, M.D., professor of Preventive Medicine in the Department of Health Policy at Vanderbilt University School of Medicine; and Sten H. Vermund, M.D., Ph.D., Director of the Vanderbilt Institute for Global Health will lead a roundtable on Ebola that will take place at Vanderbilt University Medical Center, Light Hall Room 208, 2215 Garland Ave., in Nashville, from 10-11:30 a.m. The forum is jointly sponsored by Hope Through Healing Hands (HTHH), the Center for Strategic and International Studies (CSIS), and the Vanderbilt Institute for Global Health (VIGH). It will be on-the-record, and open to media.
The United States is engaged in a two front war against Ebola – at home, and abroad in Liberia, Sierra Leone and Guinea. The four roundtable speakers will open with remarks on key dimensions of the Ebola crisis: the evolving U.S. approach to preventing, detecting and responding to cases entering the United States; the U.S. military-led mobilization in Liberia and the broader international effort under UN coordination; the exponential growth of the epidemic itself in West Africa and critical steps to break the chain of transmission; and accelerated efforts to develop new technological tools, e.g. a rapid diagnostic test, vaccines, and treatments.
A lively, interactive conversation will follow, into which Muktar Aliyu, M.D., Associate Director for Research for the Vanderbilt Institute for Global Health and James E. Crowe, Jr., M.D., Director of the Vanderbilt Vaccine Center, will be invited to add their thoughts. Over the course of the conversation, special consideration will also be given to what future changes will be needed in U.S. approaches, both to domestic public health capacities and the long-term scientific research agenda, and to post-Ebola reconstruction in West Africa, including investments in basic health services.
A big part of infectious disease control is investing money in the right places, ideally at the source of the problem as early as possible, changing habits and having the right targeted response, Frist explained. "If we had invested one-tenth of what people think we have invested, we wouldn't be in this position," he said.
"Ebola is a modern plague, which sorely tests U.S. leadership at multiple points. It requires grappling with considerable unknowns, and preserving the confidence, trust and support of the American people," Morrison commented. "We are just at the front end of a long process of thinking through the strategies that will work most effectively in this two front battle."
Sten Vermund adds, "I write this from rural Mozambique where clinics have no running water or hand sanitizer; the spread of Ebola virus from West Africa to other under capacitated regions would be catastrophic. We must control it where it emerged."
The Vanderbilt Institute for Global Health fosters multidisciplinary research, teaching, and service activities linked to health and development in resource-limited settings of the developing world, and forges a collaborative environment through multidisciplinary approaches rooted in academic research and training, and pragmatic community partnerships. This effort enables the establishment of a research and development agenda that informs training and capacity building programs throughout Vanderbilt University in the area of global health.
The Center for Strategic and International Studies (CSIS), based in Washington, D.C., is a non-partisan, independent non-profit institution that concentrates on U.S. policy approaches to defense and security, regional stability, and transitional challenges ranging from energy and climate to global health and economic integration.
FGHL Blog: Milca Nunez - Giving Back to the Community in the Long Term
By Milca Nunez, Frist Global Health Leader
Many things have happened since the last reporting period. We have been able to facilitate more health education discussions for Proyecto Alerta Joven, which has been one of my favorite activities to do. We did a short course on values and how they are interrelated with occupations, like responsibility and honesty.
Former Senator Frist: Ebola crisis in West Africa could last into next Spring
Jim Mitchell
This article first appeared in Dallas Morning News
William H. Frist, the doctor and former Senate Majority Leader, has broken his self-imposed silence with a few words of perspective about the current Ebola outbreak.
In West Africa, the crisis could easily last into next spring. In the United States, it is much more containable. And while he says the virus is very "cagey," scientists have a good understanding of how it is transmitted, know that this outbreak isn't any different than any other Ebola outbreak and the odds that this virus has somehow mutated is "very, very unlikely."
So what went wrong in Dallas? In some ways, it is also what went wrong in West Africa. Diagnostics are still too slow, meaning that samples were sent off to a lab somewhere and weren't returned for a couple of days. There wasn't a rapid enough response. And of course, the consequences years of underfunding global infectious diseases are also a factor in a virus that has been an issue on the African continent now reaching American soil.
Frist estimates that 23,000 people will die of the flu this year, and in America less than "10 will die of Ebola, hopefully just one." And while every death is tragic, the reality is that protocols have to be strictly established and followed. "This is not contagious virus like flu," he said.
Frist, in town to champion global investment for sensible family planning policies in underdeveloped countries, said the world response to HIV/AIDS showed the value of a global response. While the Ebola crisis in West Africa has lasted longer than he anticipated, he wants people to know that he is confident it will NOT spin out of control in the United States even though it might seem that public uncertainty is trumping established science.
Frankly, I think Frist is right in so many ways. A big part of infectious disease control is investing money in the right places, ideally at the source of the problem as early as possible, changing habits and having the right targeted response. "If we had invested one-tenth of what people think we have invested, we wouldn't be in this position," said Frist.
I know a key part of changing the trajectory of HIV/AIDS infections was the development and delivery of effective new drugs to patients. In the United States, those drugs saved lives. And, in Africa, drugs that reduced the transmission of HIV/AIDS from mother to child were integral in the battle. And that's why Frist's work is so important.
Frist, who is working with Hope Through Healing Hands in Nashville, wants to apply those principles to global family issues. We have all heard the stories of how a woman in an undeveloped country who delays childbirth has a greater chance to get an education and avoid a life in poverty. But there are other benefits — life itself. About 1 in 39 women in sub-Saharan Africa die of pregnancy complications. Simply spacing pregnancies at least three years apart dramatically increases over survival rates.
The overarching message is that the global health agenda must be just that — global. Generational poverty, infectious diseases and even infant/mother survival rates in Africa should concern us in the highly industrialize United States because the consequences can be just a plane ride away.
Schola Prophetarum
Language in the Global Health Arena for HIV/AIDS and Family Planning
Jennifer Eaton Dyer
Eating lunch outside the refectory of Vanderbilt Divinity School, back around the turn of the millennium, I remember stumbling across the stone etching of Schola Prophetarum, the School of the Prophets. I am sure all who have passed through the halls of the Divinity School may have reflected on their potential role as a prophet in our community, society, and our world. That is our legacy.
Meet Touch
Have you had a chance to meet Touch? This dog is changing lives and we're so excited to watch what he and Senator Frist are doing for our kids. If you haven't seen it already, watch this video now. This is such a special story: