South Sudan Medical Journal - August 2026

Dear Reader,

The August 2026 issue is online here; we thank all the copyeditors and reviewers who helped prepare these papers. If you are submitting a manuscript, remember to read our Author’s Guidelines first.

We are looking for volunteers to join the Editorial team. Email us if you have time and editing skills.

Editorial

Can the Ebola Zaire vaccine stop Bundigunyo virus? Edward Kenyi

RESEARCH ARTICLES
Assessment of airborne fungi in the emergency and traumatology departments of University Hospital Centre, Sidi Bel-Abbes, Algeria Derouicha Matmour, Samia Merad, Yassine Merad, Achwak Bendouida, Zoubir Belmokhtar, Zakaria Merad, Mohamed Amine Boumelik, Benali Beghdadli, Othmane Ghomari 

Maternal and nutritional factors associated with early childhood development in rural Indonesia Hadi Ashar, Mohammad Zen Rahfiludin, Sri Achadi Nugraheni, Dwi Hapsari Tjandrarini

Observed outcomes and costs of laparoscopic versus open cholecystectomy in Juba, South Sudan Mayen Achiek, Jingo Faride, Mohamed Ibrahim, Abraham Mafair Kezekia, Chep C. Chep, Garang D. Nyuol, Ajak M. Dhel, George Lefteri

Stakeholders’ perspectives on determinants of health financing in South Sudan: a qualitative assessment Jonathan Majok, Gabriel Loi, Solomon Dut, Aluel Ayom, Thiey Kuethpiny, David Ngor, Sarah Nyannyot

Predictors of unsuccessful treatment outcomes among adults with pulmonary tuberculosis in a resource-limited setting Tri Agus Yuarsa, Malehah Mohd Noh, Richard Avoi, Meryl Grace Lansing, Putra Agina Widyaswara Suwaryo 

Assessment of the understanding of evidence-based medicine among undergraduate medical students in Gadarif University, Sudan Khalid Mohammed Ali, Ozaz Yagoub, Inshirah Mustafa, Tarig Fadelelmoula
 
Environmental health risks associated with open dumping practices in Central Kalimantan, Indonesia: an observational study Nawan, Septi Handayani 

Assessing the quality of health facilities providing antenatal care services in Bor, South Sudan John Thon Pandak Kuot, Shalini Ninan Cherian

Prostate cancer awareness and factors influencing screening among men at St. Francis Referral Hospital, Tanzania Theresia A. Karuhanga, Zeinabu Awardh Sharif, Antony Magoda, Philbert Madoshi 

CASE REPORTS 
Long-standing aspirated foreign body in a child complicated by pneumothorax and empyema Gawar Gel, Juma Deng, Justin Rubena

Clinical rabies in an HIV-positive pregnant mother with surviving newborn Ayol Mac Ayol

BACKCOVER: WHO: Guidelines for the management of pregnant and breastfeeding women in the context of Ebola virus disease

FRONT COVER IMAGE: The grown fungal colonies on SDA media collected from different types of samples. (Article on page 149)

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The SSMJ team

Email: southsudanmedicaljournal AT gmail.com
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Our mailing address is:

South Sudan Medical Journal
Health and Social Sciences Research Institute, Juba
South Sudan
Copyright (C) 2026 South Sudan Medical Journal All rights reserved.

Ebola and Mental Health, CDC Response to Ebola in West Africa in 2014-2015: Weds 15 July

Dear Peter, we are thrilled to invite you to our upcoming Webinar: 

Ebola and Mental Health, CDC Response to Ebola in West Africa in 2014-2015 on Wednesday, 15 July at 13:00-14:00 (CEST) 

Register here 

What can the Ebola response in West Africa teach us about mental health, trust, and outbreak preparedness today? We warmly invite you to our upcoming webinar “Ebola and Mental Health: Lessons from the CDC Response in West Africa, 2014–2015” on July 15, 13:00–14:00 CEST. 

Drawing on the 2014–2015 Ebola outbreak in West Africa and its rapid escalation, this webinar will explore why mental health and psychosocial support must be considered an essential part of outbreak response. The session will connect past lessons to current challenges, including the ongoing Ebola outbreak caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda. We are delighted to welcome Dr. Anna Grigoryan as our keynote speaker. Based on her personal experience and deployment to Sierra Leone in 2015 as part of the CDC Ebola Response Mission, Dr. Grigoryan will share reflections on key response activities, communication challenges, and the intersection of Ebola response and mental health. The webinar will highlight why coordinated, international, and rapidly scaled-up responses are essential to reduce illness, deaths, fear, and psychosocial distress during outbreaks. 

Agenda 
13:00–13:30 Keynote by Dr. Anna Grigoryan 
13:30–13:50 Q&A session 
13:50–14:00 Wrap-up 

About the speaker 

Dr. Anna Grigoryan is a physician–scientist with over 20 years of international experience leading complex public health projects, fostering innovation, and building strategic partnerships. She spearheaded the WHO–CDC Collaborating Center for Global Public Health Informatics, serving as its first Program Manager. During her tenure at the U.S. Centers for Disease Control and Prevention (CDC), she contributed directly to emergency responses to major crises, including the Haiti and China earthquakes, the avian influenza outbreak, and the Fukushima nuclear accident.

In 2015, Dr. Grigoryan supported the Sierra Leone Ministry of Health during the Ebola epidemic as part of the CDC Ebola Response Mission. In her more recent role at the UN/IAEA, she managed a portfolio of projects focused on laboratory strengthening, cancer control, and emergency preparedness, supporting Member States across Africa. She has also mentored emerging leaders and promoted cultures of accountability and inclusion during periods of organizational transition.This webinar is intended for public health and mental health professionals, as well as everyone interested in Ebola response, outbreak control, pandemic preparedness, and mental health and psychosocial support.

Please note: The webinar will be recorded. If you do not wish to appear in the recording, you are welcome to keep your camera turned off.

We look forward to your participation and to an engaging discussion on the role of mental health in outbreak response.

Please register even if you cannot attend and we will let you know when the video of the webinar is available. 

For any questions, feel free to contact the Hub Management Team at info AT globalhealthhub.de. 

Warm regards,
Katrin 
------
Katrin Würfel, Global Health Hub Germany

Previously: 'ebola' : 'Africa' : 'epidemic'

South Sudan Medical Journal Vol 19 No 2 May 2026

 

Dear Reader,

The May 2026 issue is online here; we thank all the copyeditors and reviewers who helped prepare these papers. SSMJ is indexed by African Journals Online (AJOL) – go here to see who reads us.


 

Editorial 

• Ebola: The Bundibugyo virus is back Edward Eremugo Kenyi
  
  

RESEARCH ARTICLES

• Risk factors in glaucoma: Insights from a prospective case–control study, Belagavi, India Asawari Kabure, Bhushan Kulkarni, Shilpa Kodkany, Murigendra Hiremath
• OV16 antibody seropositivity reveals persistent onchocerciasis transmission and cross-border risk in Magwi County, South Sudan: a population-based survey Ezbon WApary, Yak Yak, Benson Ojara, Wilson Ladu, David Oguttu, Ian Hennessee, Pita Jane, Johan Willems, Thok Chol, Kamulete Horasio, Okot William, Amanya Jacob
• Prevalence of urinary schistosomiasis in communities along the River Niger Basin areas, North-Central Nigeria Nyamngee Amase, Ikpe Raphael Terlumun, Kayode Yusuf Abel, Sulaiman Mariam Kehinde, Akanbi II Aliu Ajibola
• Developing a communicable and infectious diseases research agenda in South Sudan: A multi-stakeholder prioritisation approach Amanya Jacob, Ezbon WApary, Dhieu Daniel, Atemthi Dau, Matur T. Tieng, John Rumunu, Cicilia Konga, Bol Atem, Betty Eyobo, Robert Napoleon, Joseph Panyuon, Kenneth L Sube, Kon Alier, Joseph Lako, John Suraj, Abuelguasim M. Hassan, Mapuor Areu, Lazarus Atem, Aja Kuol, Pizzi Wilson, Achcer Adup Mou
• Determinants of disaster preparedness among public health facilities in Juba City, South Sudan Dumba Samuel Kenyi, Muthoni Mwangi Eunice, Musa Olouch
• Evaluating the role of the health information system infrastructure in enhancing data quality in Central Equatoria State, South Sudan Matur T. Tieng, Karani Magutah, Joseph Muchiri
• Impact of developmental stimulation education on maternal knowledge and caregiving practices in stunting: a longitudinal study Ning Iswati, Azizan Omar, Sukhbeer Kaur Darsin Singh, Putra Agina Widyaswara Suwaryo 
• Holding the line: lived experiences of mental health, moral injury, and organizational support among public-health professionals in the Rohingya Camp, Bangladesh — phenomenological study Md. Ruhul Amin

CASE REPORTS 

• Endoscopic endonasal repair of post-traumatic sphenoid sinus cerebrospinal fluid leak with encephalocele Justin Rubena, Khalid Coco, Francis Swaka, Othwonh Twong 
• A rare pathological feature of portal vein thrombosis complicated by portal hypertension and haematemesis Hamidine Illa, Ganiou Tidjani Kabirou, Amadou Magagi Mahamane Ibrahim, Maman Brah Moustapha, Soumaila Abdou, Habou Garba Abdoul Malik, Adamou Harissou

REVIEW ARTICLE

• Interpersonal and community-level factors influencing intimate partner violence in South Sudan: a literature review Nyinypiu Tong Chol Adong 

SHORT COMMUNICATIONS

• Letter to the Editor J. Clarke McIntosh
• Letter to the Editor Eluzai A. Hakim
• News from the Gordon Memorial College Trust Fund Eluzai A. Hakim

BACKCOVER: CDC Poster: Flu or Ebola? 

Thanks to everyone who supports SSMJ. Tell your colleagues they can join our mailing list here.

The SSMJ team
Email: southsudanmedicaljournal AT gmail.com
Website: http://www.southsudanmedicaljournal.com
Follow us on X: @SSMedJournal and our Facebook Group,

RCN Congress: Ebola, privacy and 'care bundles'

The first discussion at RCN Congress #RCN26 on Nursing as a STEM profession, or STEAM, with the arts added, became a resolution:

https://www.rcn.org.uk/congress/congress-events/nursing-as-a-stem-profession-2026

This was marvellous as it touched so many aspects that Hodges' model readily encompasses.

There is scope for the addition of emergency items:

https://www.rcn.org.uk/congress/Submit-an-emergency-agenda-item

Yesterday I wondered about the latest ebola outbreak, national and international aid^. Plus, privacy, having noticed a stream on twitter regards the NHS and a contract with Palantir. Yes, 'X' as a source is a problem, but concerns about access to confidential clinical information is found in the quality press. What does the Information Commissioner's Office say? Well, it seems there is a history:

https://icosearch.ico.org.uk/s/search.html?collection=ico%7Esp-search&query=PALANTIR&profile=_default

While searching for 'care bundles' I came across this:

 'The scope and force of medical privacy is further supported by a secondary layer of protections based in sectoral and other forms of regulation. Anti-discrimination laws, disability rights, and employment law, for example, all recognize and operate to preserve medical privacy by restrictions of use of medical information outside of the medical setting. 

 These intersecting normative strands of medical privacy, derived from different sources, together form a set of norms designed to protect a bundle of interests that is essential to the maintenance of an effective healthcare system that encourages and protects appropriate care-seeking and treatment. Whether and how technological changes in the collection, storage, and processing of data affect the construct of medical privacy is a pressing question. Just as a bell cannot be unrung, erosion of the sphere of medical privacy is unlikely to be restored.' p.330.

I realised over the past twenty years or so I've paid less attention to the fact that sections of a population, those often most in need of healthcare will not engage, be care-seeking - if they have no faith and trust in how their information is managed and protected. Minority groups, the digitally excluded (whether by choice, or literacy, economics) the influence of media are all vulnerable. Protection of data and the integrity of health services and systems is surely a matter of professional import both clinically and informaticians? As a registrant, I've always put it to student nurses that they should be aware of what happens to the data they as a registered nurse, enter in the electronic health record.

Pierce, R. (2018). Medical Privacy: Where Deontology and Consequentialism Meet. In B. van der Sloot & A. de Groot (Eds.), The Handbook of Privacy Studies: An Interdisciplinary Introduction (pp. 327–332). Amsterdam University Press. https://doi.org/10.2307/j.ctvcmxpmp.17

 

^What, only one sentence? Yes, but I'm still worried; geography - distance now matters little. While, on the other-hand: care-seeking...?

 

Previous posts: 'ebola' : #RCN26

Book: Rethinking Global Health - open access

Rethinking Global Health

INDIVIDUAL
  |

     INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

psy-disciplines:  intra- interpersonal domains subjectification - objectification  learning emotional labour burnout precarious researchers -  acknowledgement of contributions equity personal truth	ebola, cholera, HIV/AIDS, COVID-19, PTSD ... 'emergency', natural diasters climate crises: geography local - global - glocal remote - rural - urban (physical) systems tarmac bias data, information access (SDGs?) digital  divide, epistemic justice
collective 'truth' violence against the 'others' - women, children ... symbolic, structural and  collaboration, cooperation,  co-production, co-design, co-owned with communities socialisation - (into global health work) civil society mobilisation inclusion, empowerment social/cultural/ethnic history social - community - group:  psychology	POWER, poverty global - mental health - physical health (parity of health: determinants^) institutional violence co-ownership paternalism, colonialism humanitarianism NGOs - WHO - Institutions (political) systems decision-making (where, when, who, how ...?) finance - resources 'development' political history

^All of them...

Burgess, R.A. (2023). Rethinking Global Health: Frameworks of Power (1st ed.). Routledge. https://doi.org/10.4324/9781315623788

My source: Twitter

Please also note the inter- multi- transdisciplinary bridges provided by Hodges' model, including well established 'avenues' of psycho-social, socio-technical, psycho-political, geo-political, socio-economic and others.

Book: v "Foundations of Global Health & Human Rights"

 

A few points from the book to close:

Extending Human Rights beyond HIV: The Struggle against Tuberculosis (pp.229-231).

Afterword: Resilience in the Fight for Human Rights in Global Health - 

the first lesson of first aid.

"You can best care for the world when you take care of yourself." (p.459).

 

The index is very good. I might have expected more on corruption, fraud, and counterfeit healthcare products, but then this could be a distraction. It is alarming to read of the ongoing criminalization of groups in Asia, Africa and globally concerned with substance misuse and sexual health.

Even though I can extend thanks to OUP for my copy. Reading this book is a great investment in time.

individual
|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

"You are not alone. Together, we can build a brighter future." p.460. The book's closing sentence is an appeal to practitioners and as the past 18 months and the future will surely continue to reveal places a stress on self-care.	Tuberculosis HIV Ebola COVID Malaria ...
'laws on the streets*' ETHNO- 'duty to assist' p.448 UK?	'laws on the books' -NATIONALISM (chapter 20) Human rights literacy (p.143.) Universal Periodic Review - "a basis to assess the human rights situation in states throughout the world, seeking a holistic, equitable, and balanced approach to reviewing the situation of all human rights in all countries." (p. 166.)

 

 

Many thanks to OUP.

 

*Do people have an address? p.145.

[ Previously: https://hodges-model.blogspot.com/2021/01/book-review-iii-leave-no-one-behind-lnob.html ]

Foundations of Global Health & Human Rights. (2020) Lawrence O. Gostin and Benjamin Mason Meier (Eds.), Oxford: OUP. ISBN: 9780197528303.

 

The Great Green Wall

individual

|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

The Great Green Wall

"Africa's history with the west is littered with examples of plunder masquerading as benevolence, and science is no exception. Doctors and researchers who came to help during Ebola flew out with more than 269,000 blood samples from patients in Guinea, Sierra Leone and Liberia. That has meant that researchers in those countries cannot access samples that in many cases they had collected.    'All those superpowers, all those parachute researchers ... they pretended as if they want to help, but the real agenda was to control samples, so they can do all kinds of research on them'".

 

https://www.greatgreenwall.org/

Munshi, N. (2021) Lunch with the FT Christian Happi: With pathogens, we need to play offence. FT Weekend, Life&Arts, 20-21 February, p.3. (A rewarding read.)

Image source: https://africaresearchonline.wordpress.com/2013/05/21/the-great-green-wall/

Pandemic Bonds: Beware perverse incentives and instruments?

individual - self

|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group- population

Geography Number of Countries Number of fatalities Instruments: Legal, Science, Social, Policy, Financial ... ?

"On Wednesday [24 July], the World bank said it  would give $300m in grants and loans to DRC to step up its aid response. But funding connected to the World Bank's pandemic bonds, issued in 2017 have been less forthcoming. One relatively small slice - the so-called "cash" element - has delivered $31.4m to help with the crisis." Ebola's latest resurgence in central Africa has led to more than 1,700 fatalities. But for the insurance element of the bonds to pay out, the disease must cross an international border and there must be at least 20 fatalities in the second country. The total possible insurance payout for Ebola is $150m and comes in three tranches: when 250, 750 and 2,500 people have died across at least two countries, $45m, $45m and $60m, respectively, will be disbursed."

Pandemic Bonds World Bank: Pandemic Emergency Financing Facility DRC - Rwanda border

My source: Asgari, N. (2019) World Bank pandemic bonds spark Ebola anger, FT Weekend, 27-28 July, p.17.

Photograph - adapted from original by The Independent.

Paper: Geopolitical factors and mental health I [mapped to h2cm]

" ... we propose that mental health must be seen as a key strategic goal of foreign policy and be used as a measure of success of the foreign aid to ensure that individual people with mental illness are guaranteed a role and support in the civil society and their needs – clinical or social – do not get swept under the carpet. To this end, we examine some key statistics and to address the mental health needs of those worst placed, we propose an index – the Compassion, Action, Pragmatism and Evidence (CAPE) Vulnerability Index – that identifies the most vulnerable communities so that international aid may be more appropriately targeted, possibly ‘ring fenced’ making mental health a strategic building block of foreign policy." p.779.

individual

|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

wither mental health in relief, shorter life compared with general population,  poverty including  As a child As an adult Vicious cycle 1: Disaster experiences - mental health Traumatic Stress Disorder**

Natural & man-made disasters, health crises, e.g. Ebola, Conflict, War Climate warming Humanitarian intervention: Emphasis on physical survival and physical health Statistics: globally Proposed index: the Compassion, Action, Pragmatism and Evidence (CAPE) Vulnerability Index – that identifies the most vulnerable communities

Vicious cycle 1: [**Intergenerational transmission of stress and trauma - Epigenetics, social memory]  Social upheaval, migration and displacement mental illnesses assoc with social failures such as poor parenting, school failure, domestic violence and toxic stress, impacted prospects on earning a living, stigma social exclusion Social Determinants of Health Displacement refugees, poverty, women, children,  trafficking, rape

Foreign Policy Relief: mental illness = denial of - human rights, vote, marriage, inheritance, make a will Vicious cycle 2: corruption - inequality sequestration of assets crime, law & order Disaster ('declaration') Mental health problems cost the world some US$2.5 trillion per year  (US$16.1 trillion by 2030) Foreign aid & assistance Foreign policy Populism

Persaud, A. et al. (2018) Geopolitical factors and mental health I. International Journal of Social Psychiatry, 64(8) 778–785. DOI: 10.1177/0020764018808548
https://journals.sagepub.com/doi/abs/10.1177/0020764018808548?journalCode=ispa&

n.b. I have added epigenetics and the intergenerational transmission of stress and trauma.

South Sudan Medical Journal - November 2018

 

Dear SSMJ Reader,

The November 2018 issue of the South Sudan Medical Journal is now on online and includes articles on Ebola, Caesarean Section and Obstetric fistula. You can download the complete issue as a pdf here or the individual articles listed below.

Please share this notice with your colleagues.

EDITORIAL
Keeping an eye on Ebola Virus Disease Edward Eremugo Kenyi
Between June and November 1976, the medical world was baffled by an outbreak of a ferocious haemorrhagic disease in Nzara, South Sudan (then part of Sudan). This became known as Ebola Virus Disease (EVD). The West African outbreak in Guinea, Liberia and Sierra Leone in 2014 was devastating.  A new outbreak in DR Congo in 2018 is a warning to South Sudan to be on high alert.

ORIGINAL RESEARCH
Knowledge of type 2 diabetes mellitus and adherence to management guidelines: a cross-sectional study in Juba, South Sudan Alexandre Ali M. Bili and Longying Zha
Inadequate education and the lack of efficient diabetes care centres compounded by high costs are common barriers for diabetes care. This study assesses the level of knowledge and adherence to guidelines for management of type 2 diabetes in South Sudan.

Knowledge, attitude and willingness to accept Caesarean Section among women in Ogbomoso, southwest Nigeria Olumuyiwa A Ogunlaja, Idowu P Ogunlaja, Samuel E Akinola, Olufemi O Aworinde
Caesarean Section (CS) is a common procedure in obstetrics and has contributed immensely to improving maternal and foetal outcome. The study which seeks to assess the level of knowledge, attitude and acceptance of women about CS in Ogbomoso, Nigeria, concludes that mothers should be educated on the process involved in Caesarean delivery.

Obstetric fistulae, birth outcomes, and surgical repair outcomes: a retrospective analysis of hospital-based data in Dodoma, Tanzania Athanase Lilungulua, Balthazar Gumodokab, Mzee Nassoroc, Patrice Sokac and Kibusi Stephen
Obstetric Fistula (OF) among pregnant women remains a widespread condition with devastating consequences and poses a significant challenge in a community as well as globally. The study concludes that timely fistula repair by experienced fistula surgeons will improve outcomes and limit the clinical insult and distress that OF invariably causes.

CLINICAL GUIDANCE
How to repair a vesico-vaginal fistula Brian Hancock
Most fistulae are caused by ischaemic necrosis of the genital tract and adjacent organs through prolonged obstructed labour. This article provides a brief overview and refers the reader to resources that cover the practical aspects of the surgery and holistic care of the patient.

MAIN ARTICLES
Ebola Virus Disease: epidemiology, management, prevention and control Gasim Abd-Elfarag
Ebola Virus Disease (EVD) is part of the group of illnesses known as viral haemorrhagic fevers, and was previously known as Ebola haemorrhagic fever. Infection with EVD is acute, severe and often fatal in humans. The paper provides an outline of what is known about EVD.

Ebola on our doorstep: Ebola Virus Disease preparedness in South Sudan Richard Lako and Otim Patrick Cossy Ramadan
South Sudan has previously experienced three EVD outbreaks in 1976, 1979 and 2004. With recent outbreaks in DR Congo, it is possible that a sporadic outbreak can happen in South Sudan, and so the country is always at risk. Preparedness is key.

COMMENTARIES
Internship training in South Sudan: the challenges and way forward Jessry Pasquali Oboya
The House Officer is the professional whom the patient meets most often when entering hospital and will remember for a long time. The extraordinary commitment and work load of the House Officers at Juba Teaching Hospital has received little recognition by the authorities despite the challenges they face in the course of their training.

The current crisis of human resource for health in Africa Brian Madison
Brain drain has been a source of despair for developing countries, and the healthcare sector arguably bears the biggest brunt imposed by this growing problem. The author argues that if Africa is to counter the healthcare human resources crisis, member states may need to adopt radical reforms in the healthcare sector.

SHORT ITEMS
Caesarean Section acceptability and rate in South Sudan
Call for submissions
Obituaries

BACK COVER
Neonatal resuscitation chart
This chart is designed with the ‘Helping Babies Breath’ training in mind. However, it incorporates external cardiac massage, which can be effective in some cases.

All previous issues of the journal are in the Archive section, and you can ‘search’ for particular articles.

Please support the journal by submitting items for future issues. We are interested in articles on your research, case reports, and clinical guidance, as well as news of projects, and relevant photographs. We can help you prepare these for publication (see our ‘Authors’ Guidelines’). We welcome letters to the editor and questions. Send your contributions to the Editor-in-Chief, Dr Edward Luka admin@southernsudanmedicaljournal.com. 

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Kind regards
The SSMJ team

'How to Build a New Global Health Framework': Gostin & Friedman in The Lancet

http://us5.campaign-archive1.com/?u=5556647df8c0be7cf0da07db2&id=2fa83f37fc&e=2b5ede61fe

http://www.law.georgetown.edu

May 7, 2015 - Can a true, robust global health framework be created to help prevent tragedies like Ebola while at the same time allow countries to meet everyday health needs?

Georgetown University global health and law experts say it can be done, and in a special issue of “The Lancet” focusing on global health security, they propose specific priorities to transform a fragmented health system into a “purposeful, organized” framework with national health systems at its foundation and an empowered World Health Organization at its apex.

“The Ebola epidemic in west Africa raised the critical question of who is in charge,” says Lawrence O. Gostin, JD (http://www.law.georgetown.edu/oneillinstitute/faculty/Lawrence-Gostin.cfm) , faculty director of the O’Neill Institute for National and Global Health Law (...) at Georgetown University Law Center (http://www.law.georgetown.edu/) . He and his O’Neill Institute colleague, Eric A. Friedman, JD (...) , published an analysis of global health security today in The Lancet (“A retrospective and prospective analysis of the west African Ebola virus disease epidemic: robust national health systems at the foundation and an empowered WHO at the apex.” (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60644-4/fulltext) )

“The world is ill-prepared for the next epidemic,” Gostin says. “The need for advance funding, planning and coordination from the national health system up to WHO is at the heart of preparedness, not only for epidemic disease, but also naturally occurring disasters such as the crisis precipitated by the Nepal earthquake.”

In their review, Gostin and Friedman offer a retrospective analysis of the recent Ebola outbreak and the “profound harms posed by fragile national health systems.”

In creating a new framework, the authors say, “The scope of the reforms should address failures in the Ebola response, and entrenched weaknesses that enabled the epidemic to reach its heights.”

They propose a new global health framework that has national health systems as its foundation and an empowered WHO as the “global health leader envisaged at its creation.”

To reach the goal of having an empowered WHO to lead a global health framework, Gostin and Friedman outline priorities for reform:

• Funding: commensurate with global mandate under WHO Director-General’s control,
• Technical excellence: diverse staff with multisectoral capabilities,
• Operational capacities: rapid deployment of economic and human resources,
• Normative standards: setting priorities and ensuring compliance,
• Regional offices: regional knowledge and consistency with headquarters, and
• Engaging non-state parties: harnessing the potential of civil society.

Gostin and Friedman say another critical component to a global health framework are key stakeholders such as the United Nations, The World Bank and NGOs. “In a well functioning global health system, all parties would perform functions suited to their mandate, working cooperatively, and supporting national ownership.”

In addition, the authors point out the need for a strong legal framework to enforce international health regulations: “International law and national implementing legislation can be powerful means for a more effective global health system,” Gostin and Friedman write.

Another key component to a global health framework is to shore up the national health capacities in preparation for a crisis that would better ensure health security, regionally and globally.

“Planning for rapid mobilization should be combined with strengthening health systems to build country capacity,” they say and propose reforms including a global health workforce reserve, and emergency contingency fund, a pandemic emergency facility (like that suggested by The World Bank) and an international health system fund.

“Action now on WHO and other reforms to the global health system is crucial, before the political moment passes,” Gostin and Friedman conclude.  “These reforms would not only keep populations secure against pandemic threats, but would also ensure health and safety for all needs through rights-based universal health coverage.  This is a global health framework that is achievable in the aftermath of a tragic epidemic that needlessly took 10,000 lives in one of the world’s poorest regions.”

About the O’Neill Institute for National & Global Health Law

The generous philanthropy of Linda and Timothy O’Neill established the O’Neill Institute in 2007 to respond to the need for innovative new solutions to the most pressing national and international health concerns. Housed at Georgetown University Law Center in Washington D.C., the O’Neill Institute reflects the importance of public and private law in health policy analysis. The O’Neill Institute draws upon the University’s considerable intellectual resources, including the School of Nursing & Health Studies, the School of Medicine, the McCourt School of Public Policy, and the Kennedy Institute of Ethics.

http://www.oneillinstituteblog.org/ 

http://www.twitter.com/oneillinstitute 

====

Copyright © 2015 The O’Neill Institute for National and Global Health Law at Georgetown University. All rights reserved.


My source: O’Neill Institute for National and Global Health Law via HIFA2015

Below I have related the above to Hodges' model:

individual

INTERPERSONAL : SCIENCES

humanistic ------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

group

Concepts - Understanding Global Health Conceptual Framework, Beliefs, Belief systems, Education, Individual Action Critical Thinking Access to Health Information Impact of disease/disaster on survivors Psychological health needs	Pre-vent Ebola..., Epidemic - Pandemic, Natural disasters Emergency response, Critical Action Timeliness - Surveillance, Readiness, (National-) capacity, Physical health needs, Health systems, (Infra)Structures, Technical, Operational, Processes, Coordination, Mobilisation Scales: Local, Regional, National, Global
Social Empowerment, Engagement Poverty Communities Critical Communications Concordance Local Leadership, Cooperation Behaviour of groups amid Fear / Uncertainty Socio-Technical Community-Social-Urban... Informatics	Pre-empt UN, World Bank, WHO, NGOs, Reform, Policy, Standards Rights-Based Universal Health Global Health Framework Funding, Law, Legislation Priorities, Compliance, 'HQ' Critical Governance & Assurance Civil Society, Citizenry

Ebola: impact across the care domains

individual
INTERPERSONAL : SCIENCES

humanistic ------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

group

grief, mental trauma, stress ChildFund International opens first Interim Care Center for children orphaned by Ebola: https://www.childfund.org/ChildFund-International-opens-first-Interim-Care-Center/

Dear Friends, Ebola is  frightening.  Most information from TV, Facebook, and from our governments is poor. We want to change this by providing to you the best possible scientific information  about Ebola from leading scientists from Nigeria, Africa, the Library of Alexandria and experts world wide. We have created a cutting edge lecture on Ebola for you to teach your students, share with your faculty and distribute to your friends. The Lecture has been translated by 20 scientific experts  into  Arabic, Chinese, English, Farsi, French, Hebrew, Japanese, Malay, Pashtu, Russian, Spanish and Urdu. It present the best possible scientific knowledge about this disease. http://www.pitt.edu/~super1/lecture/lec52511/index.htm ... We provide this to you as a “gift that is meant to be given”. Please share this with your students and faculty, and post the lecture on Facebook, tell others about  it through Twitter, etc.  The Library of Alexandria Lecture is free, developed by the global scientific community. Include links to this from Universities, Libraries, schools media, etc. Let us continue to learn and share the scientific facts about Ebola. Drs. Elegba, Kana, Bello-Manga and Adiri Faculty of Medicine Kaduna State University, Nigeria Ismail Serageldin, Ph.D., Director Library of Alexandria Ronald LaPorte, Ph.D. Director Emeritus WHO Collaborating Centre, Pittsburgh

Al Jazeera America The biggest concern of the Ebola outbreak is POLITICAL*, not medical: http://america.aljazeera.com/opinions/2014/8/ebola-virus-liberiasierraleonepolitics.html

Additional links:

Understanding the Ebola Virus and How You Can Avoid It:
https://alison.com/course/understanding-the-ebola-virus-history-treatment-and-prevention-revised

The Economist: Ebola and big data - Waiting on hold:
http://www.economist.com/news/science-and-technology/21627557-mobile-phone-records-would-help-combat-ebola-epidemic-getting-look

Ebola Resources:
http://ebolaresources.org/

Ebola Deeply:
http://www.eboladeeply.org/

Ebola, David Quammen, Bodley Head:
https://www.davidquammen.com/

Sources:
HIFA2015
https://sci-techuniverse.blogspot.com/2013/01/terrifying-facts-about-ebola.html
*my emphasis