Global Health Challenges

Monday, Oct 31

1600-1730

Book launch “Litigating Health Rights”

Siri Gloppen is a professor in comparative politics at the University of Bergen (UiB) and senior researcher at Chr. Michelsen Institute (CMI)           
Alicia Ely Yamin is a lawyer and political scientist. She is associate senior researcher at CMI and adjunct lecturer at Harvard University

The last fifteen years have seen a tremendous growth in the number of health rights cases focusing on issues such as access to health services and essential medications. This book examines the potential of litigation as a strategy to advance the right to health by holding governments accountable for these obligations. It includes case studies from Costa Rica, South Africa, India, Brazil, Argentina and Colombia, as well as chapters that address cross-cutting themes.

The authors analyze what types of services and interventions have been the subject of successful litigation and what remedies have been ordered by courts. Different chapters address the systemic impact of health litigation efforts, taking into account who benefits both directly and indirectly—and what the overall impacts on health equity are.

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Wednesday, Nov 2

0900-1200           

The ethics of priority setting in global health?

Reidar K. Lie is a medical doctor and philosopher. He is Head of the Department of Philosophy at UiB
Ole Frithjof Norheim is professor in medical ethics at UiB and a medical doctor at Haukeland University Hospital

Maternal and child health is prioritized both in Norway and other countries. This leads us to give less priority to the treatment of chronic diseases in adults, such as AIDS. What is the basis for such priorities?

Such prioritization is justified within standard health economic models which seek "more health for every penny". The measurement of health is quality adjusted life years, or in development terms: Burden of Disease as measured by Disability Adjusted Life Years (Daly). Many, however, have questioned whether the standard methods used are consistent with our ethical intuitions.

Should non-health costs and consequences of a treatment be considered when its value is assessed? Low income patients endure, for example, high costs of transport to get treatment. This is not included in the cost calculation today. Many would also argue that adults with dependents must receive priority. Some tropical diseases do not cause high morbidity, but have major consequences for school performance. This is also not considered when the benefits of a treatment are calculated.

We will present an international collaborative project involving scientists in Bergen, Seattle, Washington DC, India and Ethiopia which aims to develop a better method to calculate the benefit of health care in resource-poor areas, and thus can be helpful when making decisions about how we should prioritize development aid.

1200       Lunch

1245-1400 

Innovation at the nexus of poverty, health and development: Shifting the focus from people's liabilities to their assets 

Maurice B. Mittelmark is a psychologist and epidemiologist. He is professor and head of the Research Centre for Health Promotion (HEMIL) at UiB

The fields of public health, health promotion and development are shifting from a strategy that focuses on people's deficits and risk factors, to a more balanced  strategy that recognizes people's strengths and assets for health and well-being. Even in the most resource-poor parts of the world, where poverty and deprivation are severest, individuals, families and communities have skills and coping resources that are solid building-blocks for enhanced resilience.

Mounting evidence about the effectiveness of an assets-based approach to community development is being tested with success in communities right across the globe.

1415-1530           

Norway’s response to global health challenges

Helga Fogstad is Head of Global Health at the Norwegian Agency for Development Cooperation and heavily involved in the Prime Minister’s MDG 4&5 initiative, as well as the UN Secretary-General’s Every Woman, Every Child global effort.

We live in a world of rapid change. To solve the challenges of the future requires the ability to see things in context. In the area of ​​global health, this is a demanding task, both because the challenges are diverse and dynamic, and because many actors are involved.  The presentation will provide an overall representation of this diversity, providing clear priorities for the entire Norwegian global health policy towards 2020.

Health is a global public good which is also closely linked with broader issues. The session will aim to discuss the challenges for the Norwegian global health policy and what means should be taken to achieve its goal.

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Thursday, Nov 3

0900      

Introduction

Rune Nilsen is professor in international health at UiB and Director of UiB’s Centre for International Health (CIH)

0915        

Delivering high quality health services for children: Implementation challenges

Ottar Mæstad is an economist and Director of Chr. Michelsen Institute
Ida Lindkvist is an economist and a researcher at CMI

There is a substantial know-do gap in health service provision; health professionals are capable of providing much higher quality than they actually do. This represents a major challenge for the implementation of live-saving health services for children. We discuss alternative ways of closing the know-do gap.  

0945     

Infant feeding in the era of HIV: improving breastfeeding practices and reducing HIV transmission from mother to child during breastfeeding

Ingunn Engebretsen is a registered medical practitioner and a senior researcher at CIH

Breastfeeding is one of the interventions to reach the Millennium Development Goals of saving lives of children. But breastfeeding can also transmit HIV. We have formed a European - African research consortium, called PROMISE to identify the much needed strategies to improve infant feeding in the era of HIV.

1015      

Challenges in intervention research in Africa: HIV-related examples

Ingvild Fossgard Sandøy is a medical doctor and a senior researcher at CIH
Knut Fylkesnes is an epidemiologist and professor at CIH

Two of our recent HIV-related intervention studies, one cluster randomized trial and one non-randomized study, will be discussed with regards to methodological aspects, multidisciplinary approaches (and relevance to inter-faculty research collaboration at UiB), and challenges in management of research projects in African settings.

1045      

Clinical trials on zinc nutrition and pneumonia in young south Asian children

Tor A. Strand is a medical doctor and professor (II) at CIH

Pneumonia is among the leading causes of illness and death in children under five years of age. Oral zinc is effective for the treatment and prevention of childhood diarrhoea. We have, since 1998, evaluated the preventive and therapeutic effects of oral zinc on pneumonia in randomized clinical trials in Nepal and India. Zinc is seemingly beneficial in those with severe illness.

1115      

Prevention of mother to child transmission of HIV in Tanzania – Cost-effectiveness, ethical implications and research challenges

Bjarne Robberstad is a social economist and associate professor at CIH

In this economic evaluation we find that highly active antiretroviral therapy (PMTCT Plus) prevents mother to child transmission of HIV more cost effectively than the current Tanzanian standard of care with single-dose nevirapine. Although PMTCT Plus is roughly 40% more expensive per pregnant woman than single-dose nevirapine, the expected health benefits are 5.2 times greater. These results represent an equity-efficiency trade-off requiring normative weighting of the two opposing arguments.

1145       Closing discussion          

1215       Lunch

1300      

Thriving in the face of adversity - introduction

Gro Th. Lie is professor in international health promotion at UiB and academic coordinator of UiB Global

When faced with the poverty and ill-health of the most vulnerable populations in the Global South, can you do more than focus on risk factors and immediate disease prevention?  Is it possible – and meaningful – to do research with a focus on thriving, on resources, seeing health as more than the mere absence of disease and death?

This session addresses these topics in a mix of brief presentations highlighting salutogenic theory and research approaches.  Researchers and students from Department for Health Promotion and Development share experiences from the field.  We conclude by inviting the audience to a debate.

1310        

Health promotion at the University of Bergen: POSITIVE health, not merely the absence of disease and suffering

Maurice B. Mittelmark is a psychologist and epidemiologist. He is professor and head of the Research Centre for Health Promotion (HEMIL) at UiB

Health for development and development for health: connecting the fields

Torill Bull is a researcher at HEMIL

Gender and generation: Making the best of difficult circumstances

Marguerite Daniel is an associate professor at HEMIL
Morten Skovdal is a psychologist and post doctor at UiB

The focus on what goes well: The assets approach and salutogenesis

Torill Bull is a researcher at HEMIL

1345        

Research on thriving – with thriving students?
International masters students share from their field experiences using an assets approach in the “global south”

                a. With focus on children
                b. With focus on women
                c. The practitioner perspective

1445       Break

1500        

Concluding remarks and discussion

Gro Th. Lie is professor in international health promotion at UiB and academic coordinator of UiB Global

Clobal health challenges programme (pdf)