Medical Information Equity Initiative (MIE) (Formerly known as “Textbooks”)
Missing Medicines Initiative
Promoting Access to West African Healthcare - Mali Health Organizing Project (MHOP) Initiative
World AIDS Day
Guide to Navigating Global Health at Harvard
Part 1: Terms and People
Part 2: Recommended Reading List
Books and Articles (Initiative Specific)
Part 3: Course List
Appendix: HCGHAC Constitution
Harvard College Global Health and AIDS Coalition MISSION The Harvard College Global Health and AIDS Coalition (HCGHAC) believes that health should be a fundamental human right. Towards this end, HCGHAC strives to challenge and expand the role of both the university and individual students in addressing global health and development needs.
Through collaboration with various parties, HCGHAC aims to:
Engage students in a growing movement for global health through education and awareness activities
Effect policy change through advocacy and activism, both on and off campus
Address local and global health needs through direct service and fundraising
Through its initiatives, HCGHAC strives to build momentum for a social movement that seeks social justice, especially in pursuing health as a human right. HCGHAC hopes this movement will instill a lasting commitment to global health among members of the Harvard community, and empower these current and future leaders to carry out this commitment in their personal and professional lives.
OVERVIEW Founded in 2001, the Coalition was the founding chapter of the Student Global AIDS Campaign, currently an 86-chapter nationwide advocacy group that has played an essential role in AIDS advocacy movement in the United States. Over time, HCGHAC has broadened its mission to combat all types of global health inequity by advocating to policy makers both locally and nationally, and raising awareness on campus about the magnitude and contours of the current health crises faced by the world's poor. HCGHAC has also facilitated direct service opportunities for its members in health NGOs in the greater Boston area. We have strong ties with Partners in Health, the Department of Global Health and Social Medicine (DGHSM) at Harvard Medical School, and the Harvard Initiative for Global Health (HIGH), and we work closely with many influential global health faculty at Harvard including Professors Paul Farmer, Jim Kim, Bruce Walker, and Dyann Wirth. We were recently offered an institutional home and office space in the DGHSM’s offices in the Prudential building in Boston!
STRUCTURE HCGHAC maintains a social justice ethos where every member is encouraged to pursue new ideas and take ownership over programs. To encourage constructive dialog and allow new members to step into leadership positions immediately, we keep a horizontal structure, with no official positions except in the “Bureaucracy” which exists only to perform administrative duties and ensure year-to-year continuity and coordination. Thus, the core of the organization is its initiatives, which evolve from year to year, and can be started by any member at any time. Initiatives range from awareness/fundraising events like “Step it Up,” which attracted over 1000 students and raised over $6000 for PIH, to advocacy initiatives like Missing Medicines, which pressures Harvard to increase its commitment to global health, to direct service initiatives like the Boston Living Center Initiative. To foster idea production and dedication to global health causes, we put great importance in giving new members the chance to steer existing initiatives or create new ones that fit within our mission.
Harvard College Global Health and AIDS Coalition History 2001 The Harvard AIDS Coalition (HAC) is founded by a group of committed activists who see a gap in the global HIV/AIDS advocacy movement in presenting a role for students. Within two years, the organization evolves into the nationwide Student Global AIDS Campaign (SGAC), now composed of over 85 university chapters around the country.
AIDS Awareness efforts are launched and the World AIDS Day Initiative begins to take place each year on December 1st, with the goal of raising awareness on the Harvard campus and in the greater Cambridge community.
The Political Advocacy Initiative is founded with an early focus on increasing global AIDS funding. [To put this into context, global funding for HIV/AIDS was less than 1/6 of current levels (as of 2008), and grassroots advocacy campaigns through organizations like HAC and SGAC played a key role in moving this movement forward.]
Thanks to the advocacy efforts of a student and researcher campaign, Yale University renegotiates its license for the live-saving HIV antiretroviral drug d4t with GlaxoSmithKline. The result of the new licensing agreement, which allows for generic production in developing countries, is that d4t drops in price by ~95% and becomes much more available in the developing world. This campaign is spearheaded by Amy Kapsynski and Yochai Benkler, and lays the groundwork for the organization Universities Allied for Essential Medicines, which is founded two years later.
2002 Political Advocacy efforts take up access to generic HIV drugs as a key platform, meeting with policymakers and advocating at political events to increase recognition and commitments to the potential of increasing access to HIV treatment in the developing world. Bird-dogging emerges a key advocacy method.
HAC begins a long history of call-ins for various health topics including global AIDS funding, generic production, and evidence based prevention policies.
Second Harvard World AIDS Day Effort.
2003 Universities Allied for Essential Medicines (UAEM) is founded in the wake of the success at Yale with d4t. Within five years, UAEM expands to have chapters at more than 40 universities across the US, Canada, and UK. UAEM coordinates students at research universities to push for novel licensing solutions that will increase access to live-saving medicines in the developing world. The Equitable Access License (EAL) is the first proposal supported by UAEM calling for the segmentation of the market to bolster developing world generic production of medicines.
Political Advocacy targets HIV prevention research, especially encouraging increased funding for evidence based prevention studies instead of speculative or value-loaded prevention ideology.
Third Harvard World AIDS Day Effort.
HAC is a significant presence at the International AIDS Conference in Bangkok, advocating for generic production of antiretroviral drugs.
2004 StopAIDS Political Advocacy campaign calls for increased commitment and funding, not only for HIV/AIDS, but also for global TB and Malaria in upcoming presidential candidates. Signals move toward broader global health advocacy.
UAEM chapter founded at Harvard and the Licensing Initiative is born. Early steps include meeting with the Technology Transfer Office and identifying faculty champions across the university.
Cambridge Cares about AIDS Initiative founded to increase opportunities for Harvard students interested in direct service at AIDS service organizations.
Harvard hosts the North East region SGAC conference.
Fourth Annual Harvard World AIDS Day featuring an Art Exhibit in Mt. Auburn Gallery about impressions of HIV/AIDS in society, and a movie series of films on AIDS, including Philadelphia.
2005 Professor Paul Farmer becomes a “member” of HAC, and attends three meetings in 2005, speaking about HIV/AIDS in Haiti and the global health movement.
Professor Arachu Castro gives HAC presentation on her work on HIV in Cuba, and on her work with the Pan American Health Organization (PAHO).
The Assistant Director of Cuban AIDS Program gives presentation at HAC on Cuban models of HIV prevention, treatment, and care.
Textbooks Initiative is founded when Dr. Paul Farmer brings HAC-ers Matt Basilico ’08 and Luke Messac ’08 to rural health clinics in Rwanda, where they witness a lack of up-to-date medical information.
HAC organizes the Unite Against AIDS Conference on HIV/AIDS in Africa and the African Diaspora, in collaboration with the Black Men’s Forum and Black Student Association SA. The conference attracts over 500 students.
Political Advocacy Campaign sets up meetings with senior health advisors for Massachusetts senators John Kerry and Ted Kennedy about the upcoming reauthorization of Global Fund.
Infant Formula Initiative is started to conduct a market analysis of the potential for infant formula as a scaleable prevention technique, in collaboration with the Clinton Foundation HIV/AIDS Initiative (CHAI).
Fifth Annual World AIDS Day featuring Dr. Don Francis, one of the leading scientists who spearheaded the movement that discovered HIV as the infectious agent that causes AIDS. Also features movie screening of “And the Band Played On”, a documentary about the HIV discovery movement focusing on Dr. Fancis’ work. HAC builds three-story ribbon for first time.
2006 Pharmacy Access Political Advocacy Campaign launched to pressure Massachusetts state government to pass legislation that will allow pharmacies to sell needles and syringes without prescription (MA was one of three states without this legislation). Initiative identifies eight target state senators for call-ins, information distribution, and sets up meetings with four senators. Legislation passed in June 2006.
Students Promoting Equity through Aid and Research (SPEAR) started in spring with three parts: 1) Licensing, to build on efforts of Harvard UAEM chapter; 2) Neglected Diseases, to increase research for diseases neglected by global research community; 3) Aid, to examine whether Harvard could cut overhead costs from $100 million PEPFAR grant given to Harvard. HAC members participate in an independent study to pursue this research, and later expand their work into the Neglected Disease Research Initiative and the Aid Initiative. Group of HAC-ers join Novartis Protest at office in Cambridge, pressuring for generic production to increase access to Novartis intellectual property.
Grassroots Soccer Initiative is launched to create Harvard chapter that brings students to high schools to promote AIDS awareness and raise money for Grassroots’ campaigns in Africa.
“Voices from the Local Community” speaker event featuring HIV-positive man from Boston. Attracts ~80 students.
HAC sponsors FaceAIDS Film Event, which features several leading AIDS films and documentaries. Paves the way for donation of largest HIV film archive of over 500 hours of footage to Harvard.
Professor Lincoln Chen (WHO Special Envoy for Human Resources and Health) speaks on global health challenges. Attracts ~50 students.
Sixth World AIDS Day campaign with a speaking event featuring Dr. Paul Farmer and Dr. Bruce Walker. Attracts over 300 students. Second three-story AIDS ribbon.
2007 HAC changes its name to Harvard College Global Health and AIDS Coalition (HCGHAC) to reflect the larger global health scope of its efforts.
Boston Living Center Initiative founded to foster express service relationship between HCGHAC volunteers and meal serving program.
Over 30 Harvard students attend Abbot Labs ProtestHQ in Worcester, MA to oppose Abbot’s withdrawal of medicines off the market in Thailand in response to the government’s compulsory license for Kaletra, an antiretroviral HIV medicine.
HCGHAC organizes “Missing Medicines 1: Making University Drugs Accessible to the Global Poor” featuring Dr. Jim Kim, who speaks on the potential for Harvard to increase access to life-saving medicines through licensing solutions. Attracts over 200 students. Event linked with UAEM National Day of Action.
HAC organizes “Step it Up” in collaboration with BMF and the South Asian Men’s Collective (SAMC). The awareness/fundraising effort includes: Speaking event with Dr. Paul Farmer and Ira Magaziner (Chair of Clinton Foundation HIV/AIDS Initiative), which attracts over 600 students; Dance in Annenberg that attracts over 1000 students and raises over $6000 for Partners in Health and the Treatment Action Campaign.
Harvard hosts annual UAEM Conference, which attracts over 200 students from across the US and Canada.
2 Summer Initiative is launched with aim of providing undergraduates with a meaningful way to engage in global health work overseas. Links with PIH and CHAI are created and pursued.
Seventh Annual World AIDS Day runs speaker event featuring Stefan Hildebrand, leading HIV photographer and documentary film maker. Attracts over 60 students. Third annual three-story AIDS ribbon.
Speaking event featuring Dr. Kiran Martin (founder of Asha health NGO in slums in Dehli, India) at HCGHAC meeting. Attracts ~40 students.
2008 Members help in UAEM Harvard Researcher Project to determine knowledge base and interest level of Harvard researchers in access-minded licensing for medically-relevant technologies.
HCGHAC writes its Constitution.
HCGHAC organizes “Missing Medicines 2: Harvard’s Response to the Challenge of Global Neglected Disease” featuring Provost Steve Hyman, Professors Jon Clardy, Lisa Hirschorn, Jose Trevejo, Bruce Walker, Rebecca Weintaub, and Dyann Wirth, to explore opportunities for change in Harvard policies and institutions in basic science, translation, and delivery of medicines and technologies for neglected tropical diseases. Attracts ~300 students. Neglected Disease initiative becomes Missing Medicines Initiative to focus on “neglected areas of research” more broadly.
The “Petition to Action in Global Health at Harvard” is launched, calling for a stronger, more collaborative Harvard Initiative for Global Health, and increased funding for research on neglected tropical diseases and health delivery. Over 2000 undergraduate signatures are collected, as well endorsement from certain faculty.
Dr. Kiran Martin speaks at another HCGHAC meeting, attracting ~30 students.
The Textbooks Initiative is renamed “Medical Information Equity Initiative” to reflect the broader scope of the initiative’s focus and its interest in looking at increasing access to Harvard publication and online health information.
Health Sciences Initiative is started to expand HCGHAC’s repertoire to include more basic science perspectives on these complex, cross-disciplinary problems.
MHOP Initiative is started, building a link between HCGHAC and the Mali Health Organizing Project.
2-Summer Initiative is institutionalized at the DGHSM/FXB Center, to be driven by former HCGHAC-ers Arjun Suri and Nathan Sharp as university employees.
HCGHAC/HIGH/DGHSM Critical Issues in Global Health Speaker Series is coordinated through HCGHAC to supplement Anthropology 1825, taught by Professors Paul Farmer, Jim Kim, and Arthur Kleinman.
Current Initiatives “2-Summer” Initiative Though many former HCGHAC members have been lucky enough to spend summers abroad working for organizations like Partners in Health and the Clinton Foundation, on exciting projects in Rwanda, Malawi, Mozambique, Mali, Haiti, and Thailand, these positions are not easy to find without personal connections. Additionally, it can be hard to show these organizations that undergraduates do have tremendous capabilities, because often the skills needed are very specialized and can only be gained through intensive training or extended time on the ground. A traditional summer-long internship often only gives students time to get their feet wet and as soon as they begin to feel comfortable and familiar in their surroundings, it’s time to head back to school. There are two main desires founded the idea of a “2-Summer” program – first was the aim to open positions like these to everyone interested (selecting based on abilities and interest, rather than those personal connections), and the second was to make a college student truly valuable to the NGO by either training them extensively or allowing for much more than 2 months on-site. The original idea of “2-Summer” was to train students here in Cambridge for one summer in particular skills, such as language, cultural sensitivity, organization of health systems, and applicable social theory. Then, during the second summer, students would spend the whole three months overseas assisting at a clinic or related project. Another possible approach to the same issue is to allow students to spend an entire semester plus one summer abroad – up to seven months of experience and engagement – while providing them with the same credit they would receive from a study-abroad program.
As with many other HCGHAC initiatives, this original idea garnered huge support from the University – in this case, the support led to hiring two new full-time interns, Arjun Suri and Nathan Sharp (both former HCGHAC members!). Arjun and Nathan’s main responsibility is to get this program up and running. However, they will need plenty of student input, both informally through emails and conversations and formally, such as in a focus group. They might also need assistance working on the project itself – researching, setting up meetings, designing and reviewing the application process, and a whole wealth of other tasks. Like all HCGHAC initiatives, all members are welcome to contribute as much as they want to! Look out for Arjun and Nathan at HCGHAC meetings to talk about the future of this exciting process, and the help they will need from us as undergraduates. To get involved, contact Margie Thorp (email@example.com, 303-718-4117).
Boston Living Center Initiative The Boston Living Center (BLC) is a holistic care center for people with HIV/AIDS in Boston. It began informally in 1989 as small-scale get-togethers in the homes of people with HIV/AIDS in the Boston area. Today, it has grown into an organization serving over 2,400 people with HIV/AIDS, 75% of whom are low income. It offers a range of services from art classes, support groups, computer classes, a pharmacy, yoga, massages, hair cuts, and meals for its members, all of which are free.
HCGHAC began working more closely with the BLC in the fall of 2006. We first collaborated with the BLC to advertise a World AIDS Day film screening fundraiser that they put on at the Brattle Street Theater. Our relationship continued in the spring of 2007 when we fundraised $500 for the BLC through private donations paired with a highly successful door-to-door cookie sale. The $500 was matched by a larger donor to the BLC, so the center ultimately received $1000 as a result of our efforts. This fundraiser was a great opportunity for members to do hands on work and reach out to the campus. We put together bags, each containing a few cookies, and then knocked on the doors of rooms in freshman dorms. Many people gave us donations for cookies, and some even wanted to learn more about the BLC and HIV/AIDS in Boston.
By the end of the 2006-2007 school year, several members were interested in becoming more involved with the BLC. Members started volunteering there to serve meals, and one even started going to the BLC weekly to give members massages. In the fall of 2007, several members also volunteered at the BLC’s big Thanksgiving celebration dinner at the Hynes Convention Center, which was amazing to be a part of. After this event, the BLC contacted HAC again about helping with a personal care items fundraiser for BLC members. This fundraiser was needed, as BLC had an increasing number of members at the poverty line, who could not afford such items themselves. Our contribution of tooth paste, soap, and other items was the largest one that the BLC received. Indeed, the BLC has come to see HCGHAC as a reliable partner in its fundraising and volunteer activities.
During the 2008-2009 school year, there are even more opportunities to become involved with the BLC. In past years, the BLC has mainly served lunch to its members, such that volunteers were primarily needed from 10am-2:30pm. However, starting this year, the BLC will also be offering dinners on Wednesday and Thursday nights, allowing for even more times during which students can volunteer. Students have consistently found the BLC as a warm and welcoming place with a compelling mission in Boston. Thus, serving the BLC has been a rewarding experience for many HAC members over the years. For more information or to get involved, please visit the BLC’s website at www.bostonlivingcenter.org and/or contact Jean Junior (firstname.lastname@example.org, 586-202-8061).
Critical Issues in Global Health Speaker Series
Co-sponsored by HMS Department of Social Medicine, HIGH, and HCGHAC
Thanks to our friends at the Harvard Initiative for Global Health, there is a $20,000 budget for what we have dubbed the “Critical Issues in Global Health” Speaker Series, designed to supplement Anthropology 1825. The initiative is technically co-sponsored by the Department of Global Health and Social Medicine, HIGH, and HCGHAC, which gives us the best of many worlds: credibility, money and manpower! The credibility of our invitations is largely due to Jim Kim’s willingness to send the invitations to whichever leaders in the field we would like to invite. The huge budget means that we can really dream big! Names thrown around so far include Bill Rodriguez, Chris Murray, Dean Jamison, Sudhir Anand, Amartya Sen, Paul Davis, Asia Russell… and the list goes on and on. Don’t worry if you don’t recognize these names yet – you will soon! And if you can think of someone whom you would love to hear, don’t hesitate to contact Matt (email@example.com) to make a suggestion.
One of the most exciting things about the speaker series is not just that everyone at Harvard will have the opportunity to hear directly from these phenomenal personalities, but HCGHACers can have direct, one-on-one access to them as well. We hope to plan smaller events such as dinners around every speaker series, allowing many of us up-close and personal interaction. Additionally, we expect to ask one or two students to be point people to organize each speaker’s visit. This could include as much as plane and hotel reservations, airport transportation, meals, and activities for out-of-town guests. Though that may sound like a hefty load, it also is an unbeatable opportunity to get to know and engage with people who are otherwise usually unavailable. To get involved, contact Heidi Kim (firstname.lastname@example.org, 714-345-6274).
Health Sciences Initiative (Pilot) HCGHAC is committed to a multi-disciplinary approach to combating the challenges of global health inequity. We believe that our group capacity depends on broadening the member base to include more students engaged in the natural sciences. The health sciences initiative aims to deepen Harvard students’ understanding of global health issues from a natural or basic science lens. The pilot program will consist of a series of teach-ins on topics in science, including (but not limited to) disease pathology, drug and technology development, field interventions, and epidemiology, etc. In the future, we may look to author a biannual publication summarizing key global health developments in the basic science realm. This is a brand new initiative, and (as is true for all initiatives) we are looking for new members to play a leadership role as it evolves. To get involved, contact Jillian Irwin (email@example.com, 412-401-8118).
Licensing Initiative Intellectual property (IP) is held in the form of patents, which can be licensed through legal contract to parties (for example, pharmaceutical companies) wishing to further innovate upon or develop the existing intellectual property. Universities currently hold patents on many key HIV/AIDS drugs on the market – Emtricitabine (Emory), 3TC (Emory), Stavudine (Yale), Abacavir (Minnesota), T-20 (Duke). The Senate Joint Economic Committee found that 15 of the 21 drugs with the most therapeutic value were derived from federally funded research projects at academic centers. Further, every major access to medicines battle in recent news – Zemplar in Thailand, Gleevec in India, HPV vaccine in US – has a connection to an American university.
Most university research is federally funded; it is conducted using grants comprised of taxpayers’ money. The Bayh-Dole Act of 1980 (University and Small Business Patent Procedures Act) allowed universities to own, license and market the fruits of their research, which previously were released into the public domain without IP restrictions. While the goal of the legislation was to incentivize the development of federally funded basic science research—which may otherwise have lain untouched on laboratory shelves—into usable products that would benefit society, the subsequent growth in university patenting and licensing activity has significantly hampered public access to urgently needed health care tools. This is most often because an exclusive license has granted a drug company a monopoly on a particular pharmaceutical product. In the absence of market competition, drug prices for essential medicines, such as antiretrovirals, remain prohibitively high. (For example, BristolMeyerSquibb profited enormously in the late 1990s from an exclusive license on stavudine negotiated with Yale University, in whose labs the drug was first discovered. Political pressure at Yale forced the university to renegotiate this license in 2001, which caused the price of stavudine in South Africa to fall from US$1600 to US$55—a thirty-fold drop—per patient per year. A victory for the access to medicines movement, stavudine nonetheless remains a notable exception.)
The HCGHAC licensing initiative advocates for changes to the university technology transfer infrastructure which would ensure that cost is not a barrier to the fruits of university research. The initiative seeks (1) increased transparency in a largely opaque university licensing process; (2) an explicit commitment to humanitarian, or access-minded, licensing on the part of the Harvard Office of Technology Development (a central administrative body which handles commercialization of research in university labs; see http://www.techtransfer.harvard.edu/); and (3) an institutionalized mechanism for ensuring that each of the former objectives is consistently carried out in each license the university negotiates. The licensing initiative thus works to collaborate with university stakeholders, garner awareness among the university community, and generate political pressure upon university administrators to effect policy change at Harvard. These efforts have ranged from large-scale on-campus speaker events to protests at pharmaceutical company labs to editorials in local publications to focused meetings with university scientists, policymakers, and administrators; they also include cooperation with groups at other notable research universities. A body which facilitates this cooperation is the national organization Universities Allied for Essential Medicines (see www.essentialmedicine.org), of which HCGHAC is a chapter. To get involved, contact Neha Gupta (firstname.lastname@example.org, 516-423-9288).
Medical Information Equity Initiative (MIE) (Formerly known as “Textbooks”) While many of us are aware of the incredible transnational disparities concerning access to health care, the often publicized response to this is increased funding for preventative and curative services. One measure of the progress of many global health initiatives (PEPFAR, Global Fund) is to monitor the number of people who are able to access treatment. One obvious concern is the price and accessibility of medicines, which rightfully deserves much time and attention. However, while providing high quality care certainly necessitates access to medicines, an also integral aspect to health care is accessibility to information. Sadly, the demand for equitable access to information has yet to become a popularized response to health care deficiencies around the world.
Apart from inadequate supplies of medical equipment, doctors in developing countries face tremendous barriers to learning about the best quality medical practices. With copyrighted journal articles, expensive textbooks, increased shipping costs, and inadequate infrastructure for universal access to the internet, the ever expanding process of globalization has yet to ensure access to the fruits of academic research. At the close of the 20th century, over half of the research and higher-education institutions in the lowest-income countries simply had no current subscriptions to international journals.1 Poor countries shoulder a disproportionately larger amount of the disease burden (90%) and most pressingly need to utilize this information. Sadly, they are least able to do so.
Given the vast amount of resources at Harvard and the drought of resources in many clinics within developing countries, we are well positioned to effect change on an educational level, which will hopefully translate into improved health outcomes. Our goal is to encourage and foster collaboration among 3 organizations to ship medical reference textbooks to resource-poor clinics: The Sabre Foundation, Partners in Health, and Harvard University.
The Sabre Foundation is an NGO based in Cambridge that is committed to education in the developing world. The Sabre foundation is well connected with publishing companies, and is able to procure brand new medical textbooks in English, French, and Spanish for free. The Sabre Foundation requires that a 501 3 c NGO distribute these books in developing countries. The only catch is that the Sabre Foundation does not have funds for shipping. We must raise approximately $25,000 for each shipment of a 40 ft by 20 ft container (this cost not only includes shipping, but overhead and storage costs incurred by the Sabre Foundation). Partners in Health (PIH) is a social justice based NGO that operates clinics in multiple countries, including Rwanda, Haiti, Russia, Peru, United States, Lesotho, and Malawi. Co-founded by Paul Farmer and Jim Kim, PIH aims to work toward the realization of health as a human right, a public good that should not be denied to those who cannot afford it. They have clearly shaped our outlook on access to healthcare, and given our close personal connections with PIH, it is a well-positioned organization to assist with distributing medical reference books based on need in their various sites. We are hoping to connect PIH with the Sabre Foundation to eventually distribute these textbooks.
Given Harvard’s vast accumulation of wealth, with assets valued upwards of $39 billion, Harvard is very well placed, at least financially, to assist with shipment costs for distributing these textbooks. Given Harvard’s status as a leader in education, as well as its relatively close affiliations with PIH, “Harvard” is at least the first place we will turn to for financial assistance. Further, one end that we should keep in mind is sustainability. The hope is that HCGHAC can be the glue that ties all three of these organizations together to foster collaboration that hopefully yields improved health outcomes. To get involved, contact Krishna Prabhu (email@example.com, 515-450-3253).
Missing Medicines Initiative The “Missing Medicines” initiative seeks to pressure Harvard to play a bigger role in global health by expanding research on the most urgent or neglected health topics and by increasing funding and commitment to interdisciplinary and cross-university global health collaboration. This initiative focuses on two neglected areas of research: “neglected diseases” and health delivery. Because we live in a world where R&D is demand-based instead of needs-based, the destitute sick who lack “purchasing power” don’t get the drugs they need. The World Health Organization estimates that only 10% of health related research today goes to 90% of the disease burden. Instead of using R&D dollars to target diseases that cause millions of deaths around the world, the global research community focuses on products like Rogaine and Viagra because they represent a sizeable “first world” market. So-called “neglected diseases” are those which slip between these cracks in the world market, yet cause over 2 million deaths each year, including shistosomiasis, chagas disease, human African trypanosomiasis, hookworm, buruli ulcer, leprosy, and even headline killers like malaria and TB. In addition to the neglected disease issue, global health experts around the world are increasingly recognizing the need to study the delivery or implementation of health services as a science. Even when a life-saving medicine exists and is available in country, there are still enormous challenges before sick patients in developing countries are able to receive the treatment and care they need, especially in rural areas. For example, many medications must be refrigerated, which poses a major challenge to countries that lack modern health infrastructure, as refrigerators and even electricity can be in short supply.
Because of their cutting-edge science facilities, universities like Harvard conduct the basic research for close to 50% of the 100 most important medicines and health technologies available today. Furthermore, since global health challenges involve diverse research areas ranging from molecular biology to economics to anthropology, universities are perhaps the only institutions which simultaneously harbor research capacity in all relevant fields. Harvard is therefore ideally positioned to better leverage its research capacity and international influence to fill the research gap toward neglected diseases and delivery science and in doing so drastically improve health outcomes in the developing world.
Although President Faust told us she wanted global health to be a “flagship program of Harvard,” recent strategic planning efforts to provide increased funding to the Harvard Initiative for Global Health (HIGH) failed, offering only $5 million, less than half of what they asked for, and a drop in the bucket compared to the need for support in this area. Harvard is lagging behind other universities such as Duke and Emory have each recently decapitalized over $50 million from their endowments for similar global health centers. As the home to many of the world’s most cutting-edge research facilities and internationally respected health leaders such as Paul Farmer, Sue Goldie, Jim Kim, Bruce Walker, and Dyann Wirth, an equal or greater commitment from Harvard is long overdue.
To advocate change, the Missing Medicines initiative organized a 300 person conference last April on Havard’s potential role product development pipeline for neglected diseases. Speakers included Provost Steve Hyman, Professors Jon Clardy, Lisa Hirschorn, Jose Trevejo, Bruce Walker, Rebecca Weintraub, and Dyann Wirth. Building on the momentum of this conference, we launched a petition and have gathered ~2000 signatures, representing almost a third of the undergraduate population, that urges Harvard to overturn recent decisions, supporting the HIGH proposals in full, and taking immediate steps to create a robust university-wide Institute for Global Health. Having interviewed over 20 faculty members and researchers, we were granted representation on the HIGH Strategic Planning Committee and have earned a voice in the planning process. Next steps include scaling-up the petition collection strategy to attract signatories from the Medical School, Business School, School of Public Health, Law School, Kennedy School and others, and strategizing about a demonstration for the petition drop-off, which we expect will attract significant press in the Boston area. We are also in the process of a second round of faculty interviews regarding the most recent Harvard Initiative for Global Health Planning results, and planning a corresponding large-scale conference “Missing Medicines 3” for later in the year. This is a long term initiative that has much to accomplish and along these lines, we can use all the help we can get! For more information or if you’d like to get involved, contact Jon Weigel (firstname.lastname@example.org, 978-985-4053).
Political Advocacy Earlier this year, Congress passed a landmark bill regarding AIDS in particular and global health in general, called PEPFAR (the President’s Emergency Plan for AIDS Relief). The original version of this bill was put into affect in 2003, and it allocated $15 billion over five years for US-funded programs around the world to combat AIDS; the new incarnation was over three times that, specifying almost $50 billion over the next five years. This momentous occasion obviously took the support of many senators and representatives, and the president himself, but it really started somewhere else – in the minds of activists, people without elected offices but with a belief in the United State’s ability to fight global health inequity. The process in between – bringing the ideas from the imaginations of activists to the bill on the senate floor – was a tough but surprisingly simple process. It involved tirelessly pursuing senators and representatives to make sure they were on board – this meant phone calls, emails, random favors from the nephews of second cousins of neighbors, protests, rallies, sit-ins, and bird-dogging (essentially hassling policy-makers at their respective public events, especially during the primary races between April 2007 and June 2008).
Though PEPFAR is now passed, there is still much work to do. Several issues with the bill specifically stand out; first, the language of the bill calls for over $60 billion-worth of programming, and in doing so, blatantly under-funds several programs. Second, the bill restricts programs that want to go beyond abstinence-only education, though there is plenty of solid data supporting programs that aim to educate using alternative methods. Additionally, PEPFAR cannot be the end-all, be-all of US global health funding; never before has a US president made combating AIDS a top priority, but with the crisis growing and a solution available in the form of widespread ARV access, the time is now. Luckily, the election this fall presents a terrific opportunity to us as students and activists around the country – we can use our unique access to the candidates to get them to make big commitments. Candidates are much more vulnerable and accessible now than they will be once they are in office, where they will be very difficult to contact. All this means that we have to act soon.
This fall, we expect to participate in several advocacy events, including traveling to New Hampshire (a swing state) to bird-dog and protest at presidential and senatorial race events. Bird-dogging can be an exciting and very effective way to accomplish our goals, and truly anyone can do it – we’ll teach you all you need to know! These events also need students to help coordinate and plan to maximize our impact. After the election cycle is over, we’re considering attending a massive march in Washington, D.C., to help ACT UP Philly (an awesome AIDS activist group) rally support and gain attention to the potential of the next president.
Poli Advo doesn’t end after inauguration, though – email and phone call campaigns help inform the senators that these issues are hugely important and incredibly urgent. Manpower alone makes these campaigns successful, but again, good coordination and planning will maximize the effect. If you’re interested, please contact Molly Siegel (email@example.com ) or Margie Thorp (firstname.lastname@example.org ) for more info!
Promoting Access to West African Healthcare - Mali Health Organizing Project (MHOP) Initiative In Africa’s fastest growing city (UN-IRIN) of Bamako, Mali, one in four children dies before the age of five due to poverty and lack of health care infrastructure (Demographic and Health Surveys). Residents of Sikoroni, one of Bamako’s poorest slums, have identified the construction of a new clinic as a critical component to increasing access to primary health care services. Slum residents have few rights. Most are squatters who receive little help from their governments. Communities refuse to pay taxes until the government provides services, and the government refuses to provide services until the communities pay taxes. This deadlock continues indefinitely, leading to terrible infrastructure, crippling poverty, and poor health. People die of preventable diseases because of crowding and a lack of sanitation and health care.
Mali Health Organizing Project (MHOP) acts as a catalyst to bring slum residents and their governments together. The Mali Health Organizing Project (MHOP), in partnership with the community of Sikoroni and the Malian government, has committed to construct a 10-room health clinic to provide essential preventative and primary care for 30,000 slum residents in Mali, West Africa by 2009. The clinic will open in May 2009 and will require equipment ranging from mosquito nets to autoclaves. This is an opportunity for students working in the US to recruit medical supplies from donors like the Seeding Labs and Medisend International. For more information visit http://www.malihealth.org/.
MHOP is a pilot initiative of HCGHAC that seeks to increase access to primary health care by assisting in medical equipment recruitment for MHOP to serve 30,000 underserved slum residents. Recruiting medical supplies is critical to the success of the clinic and is a rare opportunity to immediately begin working for a small organization based on the Partners in Health model. Student support could expand to fundraising for MHOP or creating a speaker series focusing on issues of slum deadlock in sub-Saharan Africa. For students interested in becoming more involved and working with a community health action group over the summer, there are opportunities for four interns to travel to Mali to work as a Health Programs Coordinator or a Microfinance Coordinator. Other action steps include collaborating with the student group Seeding Labs, and creating a mechanism to identify unused medical equipment and send it to Mali. To get involved, contact Katie Walter (email@example.com, 914-329-0826).
World AIDS Day Every December, we partake in the global effort to raise awareness and remember those who live with and have died from HIV/AIDS. We extend December 1, the globally recognized day of remembrance, into a weeklong campaign aimed at fostering a community of activists on campus. Historically, we have had prominent speakers (including Paul Farmer, Bruce Walker, Stefan Hildebrand, and Phyllis Kanki), movie screenings and a film festival, a candlelight vigil, a three story AIDS ribbon, art shows featuring HIV positive artists, and other activities recognizing the gravity of the epidemic, the progress made towards eradication, and necessary steps for the future. We have also focused on campus awareness, distributing condoms, highlighting the number of people who die each day from HIV/AIDS, and informing other students about concrete steps they can take towards eradicating the disease. This year, we have tentative plans to invite Stephen Lewis (former UN Special Envoy for HIV/AIDS in Africa) and Ophelia Dahl (Director of PIH) to speak, but we will welcome new membership and are looking for new and creative ideas to make this event as broad and effective as possible. To get involved, contact Sarah Ruberman (firstname.lastname@example.org, 617-512-7816).