Collaboration between infection control and occupational health in three continents: a success story with international impact

Globalization has been accompanied by the rapid spread of infectious diseases, and further strain on working conditions for health workers globally. Post-SARS, Canadian occupational health and infection control researchers got together to study how to better protect health workers, and found that training was indeed perceived as key to a positive safety culture. This led to developing information and communication technology (ICT) tools. The research conducted also showed the need for better workplace inspections, so a workplace audit tool was also developed to supplement worker questionnaires and the ICT. When invited to join Ecuadorean colleagues to promote occupational health and infection control, these tools were collectively adapted and improved, including face-to-face as well as on-line problem-based learning scenarios. The South African government then invited the team to work with local colleagues to improve occupational health and infection control, resulting in an improved web-based health information system to track incidents, exposures, and occupational injury and diseases. As the H1N1 pandemic struck, the online infection control course was adapted and translated into Spanish, as was a novel skill-building learning tool that permits health workers to practice selecting personal protective equipment. This tool was originally developed in collaboration with the countries from the Caribbean region and the Pan American Health Organization (PAHO). Research from these experiences led to strengthened focus on building capacity of health and safety committees, and new modules are thus being created, informed by that work. The products developed have been widely heralded as innovative and interactive, leading to their inclusion into “toolkits” used internationally. The tools used in Canada were substantially improved from the collaborative adaptation process for South and Central America and South Africa. This international collaboration between occupational health and infection control researchers led to the improvement of the research framework and development of tools, guidelines and information systems. Furthermore, the research and knowledge-transfer experience highlighted the value of partnership amongst Northern and Southern researchers in terms of sharing resources, experiences and knowledge.

Promoting the health of marginalized populations in Ecuador through international collaboration and educational innovations

This paper examines two innovative educational initiatives for the Ecuadorian public health workforce: a Canadian-funded Masters programme in ecosystem approaches to health that focuses on building capacity to manage environmental health risks sustainably; and the training of Ecuadorians at the Latin American School of Medicine in Cuba (known as Escuela Latinoamericana de Medicina in Spanish). We apply a typology for analysing how training programmes address the needs of marginalized populations and build capacity for addressing health determinants. We highlight some ways we can learn from such training programmes with particular regard to lessons, barriers and opportunities for their sustainability at the local, national and international levels and for pursuing similar initiatives in other countries and contexts. We conclude that educational efforts focused on the challenges of marginalization and the determinants of health require explicit attention not only to the knowledge, attitudes and skills of graduates but also on effectively engaging the health settings and systems that will reinforce the establishment and retention of capacity in low- and middle-income settings where this is most needed.

Los Credit Default Swap (CDS) o seguros contra cesación de pagos y su estructuración legal como garantía para los inversionistas

La crisis financiera del 2008 provocó la pérdida de riqueza y el derrumbe de los mercados bursátiles y de la economía real, traducida en desempleo, reducción de la productividad, recesión profunda, e incertidumbre en los mercados financieros. En el marco de la crisis de deuda soberana europea, es cuestionable también el grado de certeza de los CDS (Credit Default Swap) como garantía para los inversionistas, considerando las negociaciones existentes entre emisores y bancos europeos para evitar el default de estos instrumentos y por tanto, evitar la indemnización a los inversionistas en su calidad de acreedores. Remontándonos, la crisis financiera internacional del año 2008 tuvo como uno de sus orígenes a las hipotecas denominadas como “subprime”. Estas hipotecas fueron “empaquetadas” junto a otras de alta calificación, en grupos de hipotecas para ser titularizadas y colocadas en el mercado bursátil, mediante instrumentos denominados CDO (Collateralized Debt Obligations), y a aseguradas en algunos casos, través de los CDS (Credit Default Swap), siendo principalmente estos últimos instrumentos financieros, blanco de las críticas y señalados como uno de los culpables de la crisis financiera internacional. Bajo estas consideraciones, se pretende en esta investigación, analizar específicamente los CDS (Credit Default Swap), para determinar su naturaleza jurídica como verdaderos seguros contra cesación de pagos, o como permutas de incumplimiento crediticio. Comprender su estructuración legal como instrumento de garantía para los inversionistas institucionales o particulares, considerando el acontecimiento de la quita de los bonos griegos, la crisis de deuda soberana europea y el default de la deuda argentina, así como las consideraciones del ISDA (International Swaps and Derivatives Association) en estos puntos; su marco legal, su contribución en la reducción del riesgo, su papel especulativo y su incidencia real en la crisis financiera del año 2008.