Involving the Public in Public Health Genomics: A Review of Guidelines and Policy Statements

Public health genomics raises exciting possibilities for preventing or reducing the occurrence of both rare and common disease. However, this area of research raises challenging ethical, legal and social issues that must be addressed. One way of addressing these issues is through public involvement in the policy-making process. This GenEdit reviews how international guidelines and policy statements related to public health genomics address the issue of public involvement. Key areas of discussion are the values and goals justifying public involvement, the proposed activities to increase public involvement, who is / who represents "the public", and the projected outcomes of public involvement.

The right to health, the TRIPS agreement and the public health safeguards to encourage the universal access to essential medicines

The privileges arising from patent protection on pharmaceutical products often prevent the full realization of the right to health, especially in developing countries with scarce resources. This thesis first identifies the international agreements that have established the right to health in international law, obligations and violations associated with it, the problems encountered in the implementation of human rights on the field, compared with the implementation and sanctions associated with economic rights from the World Trade Organization regulatory framework. A comparative study of the legislative frameworks of both developed and developing countries will reveal to what extent Canada, the United States, the European Union, Brazil, India, and South Africa conformed with patent protection exceptions arising from international patent law to protect public health. Finally, the author identifies the crucial indicators that need to be considered in order to assess the conformity of a given approach with the right to health, before he underscores the temporary character of the relevant WTO measures, and the future stakes concerning an increased access to essential medicines.

Allergies and asthma: employing principles of social justice as a guide in public health policy development

This article is an excellent example of applied ethics in public health policy development.

Allergies And Asthma : Employing Principles Of Social Justice As A Guide In Public Health Policy Development

The growing epidemic of allergy and allergy-induced asthma poses a significant challenge to population health. This article, written for a target audience of policy-makers in public health, aims to contribute to the development of policies to counter allergy morbidities by demonstrating how principles of social justice can guide public health initiatives in reducing allergy and asthma triggers. Following a discussion of why theories of social justice have utility in analyzing allergy, a step-wise policy assessment protocol formulated on Rawlsian principles of social justice is presented. This protocol can serve as a tool to aid in prioritizing public health initiatives and identifying ethically problematic policies that necessitate reform. Criteria for policy assessment include: 1) whether a tentative public health intervention would provide equal health benefit to a range of allergy and asthma sufferers, 2) whether targeting initiatives towards particu- lar societal groups is merited based on the notion of ‘worst-off status’ of certain population segments, and 3) whether targeted policies have the potential for stigmatization. The article concludes by analyzing three examples of policies used in reducing allergy and asthma triggers in order to convey the general thought process underlying the use of the assessment protocol, which public health officials could replicate as a guide in actual, region-specific policy development.

Managing Antimicrobial Resistance In Food Production : Conflicts Of Interest And Politics In The Development Of Public Health Policy

Antimicrobial resistance is a growing public health concern and is associated with the over or inappropriate use of antimicrobials in both humans and agriculture. While there has been recognition of this problem on the part of agricultural and public health authorities, there has nonetheless been significant difficulty in translating policy recommendations into practical guidelines. In this paper, we examine the process of public health policy development in Quebec agriculture, with a focus on the case of pork production and the role of food animal veterinarians in policy making. We argue that a tendency to employ strictly techno-scientific risk analyses of antimicrobial use ignores the fundamental social, economic and political realities of key stakeholders and so limits the applicability of policy recommendations developed by government advisory groups. In particular, we suggest that veterinarians’ personal and professional interests, and their ethical norms of practice, are key factors to both the problem of and the solution to the current over-reliance on antimicrobials in food production.

Public Health Genomics : une forme de rhétorique ?

Article

Guidelines for Reducing the Negative Public Health Impacts of Medical Tourism

Étude de cas / Case study

A Synergistic Approach to Human Rights and Public Health Ethics: Effective or a Source of Conflict?

Commentaire / Commentary

Engaging Ethical Issues Associated with Research and Public Health Interventions During Humanitarian Crises: Review of a Dialogic Workshop

Compte-rendu / Review

”Public Health Protection through Air Quality Controls”

Health is an important aspect of everybody’s life. Today, there is an increasing recognition and commitment to the pursuit of health both within government and beyond. Any attempt on the part of the " State to protect and promote people’s health, in turn, must be accompanied by effective controls on air quality, as air constitutes ‘ one of the important elements of man’s life and the consequences of air pollution covers a very wide spectrum ranging from material ---damage to personal discomfort and illness. The broad social and economic objectives adumbrated in the Directive Principles of State Policy including the commitment to improve public health underlying in Article 47 and the obligation to preserve and protect-the natural environment cast under Article 48A of the Constitution are being used as versatile weapons by the State to regulate the public health scenario. Preservation and maintenance of air quality is a significant area within the sphere of public health, where the regulatory arm of the law is not adequately touched and in this arena urgent State intervention through legislative and administrative action is called for in the well-being of the society. Judiciary also plays a pivotal role in this arena in the larger interest of the society and for the benefit of the present and future generations. The research study is an attempt to analyze how far the existing legal system, for maintaining air quality and in controlling air pollution, is effective in protecting public health. The study also analyzes the limitations of the control mechanisms. The study focuses on industrial air pollution, indoor and personal air pollution, vehicular pollution and noise pollution which are today appearing as the major public health hazards affecting the air quality. However, this is not to overlook the importance of controls required under other areas of public health.

Potential public health significance of faecal contamination and multidrug-resistant Escherichia coli and Salmonella serotypes in a lake in India

To assess the prevalence of faecal coliform bacteria and multiple drug resistance among Escherichia coli and Salmonella serotypes from Vembanadu Lake. Study design: Systematic microbiological testing. Methods: Monthly collection of water samples were made from ten stations on the southern and northern parts of a salt water regulator constructed in Vembanadu Lake in order to prevent incursion of seawater during certain periods of the year. Density of faecal colifrom bacteria was estimated. E. coli and Salmonella were isolated and their different serotypes were identified. Antibiotic resistance analysis of E. coli and Salmonella serotypes was done and the MAR index of individual isolates was calculated. Results: Density of faecal coliform bacteria ranged from mean MPN value 2900 -7100/100ml. Results showed multiple drug resistance pattern among the bacterial isolates. E. coli showed more than 50% resistance to amickacin, oxytetracycline, streptomycin, tetracycline and kanamycin while Salmonella showed high resistance to oxytetracycline, streptomycin, tetracycline and ampicillin. The MAR indexing of the isolates showed that they have originated from high risk source such as humans, poultry and dairy cows. Conclusions: The high density of faecal coliform bacteria and prevalence of multi drug resistant E. coli and Salmonella serotypes in the lake may pose severe public health risk through related water borne and food borne outbreaks

An assessment of potential public health risk associated with the extended survival of indicator and pathogenic bacteria in freshwater lake sediments

Microcosm studies were performed to evaluate the survival of Escherichia coli, Salmonella paratyphi and Vibrio parahaemolyticus in water and sediment collected from the freshwater region of Vembanad Lake (9 35◦N 76 25◦E) along the south west coast of India. All three test microorganisms showed significantly (p < 0.01) higher survival in sediment compared to overlying water. The survival in different sediment types with different particle size and organic carbon content revealed that sediment with small particle size and high organic carbon content could enhance their extended survival (p < 0.05). The results indicate that sediments of the Lake could act as a reservoir of pathogenic bacteria and exhibit a potential health hazard from possible resuspension and subsequent ingestion during recreational activities. Therefore, the assessment of bacterial concentration in freshwater Lake sediments used for contact and non contact recreation has of considerable significance for the proper assessment of microbial pollution of the overlying water, and for the management and protection of related health risk at specific recreational sites. Besides, assessment of the bacterial concentration in sediments can be used as a relatively stable indicator of long term mean bacterial concentration in the water column above

Virulence Potential And Antibiotic Susceptibility Pattern Of Motile Aeromonads Associated With Freshwater Ornamental Fish Culture Systems: A Possible Threat To public Health

Aeromonas spp. are ubiquitous aquatic organisms, associated with multitude of diseases in several species of animals, including fishes and humans. In the present study, water samples from two ornamental fish culture systems were analyzed for the presence of Aeromonas. Nutrient agar was used for Aeromonas isolation, and colonies (60 No) were identified through biochemical characterization. Seven clusters could be generated based on phenotypic characters, analyzed by the programme NTSYSpc, Version 2.02i, and identified as: Aeromonas caviae (33.3%), A. jandaei (38.3%) and A. veronii biovar sobria (28.3%). The strains isolated produced highly active hydrolytic enzymes, haemolytic activity and slime formation in varying proportions. The isolates were also tested for the enterotoxin genes (act, alt and ast), haemolytic toxins (hlyA and aerA), involved in type 3 secretion system (TTSS: ascV, aexT, aopP, aopO, ascF–ascG, and aopH), and glycerophospholipid-cholesterol acyltransferase (gcat). All isolates were found to be associated with at least one virulent gene. Moreover, they were resistant to frequently used antibiotics for human infections. The study demonstrates the pathogenic potential of Aeromonas, associated with ornamental fish culture systems suggesting the emerging threat to public health

TRIPS Agreement and Public Health: An Overview of International Issues

This paper deals with brief overview of the developments of international provisions on IPR related to public health. It discusses flexibilities before and after TRIPS Agreement and difficulties faced by developing countries in implementing TRIPS obligations and protecting public health. Also discussed are the reasons for the Doha Declaration and issues relating to implementation of Para 6 of the Declaration. Discusses the inadequacy in the compulsory licence based approach to solve public health crisis and argues for a more comprehensive approach to find a long term solution to the public health issues