The increasing globalization of the world circles back to health as well. That’s a key tenet in a new report, The U.S. Government Engagement in Global Health: A Primer, from the Kaiser Family Foundation. The report describes the U.S. agencies and programs involved in global health and the federal budget supporting these efforts. Following the release of the primer, NewPublicHealth spoke with Josh Michaud, a Principal Policy Analyst at the Kaiser Family Foundation focused on the U.S. government’s role in global health.

NewPublicHealth: Why did the Kaiser Family Foundation create the global health primer?

Josh Michaud: The Kaiser Family Foundation has produced primers for other health issues on which we work, including Medicare and Medicaid. We felt that global health was an area in which we’ve built up some good data and analysis and we wanted to put it together in a format accessible to as wide an audience as possible. There has also been a growing interest at universities among young people in global issues, in particular global health issues.

Another critical reason to produce the primer is to set out a baseline for discussions, whether it is for different sides of a policy debate, student’s writing papers or people just getting started in the field. We don’t come at this with a particular recommendation, it really is meant to be a portrait of all the different parts of the U.S. government that are involved in global health. In the final section of the primer, we pulled together some policy issues that are of particular importance right now.

NPH: What trends or changes does the report note?

Michaud: The major trends have been increased levels of funding and an engagement by many different parts of the U.S. government in global health. The budget has increased significantly. In fiscal year 2001 the global health budget was about $1.5 billion. In fiscal year 2012 it was $8.8 billion. And while the United States is the most important and largest donor to global health, contributions from other governments have also grown significantly.

Much of the increased funding has been driven by increases for HIV/AIDS programs worldwide, and in particular, the PEPFAR program that the United States funds, as well as U.S. funding in support of Malaria. Earlier in the decade, there were significant increases year by year. That’s now leveled off and we don’t know what will happen in the future.

Update on 2011 UN Meeting on Non-communicable Diseases
Last year the United Nations held a High-Level Meeting on Non-communicable Disease. CEOs from the American Cancer Society, the American Diabetes Association and the American Heart Association have issued a statement on the one-year anniversary and stating that the meeting helped to elevate the importance of non-communicable diseases, or NCDs—including cancer, diabetes, cardiovascular diseases and chronic respiratory diseases—on the global health agenda. Progress from last year’s meeting includes a declaration in May by U.N. Member States for a global target of achieving a 25 percent reduction in premature mortality from NCDs by 2025. Read more on global health.

Obesity Rates Higher in U.S. Rural Areas
Obesity is more prevalent in rural areas of the United States than in urban areas, according to a new study by researchers at the University of Florida College of Public Health and Health Professions. The researchers found that 40 percent of rural residents are obese, compared with 33 percent of urban residents. The study was published in the Journal of Rural Health. Read more on obesity.

U.S. Pediatricians Warn Against Trampoline Use
Despite safety measures such as nets and padding added in the past several years, trampolines should still not be used by kids at home or on playgrounds, according to the American Academy of Pediatrics. The added measures have not changed the types of injuries caused by trampoline, according to Susannah Briskin, MD, a sports medicine specialist who helped craft the new recommendation. While the number of trampoline-related injuries dropped from 111,851 in 2004 to 97,908 in 2009, the total number of trampolines has also decreased. Read more on pediatrics.

Quebec will be the host city of the 12th HIA International Conference this week, the first time the meeting will be held in North America.

Quebec is a strong choice as host city. In 2001, the province of Quebec institutionalized health impact assessments (HIAs) by requiring that all laws and by-laws that could have an effect on health be evaluated for their impact. To help develop effective strategy, internal procedures were created at the Ministry of Health and Social Services to respond to requests, as well as HIA guidelines, a research program, and communication tools to help disseminate the HIA outcomes. Over 500 requests for advice have been generated since the requirement was put in place.

NewPublicHealth recently spoke with Alain Poirier, MD, chairman of the HIA meeting’s local organizing committee and the former National Public Health Director and Assistant Deputy Minister in Quebec’s Ministry of Health and Social Services.

NewPublicHealth: How did the 2001 law come about?

Dr. Poirier: The Health Minister at the time had been an official with the World Health Organization and so was well acquainted with the work being done in some European countries on evaluation the impact of laws on health. Our Public Health Act said the health minister “shall” be consulted, not “should” be consulted on any measures resulting from a new law or by-law that could have an impact on health.

And just saying that is not enough. I was made the person in charge in the Ministry of Health and Social Services of taking responsibility for the evaluations with the help of different groups, including academia. We also have a public health institute, the Institute National de Santé Publique du Quebec, which also has a mandate to help evaluate public policies and counsel the health minister about the impact of public policy.

We’ve had a lot of demand to evaluate new proposals, in part because every five years all the ministers in Quebec are required to issue a report on strategic planning. So when we screen the strategic planning we could foresee in advance what is going to be worked on in other ministries.

NPH: What is an example in Quebec of an HIA that was done that has resulted in a change in policy?

The XIX International AIDS Conference is taking place in Washington, D.C., this week at a pivotal point in the prevention and treatment of the disease. The World Health Organization on Friday recommended using antiretroviral medicines to try to prevent the infection in people who do not have HIV but are at high risk of transmission. The recommendation is based on recent research that found the drugs effective for many people. And, the International Antiviral Society has recommended treating all patients diagnosed with HIV with antiretroviral drugs, rather than waiting for levels of the virus to reach a certain point. Earlier treatment may help prevent certain diseases associated with HIV, including cancer, heart and kidney disease.

In advance of the meeting, Conference Co-Chair Diane Havlir, MD, chief of the HIV/AIDS division at San Francisco General Hospital and professor of medicine at the University of California, San Francisco, sat down with UCSF science writer Jason Bardi to talk about the pivotal research and global commitments being discussed in meeting sessions and hallway conversations in Washington, D.C., this week. Here are some key excerpts from that conversation, which originally ran on the UCSF News Center website.

Jason Bardi: What can we expect at the AIDS 2012 conference?

Dr. Havlir: Over the last couple of years, we’ve had breakthroughs in AIDS, mostly in the prevention area which include treatment as prevention, adult male circumcision having sustained benefits, pre-exposure prophylaxis, and data showing that early treatment benefits the individual. So, the big theme at AIDS 2012 is about how we begin to end the AIDS epidemic. The conference theme is “Turning the Tide Together,” and there is going to be emphasis on the how: how are we going to start to begin the end the AIDS epidemic? And there’s going to be emphasis on the together: who’s going to finance this, and what partners do we need to bring to the table? The way I like to explain it is that we need to think about the short- and medium-term strategies and the long-term strategies.

Jason Bardi: Your research group at UCSF is presenting quite a lot of research at the conference. Can you talk about some of the highlights?

Most of the millions of people traveling to the 2012 Olympic Games in London already have their travel reservations and event tickets, so there’s time to make sure you have the vaccinations, health records and medications you might need, and to bone up on how to access care if it’s needed during the Games.

The Centers for Disease Control and Prevention (CDC) is reminding travelers that some common medical terms are different in the UK such as:

• jabs (vaccines)
• chemist (pharmacist)
• giddy (dizzy)
• A&E (emergency room).

This information can also help you keep healthy, or access care if you need it.

Up to date on vaccines?

The vaccine that protects against measles is especially important, according to the CDC and the World Health Organization. Measles outbreaks are occurring in some areas of Europe, and in 2011, more than 30,000 people in Europe got measles. Un-vaccinated Americans who travel abroad can get measles and bring it to the United States and infect others.

Check your medical insurance coverage

You may need topurchase medical travel insurance to cover unexpected health services while in the UK.

Call 999!

The Emergency Number in the UK is 999, not 911. And Emergency Rooms are called A&Es for "Accidents and Emergencies."

Be a Smart Traveler

Register with the Department of State’s STEP program (Smart Traveler Enrollment Program). The program makes it easier for U.S. embassies or consulates to help you access care or evacuation plans if you become ill or are injured. The program also provides health alerts and updates for your travel destinations.

The CDC and the UK’s National Health Service have more information on staying healthy and accessing care at the Olympic Games this summer. And check the website of the Transportation Security Administration for information on traveling with a disability or medical supplies.

Cancer Rates Predicted to Soar Worldwide by 2030

Cancer cases are expected to increase 75 percent throughout the world by 2030, according to a new study published in Lancet Oncology. In the poorest nations, cancer cases could increase by 90 percent.

The study, which used 2008 data on 184 countries from the International Agency for Research on Cancer, finds that while cases of cervical and stomach cancer may be declining, other types of cancer including colorectal, breast and prostate cancer are increasing, likely because of lifestyle changes including higher fat diets and less exercise.

The researchers also say current smoking rates in poorer countries could mean higher lung cancer rates in the future. Read more on global health.

USDA To Test for Six Additional E. coli Strains in Beef

The U.S. Department of Agriculture (USDA) Food Safety and Inspection Service (FSIS) will begin a zero-tolerance policy for six additional strains of E. coli in raw beef starting Monday June 4. FSIS will routinely test raw beef for the six additional strains. If contamination is found the beef cannot be sold, and distributed meat will be recalled.

The additional strains can cause severe illness and even death especially in young children, older adults and people who immune system is weakened. Read more on food safety.

Smoking in Pregnancy Can Impact Children in Teen Years

Black and Latino children whose mothers smoked during pregnancy are more likely to suffer from acute asthma symptoms in their teens than asthma sufferers whose mothers did not smoke, according to a new study by researchers at the University of California at San Francisco. The study was published in the Journal of Allergy and Clinical Immunology.

The study looked at data on 2,500 Latino and Black children with asthma between the ages of 8 and 17 and found that if mothers smoked while pregnant, their children had about a 50 percent increase in uncontrolled asthma, even when other factors such as income and exposure to secondhand smoke were taken into account. "Kids who are 17 years old still show the effects of something they were exposed to during the first nine months of life," says Sam S. Oh, PhD, MPH, a postdoctoral scholar in epidemiology at the UCSF Center for Tobacco Research and Education, who is the lead author on the study. Read more asthma news.

Today marks World No Tobacco Day, organized by the World Health Organization Framework Convention on Tobacco Control. The website of the World Health Organization has a database of images and graphic warnings—catalogued by disease and country—that vividly illustrate the potential health consequences of using tobacco. The site is continually updated.

Below are some examples of health effects images from several countries. Note before you click—many of the images are disturbing.

• Impact on lungs (Brazil)
• Oral cancer (Australia)
• Premature death (Brazil)
• Secondhand smoke and babies (Mauritius)

In the United States, the Centers for Disease Control and Prevention recently launched a series of video shorts about people who lives have been dramatically altered by the health effects of smoking.

World Health Statistics 2012, a new report from the World Health Organization (WHO) shows progress in some health problems that have vexed the developing world, such as maternal deaths in childbirth, but also highlights the growing problem of non-communicable diseases such as obesity, high blood pressure and diabetes. This is the first year that the report has tracked cases of diabetes and high blood pressure.

According to the WHO:

• One in three adults worldwide has high blood pressure
• One in 10 adults has diabetes
• Half a billion people worldwide (12% of the world population) are obese

The Food and Drug Administration (FDA) has released a new report that details steps the agency is taking to ensure that imported food, drugs, medical devices and other regulated products meet the same standards for safety and quality as those manufactured in the United States.

According to the agency, global production of FDA-regulated goods and materials has grown significantly in the last decade:

• FDA-regulated products originate from more than 150 countries; 130,000 importers and 300,000 foreign facilities.
• Each year from 2005 through 2011, food imports have grown by an average of 10 percent, pharmaceutical products by nearly 13 percent and device imports by more than 10 percent.
• About half of all fresh fruits and 20 percent of fresh vegetables, as well as 80 percent of the seafood consumed in America, come from abroad.
• More than 80 percent of the active pharmaceutical ingredients used to make medicines are imported.

The agency says that through its international offices in Africa, Asia, Europe, Latin America and the Middle East, the FDA is increasing its knowledge base about local regulatory systems, and improving what foreign governments and industries know about FDA regulations and standards for products that will be sold in the United States. The agency says it is also collaborating to strengthen regulatory science and evidenced-based approaches to product safety and quality.

Read the Global Engagement Report.

Foodborne illness continues to be in the news. This week researchers from the Centers for Disease Control and Prevention (CDC) presented research at the International Conference on Emerging Infectious Diseases that found that foodborne disease outbreaks linked to foreign imports appear to have risen dramatically in 2009 and 2010.

Other findings from the research, which has not yet been published:

• Nearly half of the outbreaks involved foods imported from areas that previously had not been associated with foodborne illness.
• Between 2005 and 2010, 39 outbreaks and 2,348 illnesses were linked to imported food from 15 countries. Of those outbreaks, nearly half (17) occurred in 2009 and 2010.
• Fish was the most common source of an outbreak; spices were the second most common.
• Nearly 45 percent of imported foods linked to outbreaks came from Asia.

“As our food supply becomes more global, people are eating foods from all over the world, potentially exposing them to germs from all corners of the world, too,” says Hannah Gould, PhD, an epidemiologist in CDC’s Division of Foodborne, Waterborne and Environmental Diseases, and the lead author of the new study.