As the first outbreak of ebola in West Africa in twenty years claims over seventy lives, Laurie Garrett looks back at past epidemics in the region, drawing on her own experience reporting on 1995's ebola epidemic in Kikwit, Zaire. Lessons were learned, and it's now up to Guinea to remember them.
"The UN's current polio vaccination program—sponsored by UNICEF and delivered in UN-financed convoys and flights—is fully orchestrated by the Syrian government, and in opposition-held areas, it is dependent for administration on volunteers from the government-dominated Syrian Arab Red Crescent (SARC). SARC's president, Abdul Rahman Attar, is closely tied to the government, and even has his own pharmaceutical company, which has influenced the preference given to regime territory in the administration of polio vaccines during these last three years."
Laurie Garrett discusses the legacy of the discredited research by Andrew Wakefield, and how the Council on Foreign Relations' map of vaccine-preventable outbreaks suggests, "where Wakefield's message has caught on, measles follows."
After the tragic reappearance of polio in Afghanistan's capital city, Kabul, Laurie Garrett and Maxine Builder explore how Taliban plots to obstruct polio vaccinations could derail many hard-fought gains in global health and development.
Peter R. Orszag argues that new legislation giving health-care providers full responsibility for patient care, costs, and outcomes is an encouraging step toward increasing the quality of care supplied per Medicare dollar spent.
Peter R. Orszag argues that the United States will be unable to improve the efficiency of its health-care system unless it more aggressively pursues research into the comparative effectiveness of medical treatments.
Thomas Bollyky examines the 50th anniversary of the U.S. Surgeon General's report on the dangers of tobacco, its ensuing achievements, and steps the United States can take in addressing tobacco control in developing countries.
"Doctors' charges — and the incentives they reflect — are a major factor in the nation's $2.7 trillion medical bill. Payments to doctors in the United States, who make far more than their counterparts in other developed countries, account for 20 percent of American health care expenses, second only to hospital costs."
Authors: Yanzhong Huang, Kalipso Chalkidou, Robert Marten, Derek Cutler, Tony Culyer, Richard Smith, Yot Teerawattananon, Francoise Cluzeau, Ryan Li, Richard Sullivan, Victoria Fan, Amanda Glassman, Yu Dezhi, Sam McPherson, Thiagarajan Sundararaman, Neil Squires, Nils Daulaire, Rajeev Sadanandan, and Alexandre Lemgruber The Lancet
Yanzhong Huang and colleagues examine universal health coverage and the role of technology.
Authors: Peter R. Orszag, Senator Sheldon Whitehouse, and Ezekiel Emanuel Bloomberg.com
Peter Orszag, Ezekiel Emanuel, and Sheldon Whitehouse argue that the success of the "tech surge" in improving HealthCare.gov should inspire President Barack Obama to mobilize a similar effort to reduce health-care costs.
"A day spent as an inpatient at an American hospital costs on average more than $4,000, five times the charge in many other developed countries, according to the International Federation of Health Plans, a global network of health insurance industries. The most expensive hospitals charge more than $12,500 a day. And at many of them, including California Pacific Medical Center, emergency rooms are profit centers. That is why one of the simplest and oldest medical procedures—closing a wound with a needle and thread—typically leads to bills of at least $1,500 and often much more."
"Once you have beaten back a disease to just a few hundred cases, they will almost by definition be concentrated in places where there's some barrier—geographical, cultural, political—to easy vaccination. In general, each marginal case will cost more, and will consume more time and effort and labor, than the one before it...[but] the math of cost-benefit analyses runs aground when it comes to eradication campaigns, because the benefits, in theory, are infinite."