Global Health

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Global Health

Interdisciplinary research on global health problems through the lenses of economics, nutrition and politics.

Research Spotlight

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Tackling the Health of Women and Children in Global Conflict Settings

A new four-paper series in The Lancet exposes the far-reaching effects of modern warfare on women’s and children’s health. Stanford researchers, including SHP's Paul Wise and Eran Bendavid, have joined other academics and health-care experts in calling for an international commitment from humanitarian actors and donors to confront political and security challenges.
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Ethics and Governance of Digital Epidemiology

Many countries have taken digital epidemiology to the next level in responding to COVID-19. Focusing on core public health functions of case detection, contact tracing, and isolation and quarantine, the authors explore ethical concerns raised by digital technologies and new data sources in public health surveillance during epidemics.
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Does Diversity Matter for Health? Experimental Evidence from Oakland

African-American men have the lowest life expectancy of any major demographic group in the United States and live on average 4.5 fewer years than non-Hispanic white men. This paper finds that the mortality disparity is partly related to underutilized preventive healthcare services.

Featured Scholars

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Michelle Mello

Professor of Medicine
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Doug Owens

Senior Fellow at the Freeman Spogli Institute for International Studies
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Doug Owens

Senior Fellow at the Freeman Spogli Institute for International Studies
Professor of Medicine
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Maya Rossin-Slater

Assistant Professor, Medicine
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Paul Wise

Senior Fellow at the Freeman Spogli Institute for International Studies
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Paul Wise

Senior Fellow at the Freeman Spogli Institute for International Studies
Professor of Child Health and Society

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Publications

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Working Papers

The Stanford-India Emergency Management and Research Institute (EMRI) Study: Early Findings

Grant Miller, Grant Miller, Kim Singer Babiarz, Nomita Divi, S.V. Mahadevan
Stanford University, 2014 September 1, 2014
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Journal Articles

Girls' education and HIV risk: Evidence from Uganda

Marcella Alsan
Journal of Health Economics, 2013 June 4, 2013

Uganda is widely viewed as a public health success for curtailing its HIV/AIDS epidemic in the early 1990s. The period of rapid HIV decline coincided with a dramatic rise in girls’ secondary school enrollment. We instrument for this enrollment with distance to school, conditional on a rich set of demographic and locational controls, including distance to market center. We find that girls’ enrollment in secondary education significantly increased the likelihood of abstaining from sex.

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Journal Articles

The Increasingly Compelling Moral Responsibilities of Life Scientists

David Relman
Hastings Center Report, 2013 March 1, 2013
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Journal Articles

HIV Development Assistance and Adult Mortality in Africa

Eran Bendavid, CB Holmes, Jay Bhattacharya, Grant Miller
Journal of the American Medical Association, 2012 December 31, 2012

Context  The effect of global health initiatives on population health is uncertain. Between 2003 and 2008, the US President's Emergency Plan for AIDS Relief (PEPFAR), the largest initiative ever devoted to a single disease, operated intensively in 12 African focus countries. The initiative's effect on all-cause adult mortality is unknown.

Objective  To determine whether PEPFAR was associated with relative changes in adult mortality in the countries and districts where it operated most intensively.

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Journal Articles

HIV Development Assistance and Adult Mortality in Africa

Eran Bendavid, Charles Holmes, Jay Bhattacharya, Grant Miller
Journal of the American Medical Association, 2012 December 31, 2012

Context  The effect of global health initiatives on population health is uncertain. Between 2003 and 2008, the US President's Emergency Plan for AIDS Relief (PEPFAR), the largest initiative ever devoted to a single disease, operated intensively in 12 African focus countries. The initiative's effect on all-cause adult mortality is unknown.

Objective  To determine whether PEPFAR was associated with relative changes in adult mortality in the countries and districts where it operated most intensively.

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Journal Articles

Soil-Transmitted Helminth Infections and Correlated Risk Factors in Preschool and School-aged Children in Rural Southwest China

Xiaobing Wang, Linxiu Zhang, Renfu Luo, Guofei Wang, Yingdan Chen, Alexis Medina, Karen Eggleston, Scott Rozelle, D. Scott Smith
PLoS One, 2012 September 1, 2012
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Journal Articles

Effectiveness of provider incentives for anemia reduction in rural China: a cluster randomised trial

Grant Miller, Renfu Luo, Linxiu Zhang, Sean Sylvia, Yaojiang Shi, Patricia Foo, Qiran Zhao, Reynaldo Martorell, Alexis Medina, Scott Rozelle
BMJ, 2012 July 27, 2012

Background: To study how misaligned supply-side incentives impede health programs in developing countries, we tested the impact of performance pay for anemia reduction in rural China. To the best of our knowledge, our study is the first to evaluate performance pay for actual health improvement.

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Journal Articles

Poverty, Global Health, and Infectious Disease: Lessons from Haiti and Rwanda

Marcella Alsan, Michael Westerhaus, Michael Herce, Koji Nakashima, Paul E. Farmer
Infectious Disease Clinics of North America, 2011 December 31, 2011
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Journal Articles

Health Outcomes and Costs of Community Mitigation Strategies for an Influenza Pandemic in the United States

Daniella Perlroth, Glass RJ, Davey VJ, Cannon D, Alan Garber, Douglas Owens
Clinical Infectious Diseases, 2010 December 31, 2010

Background. The optimal community-level approach to control pandemic influenza is unknown. Methods. We estimated the health outcomes and costs of combinations of 4 social distancing strategies and 2 antiviral medication strategies to mitigate an influenza pandemic for a demographically typical US community. We used a social network, agent-based model to estimate strategy effectiveness and an economic model to estimate health resource use and costs. We used data from the literature to estimate clinical outcomes and health care utilization. Results.

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Journal Articles

The Global Challenge of Antimicrobial Resistance: Insights from Economic Analysis

Karen Eggleston, Ruifang Zhang, Richard J. Zeckhauser
International Journal of Environmental Research and Public Health, 2010 August 9, 2010

The prevalence of antimicrobial resistance (AR) limits the therapeutic options for treatment of infections, and increases the social benefit from disease prevention. Like an environmental resource, antimicrobials require stewardship. The effectiveness of an antimicrobial agent is a global public good. We argue for greater use of economic analysis as an input to policy discussion about AR, including for understanding the incentives underlying health behaviors that spawn AR, and to supplement other methods of tracing the evolution of AR internationally.

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Journal Articles

Health outcomes and costs of community mitigation strategies for an influenza pandemic in the United States.

Daniella Perlroth, Glass RJ, Davey VJ, Cannon D, Alan M. Garber, Douglas K. Owens
Clinical Infectious Diseases, 2010 January 15, 2010

BACKGROUND: The optimal community-level approach to control pandemic influenza is unknown. METHODS: We estimated the health outcomes and costs of combinations of 4 social distancing strategies and 2 antiviral medication strategies to mitigate an influenza pandemic for a demographically typical US community. We used a social network, agent-based model to estimate strategy effectiveness and an economic model to estimate health resource use and costs. We used data from the literature to estimate clinical outcomes and health care utilization.

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Journal Articles

Can an Infectious Disease Genomics Project ‘Predict and Prevent’ the next Pandemic?

Rajesh Gupta, Mark H. Michalski, Frank R. Rijsberman
Public Library of Science – Biology, 2009 December 31, 2009

The world of genomics is transforming medicine, and is likely to influence the future development of new drugs, diagnostics, and vaccines. To date, the greater focus of genomics and medicine has been on conditions affecting resourcewealthy settings, primarily involving scientists and companies in those settings. However, we believe that it is possible to expand genomics into a more global technology that can also focus on diseases of resource-limited settings. This goal can be achieved if genomics is made a global priority.

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Working Papers

Pandemic Influenza and the Globalization of Public Health

Michele Barry, Karen Eggleston, Qiong Zhang
Asia Health Policy Program working paper #11, 2009 December 31, 2009

When one can circle the globe in less than the time of incubation of most infectious pathogens, it is clear every country relies to some extent on the health systems of other countries to prevent and protect their citizens from global health threats. Therefore, creating and maintaining a good health system in one country requires attention to interregional and international cooperation. Domestic and international spheres of public health policies are becoming more intertwined and inseparable.

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Journal Articles

Effectiveness and Cost-Effectiveness of Vaccination Against Pandemic Influenza (H1N1) 2009

Nayer Khazeni, Hutton DW, Alan M. Garber, Hupert N, Douglas Owens
Annals of Internal Medicine, 2009 December 12, 2009

Background: Decisions on the timing and extent of vaccination against pandemic (H1N1) 2009 virus are complex.

Objective: To estimate the effectiveness and cost-effectiveness of pandemic influenza (H1N1) vaccination under different scenarios in October or November 2009.

Design: Compartmental epidemic model in conjunction with a Markov model of disease progression.

Data Sources: Literature and expert opinion.

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Journal Articles

Effectiveness and Cost-Effectiveness of Expanded Antiviral Prophylaxis and Adjuvanted Vaccination Strategies for an Influenza A (H5N1) Pandemic

Nayer Khazeni, Hutton DW, Alan M. Garber, Douglas Owens
Annals of Internal Medicine, 2009 December 12, 2009

Background: The pandemic potential of influenza A (H5N1) virus is a prominent public health concern of the 21st century.

Objective: To estimate the effectiveness and cost-effectiveness of alternative pandemic (H5N1) mitigation and response strategies.

Design: Compartmental epidemic model in conjunction with a Markov model of disease progression.

Data Sources: Literature and expert opinion.

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Journal Articles

Safety and Efficacy of Extended-Duration Antiviral Chemoprophylaxis Against Pandemic and Seasonal Influenza

Nayer Khazeni, Dena M. Bravata, Jon-Erik Holty, Uyeki TM, Stave CD, Michael K. Gould
Annals of Internal Medicine, 2009 October 6, 2009

Background: Neuraminidase inhibitors (NAIs) are stockpiled internationally for extended use in an influenza pandemic.

Purpose: To evaluate the safety and efficacy of extended-duration (>4 weeks) NAI chemoprophylaxis against influenza.

Data Sources: Studies published in any language through 11 June 2009 identified by searching 10 electronic databases and 3 trial registries.

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Working Papers

Global Welfare Regimes: A Cluster Analysis

Miriam Abu Sharkh, Ian Gough
CDDRL Working Papers, 2009 January 1, 2009

This paper tests the claim that a small number of distinct „welfare regimes,
combining institutional patterns and social welfare outcomes, can be identified
across the developing world. It develops a methodology for clustering a large
number of developing countries, identifying and ranking their welfare regimes,
assessing their stability over the decade 1990-2000, and relating these to important
structural variables. It identifies three meta-welfare regimes: proto-welfare state

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Journal Articles

Infectious disease control policy: A role for simulation

Margaret Brandeau
Proceedings - Winter Simulation Conference, 2008 December 31, 2008

ABSTRACT

Control of infectious diseases is a key global health priority. This paper describes the role that simulation can play in evaluating policies for infectious disease control. We describe ongoing simulation studies in three different areas: HIV prevention and treatment, contact tracing, and hepatitis B prevention and control.

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Journal Articles

Health Impact Assessment of Global Climate Change: Expanding upon Comparative Risk Assessment Approaches for Policy Making

Holly Gibbs, et al.
Annual Reviews of Public Health, 2008 April 1, 2008

Climate change is projected to have adverse impacts on public health. Cobenefits may be possible from more upstream mitigation of greenhouse gases causing climate change. To help measure such cobenefits alongside averted disease-specific risks, a health impact assessment (HIA) framework can more comprehensively serve as a decision support tool. HIA also considers health equity, clearly part of the climate change problem.

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Journal Articles

Climate Change and Global Health: Quantifying a Growing Ethical Crisis

Holly Gibbs, et al.
EcoHealth, 2007 November 30, 2007

Climate change, as an environmental hazard operating at the global scale, poses a unique and "involuntary exposure" to many societies, and therefore represents possibly the largest health inequity of our time. According to statistics from the World Health Organization (WHO), regions or populations already experiencing the most increase in diseases attributable to temperature rise in the past 30 years ironically contain those populations least responsible for causing greenhouse gas warming of the planet. Average global carbon emissions approximate one metric ton per year (tC/yr) per person.

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Books

Crisis Preparedness: Asia and the Global Governance of Epidemics

Stella Quah, Chris Beyrer, Kari Hartwig, Gabriel M. Leung, Graham Scambler, Jim Whitman
Shorenstein APARC, 2007 June 1, 2007

Throughout history, nations have waged war against epidemics, from bubonic plague to pulmonary tuberculosis. Today, we confront HIV/AIDS, SARS, and avian influenza, among other major infectious diseases. The failure to contain HIV/AIDS, the longest contemporary pandemic, and the difficulties in dealing with the threat posed by avian influenza, show that the world is not well prepared for the next health crises. Because preventing and controlling these infectious diseases is a race against time, scientists around the world scrutinize viruses and bacteria more intently than ever.

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Books

Edge of Disaster, The: Rebuilding a Resilient Nation

Stephen E. Flynn
Council on Foreign Relations and Random House, 2007 February 1, 2007

We have learned little from the cataclysms of September 11 and Hurricane Katrina. When it comes to catastrophe, America is living on borrowed time--and squandering it.

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Journal Articles

How Globalization Went Bad

Steven Weber, Naazneen Barma, Matthew Kroenig, Ely Ratner
Foreign Policy, 2007 January 1, 2007

The article asserts that globalization has made the world a more dangerous and less orderly place. The authors argue that since the emergence and expansion of globalization in the 1990s, the world has experienced more problems such as increasing terrorist activity, widening gaps between religious and cultural ideologies, unstable global financial systems, expanding dangers of pandemic disease, and the growing threat of global climate change.

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Journal Articles

Feasibility and Cost-Effectiveness of Treating Multidrug-Resistant Tuberculosis: A Cohort Study in the Philippines

Thelma E. Tupasi, Rajesh Gupta, Ma Imelda D. Quelapio, Ruth B. Orillaza, Nona Rachel Mira, Nellie V. Mangubat, Virgil Belen, Nida Arnisto, Lualhati Macalintal, Michael Arabit, Jaime Y. Lagahid, Marcos Espinal, Katherine Floyd
PLoS Medicine, 2006 September 1, 2006

Background
Multidrug-resistant tuberculosis (MDR-TB) is an important global health problem, and a
control strategy known as DOTS-Plus has existed since 1999. However, evidence regarding the feasibility, effectiveness, cost, and cost-effectiveness of DOTS-Plus is still limited.

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