Featured Journal Content
30 January 2018
What’s coming for health science and policy in 2018? Global experts look ahead in their field
The PLOS Medicine Editors, Soumya Swaminathan, Robin S. Room, Louise C. Ivers, Graham Hillis, Rebecca F. Grais, Zulfiqar A. Bhutta, Peter Byass
Infectious disease outbreaks in Yemen: A man-made disaster that has a solution
One thousand days of war in Yemen have resulted in many thousands of civilian deaths as well as deliberate destruction of health infrastructure and water infrastructure and disruption in the payment of thousands of public servants . Restrictions on imports have prevented access to food, medicine, and humanitarian supplies . In 2017, almost 1 million cases of suspected cholera were reported in the country, and although laboratory infrastructure is lacking to confirm every single case, the sheer scale of the epidemic of watery diarrhea is staggering. Frontline workers have privately reported their fears that cholera is being deliberately used as a weapon of war by parties to the conflict. Publicly, despite pleas from health workers and UN agencies for humanitarian space to provide relief, blockades and bombings continue. Diphtheria cases are now also on the rise—a painful disease, with a high mortality rate that occurs when vaccination rates are too low.
These epidemics, as well as the dire lack of access to food (already 400,000 children with severe acute malnourishment), do not bode well for 2018 . Even if the fighting stopped tomorrow, the impact of these health crises would be felt for a generation. The continued hostilities are like a genocidal experiment to demonstrate just how badly the destruction of a health system can destroy the health of a nation. Every one of these medical emergencies—cholera, diphtheria, famine—is completely preventable and treatable. Without an end to the conflict, or at a minimum an agreement to open corridors of reliable safe humanitarian access, the ordinary people of Yemen will continue to suffer despite the fact that the public health community has the knowledge and the tools to stop the epidemics and save lives.
Beyond words: US federal funding for public health and science
According to media reports, Centers for Disease Control and Prevention (CDC) officials prohibited the use of 7 words and phrases in developing budget requests . CDC and US Department of Health and Human Services (HHS) officials responded to reports by stating that there was no ban or censorship [22,23]. Media coverage has centered on either condoning the “ban” as evidence of the administration’s commitment to reducing government spending or on denouncing it as yet another piece of evidence of the administration’s antiscience agenda.
There is no doubt that evidence-based policy solutions and protecting vulnerable populations have not been a priority of this administration, with or without a word ban. Budget cuts or simply maintaining current funding to the CDC, as well as to National Institutes of Health (NIH) and other science and public health agencies and initiatives, will be felt directly through the scale back of existing public health programs, research funding, and initiatives. They will be felt indirectly by reinforcing the message that certain populations and conditions are not of interest to the US government. Cuts or removal of some programs, such as the HHS Secretary’s Minority AIDS Initiative Fund (SMAIF) , which provides funding to reduce HIV-related health disparities in racial and ethnic minority communities, would have dire consequences for the most vulnerable. Irrespective of whether words are banned or simply avoided by CDC staff, the consequences of such cutbacks remain the same for vulnerable populations, whose words are often not heard at all.