Tag Archives: international

Professor: Research, training can improve South African health journalism

In discussing a large grant his university has received and the center for health journalism that it will fund, South African professor Guy Berger (bio) has unleashed a scathing critique of African health journalism, and of the profession as a whole.

Rhodes University, Grahamstown, South Africa. Photo by Pierre Nel via Flickr

Berger says South African health journalists don’t look hard enough for real news, don’t know enough about health care, and aren’t even that good at telling the stories that they do uncover.

It’s a dire picture, of course, but Berger’s overall message is one of hope. He implies that there’s a lot of great work to be done on health and the health care industry in in South Africa and the new center, he says, could help make health journalism the “healthiest trend-setter for the whole family of journalism.”

The “Discovery Centre for Health Journalism” will be funded by a $2 million grant from South African insurer Discovery Health. It will offer an honors program, six annual scholarships and an “annual symposium for working health journalists and stakeholders.” Berger also writes that it will “enjoy full academic freedom.”

For more on the center and African health journalism, see Issa Sikiti da Silva’s related post on bizcommunity.com.

GAO evaluates FDA’s overseas inspectors

A couple of new GAO reports are seeking to shed some light on the FDA’s overseas regulatory efforts. The first is part overview, part progress report (52-page PDF). It’ll answer your basic questions.

September 18, 2007: An FDA chemist is shown conducting a rapid screening using an automated immunoassay instrument to detect cell surface antigens of Salmonella on food products. Photo by Black Star/Michael Falco for FDA

An FDA chemist tests food for antigens of Salmonella. (Photo: Black Star/Michael Falco for FDA)

In 2008 and 2009, the FDA sent 42 staffers overseas to establish foreign offices. The staff are on two-year overseas rotations, though it’s been difficult to find qualified workers for certain locations, especially since some of them had to take a pay cut. There’s a map of all 11 offices on the 12th page of the PDF.

According to the GAO, what do FDA overseas offices do?

  • Build relationships with foreign regulators and stakeholders, and with other U.S. agencies that are overseas
  • Gather information about regulated products
  • Inspect overseas facilities which are exporting to the U.S. (China and India only)
  • Train foreign stakeholders to better understand FDA regulations and systems

The second report is focused specifically upon inspections of overseas drug manufacturers producing for the U.S. market. The FDA has prioritized a list of such facilities that it would like its inspectors to visit, and the overseas agents managed to check off 11 percent of that list last year. At that rate, it will take about nine years for them to cover everything. For domestic facilities, that turnover rate is about 2.5 years.

Is America’s high health spending linked to short lifespans?

The United States lags behind other developed nations in life expectancy, yet spends far more on health care than any other nation. This is not news. Now if someone could definitively tell us why, that would be news. Life expectancy’s a dangerously blunt measure of the efficacy of a nation’s health care system, as there more confounding factors than anyone can possibly account for.

Neverthless, Columbia-affiliated public health researchers publishing in the latest edition of Health Affairs (free to AHCJ members!) have taken a stab at it, doing their best to tease out the biggest confounds and determine why Americans don’t live as long as their counterparts in the other 12 large, historically developed nations, all of which happen to provide universal health care of one variety or another. The paper looked at 15-year survival rates for 45- and 65-year-olds, in order to avoid the confusion introduced into life-span statistics by each country’s different reproductive (and end-of-life) policies. It’s a little complicated, so I’ll let the authors explain:

In this paper we explore changes in fifteen-year survival at middle and older ages, alongside per capita health care spending, in the United States and twelve other wealthy nations. We then examine the extent to which the survival and cost variations over time among these nations can be explained by demographics, obesity, smoking, or mortality events that are not closely related to health care, such as traffic accidents and homicide. By comparing health system costs and mortality rates over time, it is possible to assess whether trends in risk factors for health or causes of death can explain the observed relative decline in broad health outcomes among American men and women over the past thirty years.

As it turns out, those risk factors don’t appear to explain anything. In the 30 years between 1975 and 2005, the American system has weakened relative to equivalent countries despite the fact that smoking rates declined, obesity rates grew more slowly than they did overall in the other 12 nations and accident and homicide rates remained the same. So, while risk factors stayed steady (or improved), America continued spending more and getting less in return.

The researchers didn’t come up with a perfect explanation, of course, but they have their suspicions. On the Health Affairs blog, Chris Fleming summarizes their conclusion:

Rising health spending itself, the authors conclude, might be responsible for the relative decline in survival. They cite three consequences of rising health spending: an increase in the number of people with inadequate health insurance; the inability to allocate financial resources to life-saving programs; and unregulated fee-for-service reimbursement and an emphasis on specialty care that leads to unneeded procedures and fragmented care. As a result, they conclude, “meaningful reform may not only save money over the long term: it may also save lives.”

Aussie researchers find value in health reporters

In Croakey, Melissa Sweet explains a new study about coverage of avian flu by Australian media and how it demonstrates the benefits of using specialized beat reporters to cover health stories. The study approaches the coverage from a public health communication angle, and addresses head-on concerns that the media has been a menace to public health with its reckless disregard for actual evidence.

Among other things, it notes that reporters seem to be genuinely dedicated to honest and effective reporting, which often puts them at loggerheads with editors and producers, groups which must be cognizant of what the report euphemistically calls “economic and structural imperatives.”

See Sweet’s post for more details but here are some of the highlights:

  • reporters shared the same concerns as health professionals about the depth, accuracy and social impact of their reporting.
  • specialist health and medical reporters had much greater capacity to produce better quality health stories.
  • specialist reporters had a significant gatekeeper role for letting stories in, and keeping them out, of the paper. As one newspaper medical reporter said:If all I’ve done all day long is keep three really crap stories out of the paper then I consider I’ve done a good day’s work. And sometimes that can be quite a lot of work if somebody higher up than me has got “themselves all ignited about something. Then there’s a lot of work to do to hose people down and to bring these things round.”

Croakey is, of course, the health blog of Crikey, an Australian online magazine based in Melbourne.

In another study of health journalism, just published in PLoS Medicine, researchers found that stories written by health journalists were “superior to those written by other groups.” This study also looked at stories from news organizations in Australia.

The researches point out that, given economic considerations, editors might be tempted to use stories from wire services, foreign media outlets or other news organizations for their health coverage, however, they caution that editors should choose carefully because AP achieved fairly high and consistent ratings, whereas AFP had significantly lower average scores.

The real challenge for Italian health care

Changes are on tap for the Italian health care system. Standard health care costs will be defined, which means determining the amount necessary to keep Italians healthy, starting with what “virtuous regions” spend, (meaning those regions with their balance sheets in order: Emilia-Romagna, Lombardy, Tuscany and Veneto). A saving on standard costs of at least 4 billion euro is expected.

Gianluca Bruttomesso

Gianluca Bruttomesso

Right now, Italy spends less on health care than 15 other European nations, which allocate 9.2 percent of their GDP compared with Italy’s 8.7 percent. This figure is even less than the Organization for Economic Cooperation and Development average (8.9 percent). The Italian public health care system is ranked second worldwide, according to the WHO.

However, AHCJ member Gianluca Bruttomesso raises some questions about why the system should be subjected to limits and  deceleration in development. Read more …