I’ve added a new page to the site that includes a working draft of my senior research. The temporary title is:

Social Sector Microfranchising  in the Developing World: Using the Ideas Behind McDonald’s to Deliver Essential Medicines to the Poor

I post a working draft for a few reasons:

1) In the case that there are any readers out there that have interest in this field, perhaps my research could be beneficial to them

2) In the case that there are any critics out there that have feedback, input, or criticism, perhaps they can further enlighten my research

3) By publishing this work publicly, I feel more accountable for my writing. I wonder why open-source writing projects are not found more often on the internet. I, for one, would be very interested in each step of the writing process from leading experts in any field. Likewise, I imagine that a high volume of readers could offer  insight or new ideas to improve any piece of writing.

My thesis includes case studies on the HealthStore Foundation and Living Goods organizations.  They are amazing organizations that are addressing long-standing global health issues with innovative solutions through markets.

The AIDS crisis is not over. In fact, it’s in our front yard.

Over 6,000 people in the greater New Haven community are currently living with HIV/AIDS. The disease affects every age group, every ethnicity and every sexual orientation. With 15,000 AIDS cases reported in Connecticut in 2007, the state has the ninth highest AIDS case rate per capita. AIDS is not just a global issue; it’s a local problem.

In the nearly three decades since the disease was first diagnosed, progress has been made. We have medicines, research funding and a fundamental understanding of the disease. For those on antiretrovirals, HIV is no longer a death sentence; for those with basic education, HIV is mostly preventable.

Yet even in the United States, stigma persists, discrimination abounds and misinformation continues to lead to unfounded prejudice against homosexuals, drug users and the HIV-positive community. Although HIV currently requires less medical maintenance than other chronic conditions such as diabetes, the social weight of a positive HIV test remains incomparable to other illnesses. Solving the current HIV epidemic in the United States requires more than pharmaceutical drugs, it requires a fundamental shift in how we view HIV and AIDS: a movement to end stigma and increase prevention.

Of course, progress has been made on this front as well. Many cities have needle exchange programs, and in 1998, the Supreme Court ruled it illegal to discriminate based on HIV status. This progress came as the result of a movement that made HIV/AIDS not just a disease but an issue of social justice. The group of people who spurred this movement —who educated the masses, who fought for equality — were not scientists or lawyers or teachers. They were passionate community members that recognized injustice and mobilized to do something about it.

We can continue that movement. Students, with their energy and vast social networks, are best equipped to raise awareness, lobby for change and fight for social justice. Speak up. Support the community. Donate to a cause. Martin Luther King Jr. once said “In the end, we will remember not the words of our enemies, but the silence of our friends.” Don’t be a silent friend.

Every April, hundreds of students and community members unite to hear live music, listen to inspirational speakers and walk through the streets of New Haven to raise awareness for the local HIV epidemic as part of the five-kilometer AIDS Walk. Sponsored by an organization run by Yale student volunteers, the walk has become a symbol of the community coming together to respond to a public health issue, promote individual and community wellness and help those most in need. The proceeds go to nine local charities that provide vital patient services, housing, education, hospice care and prevention projects throughout the city.

By walking together, students can leave a positive impact on the community. In the inspirational words of anthropologist Margaret Mead: “Never doubt that a small group of thoughtful, committed people can change the world. Indeed, it is the only thing that ever has.” Help bring real change to your community, and the world.

Let the AIDS Walk be your first step.

Microfranchising the Developing World: Microfranchising helps create a business model for distributing glasses in poor nations.

“Mr. President, this is a big fucking deal.”

Joe Biden’s whispered excitement, caught on media microphones at the recent health care reform bill signing ceremony, celebrates a historic event for the United States.

After a 219-212 House vote, after a year of heated debate, after 100 years of effort, President Barack Obama signed into law the health care reform bill. Not a single vote in affirmation of the bill came from the Republican Party.

“This is a somber day for the American people,” said Rep. John A. Boehner (R-OH), the House Minority Leader. “By signing this bill, President Obama is abandoning our founding principle that government governs best when it governs closest to the people.”

While health care has clearly sparked many political passions, recent protests have been downright embarrassing. Racial slurs were chanted at civil rights hero Rep. John Lewis (D-GA), one demonstrator spit on Rep. Emmanuel Cleaver (D-MO), while Rep. Barney Frank (D-MA) faced insults about his openly gay sexual orientation.

Even congressmen have joined in the inappropriate revelry. Rep. Randy Neugebauer (R-TX) shouted “Baby killer!” during Rep. Bart Stupak’s (D-MI) speech on healthcare reform. Though passions regularly flare over important policy, GOP members associated with these outbursts should be ashamed.

The Republicans have pledged to block the measure, or at least use procedural weapons to delay its final ratification. “We will not allow this to stand,” promised Rep. Michele Bachmann (R-MN), a day after the bitterly partisan vote. Already in more than a dozen states, attorney generals have filed lawsuits arguing that measures in the bill are unconstitutional.

The response from Rep. Bob Filner (D-CA)? “It is time to chill out, Republicans.”

“Now it is a fact,” declared Sen. Max Baucus (D-MT). “Now it is law. Now it is history. Indeed, it’s historic.”

A long time ago, the healthcare reform debate stopped being about health and started being about politics. Countless committees, numerous reforms, many liberals losing hope, and one removed “Cornhusker Kickback” later, a bill has been signed into law that may finally offer improvements to our nation’s failing health system.

The bill does not include a public option that would allow people to opt into a cheaper health insurance plan provided by the federal government (one of the more liberal proposals advocated for by Democrats and Obama since the beginning of the debate), but still includes some important reforms. The bill is expected to cost some 940 billion dollars, but an additional 32 million Americans will finally receive healthcare insurance.

In addition to the expansion of the Medicaid benefit cutoff to four times the level of poverty (88,200 dollars for a family of four), federal drug benefits will improve. Children can stay on their parents’ insurance plans until a later age. Subsidies are provided to small businesses to help cover insurance costs. Coverage cannot be denied based on preexisting conditions. Out-of-pocket expenditures will be capped. Individual mandates will force everyone to buy insurance or pay a penalty fee. Many of these changes, however, will be gradual and won’t occur until 2014.

If you have coverage now, there won’t be many changes next year. In fact, if Republicans make substantial gains in the next elections, some of these provisions could be legislated out of existence before they even have a chance to take effect.

Obama said it best: “This is major reform. This is not radical reform.” The signing is only a small incremental step in getting America to where it needs to be. The lack of a public option does not mean this bill is a failure, but it does mean that it is lacking. Only with a public option can the government most effectively provide adequate welfare to the poor and the sick. Insurance companies have a long history of unjustifiable profits—profits that come from refusing care to the sick and exploiting those with preexisting conditions.

The bill isn’t perfect: It’s only gradual change, and it lacks a public option. But it is the first step in addressing the health disparity in our country. It’s the first step in creating a country of healthy individuals. It’s the first step in acknowledging that everyone deserves affordable access to care.

For all the hurdles that came with the push for reform, in the immortal words of Joe Biden, it’s a big fucking deal.

On March 25: Look for a state of the union address unlike any other–State of the Planet 2010.

A biennial conference, hosted by the Earth Institute and The Economist, watch the world’s most influential and innovative thinkers tackle critical issues facing the world including: climate change, poverty, economic recovery and international systems.

Clearly all these issues greatly affect public health (a topic of  import to PHC), but this post will place focus particularly on poverty.

A short list of infectious diseases, treatable with inexpensive generic drugs, accounts for 70-90% of all childhood illness and death in the developing world — a truly appalling statistic.

These enormous global health disparities cause thousands of global citizens—sons, daughters, mothers, and fathers—to die each day from diseases for which cures were discovered decades ago. Such deaths do not come from disease as much as from complacency: killed by conditions that could be prevented with simple, affordable remedies: vaccinations, bednets, anti-malarials, hand sanitizer and antibiotics.

Disease has practically become an accepted part of life in impoverished communities, yet treatments are available for less than a cup of coffee. So what can be done?

Here is a list of some of the more innovative approaches to improve health or reduce costs for the poorest of the poor:

Selling to the poor: Social enterprises likes HealthStore Foundation attempt to use market mechanisms to create a private alternative for sustainable access to low-cost, high-quality medications.

Health Impact Fund: Yale’s own Thomas Pogge is leading the charge to radically change Pharma’s global IP policies by incentivizing R&D expenditure that would address substantial reductions in global burden of disease.

PATH’s Malaria Vaccine Initiative: Funded by the Gates Foundation, a collaborative effort to create a whole new type of vaccine will save millions of lives.

The Power of the Text: FrontlineSMS:Medic leverages the power of the cell phone to save lives in developing countries.

charity:water: No one brings clean drinking water to people in developing nations better than CW. 100% of proceeds go to fund water projects.

charity: water is launching Unshaken – a campaign to help Haiti recover by providing long-term clean water solutions.  100% of donations directly fund water projects in 11 areas in Haiti.

Katie Spotz rowed across the Atlantic Ocean solo to raise awareness and funds for clean water.  She was the youngest person to ever make the trip.  NYTimes article here.

To celebrate, you should check out the greatest coffee table book you can own from Blue Planet Run: It is beautiful.

Every 15 seconds, a child dies from a water-related disease. On average, every US dollar invested in water and sanitation provides an economic return of eight US dollars.  Learn more about the facts here.

Three twitters worth following: @water, @GoBluePlanetRun and @charitywater

In the meantime though, I wanted to link to an article that basically summarizes a part of my senior essay:

http://www.nextbillion.net/blog/2006/01/11/microfranchise-modes-of-healthcare-delivery

It’s about using a franchise model to expand access to essential medicines, eye care etc.  — a really interesting idea that I’m hoping to evaluate for my senior project.  Check it out.

The website describes it as:

A collection of readings Jacqueline Novogratz recommends to foster empathy, self-awareness and a business mindset in the Acumen Fellows, who come from around the world. It includes economists as well as novelists, activists and thinkers from an eclectic range of perspectives.

Check it out here.

• “Of all the forms of inequality, injustice in health care is the most shocking and inhumane”

Without a basic level of health, human rights mean very little.

The fight against oppression weakens over the coughs of tuberculosis.  The dream of education remains just that–a dream– of those bed-ridden by malaria.  Self-respect and dignity as a human suffer when suffering from diarrheal disease.

Yet these illnesses have easy solutions.  Malaria, TB, and diarrhea can be cured with simple treatments that cost less than a cup of coffee.  Single shot vaccines can prevent millions of future childhood deaths.

In a world with advanced laser-eye surgery, full body scans, and micro-surgery performed by robots, it’s incredible that children die from lack of the most basic antibiotics.

The outrageous extent of global health disparity in the time of MLK was appalling.  Decades later, it remains ethically unjustifiable.

• “True compassion is more than flinging a coin to a beggar… it comes to see that an edifice which produces beggars needs restructuring.”

The global tragedy of poverty cannot be solved by a system of charity alone.  To overcome the most oppressing economic issues, we must seek sustainable solutions that do no more than hinge on the endless altruism of others.  Social institutions must be transformed to promote gender equality, religious co-existence, and equal opportunities regardless of race, gender, or sexual orientation.

Poverty and it’s consequences are not solved by welfare, but by employment. Crime is not solved by police force, but by education and the creation of equal opportunities.  The act of flinging a coin is only a band-aid approach.

Organizations like Acumen Fund recognize this and seek to change the way we look at poverty.  They seek to transform the victim to the empowered, the poor to the proud.  Ultimately, the change of social structure (not single monetary donations) will gradually shift tragedy towards development.

• “In the end, we will remember not the words of our enemies, but the silence of our friends.”

Do something.  Anything.  Donate money, join a rally, hug a friend.  It’s easy to go through the motions, especially in college, and put off any public service.  Yet students are the best equipped to utilize their social network to raise awareness, lobby for change, and fight for social justice.  When a friend is fundraising, give them a small donation.  When a friend becomes active in a cause, show them your support.  When a friend experiences discrimination, don’t turn a blind eye.

To accomplish any goal, power comes from a network of loyal partners (a “tribe” of individuals dedicated to the same cause.)  We rely on each other to bring about change. Almost everyone has been in that position to ask a roommate to come to an event, or convince a friend to donate to a cause.

Don’t be a silent friend.