Controlling influenza A (H1N1) in China: Bayesian or frequentist approach.

This article discusses two approaches to controlling the newly identified influenza A (H1N1): via Bayesian and frequentist statistical reasoning. This study reviewed the measures implemented in China as an example to illustrate these two approaches. Since May 2009, China has deployed strict controlling mechanisms based on the strong prior Bayesian assumption that the origin of influenza A (H1N1) was from outside China and as such strict border control would keep the virus from entering China. After more than 4 months of hard work by Chinese health professionals and officials, the number of confirmed influenza A (H1N1) has increased steadily against the expectations of the general public. Taking into account the great financial burden in maintaining strict measures, Chinese health authorities have slowly adjusted their policies of controlling influenza A (H1N1) in China according to frequentist reasoning since July 2009.

U.S. pharmacy policy: a public health perspective on safety and cost.

A public health perspective based on social justice and a population health point of view emphasizes pharmacy policy innovations regarding safety and costs. Such policies that effectively reduce costs include controlling profits, establishing profit targets, extending prescription providers, revising prescription classification schemes, emphasizing generic medications, and establishing formularies. Public education and universal programs may reduce costs, but co-pays and "cost-sharing" do not. Switching medications to over-the-counter (OTC) status, pill splitting, and importing medication from abroad are poor substitutes for authentic public health pharmacy policy. Where policy changes yield savings, public health insists that these savings should be used to increase access and improve population health. In the future, pharmacy policies may emphasize public health accountability more than individual liberty because of potential cost savings to society. Fear of litigation, as an informal mechanism of focusing manufacturer's attention on safety, is inefficient; public health pharmacy policy regarding safety looks toward a more active regulatory role on the part of government. A case study of direct-to-consumer advertising illustrates the complexity of public health pharmacy policy.

Healing the schism: medicine and public health in Pakistan.

BACKGROUND: The relationship between medicine and public health has a long and complex co-evolution. In developing countries where the health needs are greatest and resources are few, this relationship is of critical importance. DEVELOPMENT OF MEDICINE AND PUBLIC HEALTH AT THE AGA KHAN UNIVERSITY: This paper provides a case study of the development of the relationship between medical and public health at the Aga Khan University (AKU), a leading educational institution in Pakistan, which was founded with a vision of reuniting medicine and public health. Rapid growth and development have led to successful medicine and public health programs, but have fallen short in creating the synergies needed to address the population health problems of the country. THE WAY FORWARD: In a twenty-five year history of strong growth and development, the AKU has recreated the schism that marked US institutional development in the 20th century, despite strategic consideration to address population health in the design of the University. We recommend the creation of public health schools that focus on leadership to renew an emphasis on unifying health concepts and actions following successful examples to bring medicine and public health together.

The evolving implications of health and sustainability in China.

Sustainability in the context of China is an immediate and massive concept. A society of 1.3 billion has economic growth of 9-10% and a dramatic rise in life expectancy. It has rapidly-accumulating material wealth, major lifestyle changes and growing inequalities. It is putting great pressure on natural resources such as water and air quality. The Chinese Government's new 5-year plan uses the term 'sustainable development' as an important social goal for the first time. Sustainability requires a global effort and Sino-European partnerships are important.

The medicine and public health initiative ten years later.

The Medicine and Public Health Initiative (MPHI) was created jointly 10 years ago by the American Medical Association and the American Public Health Association to bridge the nearly century-wide gulf between the respective disciplines. We review the history of MPHI and its growing significance in light of recent terrorism events. We report on current MPHI activities by examining three bellwether states-California, Florida, and Texas-as well as international sites. Upon its inception, MPHI was rapidly embraced and nationally disseminated. Sustainability 10 years later in the post-911 world requires renewed commitment by all collaborators. In order to meet the numerous health challenges facing our nation, from terrorism to chronic disease, and for MPHI to be successful, medicine and public health must work in tandem.