Global Health Updates
Dr. Joe Thomas, MSc, PhD, FRSPH
Chair, Global Health, Sustainable Policy Solutions Foundation
Global Health Update
Issue 4 Vol1. 20-26/12/21
Content
Abstract
Item 1. Impact of Colonisation on Indigenous Childhood obesity In Australia
Item 2. Racial Bias in Pulse Oximetry Measurement
Item 3. Digital Health Technologies for Remote Data Acquisition
Item 4. Covid Vaccine Research: Public Funding Private Profiteering
Abstract
Whettam and colleagues (2021) from Australia highlight social structural factors in childhood obesity among indigenous children. Oximeter has received widespread attention due to the Covid19 pandemic. Sjoding et al., (2021). Racial Bias in Pulse Oximetry Measurement. The US Department of Health and Human Services,??Food and Drug Administration invites comments on ?Digital Health Technologies (DHT) ?for Remote Data Acquisition in Clinical Investigations Guidance for Industry, Investigators, and Other Stakeholders.
Cross and colleges (2021) have done commendable research on the Covid Vaccine Research funding. The Oxford–AstraZeneca COVID-19 vaccine (ChAdOx1 nCoV-19, Vaxzevira or Covishield) builds on two decades of research and development (R&D) into chimpanzee adenovirus-vectored vaccine (ChAdOx) technology at the University of Oxford. Covdi19 vaccine research is ?Public Funding and ?Private Profiteering. The Vaccine inequity campaign must address the Covid19 Vaccine profiteering as well.
Whettam, L., Bergmeier, H., Chung, A. and Skouteris, H. (2021), The ongoing impact of colonisation on childhood obesity prevention: a First Nations' perspective. Australian and New Zealand Journal of Public Health. https://doi.org/10.1111/1753-6405.13170
Louisa Whettam is a descendent of the Wiradjuri people from New South Wales, Australia, Director of Ngiyambalgarra Consultancy. Louisa Whettam's story captures some of the common themes depicting the drivers of disparities in obesity prevalence among First Peoples of Australia. ??In her personal story in this perspective piece, Louisa highlights First Nations' perspective concerning the ongoing impact of colonisation on childhood obesity prevention.
The ongoing impact of colonialism on disconnection from culture and country, colonisation, racism and mistrust of health and social care systems, generational experiences of trauma, overweight and obesity risk among First Peoples. Solutions for targeting drivers of obesity inequity for First Peoples include an urgent need to include food and nutrition as priorities on the national Aboriginal health policy agenda are some of the issues presented in this analysis.
Health for 'First Peoples' in Australia encompasses more than the physical wellbeing of an individual. It extends "to the social, emotional and cultural wellbeing of the whole community in which each individual can achieve their full potential as a human being thereby bringing about the total wellbeing of their Community".
?This also includes (re)connecting to culture and country both a protective factor and necessary therapeutic step for mitigating experiences of intergenerational trauma and regaining health.
?Through nurturing connections to culture and country and advocating for First Nations peoples' voices to be heard, Louisa is working towards closing the inequality gap experienced by many First Nations people so that future generations of Australia's First People have every opportunity to achieve their full potential.
Sjoding et al., (2021). Racial Bias in Pulse Oximetry Measurement. n engl j med 383;25 nejm.org December 17, 2020.
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Oxygen is among the most frequently administered medical therapies, with a level that is commonly adjusted according to the reading on a pulse oximeter that measures patients' oxygen saturation. Questions about pulse oximeter technology have been raised, given its initial development in populations that were not racially diverse. The clinical significance of potential racial bias in pulse oximetry measurement is unknown.
Thus, in two large cohorts, Black patients had nearly three times the frequency of occult hypoxemia (i.e., arterial oxygen saturation of <88% despite an oxygen saturation of 92 to 96% on pulse oximetry) ?that was not detected by pulse oximetry as White patients. Given the widespread use of pulse oximetry for medical decision making, these findings have significant implications, especially during the current coronavirus disease 2019 (Covid-19) pandemic. Our results suggest that reliance on pulse oximetry to triage patients and adjust supplemental oxygen levels may place Black patients at increased risk for hypoxemia. It is important to note that not all Black patients with a pulse oximetry value of 92 to 96% had occult hypoxemia. However, the variation in risk according to race necessitates the integration of pulse oximetry with other clinical and patient-reported data.
in Clinical Investigations Guidance for Industry, Investigators, and Other Stakeholders. (Call for comments) The US Department of Health and Human Services,??Food and Drug Administration invites comments on this draft document. Comments and suggestions regarding this draft document should be submitted within 90 days of publication.??https://www.fda.gov/media/155022/download
A digital health technology (DHT) is a system that uses computing platforms, connectivity, software, and sensors for healthcare and related uses. This guidance provides recommendations for sponsors, investigators, and other interested parties on using DHTs for remote data acquisition from participants in clinical investigations evaluating medical products.
Advances in sensor technology, general-purpose computing platforms, and data transmission and storage methods have revolutionised the ability to obtain and analyse clinically relevant information from individuals remotely. As a result, DHTs used for remote data acquisition play a?growing role in health care and offer essential opportunities in clinical research. For example, compared to intermittent trial visits, the use of DHTs to remotely collect data from trial participants may allow for continuous or more frequent data collection. Some DHTs also facilitate the direct collection of information from participants who cannot report their experiences (e.g., infants, cognitively impaired individuals).
The DTH presents regulatory considerations and engagement with the Agency. Some DHTs that may be appropriate for use in a clinical investigation may meet the definition of a device under section 201(h) of the FD&C Act. Devices intended for use in clinical investigations are exempt from most requirements applicable to devices, including premarket?clearance or approval, as long as the investigation complies with applicable?trial requirements under
This document discusses the considerations when using digital health technologies in Clinical investigations,?selection of a digital health technology and rationale for use in a clinical investigation, digital health technology description in a submission,?Verification, validation, and usability of digital health technologies,?Evaluation of clinical endpoints from data collected using digital health technologies.
The document also discusses the Statistical analysis, Risk considerations when using digital health technologies,?Record protection and retention and?Other considerations when using digital health technologies during a clinical investigation. This document presents a Glossary of the terms defined for this guidance.
Vaccine inequity campaign must address the Covid19 Vaccine profiteering as well.
?Cross S, Rho Y, Reddy H, et al. (2021) Who funded the research behind the Oxford–AstraZeneca COVID-19 vaccine?BMJ Global Health 2021;6:e007321.???https://gh.bmj.com/content/6/12/e007321
Cross and colleagues traced the funding of Covid19 Vaccine research. The Oxford–AstraZeneca COVID-19 vaccine (ChAdOx1 nCoV-19, Vaxzevira or Covishield) builds on two decades of research and development (R&D) into chimpanzee adenovirus-vectored vaccine (ChAdOx) technology at the University of Oxford.
Te Oxford–AstraZeneca vaccine relies on two decades of research and development (R&D) into the chimpanzee adenovirus-vectored vaccine (ChAdOx) technology at the University of Oxford. The Oxford–AstraZeneca COVID-19 vaccine plays an essential role in the global vaccine rollout, especially in resource-limited settings, as it provides a cheaper alternative to the Pfizer/BioNTech and Moderna mRNA vaccines and does not require the same cold-chain management.
Though the authors have encountered a lack of transparency in research funding reporting, they have identified 100 peer-reviewed articles relevant to ChAdOx technology published between January 2002 and October 2020, extracting 577 mentions of funding bodies from acknowledgements.
The authors sought Freedom of information (FOI) requests to the University of Oxford to seek details of research funding. Government funders from overseas (including the European Union) were mentioned 158 times (27.4%), the UK government 147 (25.5%) and charitable funders 138 (23.9%). Grant award numbers were identified for 215 (37.3%) mentions; amounts were publicly available for 121 (21.0%). Based on the FOIs, until December 2019, the biggest funders of ChAdOx R&D were the European Commission (34.0%), Wellcome Trust (20.4%) and Coalition for Epidemic Preparedness Innovations (17.5%).
Since January 2020, the UK government has contributed 95.5% of the funding identified. The total identified R&D funding was ￡104 226 076 reported in the FOIs and ￡228 466 771 reconstructed from the literature search.
Cross and colleagues (2021) study approximately that public and charitable financing accounted for 97%–99% of identifiable funding for the ChAdOx vaccine technology research at the University of Oxford underlying the Oxford–AstraZeneca vaccine until autumn 2020.
Vaccine inequity campaign must address the Covid19 Vaccine profiteering as well.