Here’s How 8 Different Countries Officially Define What ‘Healthy Eating’ Is


To help Americans make healthier food choices, we have MyPlate: a simple graphic that explains how much of each food group to eat at every meal. The illustration, which replaced the MyPyramid graphic in 2011, is simple, easy to understand and endlessly customizable. 


But other countries have different ways to explain what makes a healthy meal. Have you ever heard of the food guideline seashell from Qatar, or the healthy eating pagoda from China


What’s fascinating about these illustrations is that despite the fact that they reflect unique historical and culinary traditions, they’re actually more alike than not, says Christopher Gardner, a nutrition scientist at Stanford Prevention Research Center.


“They are more similar than different in terms of which food groups fall into which proportions,” Gardner wrote in an e-mail to HuffPost. “Grains, veggies and fruits always fall into the largest categories.”


It sounds a lot like the pithy, and oft-repeated healthy eating mantra from food author and journalist Michael Pollan: “Eat food. Not too much. Mostly plants.”


As you scroll through the different guides, ask yourself: Am I eating enough plant-based foods? How often am I really eating foods high in sugar, salt and fat (junk foods that are not even pictured in most food guideline illustrations)? And am I overlooking any foods from my culinary heritage that could fit into a pattern of healthy eating? 


Do you want to be more mindful about eating healthy foods that’ll keep your mind and body at their best? Sign up for our newsletter and join our Eat Well, Feel Great challenge to learn how to fuel your body in the healthiest way possible. We’ll deliver tips, challenges and advice to your inbox every day. 


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What Lab-Grown Human Hearts Could Mean For The Donor Crisis


Researchers at Massachusetts General Hospital in Boston have taken a big first step toward growing human hearts in a lab, which could possibly put an end to the national organ donation crisis.


The scientists stripped donor hearts of any cells that might cause recipients to reject them and then used stem cells to rebuild the tissue.


A study detailing the process sheds light on several key elements of bioengineering human heart muscle, said Dr. Harald C. Ott. He is an assistant professor in surgery at the hospital and a senior author of the study, which was published in the journal Circulation Research in the fall. 


“While limited in force, these were the first (tiny) beats of a newly formed, human stem cell derived heart,” Ott wrote last week in an email to The Huffington Post.


Scientists still have a ways to go until they can bioengineer whole functional hearts for patients, he added. Ideally, however, they one day might be able to grow an entire organ using the donee’s own cells and tissue.


“As with many developments, time is a factor determined by funding, man and brain power,” Ott said. “Our study shows that it is in theory possible, but much work remains to be done. As a first step, I do believe that parts of human hearts will become available sooner than whole heart grafts, and we are actively pursuing this option.”


Having that option would be life-saving, as there are 4,153 people across the U.S. who need a heart transplant — and last year, about 402 people died while on the waiting list for one, according to the United Network for Organ Sharing.


Sometime in the future we will be able to grow hearts, or at least heart tissue to offset the bottleneck.”


Biologist Dr. Young-sup Yoon


The study involved 73 human hearts that had been donated through the New England Organ Bank. They weren’t suitable for transplantation but could be used for research purposes. The scientists used a detergent solution to strip away the hearts’ incompatible cells, leaving behind cardiac “scaffolds.”


Next, they turned adult skin cells into pluripotent stem cells, which can be transformed into any other cell found in the human body. The researchers induced the pluripotent cells to become cardiac muscle cells and then repopulated the remaining “scaffolds” with the new cells.


They mounted the hearts in an automated bioreactor system (see photo above) that added nutrients to the organs and applied certain stressors to them — conditions similar to those experienced by a real, living heart. After 14 days, the hearts resembled normal, immature organs and even responded to electrical stimulation.


Dr. Jacques Guyette, a postdoctoral research fellow at the hospital and lead author of the study, said in a statement that the researchers are planning to improve their methods even more.


“Regenerating a whole heart is most certainly a long-term goal that is several years away, so we are currently working on engineering a functional myocardial patch that could replace cardiac tissue damaged due [to] a heart attack or heart failure,” he said.


This technique is one of several being studied in hopes of someday providing patients with transplants that won’t be rejected, Fast Company reported. It also validates the feasibility of using human pluripotent stem cells in the future, said Dr. Young-sup Yoon, director of stem cell biology at the Emory University School of Medicine. 


“Most definitely, sometime in the future we will be able to grow hearts, or at least heart tissue to offset the bottleneck,” Yoon, who was not involved in the study, told HuffPost. “This study certainly provides a direction which may lead to such a future. … From this, we can identify that developing newer biomaterials would greatly enhance the viability of the approach, and needs further investigation.”


Related Coverage:


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Surviving the Insanity of Grad School as a Single Mom

It’s 1:00 A.M. and it’s finally quiet. By quiet I mean the baby, sorry, my 4-year-old is very loudly sawing logs next to me in the bed as I work on a tedious research paper. The screen brightness on my laptop is turned to almost nothing, which I’m sure really helps with my overall loss of night vision. My son usually isn’t in my bed, but tonight he is sick. Being a mom and a nurse is not a great combo in this scenario. Yes, it’s true, nurses don’t take their children to see the doctor unless its pretty emergent. I am no exception to this rule. However, we’ve seen so much that my sick children get direct eyes on them viewing, just in case. Tomorrow is a workday. Meaning, I rise at 5, and have my youngest out the door and on his way to daycare by 6:15 A.M. Silver lining, due to his persistent fever, he will be home, which means I will be home, which means no work for me. Tomorrow.


I have now, for the time being, classified my life into two categories. I know you’re thinking “before being married” and “after being divorced”. Very true. Those two could be spot-on for some single moms. But I am in grad school. So it is now, pre-grad school and during grad school.


Pre-grad school


I went to work and easily completed my few shifts a week. Sometimes I even picked up extra shifts. Don’t ask me why, but in my head I think of rainbows and butterflies and well just everything was a little calmer. Yes, I was still a single mom working, living solo, raising my three busy children all but every other weekend. So of course, there was still stress. However, if I had the time to go out with, a girlfriend for lunch, or even an occasional date I went. There was no, “Mommy has to study, dear,” or “No, I can’t bury cars in the dirt right now.” Or, “Yes, honey, I know I said we would look at Pinterest to learn how to paint a Fourth of July flag on your toenails, but I haven’t had time.” Or my absolute favorite — because you know kids are just awesome — “Mom, you mean you were too busy to notice that when you ordered me those shoes as a surprise, you accidentally hit the REGULAR SHIPPING versus PRIME SHIPPING BUTTON???” So that basically means it’s gonna be about six extra days right?” AND… Door slams. Isn’t that precious? And I wanted four kids. That’s cute.


During grad school.


There are zero days of non studying. There is always an assignment coming up or due. While managing my own homework, I’m also managing my two teens’ homework. Coupled with playing with my 4-year-old, usually during dinnertime. So that’s fun. Thankfully, it’s a two-year program and I’m starting to see the light. Things still get by me though. Like for instance, getting a $150 lunch balance notice from my daughter’s school. “Honey, you mean to tell me that you’ve never turned in any of the checks I’ve given you for school, like ever?” Of course, she loses them on the way to school. Perfect. So meanwhile her gracious school hasn’t called me one time and have basically been letting my daughter eat with an IOU stamped across her forehead. At this point, maybe they’ve even signed her up for a free lunch program. Who knows? I sometimes drop my kids off at school and appear homeless due to exhaustion and or paper writing. There’s no confusion on who is the diva mom with heels on and who is not. You get my point. This requires an extremely high-level of multi-tasking during this stressful time.


Here are my best tips thus far:


1. If you can, enter this grad school journey with another person. I have been lucky enough to start my program with a friend/coworker. I honestly don’t know if I would be able to do it if I didn’t have her to vent with. I am the only person who understands her rapid-fire email to the teacher about her 99.5/100 grade. That’s because I know exactly how long (13 hours) and hard she worked on that assignment, and if she’s going to miss half a point, there better be a damn good reason behind it.


2. Ask for help and hire out. This is the time to call Joe the yard guy and Felicia the cleaning lady for extra help. It’s also OK to let grandma come get the kids for an evening and not feel guilty if all you end up doing is sleeping.


3. Also let go of the guilt about only meeting your minimum work requirements. That’s right. Your extra shift a week has now turned into one extra shift every six weeks if that. Again, completely OK.


4. You will not make it without support. I will repeat that again. You will not make it without support. You don’t have the same support system at home as some of your other classmates do. This is a great time to fine-tune your village, or if you will, your people. While some will roll their eyes as you literally come running into the cafeteria just in time to catch the last 20 minutes of your son’s school play, don’t let it get to you. Your people will see the effort and send a smile and a wave over because they’ve saved you a seat.


5. It is hard. Very, very, hard. My school partner in crime always reminds me to keep my eye on the prize. If it was easy everyone could do it. Shockingly, there’s not a ton of statistical information on getting through grad school as a single mom. That’s because it’s hard as balls.


6. Lastly, remember why you’re doing it. Whether its more pay or a better outlook for your children. Perhaps you just want to add more letters to your title. Whatever the reason, whatever the case, I often find myself subconsciously and silently chanting my long time mantra of DOWIT. Do what it takes!


Which brings me back to the beginning. My 30-plus page paper did get completed that week, despite the six-day deadline. The best part, when I looked at my grade and it was a 97.5 I didn’t even flinch. I’ll take it.

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The Two “Other” Reasons Millennial Women Are Burning Out

Fast Company published an insightful article this week by Kelly Clay entitled “Why Millennial Women Are Burning Out.” The subhead referred to the fact that it wasn’t because they were becoming mothers. Shocking! In this time of endless conversations about work-life balance, that’s what we’re conditioned to assume. So why are these young women burning out?


Clay wrote that it’s mainly because of high expectations — both self-imposed as well as from their employers who demand 24/7 connectivity.


And there’s research behind the numbers. As Clay reports:


The trend of young women burning out by the age of 30 is very real and unfortunately common. A study by McKinsey shows that women account for 53% of corporate entry-level jobs, but women only hold 37% of mid-management roles. That number drops to 26% for vice presidents and senior managers, indicating a major gender disparity higher up the corporate ladder. As only 11% of women choose to leave the workplace permanently to have children, the other reason for this gap can be traced to high expectations that companies place on their employees in always-connected work environments.


This isn’t really news to anyone who’s been paying attention. And it certainly isn’t news to millennial women who are experiencing it first hand. And while I don’t doubt that the expectations from corporate America and its global counterparts are overwhelming for young women, I would argue that there are additional culprits worth mentioning.


Millennial women had to deal with two things growing up that my generation did not, which thrust these young women into adulthood and forced them to deal with a unique form of stress that started the burn-out process before they even set foot in those cool open-plan loft offices they all get to work in:


1. Transformation of high school from “the end of childhood” to “the beginning of adulthood.”


When I was in high school in the 80s, we were still kids. It is well-documented (and there are countless articles about it in The Huffington Post) that kids today are having an entirely different high school experience due to the unprecedented pressure they feel to make everything they do “college worthy.” And to figure out how the hell their college education will be paid for and what kind of suffocating debt they’re going to graduate with. The game has changed drastically, and because the rules — at least the ones that are clear — favor the extreme overachievers who consider down-time a waste of time, the result is stress levels that my peers and I could only imagine when all we really had to worry about was being “well-rounded” and making sure we didn’t skip our Princeton Review class to get stoned or go to our jobs at the record store. Sure, my peers and I wanted to get into college. And sure, we worked hard in school and collected extracurriculars like so many Benetton sweaters. But, please, don’t argue about it. It was different.


2. Proliferation of and obsession with social media.


True, there are a lot of wonderful things about social media. In fact, as soon as this article is published you can bet your mother’s BlackBerry I’m going to share it on Facebook (yes, I’m old), Twitter, and Instagram. But the downside of the Snapchat culture is clear. The constant social pressure to share, like, be liked, be validated, be followed, and create a life worth sharing is exhausting. Sure, it’s how Millennials grew up. It’s how they breathe. But still, it’s exhausting.


So now you have a young woman in her 20s. She has busted her ass to be the perfect college candidate/do well in college/get a good job. Throughout, she’s been dealing with the societal pressures of creating a social media presence among countless platforms/of keeping up with the Kardashians/of styling her dinner plate, all the time being socialized with the ideas (ideals?) that not only does she have to be a “good” mother (if she chooses to become a mother, and if she doesn’t she better come up with a good reason to tell the countless nosies who will ask), but she also has to “lean in” and have work-life balance and find a partner who will share the load and make sure she has enough “me” time so she doesn’t burn out.




It’s too late. She’s already burned out. When your path to burnout begins around the same time you get your period, do you ever really have a chance of hanging in for the long run? Until we rein in the pressure that’s going on in high school and until we rein in the pressure going on in those blinking/beeping/buzzing squares of joy/misery in our pockets, our young female workplace is screwed.


No wonder they’re leaving the workplace. But isn’t there the chance that by doing so they’ll create a new work culture? That their exodus doesn’t necessarily have to be described as shocking or disappointing because of the void it leaves in our unsustainable corporate framework? That perhaps it could be described as exciting and welcome because of the new normal it could lead to?


Just as long as that doesn’t put more pressure on them.


Susie Orman Schnall is a writer and author who lives in New York with her husband and three young boys. Her award-winning debut novel On Grace (SparkPress 2014) is about fidelity, friendship, and finding yourself at 40. Her second novel, The Balance Project: A Novel (SparkPress 2015), is about work-life balance and is inspired by her popular interview series The Balance Project. Visit Susie’s website for more information.

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Supreme Court Steps In To Keep Louisiana Abortion Clinics Open


The Supreme Court on Friday blocked a Louisiana law that threatened to close all but one of the state’s abortion providers, mere days after hearing a major abortion rights case from another state.


In a short order, the nation’s highest court effectively halted a state law that required all doctors who perform abortions to have admitting privileges at hospitals within 30 miles of the clinic.


That provision is nearly identical to one the justices considered Wednesday, when they heard oral arguments in Whole Woman’s Health v. Hellerstedt, a case from Texas that could determine the fate of similar abortion regulations in a number of conservative states. 


The court’s action Friday coincided with the justices’ scheduled private conference, in which they preliminarily cast their votes in the cases heard during the week. A decision in Whole Woman’s Health is not expected until June.


The court did not indicate which justices agreed to keep the Louisiana law on hold. Only one justice, Clarence Thomas, noted his dissent and would have allowed the admitting privileges requirement to be enforced.


Still, it is likely the justices’ deliberations in the Texas case informed what to do in the Louisiana one, which is still going through the appeals process.


In January and following a six-day trial, a federal judge ruled that the Louisiana law, signed by former Gov. Bobby Jindal (R) in 2014, unduly burdened the right to choose of “a large fraction of Louisiana women of reproductive age seeking an abortion” and prevented the law from taking effect. 


But an appeals court last week allowed the law to move forward, sending local clinics into crisis mode, since many of their doctors had trouble obtaining the required admitting privileges or were still in the process of obtaining them.


The Supreme Court’s reprieve on Friday appears to have given them a sigh of relief. The court’s action keeps clinics open at least until the formal appeal moves through the lower court. 


“Our Constitution, along with nearly half a century of legal rulings, is clear that women have the right to make critical decisions about their life and health without interference from politicians,” Nancy Northup said in a statement. Northrup is the president of the Center for Reproductive Rights, which is litigating the case.

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Distracted Drivers Are Even More Dangerous Than You Thought


You probably know that texting while driving isn’t safe. But you may not be aware that distracted driving in its many forms is one of the greatest threats to driver safety, according to public health experts. 


New Virginia Tech research, published in the journal Proceedings of the National Academy of Sciences, finds that when drivers engaged in distracting activities — including crying, reaching for objects and interacting with others in the car — they more than doubled their risk of crashing. 


“These findings are important because we see a younger population of drivers, particularly teens, who are more prone to engaging in distracting activities while driving,” Tom Dingus, lead author of the study and director of the Virginia Tech Transportation Institute, told The Huffington Post in an email. “Our analysis shows that, if we take no steps in the near future to limit the number of distracting activities in a vehicle, those who represent the next generation of drivers will only continue to be at greater risk of a crash.”


For the study, the researchers used the Transportation Institute’s naturalistic driving method, which uses technology — including radars, sensors and cameras — that is put in vehicles to collect real-world data and analyze drivers performance on the road. 


The researchers examined data from 3,500 drivers over a three-year period, pulled from across six collection sites in the U.S. They documented 1,600 crashes, including 905 more high-severity crashes, during that time. Using the naturalistic driving technique, they were also able to document the factors that led to the crashes. 


Aside from using a cell phone while driving, here are some of the other distractions that were found to greatly increase crash risk: 


      Reading or writing


      Reaching for an object other than a phone


      Using a touchscreen on a GPS or other vehicle technology 


      Driving while angry, sad, crying or highly emotional




      Interacting with an adult or teen passenger 


The researchers compared the crash rates of distracted drivers and model drivers (those who were determined to be “alert, attentive and sober”) to determine the increased crash risk. Based on analysis of six seconds of pre-crash video examined they found that 68 percent of the more than 900 severe crashes involved some type of observable distraction.


“We found in this analysis that, next to impairment, distraction is the greatest detriment to driver safety,” Dingus told HuffPost. “Distractions that take the driver’s eyes away from the roadway the longest — such as visual-manual tasks — greatly increase a driver’s crash risk.”


Surprisingly, the researchers found that applying makeup and following a vehicle too closely — factors which have previously been associated with an increased rate of accidents — were not found to significantly factor into crashes. They also found that drivers who had a child in the car were actually less likely to have an accident.


“It is our hope that our conclusions will better inform policymakers, driver educators, law enforcement agencies, vehicle designers, and the general public about the risks of various sources of impairment, error, and distraction,” Dingus said, “so that appropriate actions can be taken to help reduce such risks.” 


Also on HuffPost: 


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Chrissy Teigen Defends Choice To Have A Daughter Against Twitter Backlash


Chrissy Teigen is so ready for John Legend to become a dad to their baby girl. 


The 30-year-old, who has been busy promoting her cookbook Cravings, told People magazine that she picked out the embryo when trying to get pregnant using in vitro fertilization.  


“I think I was most excited and allured by the fact that John would be the best father to a little girl. That excited me,” she said. “It excited me to see … just the thought of seeing him with a little girl. I think he deserves a little girl. I think he deserves that bond. A boy will come along. We’ll get there too, so it’s not like we really have to pick.”


This is the first child for Teigen and Legend, who met in 2007 and married in 2013. The two dealt with fertility struggles and Teigen has been vocal about being respectful of women by not asking an invasive question like “When are the kids coming?” 


But after opening up about her choice, she received some backlash on Twitter. 












Sigh, Internet. Sigh.  




Also on HuffPost: 


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A Path Toward Well-Being

It’s been 15 years since I learned that I had Non-Hodgkin Lymphoma, a set of blood cancers, which, as they say, can be managed but not cured. When I received this devastating news, I thought that my relatively short life would soon be over. How could someone like me, a trim, active man who had a healthy diet, a lovely family, a terrific set of friends and a satisfying professional life, get cancer?




It didn’t make sense.




It made me angry.




The news stunned me. My bleak future flashed before my eyes–chemotherapy, weight loss, hair loss, bone pain, nausea, and fatigue–all leading to an untimely death. I suddenly realized how much time I had wasted on unimportant things. Confronting imminent mortality frightened me. Slowly and timidly, I moved forward on an uncertain path. In the time that I had left could I somehow experience the wonders of life? In a world of endless choice and incessant distraction, could I discover what was important?




Given our culturally-contoured and time-pressed penchant for expedience, it’s hard for anyone to figure out what is important. A diagnosis of cancer, though, can sometimes accelerate a process that sometimes points you in an existentially satisfying direction. A 15-year sojourn on cancer’s path has compelled me to think about how to live well in the world. Here’s some of things I’ve learned about the quest for well being:




1. The destructive force of anger: When I began my journey on cancer’s path, I was angry. Why had I been singled out to suffer such a horrendous fate? I quickly discovered that anger led to feelings of powerless and despair, a state that wasn’t good for me, for the people around me, or for my work as a scholar. In my view anger never leads to well-being. And so, I tried to accept my situation and attempted to cope with the anxieties of confronting an incurable disease–none of which is easy.




2. Combating bad faith. In his incomparable play, No Exit, Jean-Paul Sartre confronts the specter of bad faith, a collective set of beliefs based on illusion. In bad faith we construct the world as we want it to be, which blinds us to the world as it is. In bad faith, we make life choices based on wishful fantasy rather an inconvenient truth. The political world is rife with bad faith thinking and decisions–the fateful decision to wage war in Iraq, the denial of climate change, the dogged belief in supply side economics, and the distrust of science. In the world of cancer bad faith thinking and decision-making can compel people to deny their medical status. It can convince a person to seek unproven miracle cures. The negative results of bad faith thinking also tend to reinforce anger, which in turn, leads to bitterness. Long before I understood much about anything, Adamu Jenitongo, a wise man among the Songhay people of West Africa, taught me to consider a situation realistically. He said that a person needs to accept her or his limitations and live well within the parameters those limitations set. That advice only made sense to me when I had to consider how remission from cancer, a way station between health and illness, between life and death, limited my possibilities in the world. Those limitations, I soon discovered, did not prevent me from living well in the world.




3. The importance of human connection: If you live in isolation, chances are you will construct a world shaped by bad faith. If you have the good faith support of friends and family, you are likely to confront your remission realistically, a position that allows for a life filled with little as well as big pleasures. It is well known that social isolation often leads to alcohol and drug abuse as well as to a variety of domestic dysfunctions. It is also well known that the absence of social support contributes to heath declines and premature mortality. No one should be be alone when confronting the physical and emotional challenges of cancer diagnosis, treatment and remission.




4. The value of patience: In America, we live in an impatient, results-oriented society. We take the furiously fast straight highway–not the slow sinuous side road–to get from one place to another. We expect such an emphasis in the corporate world, but we also find it in academe. In academe there is an emphasis on results. Did you get the grant? Did you publish in one of the most prestigious journals? Are your ideas cutting-edge? How many books have you published in the last five years? Are you on the fast-track to a distinguished career? When you begin treatment for cancer, no matter who you might be, the world slows down. You can continue do elementary things like walk or get out of bed, but you have to do them slowly, deliberately and mindfully. When you undergo chemotherapy, you have to sit in a chair for long periods of time–two, three, or, in my case, five hours. The side effects of treatment demand a slower orientation to life; they require patience. This slow approach to learning is consistent with apprenticeship during which novices spend ten, twenty of even 40 years slowly mastering their art or their science, patiently waiting for their paths to open. When they do, they are ready to make important contributions to the world.




I don’t know what the future will bring. I do know that patience shows us the way to a path that opens to the world. On the open path we understand how to proceed. With a clarity of purpose we take small but confident steps. Along this path we understand what we can do in the world. Comfortable in our skins we savor a measure of well-being. That profound feeling leads us to expressions of deep gratitude, which are, answered, in turn, with the embrace of human warmth.




For me, that is path worth following.

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What The Ebola Crisis Can Teach Us About Responding To The Zika Outbreak


Every week, The WorldPost asks an expert to shed light on a topic driving headlines around the world. Today, we speak with Georgetown University’s Daniel Lucey and Lawrence Gostin about the global response to the Zika virus.


The World Health Organization was widely criticized for delays and mismanagement in its response to the Ebola crisis that ravaged three West African countries in 2014. 


The Ebola virus has killed over 11,000 people, mostly in Liberia, Sierra Leone and Guinea, since 2013. Liberia and Guinea have recently been declared Ebola-free, although experts warn the virus can quickly re-emerge.


Now, a new public health crisis is emerging in the Americas. The Zika virus, first discovered in Uganda’s Zika forest over 60 years ago, spread in recent years to the South Pacific and the Americas. The virus, which is transmitted by mosquitoes and, like Ebola, has no vaccine or cure, was initially not thought to be very dangerous, mostly causing a mild rash or fever. But a large outbreak of the virus in Brazil last year was linked to an explosion in reported cases of microcephaly, a condition that causes babies to be born with abnormally small heads. The possible connection between the Zika virus and microcephaly, which has yet to be confirmed, led Brazil to declare a national emergency in November.


The virus has spread rapidly, with reported cases in 23 countries and territories in the Americas. Earlier this month, the U.S. Centers for Disease Control and Prevention issued an alert advising pregnant women to consider postponing travel to countries with the Zika virus. 


On Thursday, the WHO announced it will convene a special emergency committee on the Zika virus on Monday, the first step towards possibly declaring a public health emergency.  A few days earlier, Georgetown University’s Daniel Lucey and Lawrence Gostin had published a paper in the Journal of the American Medical Association urging the WHO not to delay its response to the Zika virus any further. The WorldPost spoke to Lucey, a senior scholar at the O’Neill Institute for National and Global Health Law at Georgetown, and Gostin, the institute’s director, about the lessons of the Ebola crisis.


What lessons do you hope the WHO has taken from the Ebola crisis that can be applied to the emerging Zika pandemic?


Lucey: The WHO director general Margaret Chan delayed very, very long the convening of the special emergency committee with regard to the Ebola epidemic in West Africa. I was working with Ebola patients in Sierra Leone and Liberia during the outbreak in 2014, and it really made a searing impression on me as to the real world, on-the-ground and in this case catastrophic consequences of decisions that are made — or not made — in places like the WHO headquarters in Geneva.


That was a large part of what motivated me to write the article with my colleague, Professor Gostin, urging the WHO director general to convene a special emergency committee. She delayed doing it again with Zika, although hopefully not with such catastrophic consequences as with Ebola.


It was already evident several weeks ago that the Zika pandemic is worth paying attention to.  The question will arise as to how much earlier should the committee have been convened, particularly if there are waves of epidemics of microcephaly in other countries affected by Zika. I hope and pray that there won’t be. But if there are epidemics of microcephaly in other Latin American countries, it’s a tragedy, and there’ll be more lessons to learn from that.


When she said on Thursday she was going to convene the committee, honestly, I was overjoyed. The committee has very specific responsibilities — it really galvanizes the international community under the leadership of the WHO headquarters, so the entire world can benefit from harmonized communications and guidance about the outbreak. But it’s only the beginning. It’s like the key that you have to turn to unlock the door, and now you have to go through the door.


If there are epidemics of microcephaly in other Latin American countries, it’s a tragedy, and there’ll be more lessons to learn from that.


Daniel Lucey


Gostin: The critical lesson is not to wait until a crisis spins out of control. Act rapidly, decisively and with leadership. When the Emergency Committee on Zika meets, actions will speak louder than words. These actions are vast mobilization of funding and international support to drastically reduce the mosquito population in Zika-affected areas, intense surveillance, determining conclusively the link between Zika and infant malformations and accelerated research for a vaccine.


Are there other ways the WHO and the international community have applied some of the lessons of the Ebola crisis so far?


Lucey: I think so. For example, Brazil responded in a very timely manner to the growing epidemic of microcephaly, and the Pan American Health Organization (PAHO) has done an excellent job at issuing epidemiological alerts. I think the U.S. CDC issuing a level 2 travel alert was appropriate, balanced advice and a proactive step.


It’s about the speed of response, the resources put in, and making sure the resources are appropriate. You have to frequently reassess the situation. That’s very important lesson that should be learned from Ebola. After a sharp increase in patients in Liberia it was predictable [that it would spread further], but there just weren’t enough diagnostic laboratories or healthcare workers.


Zika is very different from Ebola. What new challenges does the Zika virus present to the international community?


Gostin: Zika’s challenges come from the mosquito vector. This mosquito is ubiquitous, found in every region of the world. If we are not proactive and attack the problem with overwhelming resolve, the hazard of Zika will spread worldwide. If we see a wave of fetal abnormalities nine months after Zika outbreaks, it will be an enormous ethical and public health failure.


Lucey: Brazil has a wonderful medical research tradition and healthcare providers. To my knowledge, there’s no shortage of hands-on patient care that there certainly was in West Africa. There is an urgent research issue and it is being addressed.


One challenge is the amount of travel to places where Zika is transmitted. There’s so many more travelers to the 21 or so countries or territories in the Americas with reports of the Zika virus than there was to the three very underdeveloped, impoverished countries impacted by Ebola.


The critical lesson is not to wait until a crisis spins out of control. Act rapidly, decisively and with leadership.


Lawrence Gostin


What lessons should the public health community apply from the development of Ebola vaccines and treatment during the crisis in West Africa to the current response to the Zika virus?


Gostin:  What we have learned is you need two things to speed vaccine research. First, there is the need for enormous funding. Second is the need for public private partnerships to harness the best talent in government and industry.


Lucey: Even though there’s still no licensed Ebola vaccine, one of the good things the WHO did early during the Ebola crisis was to bring together experts who decided that it would be ethical to do investigational studies for treatments and vaccines in the middle of an outbreak, as long as it’s done in a transparent, ethical manner with the approval of institutional review boards and ethical oversight from within each of the countries.


It was really a phenomenal thing that so many partners came together to do a study in Guinea. The results of this research are still going through an approval process, but it’s a remarkable success story. I think if Brazil and other countries affected by Zika epidemic choose to work with international partners, then they can look back to the recent successful precedent with Ebola vaccines in West Africa.


The interview has been edited and condensed for clarity. Interviews were conducted separately with Daniel Lucey by phone, and with Lawrence O. Gostin via email on Friday.





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If Our Presidential Candidates Think Drug Use Is a Health Issue, Here Are 8 Ways to Prove It

Substance use and abuse touches virtually every family in the United States. The New York Times ran a front page story last week documenting the explosion of overdose deaths throughout the country. 47,000 Americans died from an overdose in 2014 — more than from either car crashes or guns.


Addiction, overdose, and drug policy reform have become major issues in both the Republican and Democratic Presidential primaries. It has been striking to see how many of the leading candidates have a personal connection to these issues. Jeb Bush has been open about his daughter Noelle’s addiction and time behind bars for using unprescribed Xanax and for being busted with crack cocaine. Carly Fiorina has spoken out about losing her stepdaughter to “the demons of addiction”. Gov. Chris Christie of New Jersey has spoken emotionally about a law school friend who died of a Percocet overdose. The Clintons have lost family friends to overdose and these experiences have been an impetus behind Hilary’s proposals.


I appreciate the new rhetoric from the many candidates saying that drug use and addiction are a health issue, not a criminal issue. But there’s a huge disconnect between this rhetoric and their actual policy proposals. If candidates truly believe that drug use is a health issue, why have none of them come out in support of ending arrests and criminal penalties for drug use and possession? Well over a million people — disproportionately black and Latino — are still getting arrested each year in the U.S. for nothing more than using or possessing an illegal drug.


It’s time that we hold the candidates’ feet to the fire and demand real solutions. Here are eight concrete steps that they should all get behind:


1. Decriminalize drug use and possession. Roughly two dozen countries — most notably,Portugal — and dozens of U.S. cities and states, have taken steps toward ending arrests and criminal penalties for drug use and possession. By decriminalizing possession and investing in treatment and harm reduction services, we can reduce the harms of drug misuse while improving public safety and health. A DPA poll released earlier this week found that 61% of New Hampshire voters support ending arrests for possession of any drug. Punishing people for possessing drugs doesn’t make things better. As long as drug use is a crime, people will be afraid to get help.


2. Make treatment available to those who want and need it. It is tragic that so many people who need treatment can’t get it. It is outrageous that we taxpayers spend, on average, $30,000 a year to incarcerate someone with a drug problem, but we skimp on treatment programs that are less expensive and more effective in reducing illegal drug use and other crime. Too many people who want treatment are told there are no open slots and turned away.


3. Offer methadone and bupunorphine to those with opioid addiction. Methadone and buprenorphine have been the gold-standard treatment for opioid addiction for decades. These replacement therapies can allow people to live normal lives without the highs and lows of illegal heroin and other opioids.


We need to remove the obstacles to making these life-saving medications more readily available and end the stigma that discourages people from seeking out the most effective treatment.


4. Honest drug education. We urge young people to stay clear of alcohol, tobacco and other drugs, but the reality is many will experiment with using substances no matter what. We must teach them the risks and consequences of drug use.


Most overdose deaths are a result of mixing opioids and alcohol but most people don’t know that. Anyone who receives a prescription for a pain medication, knows a person misusing heroin or other opioids, or who cares about keeping people alive, needs to know the incredible risks of mixing with alcohol.


5. Good Samaritan laws for 911 callers. Most people who overdose don’t die. But the chance of surviving an overdose, like that of surviving a heart attack, depends greatly on how fast one receives medical assistance. Unfortunately people are afraid to call 911 because they don’t know if the police who respond will focus on arresting those present rather than saving someone’s life.


More than two dozen states and D.C. have passed “911 Good Samaritan” laws that encourage people to call for help without fear of arrest.


6. Make naloxone, the antidote to an overdose, more available. Naloxone is a safe, generic, inexpensive, non-psychoactive drug that works quickly and is easy to administer. It has saved hundreds of thousands of lives but could be saving many more.


Many states are just starting to take some great steps to get naloxone in the hands of more people, including law enforcement and emergency responders. Anyone who uses opioids for any reason at all should have naloxone readily available, and friends and family who know how to administer it.


There’s no really good reason, moreover, why this antidote should only be available by prescription. If we really want to save lives, pharmacists should be allowed to sell it to whoever needs it.


7. Supervised injection facilities. Dozens of cities around the world have supervised injection facilities where people can inject their drugs in a clean, safe place with medical professionals on hand.


These facilities eliminate overdose fatalities, reduce dangerous drug consumption practices as well as HIV and hepatitis C, minimize the public nuisance of people using drugs in public places and more than pay for themselves by reducing the need for criminal justice and emergency medical services. It has been particularly successful in Canada.


The scientific consensus demonstrating the benefits of these facilities has yet to result in one such facility being opened anywhere in the United States. It’s time already.


8. Heroin-assisted treatment. Conventional treatments do not work for many people addicted to opioids and want to stop taking them. That’s why more than a half dozen countries in Europe and Canada have developed a second-line option: heroin-assisted treatment.


With this treatment, pharmacological heroin is administered under strict controls in a clinical setting to those who have failed to succeed with other treatment options. Virtually every published evaluation of heroin-assisted treatment has shown extremely positive outcomes: major reductions in illicit drug use, crime, disease and overdose; and improvements in health, well-being, social reintegration and treatment retention.


The hundreds of billions of dollars spent on the drug war has nothing to prevent the dramatic increase in addiction and overdose fatalities. Indeed, the drug war has fueled the number of people who die from an overdose, while filling our prisons with people who shouldn’t be there. Candidates’ words are good. But we need action.


Tony Newman is the director of media relations at Drug Policy Action, the C4 arm of the Drug Policy Alliance

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