Wrapping-up after a sensational week in Mongolia. Here to film a short-film for our recently-launched health advocacy initiative, we have spent the days profiling a young, inspiring, local, health change-maker – Byambaa.

NCDFREE is a global social movement against the world’s leading cause of death: NCDs (or Non-Communicable Diseases). Founded earlier this year, NCDFREE sets out to change the way societies world-wide think about diabetes, heart disease, cancers, lung diseases and mental health (NCDs).

But also the way we communicate them.

As an academic, I traditionally communicate through scientific journals. As a branding and design expert, co-founder Giuseppe uses very different tools to connect with society. Our idea is to use the latter, to “rebrand” this global health challenge and paint an accurate face of the global epidemic.

You see, when people think of these diseases, they think of old, fat people in rich countries. Actually, 80% of disease occurs in the world’s poorest nations, where the burden is rapidly rising.

The true face of the global epidemic is in fact, likely to be Asian, below 70, female and impoverished.

Change

The film follows a young female cardiology-trainee, who has seen the transition from communism to democracy in her lifetime. She has seen a city double in size and a GDP more than quadruple. But with this, she has also seen a change in the nation’s diet – in fact just this month the first KFC store opened in UB – and a change in the lifestyles of the populations as they replace the horse for an SUV. Transition from a ger to an apartment, and from the steppes to a dense, urban centre.

30% of the population may still live in poverty, but this is a 25% drop from 1 year earlier.

Rapid change is occuring.

“And although this all represents important and needed progress for Mongolia” describes Byambaa, “it has also brought major changes in the health of the population”. As infectious diseases and childhood illnesses dive – obesity, hypertension and NCDs have skyrocketed.

Through the story of this young community advocate and doctor from Ulaanbaatar, NCDFREE plans to change the way people think about these diseases. Connecting NCDs with the reality of poor, marginalised people – often facing a lack of health-promoting opportunities.

Health

Byambaa is confident – in the future and in the health trajectory of her nation.

Spend much time with her, and you will be confident too.

She sees great potential in her colleagues and peers, and tells of a young generation that is very different from the one before. One that is globally connected, globally educated and passionate for change in their country.

Change that will not only see a continuation of economic prosperity and development, but one that will also empower and enable a population to live healthier and longer lives. Free from chronic, debilitating disease.

Future

Well, we’ve been here a week and today we’re finishing up. Packing away the cameras and with it, footage of nomadic families, Ulaanbaatar’s poorest districts, the beautiful countryside, the generous locals, the rapidly transforming city and the optimism of a young generation.

Footage which will not only show a stunning and fascinating journey of a young leader and passionate health-promoter, but also rally a global community to action on a group of largely ignored, mostly-preventable yet highly deadly diseases.

–

Listen to a podcast interview focusing on NCDFREE and our trip to Mongolia, broadcasted live yesterday on ABC Radio Australia.
 

–

Connect with Sandro on Twitter via @SandroDemaio.

To follow our trip more closely this week, head to the NCDFREE Facebook page.

Dr Alessandro Demaio is a medical doctor, originally from Melbourne, Australia, with a Masters in Public Health. In 2010, Sandro began a PhD in Global Health with the University of Copenhagen, focusing on Non-Communicable Diseases (NCDs). His primary research project is based in Mongolia. As a Director for NCD Action, in 2013 Alessandro is a fellow at the Copenhagen School of Global Health and Harvard Medical School.

A few weeks back, at the World Health Assembly, World Bank President Dr Jim Kim said the world is at a crossroads when it comes to health. A defining moment in history, from which our future trajectory will be decided.

Not many nations better embody this concept, than Mongolia.

Here this week to make a short film focusing on young, inspiring health change-makers working to address the leading cause of death (which might surprise you, is heart disease) I can see Mongolia is at a serious, but exciting moment in history.

In the midst of a mining boom, with economic growth eclipsing most nations, Mongolia is in the middle of rapid economic, social, cultural and health transitions. Once a small town, its capital Ulaanbaatar is one of the fastest growing urban centres in the world and now accounts for more than 60% of the nation’s 2.8 million population.

A bustling city overflowing with cars, their drivers not so long ago would have been on horseback.

As a foreigner, one senses the excitement of the potential opportunities which lay ahead for this landlocked nation. Having done my PhD here over the last years, I have seen the city literally transform. Sky-scrapers and high-rises where there were gers just a few years ago. Traffic jams and footpaths where there were neither less than a decade earlier.

The cost of living is rising rapidly, but so is the standard of living.

Speaking to two young Mongolian doctors, they explain the optimism held by the young generations. “As money floods in, so do opportunities for Mongolians. We are able to travel abroad to study, greater work opportunities and if the money is spent well – a promising future for our nation.”

Byambaa and Nara are both Mongolian born and raised. They lived through transition to a free-market economy after the collapse of the Soviet Union, they have seen their capital city double in size and their national infant mortality halve in the last 20 years.

They have such inspiration and vision for their country and its people. Part of a new generation determined to capitalise on the abundant natural resources of their nation, they’re committed to seeing change that affords all Mongolians greater opportunity and prosperity.

But they also acknowledge Mongolia faces big challenges – one such example is from the quickly rising burden of Non-Communicable Diseases (NCDs) including heart disease, diabetes, mental illness and cancers.

We are making a short film about one of these young doctors. Through her story, we hope to show the world that heart disease is not just a challenge faced by rich countries – and that many Low and Middle-Income Countries are facing a difficult double burden. NCDs and an unfinished agenda of maternal and child health challenges, infectious diseases and more.

A filmographic call for attention, action and investment toward this misunderstood global health issue.

But also, crucially, we will show that a young generation exists that is serious about changing the situation. Bringing health and health equity for their populations. Paving the way for a healthier future.

Profiling these motivated young people and capturing their narratives, including Byamba who has dedicated her life to becoming a cardiologist (in a country not linked with cardiovascular disease in the minds of many), we hope to rally global societal and political support for these young people, their quest and this neglected group of largely preventable diseases.

Inspired and inspiring young change-makers, they represent a global challenge, but also an untapped resource of vision and commitment.

Mongolia may be at a crossroads, but these young leaders promise to steward this nation to a healthy future.

It’s an exciting time.

–

To follow our trip more closely this week, head to the NCDFREE Facebook page.

Connect with Sandro on Twitter via @SandroDemaio.

Win a trip to Vienna to join NCDFREE at the WHO Ministerial Meeting on Non-Communicable Disease. (click on above to watch)

NCDFREE is a global social movement that aims to bring societal and political attention to NCDs (diabetes, heart disease, cancers, lung disease and mental health) through personal narratives focusing on inspiring, young change-makers.

Launched last week, in time for the World Health Assembly, NCDFREE has a new challenge for the global community.

You have one week left to submit 15 seconds of footage of yourself, and answer 3 questions via the NCDFREE website. All you need is a smartphone, camera or video camera and a passion for addressing NCDs!

Two contributors, passionate about Global Health, will get the chance to join the NCDFREE team in Vienna next month for the UN meeting!

Go to www.ncdfree.org for more information and support this important Global Health cause today!

It is a sad fact that in modern day society, stigmas are still rife. Varied in nature, subject and conspicuousness they are still very real and very alive.

What is cool, what is not. Don’t wear this, never listen to that and definitely don’t be seen there… But one stigma I am really sick of (no pun intended), is the concept that being healthy – is not manly! Caring about your body, what you eat and how you live makes you less of a man.

If I want to be “manly” it seems I need to ignore my stresses and emotions. I need to take up smoking, drink hard alcohol and eat fried food. Ludicrous, as these are all risk factors for heart disease, diabetes, cancers and – ironically – impotence!

Even seeing your doctor is not ‘blokey’.

To be manly, I have to practically ignore everything my doctor told me and worst of all – I am only really manly if I don’t actually care!

Is the peak of manliness to be 6 feet under!?

Why is eating well and watching my weight “girly”?… Caring about my health, protecting my skin from the sun, avoiding tobacco smoke and sharing my stresses can only be done by women?

Males of all ages are more likely to practice more than 30 behaviours linked to higher mortality, than females, and less likely to take up protective behaviours – a US study showed.

But we have also all seen it ourselves – what is more manly, a burger or a tofu burger? A salad or a sausage? A light beer or a full-strength?

Masculinity should not be measured by poor health-behaviours and I should not risk being any less of a man because I choose to enjoy a lighter meal, moisturise each day or don’t feel the need to speed along on a two-wheeled death-trap!

So let’s just take a step back for a moment and reflect on the effect this unhelpful, even harmful rhetoric has on the men in our society.

Not to mention the women who want to enjoy the odd burger.

Let’s lose the absurd associations we make between unhealthy practices and being “a man”. Being healthy, man or woman, should be encouraged, celebrated and congratulated. Particuarly given how hard maintaining health can be in today’s world.

To paraphrase Marie Antoinette, let them eat tofu.

It won’t kill us all to be a little less complacent with our language, but it might improve the health of one in two of us.

–

Connect with Sandro via Twitter using @sandrodemaio.

This article is dedicated to Dr Jess Nehme – for inspiring these words, but also her inspiring work this past year.

Understanding where food comes from, how it’s produced and where it has been between farm and plate is becoming a rare quality. Almost a novelty. Despite a near-obsession with food-related TV shows – seasonality and slow-food are becoming foreign or niche concepts as supply becomes constant and expected, and fast-food becomes ubiquitous.

Now it’s sad that we don’t know a peanut grows underground, or that a tomato is a summer fruit – but it’s actually much more concerning than a lack of trivia knowledge.

This broad-sweeping inability to use and understand food impacts our hip pockets, but also our hips!

You see, in kitchens across Southern Europe, from Madrid to Milan, something interesting is happening. Something unexpected, and really quite delicious. An uprising of a different variety – the culinary variety – as people are turning to the dough as a means of saving, well, dough!

Spurred by the financial crisis, a wave of home cooking is sweeping across France, Italy and Spain. Nations which have seen their fair-share of junk food and resultant obesity, are now swapping the burgers for homecooked baguettes – in record quantities. In fact, a third of all Italians are now making pizza at home and one in five making their own bread – the highest levels since World War II.

In a time of economic strife, we are seeing a return to home cooking, basic recipes and seasonal produce in many countries, to save money.

But what happens when these recipes are lost? When people no longer know how to make bread? Would this movement back to homecooking be possible in Australia, the UK or the USA?

Understanding your food is also essential to a healthy life. Knowing what food is, where it comes from, and what’s in it allows us to make informed decisions about what we put in our mouths. This basic dietary literacy is essential in being able to work out what is healthy and what is not – and in the midst of an obesity epidemic it has never been more important. But with this disconnect to food comes an inability to digest this information and make the best decisions for our health.

So what can be done?

First and foremost, we cannot blame parents, nor should be blame teachers.

In fact, let’s just not blame anyone.

Instead, I say bring back compulsory, funded, comprehensive food and cooking education to primary schools… All primary schools. Because let there be no misunderstanding, the phasing out of early-education on food and food supply to save money, only to spend more on chronic disease resulting from a fundamental misunderstanding of food – is a completely false economy.

Programs like Stephanie Alexander’s Kitchen Garden initiative should be celebrated and replicated in all schools across the board. Let’s wake up and realise that the work of Jamie Oliver and the team at Food Revolution is as much about health, sustainability and economic security – as it is about being able to cook.

An eggplant should be as obvious to a 7 year old as an iPhone. Knowing how to make a loaf of bread should be part of the national curriculum, and an understanding of seasonality and our food supply should be taught from a young age.

Children need to be educated what food is early, to respect it and how to use it wisely.

We might be losing our connection with food, our understanding of the food-supply and our abilities to prepare healthy, fresh meals – but it is not too late.

Food, and cooking, must be seen as educational, economic and health priorities for our societies. Some food for thought and action, on Food Revolution Day.

Anything less, I fear, is a recipe for disaster.

–

Connect with Sandro on Twitter, via @sandrodemaio.

Following our live posts from TEDMED 2013 in Washington DC, this week we cross the Atlantic and hand the reigns of PLOS TGH over to Alex from the team at TEDMEDLive –  Imperial College. 

TEDMEDLive had seen a fantastic start to the day and delegates were looking forward to a further five speakers. During the breaks there was time to get an EEG brain scan from Emotiv Lifesciences, and visit the human parts art display by artist Gina Czarnecki.

Welcome back to TEDMEDLive Imperial College!

Talks streamed from D.C. included Eli Beer’s story of United Hatzalah – a fast response team of paramedics in Jerusalem; David Solomon’s account of illness and identity; and Zubin Damania (a.k.a. ZDogg MD), who held the London audience in fits of laughter.

Innovation

Justyna on stage.

Swedish cancer researcher Justyna Leja gave an inspiring account of her efforts to crowd fund clinical trials of a novel neuroendocrine cancer treatment – an oncolytic virus (genetically modified adenovirus) – developed during her PhD studies.

“I realised I had developed a treatment I could not use. This happened two years ago and it has been in the freezer ever since.” – Justyna Leja

They called the ongoing crowd sourcing campaign iCancer – secretly in the hope that Apple would sue them and give them wider exposure! No such luck. So far the campaign has raised £250,000 for the oncolytic virus fund, but their desired goal is £1 million.

“These days, to develop one drug it takes as long as it did in Ancient Eygpt to build a pyramid!” – Justyna Leja

Art

Our surprise guest of the day was Imperial graduate Suman Biswas – anaesthetist, lyricist, vocalist and pianist. Suman delighted the audience with medical parodies of popular songs.

Suman on stage.

“Once upon a time I took pride in my job, but now I think it’s time to depart, ‘cause I just sit here everyday and listen to blips of the heart…” – Suman Biswas (The Anaesthetist’s Hymn)

“Total Eclipse Of The Heart” became “Blips Of The Heart” – the musings of a disillusioned anaesthetist – and “Supercalifragilisticexpialidocious” became a pitch for the miracle drug, Paracetamoxyfrusebendroneomycin (“It’s our brand new wonder drug we think you’ll find enticing…”). Suman has become one of the world’s most famous anaesthetists through his comedy musical exploits.

“There’s Lithium, Fluoxetine, and also Amitripyline; Paroxetine, Digoxin, GTN and Azathioprine; Miconazole, Atenolol, and also Chloramphenicol and if you want to overdose there’s always Paracetamol…” – Suman Biswas (The Drugs Song)

Universal Health

Plastic, reconstructive and burns surgeon Mohammad Ali Jawad took the stage to dispel the Nip/Tuck stereotype. Mohammad was the surgeon who restored the beautiful face of British model, and acid victim, Katie Piper.

“For me beauty is in restoring human dignity.” – Mohammad Jawad

He went on to describe tragedies of acid violence against women in his home country Pakistan – one of the global humanitarian challenges to which he could respond. The Oscar-winning 2012 documentary Saving Face followed his journey as he sought to provide free reconstructive surgery for these acid victims.

“When I heard about this kind of violence in my homeland I knew I must do something.” – Mohammad Jawad

Mind

Music psychologist Victoria Williamson gave a fascinating account of the extraordinary power of musical memory, illustrated with the Tale Of Three – the Star, the Survivor and the Miscreant.

“Your memory is more than just a mental store cupboard – it is the glue that holds you in the present moment.” – Victoria Williamson

Vicky on stage.

The Star is Italian conductor Toscanini who held the ability to recall entire symphonies in seconds. The Survivor is British musicologist Clive Wearing who suffers both anterograde and retrograde amnesia following serious illness. Clive still recalls how to play piano and conduct a choir despite having no recollection of his musical education. The Miscreant is an earworm – an involuntary musical memory (a song stuck in your head on repeat), and 90% of people report experiencing this peculiar phenomenon at least once a week. After Suman’s performance, I had Paracetamoxyfrusebendroneomycin earworms for hours! Vicky runs an international survey called the earwormery – where you can tell her all about your own earworms.

Vicky explained that music resides deep within our minds across multiple systems, cleverly maximising its chance of survival, and outlined potential applications for our everyday feats of memory. She did not come dressed as an earworm like she’d promised me in rehearsals, but looked lovely nonetheless.

Popular pickpocket, magician and hypnotist James Brown closed the show… by glueing one of our students to the stage.

The audience get stuck.

“You have the optimist who believes the glass is half full and the pessimist who believes the glass is half empty; I’m the opportunist, I simply laugh and drink water.” – James Brown

James sought to demonstrate the power of belief by first asking the audience to imagine their index finger and thumb stuck together with glue. While many attendees proudly wiggled their fingers, claiming, “I’m immune to suggestion!” there were some who genuinely could not escape from their ‘glued’ position.

James and his volunteer.

James invited one of these suggestible individuals to participate in ‘The Magic of Belief’. Pritesh, or ‘grit’ as he’d be nicknamed through an introductory miscommunication, joined James on stage where he experienced the inability to move either of his feet from the floor, or even remember his own name.

James explained that for years the concept of hypnosis and suggestion has been shrouded in an unnecessary air of mystery. The process is actually straightforward (as we saw on stage). He concluded with how these techniques may be employed more effectively (not deceptively) by medical professionals.

“45 minutes to remove someone’s fear of spiders is 35 minutes too long.” – James Brown

Goodbye from TEDMEDLive Imperial College.

We have come to the end of a fantastic day, featuring inspirational speakers and interactive workshops. The 20 student volunteers (surprisingly, predominantly non-medics) who helped make this day possible were able to enjoy the success of their incredible efforts over the past few months.

TEDMEDLive Imperial is over… until 2014!

–

To experience the first half of #TEDMEDLiveIC, take a look at Part One.

I hope you enjoyed TEDMEDLive Imperial College as much as we did.

Alex.

Alexandra Abel is a Biomedical Science and Global Health graduate from Imperial College London. She is currently studying for a Masters at the Royal College of Music.

Join her on Twitter via @alexandraabel and #TEDMEDLiveIC 

TEDMED activities kicked off last week with talks from D.C. streamed into our lecture theatres. Finally, on Sunday April 21, after months of planning by dedicated committee members (some had only just got back from enjoying TEDMED stateside), compère Professor Armand Marie Leroi took to the stage to welcome an audience of 500 delegates, representing over 15 countries.

Welcome to TEDMEDLive Imperial College!

Delegates wait outside the Royal Geographic Society in the South Kensington sun.

The day encompassed several themes – Innovation, Universal Health, the Mind, and Art – inspired by a quote from Persian polymath and philosopher Avicenna: “There are no incurable diseases, only lack of will”. 

Innovation

The first speaker of the day was Imperial Professor Roger Kneebone. Roger spoke about the three phases of his career: as a surgeon in Southern Africa, as a GP, and as an academic – he currently heads the UK’s only Masters in Surgical Education (MEd).

Roger Kneebone on stage – first speaker of the day.

Roger’s work in simulation for teaching is wide reaching; its applications have even stretched as far as a performance simulator at the Royal College of Music to help musicians overcome stage fright. He drew parallels with his surgical endeavours and the work of his friend, a bespoke tailor in London, noting that neither one could do the other’s job despite similar requirements in dexterity.

Roger believes there is much to be learned from sharing perspectives: he created his inflatable portable operating theatre with this purpose in mind, allowing others to enter the world of surgery.

“It is our patients and their families who are most important… and we want to see things from their perspective.” – Roger Kneebone

Footage from London’s Big Bang Science Fair showed an 8 year old boy operating a neurosurgical cranial perforator and some fellow classmates watching from the sidelines with worried expressions on their faces.

Emergency brain surgery at Roger’s workshop.

TEDMEDLive attendees entered the inflatable operating room themselves to attempt some emergency brain surgery during the workshop.

Roger ended with an apt T. S. Elliot quote: “We shall not cease from exploration, and the end of all our exploring will be to arrive where we started and know the place for the first time”.

Alex Seifalian on stage.

Next up was fellow innovator, Alex Seifalian, Professor of Nanotechnology and Regenerative Medicine at University College London. Alex and his team are aiming to make organ donation a thing of the past, combining nanocomposite materials with stem cell technologies for the growth of replacement organs.

There aren’t many scientists who have grown human cells on the back of a butterfly wing, but Alex is one of them! He related his efforts to build a trachea for a patient in 10 days – it would normally take months.

“Welcome to the body parts shop… would you like to place an order?” – Alex Seifalian

Home-grown organs at Alex’s workshop.

TEDMEDLive attendees saw Alex’s home-grown organs for themselves during the tissue engineering workshop.

Mind

Henrietta Bowden-Jones gave a personal talk explaining her motivations for setting up the UK’s first and only National Problem Gambling Clinic. She shared her experiences of growing up in Milan, where drug use was so rife that she and her friends would collect blood-filled syringes from local parks as a childhood game. It was here she discovered her urge to uncover the underlying psychological vulnerabilities that lead people to addiction.

“I remember as a 6 year old on my way to school, seeing addicts injecting at the side of the road and thinking, why isn’t anyone trying to help them?” – Henrietta Bowden-Jones

Henrietta on stage.

Henrietta presented some shocking statistics: there are 500,000 pathological gamblers in the UK; 84% have committed illegal acts; the average loss made is £150,844.

People call it the hidden addiction – there are no track marks on the arms of gamblers. She also invited the audience to have a go at the Cambridge Gamble Task – a preliminary measure of predisposition to risk-taking.

Universal Health

Lord Robert Winston, Professor of Science and Society, and Emeritus Professor of Fertility Studies at Imperial, gave an expectedly brilliant and eagerly anticipated talk (“How can anybody get pregnant?”) outlining the challenges for IVF and its necessity in the struggle for gender equality in the workplace.

“By tomorrow, Armand Leroi will have produced enough sperm to fertilise every woman in the United Kingdom.” – Robert Winston

Robert Winston on stage.

Lord Winston admirably wore a suit, despite being told by a committee member to come casual. Backstage he advised us not to always go with what people tell you to do if you want to be successful – applicable to facets of life outside of the fashion sphere!

Art

Neil and Lord Winston, backstage after the sock symphony.

Sonochromatic cyborg artist, Neil Harbisson, gave a unique musical performance… based on socks. Neil helped to design the prosthetic “eyeborg” device that allows him to hear colours – even those beyond the range of human sight.

He brought with him on stage several different coloured socks, which he then used to compose his “colour concert”.

“I hope you enjoy the sounds of my socks.” – Neil Harbisson

–

Check back tomorrow for #TEDMEDLiveIC Part 2.

Until then,

Alex.

Alexandra Abel is a Biomedical Science and Global Health graduate from Imperial College London. She is currently studying for a Masters at the Royal College of Music.

Join her on Twitter via @alexandraabel and #TEDMEDliveIC

Soon, a smorgasbord of talks and highlights will be up online for all to feast on. Before that happens, though, I thought I would relay some of the stand-out concepts, ideas and innovations which caught my imagination.

Cool ideas from TEDMED 2013, Day 3.

Capsules in the Cloud

Chronic disease presents many challenges for patients and clinicians. The need for sustained, regular care – often at the primary care level – requires long-term investment, healthcare infrastructure and human resourcing. Crucially important, because even a small disruption in care for people living with chronic disease can result in long-term or even permanently higher levels of morbidity.

One of the challenges is ensuring this population remembers to take their daily medication.

Well a young group from West-Coast US have combined the cloud with the capsules! Connected the mobile to the meds… The standard pill-box has the seven days of the week, and inside each day is the medication one must not forget to take. This group have integrated a cellular-phone sim card into this very device. Genius, no?

The result – it will SMS you if you forget to take your daily pills. Even let your nurse or doctor know if you miss them regularly and arrange an appointment to discuss and resolve the problem. Send data to an app to monitor when and why you forget.

A simple idea, hugely-cost saving and importantly, health-promoting!

Nudging At Google

During one the of panel sessions, there was a representative from Google. Talking about their (famously impressive) offices, they discussed some simple, yet effective ways they are making health easier for employees. Because after all, healthier employees mean greater happiness and productivity of their company. And no-one can question the productivity of Google!

Just Google it!

Simple nudges, or carefully crafted reminders to encourage health-preferred decision-making. Google did things like put candy into opaque jars with a lid, instead of open glass jars, lit their stair-wells and lined them with plants, decreased serving sizes in their cafes (which are free, so employees can still have seconds if they wish) and removed the clear glass from vending machines filled with less healthy foods.

Sounds simple, but they actually found that these small changes, whilst they did not remove choice for employees, did result in the Google group eating literally millions of less calories! And walking the stairs, more often than not.

A reminder of the power of a healthy nudge.

A brush with technology

Many figures stagger me – and they are strong incentives to reflect and think on our lives, lifestyles and legacies. For example, the figure that of all the people in history, who have lived longer than 65 years, two-thirds are alive today. For me, this represents the incredible progresses we have made in public health. Nutrition, hygiene and medical care have all resulted in enormous gains in life-expectancy and quality.

At TEDMED, a talk boldly stated the fact that more people now have wireless internet in the world, than own their own toothbrush. Think upon that for a moment.

More people in India have mobile phones, than toilets.

The message? We need to get better at translating these technologies and the empowerment they bring, to health. In short, technological transition is leaping forward, whilst health and infrastructure lags, slows or worse, stalls.

e-PIDEMICs

As an epidemiologist, or someone who studies disease at a population level, I can tell you that when it comes to epidemics – the sooner they are identified, the smaller they tend to be. The earlier we find them, the easier they are to control.

Sounds intuitive? It is.

Some great news, we have have been highly effective in reducing the time taken to detect the major epidemics of the last century. In fact, we have made enormous progress in the last 2 decades. From 170 days to recognise and report an epidemic to the global level in 1996, to just 23 days in 2009. This results in fewer people affected, smaller economic and social impacts and less deaths.

How has this been achieved? Technology and the increasing connectedness of the globe. Which is somewhat ironic as it is also the processes of globalisation that have lead to greater risk from epidemics. But gains have also come from greater global governance, organised response processes and mandated resourcing.

Flu Near You is an initiative from the USA which aims to engage the lay public, connected by social media and a unique, sleek surveillance platform, to monitor and identify flu cases.

Putting the (epidemiological) power with the people!

Through their network of 41,000 US-wide, they can monitor flu-like symptoms in real time and generate data almost instantly for public health responses.

Similarly, global organisations through the partnering with social media companies, are able to look for ‘trending’ references in people’s Tweets or Facebook status updates relating to flu or other infectious diseases.

If you feel unwell, you’re likely to Tweet or Facebook about your illness. Then your neighbours or friends feel unwell and do the same. This can be monitored, in real time!

Although in its infancy, this technology represents a major breakthrough. If applied globally, it could reduce that number from 23 days to 23 hours… Or minutes!
 

Well, once again, be sure to follow the TEDMED vodcasts as they’re uploaded and also the live updates from TEDMEDlive at Imperial College London and around the world.

This was a whirlwind tour of just a few innovations – be sure to explore more.

From DC, once again, signing off.

–

Check out Day 1 & 2 highlights and join me on Twitter via @sandrodemaio for live updates.
 
 

Dr Alessandro Demaio is a medical doctor, originally from Melbourne, Australia, with a Masters in Public Health. In 2010, Sandro began a PhD in Global Health with the University of Copenhagen, focusing on Non-Communicable Diseases (NCDs). His primary research project is based in Mongolia. As a Director for NCD Action, in 2013 Alessandro is a fellow at the Copenhagen School of Global Health and Harvard Medical School.

Assuming the data is put in the right hands.

Two interesting reflections emerged from the Day 2 sessions regarding data though… And I promise not to make this too nerdy or jargonistic.

Open Data & Open Access

The first, was around open data and open access science. Exploring notions of science, money and the free flow of information. The term ‘open’ describes the unrestricted, uncontrolled provision of data or science to anyone, anywhere, anytime. Free from financial barriers.

Traditionally, when data is collected by scientists, it is kept closed, secret and locked away. The raw information is reserved only for those who collected it to analyse and report – a process which can take years. Think about a cancer registry, or a block of data describing cancer trends and occurrence in a population. If this data is closed and accessible only to a select group of people, only a select group of questions will be asked and therefore answered. But imagine if the data (de-identified) was available to anyone to analyse, test and make breakthroughs on. No barriers to innovation – encouraging competition & transparent science.

Similarly, open access is about unrestricted sharing of scientific outcomes and findings.

“Open access to knowledge for students, doctors and citizens cannot be separated by economics, access to science is good for science, business and society” argued TEDMED presenter Deborah Estrin. “The current system is outdated – a subscription or user-pays system is inequitable, ineffective and regressive.” She outlined that open access frontliners PLOS have “shown that open access illuminates artificial constraints on publication and leads to greater science for all.”

Profit is not a dirty word, but we must keep in mind that science is about accumulating knowledge for innovation and universal benefit. The greater the access, the greater the innovation and benefit.

Surprisingly, open data and open access to published data is controversial still to some. To me, it seems not only logical – but also just. Science should be accessible to all, not just those who can pay…

I have written about this before, but will echo Estrin. A day when the only limits on scientific publication and access are the boundaries of our minds, will be a wonderful day indeed.

Small Data

There has also been a lot of discussion about BIG data in recent years. Big data describes data sets that are so immense and complex, that they require technological and scientific innovation to unlock the nuggets of science contained…

Small data, is also a fascinating concept. What is small data?

Many of us donate. Money, blood, time or our voice. Imagine if we could donate our data.

Knowledge donation like blood donation. Blood is precious, we give it for the greater good and entrust it with leading organisations and NGOs in our community. Place it with a bloodbank. It is used to maximum benefit for all, regulated and protected. Society bands and donates in mass when it is needed and the blood donation is anonymous.

Could we do the same with health data?

Information donation to a databank. Controlled by us, donated by us for the greater good. Full control with, transparency and feedback for the donor. It could be our height and weight, our age, our ECG or our blood results. But it could also be more. How we feel, what we worry about, how treatments or diagnoses affect us.

All of this could be donated to science and health. To help others, or to help ourselves. We could support specific causes, say cancer or men’s health, or specific research studies for a once-off donation. We could even donate the information direct from our smart-phones, or via a secure link from our local GP.

A carefully constructed, transparent approach to health datasets combined with some simple, secure, innovative technology – and patients as the starting point.

Where n = me, but combined our collective data furthers and catalyses a range of science domains.

Some food for thought and more to come. From DC again, signing off for now.

–

Check out Day 1 highlights and join me on Twitter via @sandrodemaio for live updates.

Dr Alessandro Demaio is a medical doctor, originally from Melbourne, Australia, with a Masters in Public Health. In 2010, Sandro began a PhD in Global Health with the University of Copenhagen, focusing on Non-Communicable Diseases (NCDs). His primary research project is based in Mongolia. As a Director for NCD Action, in 2013 Alessandro is a fellow at the Copenhagen School of Global Health and Harvard Medical School.

Building bridges across thinking disciplines, the coming 3 days are sure to be nothing less than incredible – judging on the first few hours.

TEDMED is a multi-disciplinary community of innovators and leaders who share a common determination to create a better future in health and medicine. Their stage program allows us (the TEDMED community) to recharge our brains, jumpstart new thinking, energize our work… and alter how we imagine new possibilities – forever.

After registration and introductions, Curator Jay Walker took to the stage to open the conference. Calling for radical innovation to solve the biggest global challenges in health, he reminded us all that the most powerful and exciting innovations often come from unexpected connections.

I won’t outline everything from the opening session, because everything from TEDMED will be available online soon – or live via TEDMEDlive.

But here are some bite-sized portions to wet your TEDMED appetites!

John Maeda – President of the Rhode Island School of Design.

Do we need more design in health and public health? YES!

John called for greater design and design theory as well as flexible design and innovation for health. He argued that healthcare and public health needs better design, better communication and better branding… That we need to be better at selling, packaging and promoting health as a desirable commodity. A welcome call I thought! Not only as selling health to a global community has never been more crucial… But also because we need to be smarter at tackling the industries who profit from obesity or ill-health front on.

Combat the pernicious, purposeful and powerful branding of illness with even more effective health messaging.

Danny Hillis – American inventor, scientist, engineer, entrepreneur, and author.

Pre-emption, not prevention was the key… Moving away from preventative, to pre-emptive health. Looking at the individual patient and using technology to tackle disease through identifying and “tweaking” the biological pathways away from a road to disease.

Controversial, complex but captivating.

America Bracho – Executive Director of Latino Health Access, health advocate and force of nature!

An energetic woman bringing meaningful, inspired and inspiring change to her community, America reminded us not to disregard “the other group of experts – the mothers who must deal with a lack of food or the people living with disease… Rather than just the technocrats making decisions about the disease from behind a desk”. She flagged many crucial concepts and called for action on social determinants, after all, “diabetes is the destiny of the poor, due to a lack of opportunities”.

Finally, when asked the essential element for inspiring meaningful change in communities, Ms Bracho answered “a passion for social justice, is the essential element to health change and changers”.

An emotive and inspiring talk.

Jay Walker – TEDMED Curator and Chairman.

Finally, back to Jay Walker, who left us with some food for thought and something to chew on for the walk home.

“All facts have a half-life and science is changing the way we understand. We know that our world view is wrong, we just don’t know how wrong”.

What does this mean?

He called for continued reflection and innovation for health.

To cap off, Jay left us with some final advice for the week… In aiming to create 10,000 new and unexpected connections among the TEDMED participants, he urged us all to drop the jargon, talk about and share challenges and failures, and ask LOTS of questions.

Sensational advice not just for us this week, but for us all. Always.

That’s it for now… And this is just the first 2 hours!!! More imagination, innovation and inspiration to come…

Signing off from DC.

–
Check out TEDMEDlive or join me on Twitter via @sandrodemaio for live updates.

Dr Alessandro Demaio is a medical doctor, originally from Melbourne, Australia, with a Masters in Public Health. In 2010, Sandro began a PhD in Global Health with the University of Copenhagen, focusing on Non-Communicable Diseases (NCDs). His primary research project is based in Mongolia. As a Director for NCD Action, in 2013 Alessandro is a fellow at the Copenhagen School of Global Health and Harvard Medical School.