News from the Yale Global Health Justice Partnership

Issue IV: September 6, 2016
Keep up to date with events, research, and policy work happening at Yale GHJP, an initiative of Yale Law School and Yale School of Public Health. 

2016 GHJP Levi-Strauss Internships

This summer, GHJP coordinated three summer internships with funding and support from the Levi-Strauss Foundation. This innovative initiative seeks to harness the powers and resources of a university to support  more effectively the work of local NGOs working with underserved populations. This summer’s interns worked on projects regarding the negative impact of prostitution policies on HIV, health, and human rights through an interrogation of criminal law and policing. Their work also analyzed the relationship between criminal justice reform (and the new trend for ‘diversion courts’ for adults, for example, or ‘Safe Haven’ laws for juveniles) and health systems more generally. Here are some personal reflections on their experiences this summer:

Aaron Berman: I spent this summer interning with the Solutions Not Punishment Coalition (SNaPCo) at the Racial Justice Action Center in Atlanta, Georgia. During my internship, I provided research support for the Atlanta/Fulton County Pre-Arrest Diversion Initiative, which is set to launch in early 2017. The initiative, which originated in response to the Atlanta City Council's highly controversial "banishment ordinance" proposal in 2013, seeks to divert individuals who would otherwise be arrested for low-level "quality of life" offenses (such as drug possession and idling and loitering) out of the criminal justice system, instead connecting them with social and health services. While the Initiative is still in its early stages, it was amazing to see how far SNaPCo had come in shifting the attitudes of city officials and the Atlanta Police Department in such a short period of time. It was also striking to note how seamlessly public health principles and the concept of harm reduction are starting to be incorporated into discussions surrounding criminal justice reform. I hope to stay involved and up to date with the Initiative's progress remotely while I finish my MPH at the Yale School of Public Health this year!

Marlene Edelstein: I spent the summer working as a policy intern at the Sex Workers Project (SWP) in New York City. My primary project was to conduct research on laws meant to help minors from being arrested for prostitution and to develop policy recommendations for SWP. The internship was an incredible opportunity to learn from my supervisor, Kate D’Adamo, who is an accomplished advocate and activist. Through my research, I was also able to connect with service providers from all over the country who work with victims of human trafficking.

Shaylen Foley: I spent the summer in New Haven researching prostitution diversion programs.  The bulk of my work consisted of qualitative interviews with individuals who have participated in these programs. My goal was to obtain their perspective and descriptions of their experiences. Every person I interviewed had so much knowledge to share! I am excited to see how their collective stories shape our understanding and critique of these programs.

Welcome to the CRIT Team!
The Collaboration for Research Integrity and Transparency (CRIT) is open for business!  CRIT is an interdisciplinary initiative in law, medicine and public health that addresses the need for transparency and integrity in medical product research.

Jeanie Kim, Research Fellow, graduated from Northeastern University Law School in 2015, where she worked on the intersection of law and public health. “CRIT’s mission to promote the quality and transparency of clinical research will have a significant impact in advancing biomedical science, healthcare, and public health. I’m excited to use my background in law and science towards this cutting-edge work, and I hope to combine research and advocacy to improve the evidence base that forms our understanding of medical products.”   

Cortelyou Kenney, Staff Attorney, is a 2009 graduate of the University of California, Berkeley School of Law. She came to CRIT after an academic fellowship at Stanford Law School where she taught public-interest impact litigation. She hopes to combine her passion for social justice with her litigation, policy, and research skills to promote better health outcomes for all. Her work at CRIT has thus far focused on obtaining information about the safety and efficacy of two drugs used to treat Hepatitis C.  

John Langford, Abrams Clinical Fellow for the Information Society Project's Media Freedom and Information Access Clinic, is a 2014 graduate of Yale Law School, with experience as a federal clerk and a litigator.

Margaret McCarthy, Executive Director, has a law degree from Columbia University Law School (1989) and a Ph.D. from Cornell University in Human Development (2014). "Access to detailed information about medical products is crucial to informed medical decision-making for patients and medical providers. CRIT will serve to make this life-saving information more readily available."
An additional medical research fellow will begin work in January 2017.

CRIT is a joint project of GHJP, the Media Freedom and Information Access Clinic (MFIA) at Yale Law School, and the Yale Open Data Access (YODA) Project within the Center for Outcomes Research and Evaluation (CORE) at Yale-New Haven Hospital and the Yale School of Medicine.  CRIT's core leadership team includes Amy Kapczynski (GHJP) Gregg Gonsalves (GHJP), Harlan Krumholz (CORE/YODA), Joseph Ross (CORE/YODA) and David Schulz (MFIA).

The CRIT Team
Back (L to R): John Langford, Harlan Krumholz, Gregg Gonsalves, Joseph Ross; Front: Margaret McCarthy, Cortelyou Kenney, Jeanie Kim, Amy Kapczynski; Missing: David Schulz

Contemplating risk and rights: new GHJP research on Zika

·   In June, GHJP practicum students, faculty, and partners published an article in Cadernos de Saúde Publica, a Brazilian public health journal, presenting a health and human rights analysis of the Ministry of Health’s current Zika guidelines for health care providers. The analysis identified various shortcomings in the guidelines and emphasized the need for expanded reproductive health information, counseling, and services for women and men affected by Zika. The article is available in English here. The analysis was also the basis for an expert’s statement that was recently submitted as part of a petition to the Brazilian Supreme Court to expand services for women and families affected by Zika. Read more here.

·   Leading up to the recent Olympic Games in Rio de Janeiro, there was much concern about the potential risk for further spreading Zika. In response, GHJP student fellow Joseph Lewnard; who is a PhD student in the Epidemiology of Microbial Diseases (EMD) at YSPH; co-director Gregg Gonsalves; and EMD Professor and Chair Albert Ko used mathematical modeling to demonstrate that these concerns were largely exaggerated and the that event’s effect on the epidemic would be negligible. The paper was published in July in the Annals of Internal Medicine and was widely cited in the international press.

·   GHJP Clinical Fellow Christine Ricardo was in Rio de Janeiro this summer conducting interviews with women and men about Zika, reproductive decision-making, and access to health services. The interviews are the first stage of a qualitative study that is being carried out in collaboration with Fiocruz/IFF and Ipas and will be replicated in other Brazilian locations.
Recent GHJP Press

From Yale Law School: U.N Acknowledges Responsibility for Haiti Cholera Outbreak

From The New York Times: 
U.N. Admits Role in Cholera Epidemic in Haiti

The U.N.’s Cholera Admission and What Comes Next

From The Guardian: Zika emergency pushes women to challenge Brazil's abortion law

From the LA Times: Why the Rio Olympics are not likely to increase the spread of Zika across the world

From Health Day: Zika won’t Pose Risks at the Olympics: Health Experts

Battling Superbugs: Developing Legal and Political Responses to Drug-Resistant Bacteria

Monday, Sept.19th
YLS Room 129

Antibiotics are the cornerstone of modern medicine. Everything from cancer treatment to hip replacements, complex pregnancies to routine throat infections, relies on these “miracle” drugs.  This may all change, however. Bacteria are rapidly developing resistance to antibiotics, leaving them ineffective, and there are few new drugs in development. By 2050, antibiotic resistance is predicted to cause 10 million deaths annually at a cost of $100 trillion. This panel will discuss the local, national, and global strategies needed to address antibiotic resistance.

Panelists: Manica Balasegaram, Director of the Global Antibiotic Research and Development Partnership; Rachel Cohen, Regional Executive Director of Drugs for Neglected Diseases initiative, North America; Steven Hoffman, Associate Professor of Law and Director of the Global Strategy Lab, University of Ottawa; Aaron Kesselheim,  Associate Professor of Medicine, Harvard Medical School, and faculty member, Brigham and Women’s Hospital.


GHJP Fellows Fall Reception

Thursday, September 15th
YLS Faculty Lounge

Each year, GHJP recruits a small, select number of Yale graduate and professional students to become Student Fellows. As part of a unique interdisciplinary community, Fellows gain exposure to top leaders and thinkers on issues of global health justice, have opportunities for mentorship from GHJP faculty, fellows, and diverse partners, and are invited to propose and help organize events.
Come learn more about the Student Fellows Program! Read more here


GHJP Alumni Spotlight: Rose Carmen Goldberg 
Rose Carmen Goldberg, who graduated from Yale Law School in 2015, worked with GHJP during her time in New Haven. She contributed to the “Fulfilling Broken Promises” report on reforming the compensation system for miners in South Africa. While at Yale, Rose served as Editor-in-Chief of the Yale Journal of Health Policy, Law, & Ethics and participated in the Veterans Clinic. Prior to law school, Rose worked for several years at the Department of Health and Human Services on Medicare hospice policy and was selected to serve on a health reform evaluation committee. Previously, Rose also worked on HIV/AIDS issues in Uganda and Russia. Rose has an M.P.A. from Columbia University and a B.A. from St. John's College in New Mexico.

1. Can you briefly describe the work you did as a GHJP fellow?  
My involvement began with GHJP's inaugural project: reform of the broken compensation system for gold miners in South Africa suffering from silicosis and tuberculosis. As a member of an interdisciplinary team of students (law, epidemiology, and international relations), I analyzed potential solutions to this century-old cycle of disease and neglect. My team conducted a comparative assessment of miners' health compensation systems across the globe. We also traveled to South Africa to learn from the miners fighting to realize their rights to compensation and treatment, and to speak with government officials at the helm of the responsible bureaucracies.

Thereafter, I transitioned into the role of student director for GHJP's Ebola quarantines project. In that capacity, I helped supervise an analysis of the constitutional implications of the US-based quarantines. I also formulated strategies for assessing the nature and scope of the harms flowing from these fear-based confinements.

2. How did your experiences with GHJP inform what you have done since leaving Yale?

I came to law school and GHJP with a passion for health law. I left GHJP to become a lawyer with a conviction that interdisciplinary collaboration is essential to advancing health justice. Without the perspectives of the medical professionals who treat the intimate physical and psychological wounds attendant societal neglect, movements for change are less attuned to the needs of those they hope to serve. As such, they are less effective.

Inspired by this teaching--and my work in Yale Law School's Veterans Legal Services Clinic--I designed a health justice project that links legal and medical care. As a Skadden Fellow, I will represent veterans suffering from mental health and substance abuse issues through a new medical-legal partnership (MLP). In developing veterans' claims for healthcare and benefits, I will work closely with their clinicians to marshal robust medical evidence. On the flip side, my consultations with clinicians will help ensure that my legal representation is sensitive to my clients' therapeutic needs.

The skills I developed through GHJP will help me build these bridges. Thanks to GHJP, I will be better able to ask medical questions in such a way that the answers empower my legal representation. I will also be better equipped to provide representation that not only "wins" cases. My services will be more attuned to the complexity and diversity of what improved health means for different individuals. This will help me recognize when the costs of a legal battle might outweigh the benefits.           

3. What advice might you give to current GHJP fellows or students in the practicum about doing work at the intersection of health, policy, human rights, and law? What are the challenges and benefits with working in multidisciplinary teams, and what are some best practices you might suggest?

Don't underestimate your colleagues' capacity to make project contributions outside their fields. Granted, there is, of course, some truth to the old saw about "barriers" between different disciplines. My epidemiologist teammate certainly had a much better grasp of the health science data on lung diseases caused by mining work, for instance. But throughout my time with GHJP, I was actually more struck by the opposite phenomenon: how much my non-lawyer teammates and field partners understood about the legal dimensions of the problems we confronted, without having taken a single law school class. Indeed, sometimes their outsider perspectives helped me see absurdities in legal principles or structures I'd taken for granted. This dynamic strengthened my team's ability to question and aggressively challenge the status quo. Put simply, prepare to be humbled by your GHJP teammates, partner organizations, and clients. 

Keep up with GHJP over the summer on Twitter, Facebook, and our website. We'll be posting regular updates, news, and publications on relevant media outlets.

Join the GHJP listserv and receive information on upcoming events and opportunities by clicking here or scanning the QR code below 

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