Suchergebnisse

END OF THE VIETNAM WAR MARKED THE CULMINATION OF AN ERA IN SOUTHEAST ASIA AND BROUGHT ON A NEW ERA WHEREIN THE US IN NO LONGER THE PARAMOUNT POWER. BASIC QUESTIONS OF POLICY NEED TO BE EXAMINED IN LIGHT OF THESE CHANGES.

The use of genetic and genomic testing is becoming more widespread in health care and more inherited explanations for family history of diseases or conditions are being uncovered. Currently, relevant genetic information is not always used in the care of family members who might benefit from it, because of health professionals' fears of inappropriately breaching another family member's confidence. Such examples are likely to increase as testing possibilities expand. Here we present the case for use of familial information in the care and treatment of family members. We argue that whilst a clinical diagnosis in person A is confidential, the discovery of a familial factor that led to this diagnosis should be available for use in depersonalised form by health professionals to inform the testing and clinical care of other family members. The possibility of such use should be made clear in clinical practice at the time of initial testing, but should not require consent from the person in whom the familial factor was first identified. We call for further debate on these questions in the wake of high profile non-disclosure of genetic information cases, and forthcoming Data Protection legislation changes.

An 'epidemic' is defined as an increase in cases of disease over and above what would normally be expected in a community or region during a specified period. War, displacement, poverty and natural disasters are frequently associated with epidemics, and it is not unusual for humanitarian agencies to be called upon to prevent or contain them, especially in resource-poor settings. Although there is a considerable body of literature critiquing the work of humanitarian agencies on epidemics, it would be misleading to generalize too readily from cases of failure. There are many instances in which they have prevented the occurrence of epidemics, but these achievements have rarely been recorded in any detail and they are hard to assess comparatively. This chapter does not, therefore, attempt to provide a comprehensive overview of humanitarian engagement with epidemics. Instead, the first part of the chapter presents three case studies from Zaire (now the Democratic Republic of the Congo – DRC), Haiti and Somalia. These case studies look behind the narratives of 'failure' and 'success' to explore salient issues which routinely arise for humanitarian agencies working in challenging circumstances. The second part of the chapter then turns to the largest humanitarian programme ever attempted to control an epidemic: the outbreak of Ebola in West Africa between 2013 and 2016. In so doing, it becomes evident that humanitarian programmes, which adapt and respond to the specific social, political and economic contexts in which they are working, tend to be more effective. It is also clear that the nature of humanitarian engagement with epidemics is increasingly being shaped by narratives linking infectious diseases with global security.