TEDMED Blog

Announcing the TEDMED 2017 Editorial Advisory Board

Blockchain in healthcare; Synthetic genomics; Healthcare reform; The opioid epidemic; Drones for good; The effect of social determinants on health; Cost of drug innovation; Impact of climate change on health. These are just a few of the topics that we explored in our first Editorial Advisory board meeting last week in New York City. We’re looking forward to our second meeting in San Francisco this week, as we begin to design the stage program for TEDMED 2017. We work hard to ensure that the most important and timely topics in health and medicine are covered every year, and in order to curate a truly multidisciplinary program, we rely on the guidance and participation of the TEDMED Community – more specifically, TEDMED’s Editorial Advisory Board (EAB).

The EAB members contribute their time, expertise and insights to help design TEDMED’s annual program. This year’s passionate EAB represents organizations that intersect all areas of health and medicine, including technology, academia, philanthropy, journalism, foundations, and much more. Their diversity ensures that TEDMED’s stage program represents a broad range of cutting-edge ideas in health and medicine.

The 21 thought-leaders that make up this year’s EAB represent influential leaders across the landscape of health and medicine. Some share their expertise from serving on the board in previous years, while others bring the fresh perspective of new members.

We’re delighted and honored to announce the members of the TEDMED 2017 Editorial Advisory Board and we thank them for their collaboration:

Atul Butte, MD, PhD, Director of the Institute of Computational Health Sciences at the University of California, San Francisco

Bijan Salehizadeh, MBA, MD, Managing Director, NaviMed Capital

Celine Gounder, MD, ScM, Internist, Epidemiologist, Journalist, and Filmmaker

Daria Mochly-Rosen, PhD, Professor of Chemical and Systems Biology at Stanford University and Founder and Director of Stanford University’s SPARK program

Giles Newton, PhD, Head of Editorial at Wellcome Trust; Editor-in-Chief of Mosaic

Hemai Parthasarathy, PhD, Scientific Director, Breakout Labs and Founding Partner, Breakout Ventures

Jeff Karp, Associate Professor, Brigham and Women’s Hospital and Harvard Medical School

Kafui Dzirasa, MD, PhD, Assistant Professor of Psychiatry and Behavioral Sciences at Duke University

Leonard Sender, MD, Director of Cancer Services at University of California

Lucy Kalanithi, MD, FACP, Clinical Assistant Professor of Medicine at Stanford School of
Medicine

Michael Painter, MD, JD, Senior Program Officer at the Robert Wood Johnson Foundation

Michael Penn, MD, PhD, Vice President of Diversity, Outreach, and Mentoring at the
Gladstone Institutes

Orin Levine, PhD, Director of Vaccine Delivery at the Bill & Melinda Gates
Foundation

Pam Belluck, Health and Science Writer, New York Times

Roxanne Khamsi, Chief News Editor at Nature Medicine

Sandeep “Sunny” Kishore, MD, PhD, Associate Director of the Arnhold Institute for Global Health

Stacey Chang, Executive Director of the Design Institute for Health, University of Texas at Austin

Susan Skochelak, MD, MPH, Group vice president, Medical Education American Medical Association

Udaya Patnaik, Founder and Principal, Jump Associates

Ursheet Parikh, Partner, Mayfield Fund

Vanessa Ruiz, Founder of Street Anatomy

A Global Mindset for Local Innovations

This guest blog post is by Partho Sengupta, the incoming Director of Cardiovascular Imaging and Chair of Cardiovascular Innovation at the Heart and Vascular Institute at West Virginia University, Morgantown. He spoke on the TEDMED stage in 2016 and you can watch his talk here.


Dr. Sengupta scanning and educating volunteers in American Society of Echocardiography Humanitarian Events in Sirsa and Delhi, India in 2011. Image courtesy of the American Society of Echocardiography (ASE) foundation for cardiovascular ultrasound (www.asefoundation.org).

By 2030 cardiovascular disease is projected to account for 25 million deaths worldwide. Over the last few decades, the cardiovascular community globally has continued to respond to this pandemic with groundbreaking innovations. However, the diffusion of innovation remains unequal since healthcare sectors around the world are characterized by social inequality, depending on where the patient lives and the system in which care is received. When I came to the US in 2004, I wondered if my research or any of my breakthroughs would ever impact the lives of patients in India or other countries.

In 2011, I was tasked by the American Society of Echocardiography (ASE) to develop international programs that address educational needs of the international membership. And here was an opportunity to engage people from both US and abroad in a meaningful way. Inspired by the work of Saint Gurmeet Ram Rahim Singh Ji Insaan and the help of my colleagues who perform humanitarian work in Sirsa, a rural village town in North India, I decided to combine humanitarianism with new technology as a model of innovation. One of my first projects in India brought together industry support, membership engagement, education and research simultaneously over 2 days. We performed focused echocardiographic studies with Web-based assessments in which over 1000 examinations were performed in remote India over two days, which were uploaded to the cloud and read by over 75 institutions worldwide. After the success of the first event, we performed several such cardiovascular camps and simultaneously educated local health personnel – a practice that now forms the heart of the ASE Foundation Programs. It has been fulfilling to see the enthusiastic adaption of such humanitarian program by societies across UK, Europe, Asia and South America.

ASE volunteers who participated in the humanitarian-innovation event in Delhi, India. Image courtesy of the ASE Foundation for Cardiovascular Ultrasound (www.asefoundation.org).

We in the United States are diverse and form a microcosm of different societies and communities, each with their own specific needs in this large health care system. I have often pondered if the real value of addressing the technological and educational needs of the global healthcare community could be in finding solutions to some of our own needs within the US- an investment with dual purpose! There are regional pockets in the US with extremely high rates of death and morbidities related to income, education level, sex, race, and ethnicity and employment status. One of the states with the highest prevalence of cardiovascular disease (13.7%) is West Virginia. The rate of heart attacks is the highest in the nation (7.8%). The prevalence of obesity in adults is 35.1%, with over 40% having hypertension and only two out of 10 adults ever screened for cardiovascular risks. The expansion of Medicaid under the Affordable Care Act resulted in nearly half a million new enrollees in Medicaid by 2015. However, the state continues to grapple with efforts to reduce shortage of healthcare professionals.

The success of the humanitarian innovation program carried out in India by Dr. Sengupta also kindled interest in other world societies. Seen in the picture are volunteers of a similar project that was carried out by British Heart Foundation in Africa. Image courtesy of the Mark Monaghan, British Society of Echocardiography (www.echoinafrica.org).

In mid 2016, at the same time I was asked to participate in TEDMED, I received an invitation from a newly formed Heart and Vascular Institute at the West Virginia University, Morgantown to steer the vision for a statewide Noninvasive Cardiovascular Imaging program with creation of a Cardiovascular Innovation Center that would focus on developing new strategies. Some might question why I would ever leave my position in New York City and move to West Virginia. But as I put my TEDMED talk together, I realized perhaps West Virginia offered a fertile ground for innovation to implement the vision of automated technologies, robotics and implement novel processes to screen latent cardiovascular disease that I was talking about.

The successful humanitarian-innovation projects in India spurred interests widely. Here is seen a similar project organized along with Care Harbor healthcare clinic for the uninsured, underinsured and underserved in LA County in 2014 at the Los Angeles Sports Arena. This was the ASE Foundation’s first U.S.-based humanitarian mission besides the other programs carried out in Vietnam, Argentina, Philippines, Kenya, central China, and Cuba. Image courtesy of the ASE Foundation for Cardiovascular Ultrasound (www.asefoundation.org).

When I think about the opportunities over the years that have come my way, I feel fortunate and it becomes even more relevant that I find ways not just to practice medicine but push the field forward meaningfully. What if high resource urban health care center in the US may have locked up the funding and physicians, creating even greater disparities in the US? Perhaps I feel that there is opportunity to disrupt this meaningfully.

I believe that organizations like TEDMED can encourage free minds to make a real change, and I certainly believe, as my talk travels far and wide, it could serve as a vehicle for engaging collaborations with industry partners, non-profit organizations, national societies, local state bodies and university professionals to bring this vision to fruition in West Virginia and the world.

Finding common ground through music

This guest blog post is by Sam Maher, a West Australian instrumentalist and drummer who is best known for his unique playing style on the handpan. He spoke and performed on the TEDMED stage in 2016 and you can watch his talk here.


In 2013 I found myself caught in the midst of a torrential downpour in the city centre of Perth, Western Australia – stunned, I decided to run for it. As I bolted for shelter within the central train station I was completely unaware of the pivotal encounter that would soon take place and change the direction of my life forever. Catching my breath and wiping the rain from my brow I accepted the fact that I wouldn’t be leaving the station anytime soon and took a seat against the wall of a deli that had its roller shutters pulled down – Sunday trading was still a relatively new concept in Perth back then and the station was completely abandoned.

A couple of weeks before this I received an instrument in the mail direct from Germany which I spent close to a year obsessively searching for. It wasn’t easy to find – the instrument, still in its infancy, had only been successfully crafted by a handful of committed artists across the globe, and the hypnotic tones that it created when struck caused a ripple effect around the world, establishing hoards of dedicated admirers, all desperate to get their hands on one – myself included.

The original name of this instrument is the “hang” – created by Felix Rohner and Sabina Schemer in Switzerland in 1999 after many years of researching the construction of the traditional steel pans of Trinidad and Tobago. By combining these techniques to the ideas of other ethnic percussion instruments such as the Udu of Africa and the gamelan instruments of Indonesia the Hang was born. The idea of the instrument laid dormant for several years, confined to its birthplace in the Swiss mountains and inside the hearts of the very select few that were lucky enough to be accepted to own one. The instrument’s appeal grew when the internet began finding its way into households worldwide, and before too long the hang was a viral phenomenon. With the demand far outweighing the supply, independent innovators attempted to fill the gap by recreating their own versions of the hang, each giving it their own title. The controversy that followed is still in full force today and somewhere along the way in an attempt to void the feud it was decided that the generic term for the instrument would be the “handpan” unless the instrument was in fact an original hang made by Felix or Sabina.

Now – back to the train station.

I had my handpan with me that stormy afternoon, and the situation presented a perfect opportunity for me to experiment with it. So experiment I did. For close to an hour I sat with my eyes closed as I navigated my hands around the instrument’s cylindrical surface, striking each hammered circle with my finger tips and the bulging knuckles of my thumbs, hearing the smooth frequency that arose and observing how each carefully placed note related to one another as the metal vibrated in perfect harmony. When I opened my eyes I found myself seated next to an elderly aboriginal woman who appeared to be homeless. She looked at me with a tear in her eye as she asked if I could continue playing. Over the next half hour we were both swept up in a wave of emotion as I bore witness to the downpour of her life’s trials and tribulations; living as an Aboriginal woman inside a country that has chosen to strip her of rights, and rape and ignore her. The misery and power of that moment changed my life forever.

 

Music is unique in its ability in allowing us to experience the same emotions regardless of political views, race, sexuality, faith – it proves that we are the same, and brings us together. It allows us to express and understand our feelings freely, to come to terms with the difficulties, the triumphs and the collective challenges we face in our lives.

 

The handpan has proved itself as a powerful communication tool capable of transcending language, cutting straight to the emotional core of anyone who chooses to listen to it. In the the time that followed that chance encounter 4 years ago I have spent 14 months traversing the Americas, from Mexico City down to the Patagonian region of Argentina, learning the instrument on the go, surviving mostly from the money and acts of human kindness I earned from the streets. At the end of that trip a video surfaced of me improvising with the instrument in the subways of New York City which subsequently reached over 20 million people. I have now performed in over 22 countries around the world, and have come into contact with hundred of thousands of people completely different than myself, yet for a brief moment of time we were all the same. To be accepted and accept these otherworldly places, people and ideologies, so different to my own, through the language of music and the artistry of the handpan is something that will never fail to astound me.

Love is Not Enough

This guest blog post is by Sue Klebold, passionate advocate for brain health awareness and mother of Dylan Klebold, one of the two shooters at Columbine High School in 1999. She spoke on the TEDMED stage in 2016 and you can watch her talk here.


It has been almost 18 years since my son and his friend killed twelve students and a teacher at Columbine High school, and injured more than twenty others before killing themselves. From the moment the tragedy happened, it seemed to belong to the planet rather than the community. Live news coverage of its evolution reached every corner of the world, and people across the globe seemed to know what was happening in the school before some of its victims did.

At the time of the tragedy, Americans rarely heard about school shootings, and 24/7, on-the-scene news coverage was in its infancy. Social media as we know it today didn’t exist. I didn’t own a cell phone, and I was just learning to use the Internet. I had no idea that my seventeen-year-old son could purchase guns without my knowledge or permission. I believed that suicide was something that happened in other families – not in mine – because I loved my children deeply and I believed that my love would protect them. I didn’t think about homicide because I’d never known anyone who was killed or who had killed someone else.

A lot has changed since the Columbine tragedy, but a lot hasn’t. We hear more about heartbreaking murder-suicide events in the news, but we are just beginning to consider the role suicidality might have played in the incident. Whatever concerns we may have had about youth suicide and teen depression in 1999 couldn’t have prepared us to accept the ongoing increase in these health problems nearly twenty years later. Despite growing efforts to mitigate depression and suicidal thoughts/actions in youth, we have not been able to reverse the rates that continue to inch upward.

As I began a journey of recovery after the tragedy, I tried to find a way to accept the horror my son perpetrated. In my desire to understand, I learned that if my son had gotten effective help in a timely manner, he probably would not have participated in the shootings or taken his own life. My eyes were opened to the extreme costs to society of not providing adequate care in a timely manner. The tragedy itself, followed by my own bouts of panic disorder after the shootings, convinced me that advocating for brain health was the most important work I could do.

Numerous efforts to reduce suicide rates and improve mental health care are in development around the world. Many of these focus on system improvements within schools, hospitals or the military. They rely on research from a broad spectrum of disciplines.

The umbrella of brain health is vast and it’s hard to know where to start. When I am asked what people can do when they struggle with lethal thoughts, the first thing I suggest is to contact the National Suicide Prevention Lifeline at 1-800-273- TALK (1-800-273-8255) or go to the website at http://suicidepreventionlifeline.org. The Lifeline provide free and confidential support to people in emotional distress or suicidal crisis all day, every day, across the U.S.

In my own efforts to raise awareness and improve services for those who struggle, I chunk the work into three major areas of focus.

1) We need to remove the psychological barriers that prevent people from seeking help. Too many people fear negative consequences from revealing their pain, or believe that their inability to function normally is a character flaw rather than an illness. Unfortunately, the better they hide their aberrant thoughts, the more difficult it becomes for others to recognize their need for care. (This is what happened with my son.)

2) We need to increase the general public’s knowledge about mental illness and the recognize signs that someone’s brain health may be deteriorating. This includes learning better ways to talk, to listen and to respond.

3) Sadly, those who know they need help can’t always connect with professionals who can provide a continuum of effective, affordable, evidence-based interventions and treatment. Much work needs to be done to educate professionals, and improve the systems in which they work.

The work is there and there is plenty for each of us to do. Let’s get going.

Mending the Strains in our Social Fabric: Protecting and Healing Trafficking Survivors

This guest blog post is by Susie Baldwin, Co-Founder and Board President of HEAL Trafficking and TEDMED 2016 Speaker. You can watch her TEDMED talk here.


January is National Slavery and Human Trafficking Prevention Month in the United States. During his last weeks in office, President Obama proclaimed this month’s commemoration, noting that despite the rejection of slavery by our nation, “Today, in too many places around the world — including right here in the United States — the injustice of modern slavery and human trafficking still tears at our social fabric.”

Strains in our social fabric not only result from the injustice of human trafficking, but create the problems of human trafficking and exploitation. The conditions that frame our lives— factors known as the social determinants of health— can increase or reduce vulnerability to trafficking. These “upstream” determinants of health include: the availability of resources to meet the needs of daily life, such as safe housing and adequate nutrition; access to education, health care, employment opportunities, and transportation; and freedom from violence, discrimination, and poverty.  Relationships with other people—the presence or absence in our lives of others whom we trust, and who provide us with support or love— are also key social determinants.

cropped-heal-logo-1-e1426167334902 (1)The stories of the trafficked patients I have cared for reveal how vulnerabilities created by the social determinants underlie human trafficking. For example, Olga experienced domestic violence and left her husband. As a teacher in a country that was no longer able to pay its educators, she needed to find a way to support herself. She answered an ad for a job as a housekeeper in the U.S., and wound up a domestic servant. Jaclynn experienced child abuse and neglect at home, where her drug-addicted mom was unable to properly protect her, and found solace in the arms of a man who manipulated her and sold her to other men. Narong wanted to earn a living for his family and came to the U.S. for a job as a welder, only to be trapped working in a restaurant for long hours with barely any pay.

These survivors are the lucky ones— they escaped or were rescued from trafficking and managed to connect with services provided by my long-time partner, the Coalition to Abolish Slavery and Trafficking, including case management and legal services. But as I worked to help my patients cope with the physical and mental health consequences of trafficking, I learned that their struggles to rebuild their lives often hinged on social determinants. Perhaps most critical was their search for jobs and affordable housing that would allow them to achieve and sustain independence. Sometimes, they were re-victimized. Alma, for example, another patient who had escaped domestic servitude, wound up—as a free woman— working as a housekeeper for room and board, without receiving any pay.

Though it wasn’t true in Alma’s case, for many trafficking survivors, a criminal record poses a barrier to gainful employment. Trafficked people are commonly charged with offenses that burden them with criminal records for the rest of their lives, making it difficult for them to find housing and jobs, and unable to access loans and grants. These negative social determinants leave them vulnerable to being exploited and trafficked again.

Fortunately, it doesn’t have to be this way. Bipartisan legislation in the new 115th Congress, called the Trafficking Survivors Relief Act of 2017, would allow courts to erase survivors’ nonviolent federal criminal convictions resulting from being trafficked. While this law only helps survivors with federal criminal records, it provides an important model for criminal justice systems in cities and states around the U.S. To learn more about this bill and express your support for it, please see: http://act.polarisproject.org/p/dia/action3/common/public/?action_KEY=23688.

To support trafficked people on their journey to safety and recovery, HEAL Trafficking, the organization I founded with colleagues three years ago, has just released our Protocol Toolkit for Developing a Response to Victims of Human Trafficking in Health Care Settings. This toolkit guides health professionals through the process of mobilizing interdisciplinary responses to trafficked people who present for care. It encourages cooperation with the diverse agencies and individuals who can address the social determinants that put trafficked people at risk, and which can hinder healing of the body and mind. HEAL Trafficking believes that together, we can create conditions and systems that allow survivors to thrive, and that prevent human trafficking in the first place. Please join us.


HEAL Trafficking is a network of over 800 multidisciplinary professionals dedicated to ending human trafficking and supporting its survivors. We aim to heal the world of trafficking by approaching the problem through the lens of public health and trauma-informed care. We work to expand the evidence base, enhance collaboration among multidisciplinary stakeholders, educate the broader anti-trafficking and public health community, and advocate for policies and funding streams that enhance the public health response to trafficking. 

The Missing Piece for Healing Community-Wide Trauma

This guest blog post is by James Gordon, founder of the Center for Mind-Body Medicine and TEDMED 2016 Speaker. You can watch his TEDMED talk here.


Not long ago, a revered Lakota elder told me that our work at the Center for Mind-Body Medicine’s (CMBM) was “the missing piece” for his people and indigenous people everywhere. He and other elders have said that we’re giving them the practical, scientific tools to help a severely traumatized people restore balance to their minds and bodies. As they work with us they’re realizing their capacity to live in the light of traditional wisdom as they meet the challenges of the modern world.

Working with Pine Ridge.

Working with Pine Ridge.

Their experience reflects the impact our work has had over the last 25 years. We‘ve seen it in some of the world’s most troubled places – in Bosnia, Kosovo, Gaza, Israel and Haiti, with Syrian refugees in Jordan as well as here at home: among our veterans and first responders; with the homeless as well as the privileged; for the desperately ill as well as the highly functional but highly stressed.

Everywhere we’ve worked the model of self-care and group support has been embraced. The tools we teach – meditation, guided imagery, biofeedback, yoga, self-expression in words, drawings, and movement, and genograms (family trees) – had been easy to learn and use to reduce stress, improve mood, and enhance hope. Our small group model has been welcomed and recognized as a powerful and nurturing context for healing.

The Pine Ridge Indian Reservation in South Dakota has been one proving ground for our approach, for the way we work collaboratively to bring healing and hope to a long traumatized community.

Working with Pine Ridge.

Working with Pine Ridge.

Located in one of the most impoverished counties in the United States, the proud and determined Pine Ridge community suffers from economic devastation, violence, self-destructive behavior, and demoralization. Pine Ridge has 8 times the national rate of Type 2 diabetes. 80% of the population is affected by alcoholism and 85% are unemployed. In the year before we began our intensive training program, 20 young people committed suicide and 200 more attempted to do so.

In 2015, after the 20 young people had killed themselves, Basil Braveheart, a Lakota elder and other community leaders, told us of the urgent need to develop a reservation-wide program for healing the community’s trauma. With generous support from the Swift Family Foundation, Battery Powered, Open Road and Administration for Native Americans, and US Department of Human Services, we were able to bring our comprehensive program of self-care and group support to 70 elders, clinicians, teachers, and youth activists. The training featured the seamless integration of CMBM’s evidence-based model and traditional Lakota ceremony led by participating tribal elders.

We were able to touch hearts change the lives of these community leaders. “Amazing” said Cindy Catches, an elder, “The trust, the love, the tools that were given… I saw the beginning of a real healing.” “Life-changing” said Lisa White Bull, a counselor at the Little Wound School, “I believe our prayers for help have been answered”.

We gave these 70 leaders tools they were then able to share with troubled young people and their families. In the 15 months since that training there have been no youth suicides.

Mind-Body Skills Groups at Standing Rock.

Mind-Body Skills Groups at Standing Rock.

The success of the program inspired the US Department of Health and Human Services to award a grant to the Little Wound School to bring the CMBM model to every child in all 7 of the reservation’s tribal schools, and to all the children’s families and all their teachers.

Committed to bringing this missing piece to the Standing Rock Reservation and other indigenous communities, to Syrian refugees throughout the Middle East, and to communities in the US which are severely challenged economically, and divided by racial mistrust, I believe that our model of providing community-wide trauma relief is needed more than ever. We invite you to become a part of our work and to support it – to join our healing community.


James S. Gordon MD, a psychiatrist, is the Founder and Executive Director of The Center for Mind-Body Medicine, a clinical professor of psychiatry at Georgetown Medical School, and author of Unstuck: Your Guide to the Seven-Stage Journey Out of Depression. He will also be leading trauma workshops in February and July at the Kripalu Center for Yoga & Health.

The Center for Mind-Body Medicine is expanding their professional trainings to meet the needs of all those who want to serve their communities. You can find out more about their upcoming US trainings on our website. CMBM.org. On the website you’ll also find articles and videos that feature their work with population-wide trauma – from The New York Times, The Washington Post, The Atlantic, and CBS 60 Minutes – as well as other information about their global trauma-relief programs.

Lessons From The Pandemic Frontline

This guest blog post is by Jeremy Farrar, the Director of the Wellcome Trust and TEDMED 2016 Speaker. You can watch his TEDMED talk here.


Working through an epidemic of an untreatable disease is the most frightening thing I’ve ever experienced. As a doctor, there is no worse feeling than telling a patient you have no treatment, but this was exactly the degree of helplessness felt during SARS and in West Africa during the Ebola epidemic.

Thankfully, with trials now confirming the 100 per cent efficacy of the rVSV Ebola vaccine, such fears surrounding the disease are beginning to subside. We should now be able to contain Ebola – at least if we can get the vaccine to those that need it. But these positive results shouldn’t stop us from taking stock and questioning what needs to be done to prepare us for the next emerging infectious disease, whatever it may be.

The Ebola vaccine trials were of course a remarkable success, and not just because of the numbers. They showed that, by working collaboratively across international borders and sectors, we can develop and test vaccines rapidly. The global coalition that worked on the vaccine achieved in a year what would normally take decades and, uniquely, developed a vaccine within an epidemic. That is something that has never been accomplished before, and a testament to what can be done when we collaborate.

So when Ebola next reappears – and it will – we will be ready. But we must remember that we weren’t ready last time. Because we were reactive, we were far too slow, too late. Over 11,000 people died in West Africa, and the economic cost to the countries affected runs into billions of dollars.

It’s important too to remember that the partnership that delivered the vaccine – involving pharma, philanthropic organisations, governments, regulators and NGOs – was an ad-hoc one, hugely reliant on the goodwill of those involved. This way of working, while inspiring, is neither reliable nor sustainable in the long term.

The partnership’s success was also based on having Ebola vaccine candidates ready to be tried in humans at the beginning of the outbreak. For MERS, Zika and many others, there are not yet such candidates.

We must start developing tools to fight these diseases now, and set up the permanent partnerships and systems necessary to do so. Progress is being made. The WHO has drawn up a blueprint for R&D to prevent epidemics and a new global public-private coalition – CEPI – has been established to advance the development of new vaccines for epidemic diseases so that we have candidates ready to test when an outbreak occurs.

But preparedness doesn’t end with the development of vaccines. While in 2016 many were watching the Zika emergency unfold, in central Africa another great but under-reported crisis was emerging: a large outbreak of yellow fever. It began months before the alarm was raised, gathering momentum in Angola and the DRC while diagnostic tests on its first victims were still being run in foreign labs, as there were no suitable facilities close by.

Once the magnitude of the outbreak became clear, it was quickly understood that the world’s emergency stockpile of the yellow fever vaccine would be insufficient – and likewise its capacity to manufacture new doses in time. Ultimately the outbreak was contained: other countries donated their vaccine stockpiles, doses were diluted to spread coverage, and a huge immunisation campaign was implemented – all thanks to a well-coordinated collaboration between the WHO, governments, health authorities, NGOs and volunteers. But again we were lucky.

If the stories of these two outbreaks seem largely doom and gloom, they shouldn’t. They show us what amazing things we can do when we work together, against what at times may seem like long odds. And they show us that, despite what the cynics and scaremongers say, we do have the ability to prepare for and fight against emerging infectious diseases. If we don’t yet have the tools, we can make them. We have the ability to make the world a safer place.

And in showing us our shortcomings, the histories of these outbreaks show us the way forward. If we want to make the world safer, we cannot be passive bystanders. We must be proactive in the face of health challenges in order to be a step ahead, or else expose ourselves to vast risks – and the dreadful consequences that can accompany these.

In a world of denser cities, increased international travel, migration and ecological change, the ability of emerging infectious diseases to spread and cause devastation is increasing. That’s not going to change, which means we have to. We’ve shown already that we can respond effectively to epidemics. Now we need to demonstrate that we can prepare for them effectively too.

Finding Time to Recharge and Reconnect

The ending of one year and the start of another lends itself well to reflection and reconnection.  Like so many of you, the TEDMED team values this time of year because it allows us to reconnect with friends and family while also taking time to be thoughtful about the year to come. As this year draws to a close, we look forward to unplugging and spending quality time with family and friends, writing down reflections of the past year and intentions for the new one, spending time outside in nature, and finally reading that book we picked up at this year’s onsite bookstore.

As we prepare to take some time off, we were curious to know how some members of the TEDMED community rest and recharge their minds and bodies as they enter into the New Year.  In response to specific questions, Jim Gordon, Lucy Kalanithi, Mark Zhang, Sarah Outen, and Sharon Terry shared with us the ways in which they recharge this time of the year.  We hope you find their responses as inspiring as we do and hope they are helpful as you think about how you will spend this time of year.

The first question we posed was: How do you use this time leading up to and entering the New Year to unwind or reflect?”

In their responses, these community members explain that they use this time as an opportunity not only to reflect and recharge, but also to “rebalance,” as Sarah Outen edsc_9130xplained. In the wake of what Sarah describes as a “full on year with its own storms and mountains” she plans to increase her time meditating and exercising as she “reflects on the past year and looks ahead to the shape of the next year.”  As we each reflect on the various storms and mountains unique to the past year of our own lives, we might benefit from what Jim Gordon describes as “going inward.”  Jim shares that “this will be, as the season urges, a time for me to go inward, to appreciate my connection with nature, and also to become aware of and let go of attitudes, worries, concerns, and recriminations that no longer serve me, if they ever did.”  

Part of this process of going inward involves meditation and reflection, something that Sharon Terry plans to spend extra time jh1_7100doing in the coming weeks.  She shared with us that her method for reflection “is a combination of writing, reading, and engaging in wonderfully deep conversation with family and a few close friends.” Similarly, Lucy Kalanithi unwinds and reflects by focusing on “mindfulness meditation, reading books and getting enough sleep!!” Lucy adds that exercise, family, and friends help to keep her going throughout the year.  Sleep seems to be an important component of this time of the year for all.  As Mark Zhang put it, “The holiday season is my time to enjoy time with my son, good food, and even better naps.”

We also asked: “In what ways will you be connecting with loved ones and yourself over the next few weeks?”

Connection with family and friends was top of everyone’s list for the coming weeks.  Lucy looks forward to celebrating Christmas with family in Southern California, which she explains that, after growing up in cold-weather climates, “still feels weird, and it still feels like a huge treat.”  Jim uses the time to call his brothers, children, god-children and, “any man or woman who has a speciimg_5275al but not recently visited” place in his heart, adding that he feels “a palpable joy in each of the connections and in the web that links all of us.” Reconnecting with family and friends is important to Sarah who, having recently completed her nearly 6-year London2London journey around the world, says that “after so many years away I am really glad to have time ahead with my family and friends.” Mark also plans on spending quality time with family, specifically by “reading more Richard Scarry books with my son!”

The usual time spent with family over the coming weeks will include some new themes for Sharon. She and her husband plan to have a “deep dive conversation” with their 2 children and their spouses, specifically discussing their plans for 2017, asking “how will they make space for the things that nurture them and their dreams,” and what Sharon and her husband can do to help. Sharon and her family will also be engaging in a conversation about end-of-life and death, something that was explored throughout TEDMED this year.  She will be having what she describes as “a death dinner!” during which she and her husband will share what they want the end of their lives to look and feel like, and ask that their family and close friends commit to making that happen. At TEDMED, we love this idea of a “death dinner,” which reminds us of Michael Hebb’s 2013 talk, “What happens when death is for dinner?” Sharon said that this dinner may seem sort of odd, but she loves the idea of communicating their decision with family and friends, adding that “they are up for it! They are used to how weird we are!”  

Finally, we wanted to know, “What are you looking forward to most in 2017?”

So much of what each community member is looking forward to in 2017 connects back to family, but also to their work, which is a source of great purpose, passion, and fulfillment to each.  The organization Sharon founded, Genetic Alliance, is marking its 30th anniversary, and she and her team are excited for what the future holds.  She told us that they have spent nearly 6 months “in profound contemplation” of what they want to be in the world, animg_3513d they discovered that their “heart and soul is in enabling a path for people to be authentically involved in all aspects of health – at home, in health care services and in biomedical research.” Mark shares that he and his colleagues at Cake are “excited to be in the inaugural cohort of companies participating in PULSE@MassChallenge in 2017” and that they will be rolling out new features to Cake.  We look forward to following the increasing impact that both Genetic Alliance and Cake are sure to have for those who are in search of better health.  

Lucy shared that in 2017 she will continue speaking about her late husband’s memoir, When Breath Becomes Air, while also prioritizing advocacy “for patients, caregivers, and for all those who need compassion from us and from our new President.” This intention to work for greater compassion and understanding in the wake of 2016’s tumultuous election is shared by others.  Jim explained that for him the election was a wake up call and a “summons to reach out to and find common ground with people who appear to look at the world very differently” from him.  Sharon commented that “as we enter 2017, America is not a predictable place, nor is the globe.” One of her intentions for 2017 is to explore the questions: “How can we love each other amid the massive strife on the planet for plants, animals and people? How can we love each other in our differences?” adding that she looks forward to the “joy and the pain in the undertaking” of finding the answers.

img_4632In 2017, these community members also intend to deepen their connections with family and continue what Sharon refers to as “inner work.”  For Lucy, 2017 will be filled with the joy brought by her growing toddler, Cady, who is “talking up a storm.” Jim is looking forward to watching his 14 year old son “drive to the basket” and also to “exploring the world with the little children” in his life.  For Sarah, the transition back into life at home following her London2London journey has been challenging at times, so in 2017 she is aiming for balance, “hoping to find increasing peace,” and looking forward to spending more time with loved ones. Sharon will continue to be deeply committed to her inner life work and growth as a path to serving the world. She shared with us that she will be entering a long-term study program called Gestalt Practice, “the aim of which is unfoldment, wholeness, and growth” that will, she explains, help her to follow and trust her own process, adding that, “it will help me get out of the way of meaningful growth.”

We hope these thoughts and reflections from some members of the TEDMED community have inspired you as you enter into this holiday season, bid adieu to one year, and welcome in a new year.  
From all of us at TEDMED, we hope you have a very happy and healthy holiday season. We look forward to collaborating with you in the year ahead!

WHAT IF you made earning a college degree a community goal?

This post is tenth in a guest series from the Robert Wood Johnson Foundation, about the winners of its 2016 RWJF Culture of Health Prize.

What does a college degree have to do with health? Quite a lot, says Mary Gwen Wheeler, executive director of 55,000 Degrees. Her organization has an audacious goal: see to it that at least half of adults in Louisville, Ky., have an associate degree or higher by 2020.

People with college degrees enjoy higher average incomes, are less likely to have ever smoked or to be obese, have fewer divorces and are more likely to exercise compared to those without a degree.

“We set this goal because we saw it as a proxy for increasing quality of life,” Wheeler says.

The dozens of business, education and community-based partners that launched 55,000 Degrees in 2010 have witnessed significant progress. The number of high school students who graduate with the skills to attend college and start their careers reached 63 percent last year, compared with 45 percent in 2012. The number of college students completing degrees has gone up at 4-year institutions, even as enrollment has gone down.

“We’ve been able to move all populations, but we haven’t been able to close the gaps” between white and minority students, Wheeler says. “That led us to the mayor’s Cradle to Career initiative. We understood we needed to start much earlier.”

Now 55,000 Degrees is one of four organizations with lead roles in a continuum of programs that begin with preschool and bolster education and training for Louisville residents beyond their high school and post-secondary graduations.

  • The United Way will spearhead work to get more children into quality preschool programs and prepare more than three-quarters of students for kindergarten by 2020, compared to about half today and a little more than one-third a few years ago.
  • The school district aims to have every student reading at grade level by the end of third grade. By 2020, it plans to raise the number of students who graduate from high school to more than 9 in 10 and ensure that 85 percent of high school graduates enroll in college, using steps such as summer coaching to keep new graduates on track.
  • The nonprofit KentuckianaWorks offers training and programming to give working-age residents the skills to get jobs and succeed in the region’s manufacturing, tech and healthcare sectors.

Taken together, these efforts will ultimately give more Louisville residents a chance at obtaining a degree—and a better life.

WHAT IF you used a land trust to build a grocery store and a movie theater — and give residents a greater sense of social connectedness and well-being?

This post is ninth in a guest series from the Robert Wood Johnson Foundation, about the winners of its 2016 RWJF Culture of Health Prize.

With just four screens and an unassuming Art Deco marquee, the 24:1 Cinema in Pagedale, Mo., may not seem like much to an outside observer. But to Alderwoman Marla Smith, the one-year-old movie theater’s lights are “eye candy” and a herald of the renaissance she fervently wants for her city.

“When I was a little girl, Pagedale was popping,” says the 44-year-old mother of three. People owned their homes and lived in them in this small municipality that is one of two dozen northwest of St. Louis, Mo., known collectively as the 24:1 Community. Big employers such as the Lever Brothers soap factory and the Stix, Baer and Fuller department-store warehouse anchored the community.

But by the mid-1980s, many Pagedale businesses were in decline or had shuttered. Unemployment rose, and X-rated movies were showing at the Olympic Drive-in. There hadn’t been a grocery store since the 1960s. Houses went dark when homeowners lost their jobs and mortgages.

In the 1990s, Mayor Mary Louise Carter and the neighborhood development group Beyond Housing began working together to replace dilapidated homes and vacant lots with affordable housing. Then about 10 years ago, they began meeting with residents to ask what else would make their lives better.

“Everybody agreed that a grocery store they could walk to and get fresh fruits and vegetables and get healthy meals was one of the first things they wanted,” Carter says.

It seemed a simple enough wish, but enticing a developer to build a store in a low-income community proved challenging. In the end, Beyond Housing financed construction with local taxes, and discount supermarket chain Save-A-Lot agreed to run the store, which opened in 2010.

A flurry of other development projects aimed at making Pagedale more livable and walkable has since brought in senior housing, a bank, and the cinema—all within a few blocks of each other. The city has used grant funding to repave the formerly uneven, unlit sidewalks near the theater and supermarket and has added streetlamps. A barbershop, health clinic, and county social services center will open next to the theater this year.

Because the cinema and supermarket are owned by a community land trust, their profits fund neighborhood development, which is a boon for Pagedale and the surrounding municipalities.

Though it might take some time, one of Smith’s biggest hopes is to attract a family restaurant to downtown Pagedale.

“Who wouldn’t want to go have dinner and go to a movie?” she says.