Kenneth Bridbord

A Personal Perspective on the Initial Federal Health-Based Regulation to Remove Lead from Gasoline

Objective This article describes the personal experience and perspective of the authors, who had primary responsibility for drafting the initial health-based regulation limiting lead content of gasoline during the early 1970s while employed by the U.S. Environmental Protection Agency (EPA). Data source Information used by the U.S. EPA in developing the initial health-based regulation limiting lead content of gasoline in December 1973 and studies documenting the impact of that and subsequent actions. Data extraction Among the lessons learned from this experience is the importance of having input from independent scientists to the regulatory decision-making process. This also demonstrates the critical role of independent peer-reviewed research, such as that supported by the National Institutes of Health, as well as research conducted by scientists from the Centers for Disease Control and Prevention, in delineating the consequences of lead exposure in the population. Data synthesis Removal of lead from gasoline in the United States has been described as one of the great public health achievements of the 20th century, but it almost did not happen. The experience of the authors in developing this regulation may be helpful to others involved in developing health-based regulatory policy in the future. Conclusion The initial U.S. EPA health-based regulation to remove lead from gasoline is clearly an example where science successfully affected public policy. The leadership of the U.S. EPA at that time deserves much credit for establishing an atmosphere in which this was possible.

Global Health: The Fogarty International Center, National Institutes of Health: Vision and Mission, Programs, and Accomplishments

The Fogarty International Center (FIC) of the US National Institutes of Health has supported long-term training and research for more than 3600 future leaders in science and public health from low-income and middle-income countries; tens of thousands more persons have received short-term training. More than 23 extramural training and research programs plus an intramural program are now operating. Newer FIC training programs are addressing chronic, noncommunicable diseases and strengthening the quality of medical schools and health care provider training. Most FIC trainees return to their countries of origin, where they mentor and train thousands of individuals in their home countries.

Principles of building the global health workforce

Publisher Summary Recent past has brought a sea change in the attention focused on global health problems, and a determination to take action to alleviate the distress. There is a broadening of political will and support beyond the traditional humanitarian base to include economic, security, diplomatic, scientific, ecologic, and other self-interests that favor aid growth of global health assistance. The entire spectrum of government and nongovernment organizations is increasingly focused on global health, as evidenced by the setting of the UN Millennium Development Goals to be achieved over the next decade, and dramatic commitments of additional funds by government and nongovernment sources. A critical limiting factor in the response to the formidable global health challenge is the paucity of human resources in most low- and middle-income nations. Help is needed at all levels, from national leadership and planning to the most downstream interactions of health workers with individuals and communities. It is believed that certain key factors/principles are core to the success of health-training activities, whether the focus is clinical, research, public health, or administration/infrastructure building. There is a growing consensus in the scientific community that the determinants of infectious diseases are much more complex than simply the traditional host–pathogen interaction, and that social, economic, ecological, and political factors are powerful forces.