PacificSci GLOBAL PERSPECTIVES goes into HIBERNATION!

After more than 7 years of blogging (89 posts including this one), we wish to announce that we are suspending our involvement in this activity indefinitely, or at least until further notice.

All our existing posts will remain available on-line, and there is a lot of material there now for people who might like to browse on our observations since we began this blog on November 25, 2006.

Creating and maintaining this stream of information, observation and opinion has been a significant challenge, yet an invaluable source of motivation for us to keep up with global policy related issues.

However, as both principals (Franklin White and Debra Nanan) are now more engaged in editorial work of a more formal nature e.g., journal articles, and recently the book GLOBAL PUBLIC HEALTH - Ecological Foundations (see sidebar to the right), and thereby contributing actively to the more formal health and life science literature, the time has come for us to channel our energies more emphatically in those directions.

Needless to say, we reserve the right to reactivate this blog at some future time, especially as we may miss the discipline of developing monthly material of a less formal and eclectic nature.

In the meantime, we thank our readers for their interest, and the growth in readership that has taken place, which is now in excess of 1,000 visits per month, and steadily approaching 50,000 blog lifetime visits.

Best wishes to our readers and supporters around the world!

Frank and Debra

INTERNATIONAL AND GLOBAL DEVELOPMENT - YEAR IN REVIEW 2013

PREAMBLE: This, our 7th annual review of topics covered over the preceding year. As is our custom, we lead with praise (“flowers”) and criticism (“fertilizer”) in 3 categories: global stewardship, international development, and human rights. A synopsis of monthly blog themes follows.

1. Global Stewardship

Flowers for leadership go to Nelson Mandela (1918-2013) who passed away in South Africa on December 5, 2013.  His life exemplified what authentic global leadership entails, including the meaning of truth and reconciliation. To represent his gift to us, we offer the wisdom of his words: “…to be free is not merely to cast off one's chains, but to live in a way that respects and enhances the freedom of others."

The fertilizer award goes emphatically to the Republican Party (RP) in the USA: what a contrast this makes! Watching the spectacle of continual obstructionism, it was difficult to accept that the USA – a nation often projected as leader of the free world – was subjected to what can only be viewed as a form of sedition by self-proclaimed defenders of political freedom, threatening default on U.S. debts despite a fragile global economy already weakened by irresponsible U.S. banking and investment practices.

2. International Development

Flowers again go to the many Developing Countries (DCs) for progress in addressing major planks of the Millennium Development Goals (MDGs). Last year we recognized DCs collectively only in reference to improved access to potable drinking water. However, we now wish to expand (and amend) that accolade to include the following accomplishments achieved by many ahead of the 2015 target.  Here are highlights, captured from a report published by one of us in late 2012

Reference: White F. What’s New in Public Health? Med Princ Pract 2012;21:505-507 (DOI: 10.1159/000342566)

·        *  Extreme poverty is falling in every region and the poverty reduction target has been met: the global poverty rate at $1.25 a day fell to less than half the 1990 rate by 2012. 

·        *  The target of halving the proportion of people without access to improved water sources has been met: the proportion using an improved source rose from 76% (1990) to 89 % (2010).

·        *  Improvements in the lives of urban dwellers exceeded the slum target: The share of urban residents living in slums declined from 39% (2000) to 33% (2012).

·        *  Parity in primary education between girls and boys has been achieved globally: The gender parity index now falls within the margin of error for 100.

·        *  Many countries made significant progress towards universal primary education. Enrolment rates increased markedly in sub-Saharan Africa, from 58% to 76% (1999-2010).

·        *  Child survival progress is gaining momentum. Despite population growth, under-5 deaths worldwide fell from more than 12.0 million (1990) to 7.6 million (2010).

·        *  Access to treatment for people living with HIV increased in all regions. At the end of 2010, 6.5 million people were receiving antiretroviral therapy in developing regions. The 2010 target of universal access, however, was not reached.

·        *  The world is on track to begin reversing the spread of tuberculosis. Globally, incidence rates have fallen since 2002; projections suggest that the 1990 death rate will halve by 2015.

·        *  Global malaria deaths have declined. Incidence decreased globally by 17% since 2000, while associated mortality rates decreased by 25%.

The fertilizer award in this category goes to Canada’s Conservative government.  For this there are many reasons, from failure to participate meaningfully in global climate initiatives, to withdrawal from the UN Convention to Combat Drought and Desertification, to reneging on provisions supporting the health of refuges accepted into Canada. However, for focus, we select just one: the merging of a once respected Canadian International Development Agency (CIDA) into a new Department of Foreign Affairs, Trade and Development.  This has rendered this once independent agency subservient to Canada’s trade interests. The agency recently recommended reducing or ending aid to the Sudan because it is not of strategic importance” t Canada. The report, entitled Reviewing CIDA’s Bilateral Engagement, shows the federal government evaluated commercial opportunities in dozens of developing countries to help determine how foreign aid should be disbursed. Shame!

Reference: The Globe and Mail, January 10^th, 2014. http://www.theglobeandmail.com/news/politics/cida-recommends-cutting-sudan-aid-as-south-spirals-into-new-violence/article16276683/

3. Human Rights

We offer flowers to whistle-blower Edward Snowden, for revealing the extent of US National Security Agency’s electronic snooping on the private lives of innocent people in other countries (as well as its own).  Surely this is nothing less than a complete sell-out of human dignity: its widespread acceptance in the US "homeland security" subculture is a wake-up call regarding the deterioration of common decency.

Worse, there is evidence of collusion by authorities in other countries (including Canada) even to the detriment of their own citizens. For a case study of a disabled Ontario woman wishing to take a package cruise out of New York, then denied entry to the US because of her history of "mental illness" (clinical depression) that no US "authority" should ever have had the privilege of knowing about, is revealing of how insidious, pervasive and inhumane this has become. For a review of this episode visit: http://www.thestar.com/news/gta/2013/11/29/access_to_canadian_health_files_by_us_border_agency_sparks_demands_for_inquiries.html

So who should we take reassurance from in this matter: defenders of the snooping trades (a growth industry), or advocates for human rights? Snowden's revelations have been enlightening.  However, they do not stand alone: we can make our own observations and interpretations about a security subculture out of control. 

At the other end of the spectrum, we confer a deposit of rather smelly fertilizer to the US National Security Agency and their bedfellows: obviously they all need to clean up their act!

January 2013:  New Textbook Release: GLOBAL PUBLIC HEALTH – ECOLOGICAL FOUNDATIONS

"Global Public Health - Ecological Foundations", published by Oxford University Press (New York), , and illustrated at the top of the sidebar at right, offers important new work by Franklin White, Lorann Stallones and John M Last.  Written for students of public health, development studies and environmental studies, the book should also interest other readers seeking a perspective on the global health and related environmental challenges that face our planet. 

ABOUT THE BOOK

With an emphasis on ecological foundations, this book approaches public health principles-history, foundations, topics, and applications-with a community-oriented perspective. By achieving global reach through cooperative, community-based interventions, this text illustrates that the practical application of public health principles can help maintain the health of the world's people.

Blending established wisdom with new perspectives, Global Public Health will stimulate better understanding of how the different streams of public health can work more synergistically to promote global health equity. It is a foundation for future public health measures to be built and to succeed.

Features

• Ecological approach to public health
• Full global scope, including developing countries
• Describes integrative approaches that are locally applicable
• Community-centric approach to public health

Table of Contents

Preface

1. History, Aims and Methods of Public Health

2. Scientific Basis of Public Health

3. Philosophical and Ethical Foundations of Public Health

4. Community Foundations of Public Health

5. Health of Populations: health situation analysis & public health surveillance

6. An Integrated Approach to Disease Prevention and Control

7. Air, Water and Food Safety and Security

8. Public Health Organization and Function in Evolving Health Systems

9. Global Ecology and Emerging Health Challenges

Epilogue

Reviews

"Global Public Health: Ecological Foundations is stunning proof of the power of global thought and focused scholarship. It is simultaneously ambitious in scope and simple in approach, and the result is the definitive textbook for anyone studying public health at any level. I warmed to this book from the first page and could not put it down."

-- Hugh H. Tilson, MD, DrPH
Professor of Public Health Leadership, Epidemiology, and Health Policy, Gillings School of Public Health, University of North Carolina

"People across the globe are more connected now than ever before. This important new work by White, Stallones, and Last clearly articulates the power of this connectedness and the potential to improve health across the levels of an ecological framework. The authors effectively communicate the core principles of public health and relate these to a variety of critical global health issues."

-- Ross C. Brownson, PhD
Professor and co-director, Prevention Research Center, Washington University in St. Louis, St. Louis, Missouri

For additional details on authorship, and information on pricing, ordering and shipping, visit Oxford University Press at: http://www.us.oup.com/us/catalog/general/subject/Medicine/EpidemiologyBiostatistics/?view=usa&sf=toc&ci=9780199751907

February 2013: New Textbook recognizes GUN VIOLENCE AS A PUBLIC HEALTH PROBLEM

According to the US Centers for Disease Control and Prevention, guns kill more than 31,000 people each year in the U.S., including more than 11,000 homicides. The U.S. homicide rate is seven times the average of other high-income countries.[1]  

Yet, most public health textbooks from the United States (there are exceptions) give minimal attention to gun violence. For example, in the index of Public Health & Preventive Medicine (15th edition, 2008), the most comprehensive public health textbook published in the US, the word “gun” does not appear at all. By contrast, in the 12th edition (1986), “gun” was allocated six index lines. Why this apparent reduction in the higher educational recognition of a public health problem, when the problem itself has grown 50% in the interim? 

This does not mean that the issue is going unrecognized in the US public health community. To the contrary, on the heels of a deadly massacre of primary school children in December (Newtown CT), on January 14th and 15th, the Johns Hopkins University brought together more than 20 leaders in gun policy and violence—representing the fields of law, medicine, public health, advocacy and public safety—for the Summit on Reducing Gun Violence in America. 

Within weeks of the Summit, the Johns Hopkins University Press will publish the book, Reducing Gun Violence in America: Informing Policy with Evidence and Analysis. Collected for the first time in one volume, this reliable, empirical research and legal analysis will inform the policy debate by helping lawmakers and opinion leaders identify the policy changes that are most likely to reduce gun violence in the U.S…. Copies of the book will be delivered to policymakers from across the country, including members of Congress and the Administration.

In the meantime however, Oxford University Press has already published Global Public Health – Ecological Foundations, illustrated at the top of the sidebar at right (and see last month’s blog for details). This new text book includes a case study on gun control as a community work in progress in the US; the index makes explicit reference to gun control, the Brady Bill and the adversarial role of the NRA.

March 2013: BEATIFICATION & SAINTHOOD?: A CASE TO RECONSIDER IN THE 21ST CENTURY

This month’s blog showcases a report extracted from the website of the Université de Montréal, authors cited, to whom belongs full credit. We did so as a way of asking whether the practice of beatification (third step towards sainthood), as illustrated by Mother Teresa, might be standing in the way of the Catholic Church moving forward to full acceptance of a literate thinking world, and thereby impeding its good pastoral work in many local settings around the world. This choice of blog topic is intended to support freedom of expression, with the hope that the need for extensive reform in the Catholic church will indeed follow the appointment of a new leader in Pope Francis. It is not intended to diminish Catholicism as a faith.  The researchers conclude that her hallowed image (not supported by the facts) was constructed, and that her beatification was orchestrated by an effective media relations campaign.

Source: Mother Teresa: anything but a saint... UdeMNouvelles March 1, 2013 http://www.nouvelles.umontreal.ca/udem-news/news/20130301-mother-teresa-anything-but-a-saint.html

Note: On March 11, Argentine Cardinal Jorge Mario Bergoglio was elected pope. Son of an Italian immigrant, he is celebrated as the first from outside Europe to become pope in over a millennium; also, the first from the ascetic Franciscan Order to be so installed, he will be known as Pope Francis after Saint Francis of Assisi.  It is hoped that he will lead the Catholic Church out of a wasteland of moral deficits, the most glaring being the sexual abuse of minors inflicted by priests in numerous countries.

April 2013: CANADA MERGES INTERNATIONAL DEVELOPMENT WITH FOREIGN AFFAIRS AND TRADE – Bold Vision or Policy Blunder?

As noted in our fertilizer award in the International Development category, the merging of a once-respected Canadian International Development Agency (CIDA) into a new Department of Foreign Affairs, Trade and Development has rendered this once independent agency subservient to Canada’s trade interests. Canada, under its current highly Conservative government, seems ever more committed to shrinking its role in global leadership. Announced March 22, CIDA, will be merged with foreign affairs and trade into a newly named Department of Foreign Affairs, Trade and Development. Rumours of CIDA's demise as a stand-alone department had been circulating since its budget was drastically slashed in 2012. The decision to merge it with foreign affairs and traded has attracted criticism from aid organizations and opposition members alike.  As stated in the blog, Canada's reputation in the global development agenda is a big thing to gamble. The proof will be in the pudding: let us now see whether Canada’s international development performance will improve under this new regime, or whether it will continue to lose its way on the world stage. The move requires new legislation and no timeline has been put forward.  Perhaps our best hope for a more progressive country lies in the next federal election. 

May 2013: CANADA WITHDRAWS - UN CONVENTION TO COMBAT DROUGHT AND DESERTIFICATION

The Conservative Government of Canada,  has shamed the nation in the eyes of many of its citizens and the world at large, by withdrawing from a United Nations treaty to combat drought and encroaching deserts mostly located in developing countries.   For this post, we drew from the blog of Elizabeth May, Leader of the Green Party of Canada, which also drew from a statement from the Honorable ralph Goodale, former Liberal Finance Minister, among other notable commentators.  Further:

“Canada’s diplomatic corps is shocked. Former Ambassador to the United Nations, former Deputy Minister of National Defence and victim of a terrorist kidnapping in Mali, Robert Fowler, sent an email to the media. Calling our withdrawal from the treaty ‘a departure from global citizenship,’ here’s what he said:  ‘It (the Harper administration) has taken climate-change denial, the abandonment of collective efforts to manage global crises and disregard the pain and suffering of the peoples of sub-Saharan Africa (among many others) to quite a different level.’Responding to Foreign Minister John Baird’s defence that Canada won’t ‘go along to get along,’ Fowler continued:  ‘…Such vainglorious nose-thumbing at the international community’s efforts to tame a very present threat to hundreds of millions of the world’s poorest and most desperate is nothing short of incomprehensible.’  Another former Ambassador to the United Nations, Paul Heinbecker, agreed that the move was both inexplicable and bound to confirm to the international community that Canada cared nothing for climate action, nor for the fate of Africa. The UN itself was shocked. Noting that Canada will now be the only nation on earth not part of the convention, it, in typically understated diplomat-speak, called Canada’s decision ‘regrettable.’ 

June 2013: FOOD SYSTEMS FOR BETTER NUTRITION........ A Case Study - System of Rice Intensification (SRI)

This issue focused on two items:  1. A report recently released by the United Nation’s Food and Agricultural Organization (FAO 2013), entitled  “Food systems for better nutrition” which notes that that improved food systems can make food more affordable, diverse and nutritious. 2. A Case Study of the System of Rice Intensification (SRI). The benefits of SRI use include: increased yield, water conservation, reduced production costs, and increased income. However, it is unclear how much better SRI is at delivering increased yield and other gains to rice farmers, such as healthier soils, when compared with established recommended best management practices for rice production. According to the IRRI, "The flexibility in SRI’s definition of practices renders SRI a challenge for evaluation and assessment of adoption."; this implies difficulty in evaluation, with critics claiming a lack of details on methodology used in trials, and few peer-reviewed publications.

July 2013: EQUAL PROTECTION BEFORE THE LAW - Does it really exist in the United States?

This blog draws attention to a 2012 world survey of the rule of law, which consistently finds that the US ranks poorly relative to its peers (the bottom 20% of wealthy nations) in term of equal protection under criminal law; in some categories the US ranks below some developing countries such as Botswana and the Republic of Georgia. The blog was written on the heels of the Travon Martin case, in which a white vigilante (George Zimmerman) was acquitted of killing a black teenager walking near his home, thus upholding a controversial Florida “stand-your ground” law.  Around the world this was viewed by many as a travesty of justice, even as “access to justice” is said to be a core American value.  The lead prosecutor for the state of Florida declared that theirs was “the best justice system in the world”.  

August 2013: REFUGEES, ASYLUM SEEKERS, DISPLACED AND STATELESS PERSONS – A Primer

This issue lays out the mainstream terms used in this increasingly complex field of humanitarian concern, and offer a selection of statistics on the dimensions of the refugee movement globally. Our sources include Refugees International (RI), a US based organization started in 1979 as a citizens’ movement to protect Indochinese refugees. Since then, RI has expanded to become a leading advocacy organization that provokes action from global leaders to resolve refugee crises. RI does not accept government or UN funding. We select global trends (2012) from the United Nations High Commissioner for Refugees (UNHCR) publication on Displacement the New 21st Century Challenge, and we develop a brief statement on “environmental refugees” from a National Geographic sources (references cited below).

September 2013: New Publication: A GLOBAL REVIEW OF PUBLIC HEALTH EDUCATION & CAPACITY BUILDING

This month we drew attention to a comprehensive review by Franklin White, on the topic of “The Imperative of Public Health Education: A Global Perspective.”  Published in the peer reviewed journal Medical Principles and Practice, this full text article is available on-line free of charge as noted below:

Full Reference and Link to article: White F. The Imperative of Public Health Education: A Global Perspective. Med Princ Pract 2013 August 21 DOI: 10.1159/000354198 [Epub ahead of print] http://www.karger.com/Article/FullText/354198

October 2013: LAUNCHING UNIVERSAL HEALTH CARE IN THE UNITED STATES – Global Perspective

In the USA, the private sector has long dominated health care, yet has failed to meet the health needs of ~50 million non-insured people, about 20% of the population. The Patient Protection and Affordable Care Act (modeled after a system now in place in Massachusetts brought in by former Republican Governor George Romney, but dubbed “Obamacare” by political opponents), intends that everyone has access.

Dramatic changes are taking place: under this legislation (to be fully phased in by 2020), the US will begin to close the gap on universality and other deficiencies will be addressed. The legislation was upheld by the Supreme Court on June 28, 2012, against challenges by numerous states and individuals and the National Federation of Independent Businesses. Nonetheless, even with this policy shift, the US will remain the only developed nation that depends predominantly on a private insurer, private provider entrepreneurial model. This acknowledged, the US system also contains substantial public sector elements that will continue to grow: Medicare for the elderly (a universal single payer system, providers not directly employed by government); a program called Medicaid to address essential health care for low-income families based on eligibility criteria, financed jointly by state and federal governments; Veteran’s Affairs health care (a single payer system, providers employed by the Department of Veterans Affairs, but not applied to persons in active service who are covered by private insurers under “Tricare” - an employer based insurance scheme).

The Patient Protection and Affordable Care Act (passed 2010) is too complex to address fully here. People of developed countries with equitable systems will find US barriers to health care access and/or affordability to be instructive, e.g., insurance companies deny coverage for pre-existing conditions – a practice to cease in 2014.  Readers interested in further information on Act as upheld by the US Supreme Court, a summary of key features is available at: 

Senate Democrats  http://dpc.senate.gov/healthreformbill/healthbill04.pdf

Wikipedia has also been updated on this topic: http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act 

November 2013: CANADA' CONSERVATIVE GOVERNMENT MUZZLES SCIENTISTS

This issue reports on a survey commissioned by the Professional Institute of the Public Service of Canada which found that 90% of federally employed scientists feel they are not allowed to speak freely to the media about the work they do and that, (if contesting) a departmental decision that could harm public health, safety or the environment, nearly as many (86%) would face censure or retaliation for doing so.

The survey, the findings of which are included in a new report titled The Big Chill, is the first extensive effort to gauge the scale and impact of “muzzling” and political interference among federal scientists since Canada’s Conservative government introduced communications policies requiring them to seek approval before being interviewed by journalists. Information Commissioner Suzanne Legault is currently conducting her own investigation of the policies, which have been widely criticized for silencing scientists, suppressing information critical or contradictory of government policy, and delaying timely, vital information to the media and public.

FULL REPORT: http://www.pipsc.ca/portal/page/portal/website/issues/science/pdfs/bigchill.en.pdf  

December  2013: A DECADE OF SOCIAL ENTERPRISE Celebrating the 10th Anniversary of Pacific Health & Development Sciences Inc. (PacificSci)

This posting was a candid account of the experience of Pacific Health & Development Sciences Inc., during its first 10 years of operation. During this period, PacificSci, as a “business venture with a social purpose” has succeeded in delivering on its mission:  “seeking solutions to health and social impacts of economic development”. Our “fourth sector” model of social enterprise has facilitated flexibility, so that we, as principals, can make choices we are comfortable with and motivated by professionally.

AND for 2014… we wish you all A HAPPY NEW YEAR!
We extend to readers our best wishes for 2014, with hopes that the global challenges of recent years will be better understood and more humanely managed going forward. 

A DECADE OF SOCIAL ENTERPRISE Celebrating the 10th Anniversary of Pacific Health & Development Sciences Inc. (PacificSci)

PREAMBLE: The term “Social Enterprise” is not yet a fully mature concept, and its various forms are continually evolving. In 2008, on our 5^th Anniversary, Pacific Health & Development Sciences Inc. (“PacificSci”) applied (in this blog) other terms to describe our company and its modus operandi: as “a hybrid organization”,[1,2] falling within the domain of “fourth sector” or “for benefit” enterprises. Such entities represent a new paradigm in organizational design, aiming to link two concepts often falsely held as dichotomous: private interest and public benefit.  Since 2008, the term “social enterprise”, perhaps being more intuitive in its meaning, seems to be gaining ascendancy.

Definitions for “social enterprise” vary globally.  The definition used by the Social Enterprise Council of Canada (SECC): … “businesses owned by nonprofit organizations,… directly involved in the production and/or selling of goods and services for the blended purpose of generating income and achieving social, cultural, and/or environmental aims.”[3]. Although based in Canada, PacificSci does not meet this restrictive definition as we are not “founded by” a non-profit entity.  However, we do fit the more inclusive definition of the Social Enterprise Alliance USA,[4] namely: “Social enterprises are businesses whose primary purpose is the common good. They use the methods and disciplines of business and the power of the marketplace to advance their social, environmental and human justice agendas.”  Perhaps the most neutral definition is that of Wikipedia: “…an organization that applies commercial strategies to maximize improvements in human and environmental well-being, rather than maximizing profits for external shareholders. Social enterprises can be structured as a for-profit or non-profit, and may take the form of a co-operative, mutual organization, a disregarded entity, a social business, or a charity organization.”[5]

Now, on our 10^th anniversary (December 8, 2013), the scope of PacificSci is mostly in international and global health and development - we know who we are and what we do, and label ourselves accordingly.  And as a legally constituted corporation in Canada, we fit most definitions of social enterprise, even if not the dominant one used in Canada.

Background Analysis

Before reviewing the story of PacificSci, we ask readers to revisit the observations below (first shared in our December 2008 blog) regarding conflicts confronting traditional organizations:

• Private companies have always had to balance between achieving the largest possible profits for their shareholders and retaining trust and contact with their other stakeholders: the local community, consumers, sub-contractors, pressure groups, etc.

• The public sector for years now has faced enormous political pressure in favour of privatization of a wide range of functions - and then being forced to 'repurchase' the very same functions and institutions when private companies no longer find them profitable.

• Voluntary organizations: fierce competition among voluntary organizations along with tight state financing has led to organizations experimenting with their independent income - the sale of services and new products. (For examples of this, visit the Social Enterprise Council of Canada website, already referenced below). However, pitfalls exist as certain activities and financial priorities can be at variance with an organization's main goals and mission.

Regarding the private sector, the recent and ongoing world financial crisis amply demonstrates that some firms are perceived as “too big to fail”, despite incompetent and unethical leadership e.g., the US bailing out its once mighty banking industry. Clearly, western industrialized nations are capitalist when going up, and socialist going down!

Equally, it is increasingly clear that neither public nor voluntary sector organizations truly operate in the “pure” manner traditionally implied. Increasingly public enterprises compete with the private sector, while the voluntary sector has become more commercially oriented.

For example, many voluntary not-for-profit organizations today operate with a fully funded core staff, supplemented by contract income, thus building handsome “working capital funds”, while remaining eligible for government grants.  In effect, such non-governmental organizations or NGOs (once mostly charitable organizations) have actually become a good “business model” with a competitive advantage over other types of organization.

In the meantime, many public sector (government) entities have become so hollowed out that they must hire private contractors to deliver the expertise that actually belongs with their public mandate. In addition to consulting firms, much of that expertise (sometimes hidden) is obtained from universities, themselves having become “hybrid” organizations. Even publicly funded universities now engage in industry partnerships while receiving government financing, and simultaneously contracting out services to government. See Menard, cited below.

In this complex scenario, where the traditional rules separating organizational forms are increasingly less applicable (if not broken), the emergence of hybrid/fourth sector/social enterprises is virtually inevitable, breaking with earlier concepts of relationships between the state, private and voluntary sectors.

Operating outside the world of grants, yet within the economic boundaries of surviving as a business, the bottom line for our company is nonetheless one of social purpose: in many ways we are participating in a modern renaissance of motivation to improve the human condition.

Note: A further development of this discussion can be found presented in our recent book Global Public Health-Ecological Foundations, published by Oxford University Press.[6]

With this backdrop we now update the short story of PacificSci as a fourth sector organization.

Feature Story – TENTH ANNIVERSARY OF PacificSci

Pacific Health & Development Sciences Inc. (PacificSci), was incorporated ten years ago, on December 8th, 2003, as a health systems consulting firm, with the mission of “seeking solutions to health and social impacts of economic development”.

As a joint venture of principals Franklin White (FW) and Debra Nanan (DN), currently President and Vice-President respectively, PacificSci was conceived primarily as a vehicle for our continued involvement in the field of public health, within which we had accumulated some 50 (now 70) years of combined professional expertise and experience. With FW having worked outside Canada for the previous 15 years, and DN then a new resident of Canada, it was clear that one way to promote and sustain involvement at appropriate levels of philosophy and responsibility was to establish our own entity.

The act of incorporation was carried out without professional legal assistance, using a simple “how to” guide. Within the first year, we were listed on various public sector registries in Canada, and launched our first website, subsequently upgraded in 2007 using SiteCube.com. In 2006, "PacificSci" was approved as our registered trademark. See http://www.pacificsci.org/

Since incorporation, PacificSci has engaged in a blend of contractual and pro bono activities, mostly with an international focus, and with an expanding domestic portfolio. Without attempting to be fully comprehensive, the following is a selection from our portfolio.

International Development-related Contracts

Contractual work is the primary source of corporate income. We have been successful in attracting both international and domestic assignments which reflect our social mission, while committing to the same level of rigour and professionalism as previously applied to our former substantive careers in both academia and government service.

Currently(2013-14),  PacificSci serves as the designated health systems expert with Universalia Management Group (Ottawa, Montreal) in an evaluation of research grant influence on external policy decisions, on behalf of the International Development Research Centre (IDRC Ottawa).

In 2010 and again in 2013, PacificSci accepted subcontracts from Universalia as Internal Advisor for quality control in consecutive management evaluations of the World Health Organization (WHO) on behalf of the Multilateral Organisation Performance Assessment Network (MOPAN), comprising 17 donor countries with the common interest of assessing the effectiveness of organizations they fund (Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Ireland, the Netherlands, Norway, South Korea, Spain, Sweden, Switzerland, UK and USA).

In 2009, PacificSci performed a Performance Review for the ICDDR,B (International Centre for Diarrhoeal Disease Research, Bangladesh) for 6 donor nations (Australia, Canada, Netherlands, Sweden, Switzerland, and the UK). 

From 2005 through to 2010, PacificSci engaged in Health Project Monitoring in Pakistan: In 2004 PacificSci had participated with Universalia Management Group to bid for this Canadian International Development Agency (CIDA) role. During this period we conducted M&E tasks in relation to four CIDA-supported initiatives:

- Family Planning Association of Pakistan (FPAP)
- HIV/AIDS Surveillance Project (HASP)
- Systems-Oriented Health Investment Programme (SOHIP)
- Lady Health Workers Programme (LHWP)

Notes:

PacificSci’s task in relation to the LHWP was to provide external review service to Oxford Policy Management (OPM), which had a lead role in this evaluation. In 2006, we reviewed a World Bank (WB) evaluation of a primary health care initiative in Pakistan.  Both efforts were acknowledged by these partners: OPM and the WB respectively.

In 2005, we were contracted by Sweden’s International Development Cooperation Agency (SIDA) to represent them in a joint donor evaluation of the African Medical Research Foundation (AMREF). From October 2005 this entailed site visits to headquarters and field operations in Kenya, Uganda and Tanzania; the assignment was completed in March 2006.

NOTE: Links to several of these projects are supplied on our website: http://www.pacificsci.org/

Domestic Contracts

Domestic contracts have also been a source of revenue compatible with our mission, the most significant of which have been:

. University of Victoria, School of Public Health and Social Policy: In late 2012, the firm contracted to develop a new on-line course entitled Foundations of International and Global health and Human Development, for delivery at both senior undergraduate and graduate levels.  In Spring of 2013, we then accepted a contract to deliver the course. 

. Royal Roads University, Centre for Health Leadership & Research (CHLR): From April – September 2008 Nanan, PacificSci, contracted to support CHLR research. In July 2007, both principals delivered a review of process evaluation for population health initiatives. In Sept 2006, White co-developed with Graham Dickson, CHLR a concept paper to support the ActNow-BC initiative, Ministry of Tourism, Sports & the Arts.

. EDS Canada: From December 2005 to February 2006, PacificSci was retained for technical expertise to assist EDS in a response to a federal-provincial Request for Proposals to develop a Pan-Canadian system disease surveillance and management system. Out of 10 bidders, EDS ranked second to IBM Canada, and ruled eligible if IBM did not fulfil contract requirements.

. British Columbia Ministry of Health: in 2004 PacificSci developed the Provincial Health Officer's (PHO) 2003 report. "Every Breath You Take..." This cites ~200 references, original analyses of air quality and morbidity data, and includes the first health impact analysis of 2003 forest fires. It was presented by the PHO to the BC Legislature.

Pro Bono and Academically-Linked Activities

PacificSci has been active in various (mostly honorary and voluntary) roles with: the University of Victoria (UVIC, where both principals are adjunct faculty), Kuwait University (KU), the Aga Khan University (AKU), Dalhousie University (Dal, where one principal (FW) also has an adjunct appointment), Royal Roads University (RRU), the University of Wisconsin (UWisc), Michigan State University (MSU) and others. The roles have included serving as: Advisory Board member (UVIC); advisor, external examiner and reviewer (KU); visiting speaker (UWisc); thesis supervisor and consulting researcher (Dal); co-grantee and collaborative researcher (AKU); and co-author (UMich and others).  Again, more details are accessible from our website:  www.pacificsci.org

Both principals serve on the board of the on-line publication Global Journal of Medicine and Public Health, and FW, since its launching in 2012, also serves as its (founding) Executive Editor. This journal, based in Kashmir India, is included in the List of Open Access Journals and other indexes, and attracts an international array of contributors.

PacificSci’s activities in this category have also included many hundreds of pro-bono hours in mentoring individuals and groups abroad and in Canada, participating in e-communities and in health policy groups, and peer reviews for scientific journals.

Regarding interactions and connections, we are currently active in Linked-In groups, most actively “The Economist” and “Global Public Health” groups. In 2006 the firm launched this particular blog (PacificSci Global Perspectives) presenting on a monthly basis an independent view on current affairs, emphasizing the determinants of health and social well-being. We were also a Communications Partner for the World Urban Forum (WUF) 2006, Vancouver.

On January 10, 2006, we launched PacificSci GLOBAL HEALTH DATA LINKS [7], a free subsidiary website developed primarily for students of international and global health providing annotated links to the following sources:

. UNDP Human Development Statistical Reports

. WHO Statistical Information Systems

. US Census Bureau International Database

. Population Reference Bureau Data-Finder

. WHO's Global Health Atlas.

Since incorporation, PacificSci principals have reviewed various scientific and professional articles for the following leading international journals:

Anthropology & Medicine; Archives Medical Sciences; Bulletin of the World Health Organization; Canadian Medical Association Journal; Diabetes/Metabolism Research and Reviews; Evidence-based Complementary and Alternative Medicine (eCAM); Global Journal of Medicine and Public Health; Globalization & Health; International Journal of Medicine and Public Health; International Journal for Quality in Health Care; Journal of Global Infectious Diseases; Journal of Public Health; Medical Science Monitor; Preventing Chronic Disease (US Centers for Disease Control and Prevention); Qualitative Health Research.

Also: We are utilized as a book proposal reviewer for Oxford University Press (New York).

Since incorporation, as an expression of ongoing commitment to the population health sciences, PacificSci principals (in addition to numerous contracted technical reports) have themselves authored or co-authored 34 articles in peer-reviewed journals, 1 book, 2 book contributions, 4 conference abstracts and 1 on-line video. Franklin White is the senior author of a new Oxford textbook: White F, Stallones L, Last JHM.  Global Public Health – Ecological Foundations.  Oxford University Press. New York. 2013 (see URL with citation below, which provides more information about this book). He also served as an Associate Editor and Debra Nanan as a contributor in: Dictionary of Public Health. JM Last (ed) Oxford University Press 2007. [Oxford Reference Online Series.]  White is also a contributor to Porta M. Editor. Dictionary of Epidemiology. 5^th edition. International Epidemiological Association. Oxford University Press. 2008. New York.  Together, both principals also completed a major book chapter: White F, Nanan D. International and Global Health. Chap 76. In: Maxcy-Rosenau-Last, Public Health & Preventive Medicine. 15th Ed. McGraw Hill 2008.

Unlike most other university and government colleagues, who are compensated for similar efforts as part of their job descriptions/academic or service expectations, these contributions are of a pro bono nature. Thus, we are in touch with and maintaing leadership in our field, while developing PacificSci as a fourth sector organization.

NOTE: Links for many of the items noted above are on our website: http://www.pacificsci.org/

Discussion
The most significant discovery in growing our enterprise is the unique and valued contribution to the public good our company delivers, despite working outside the formal system. While much less personally remunerative than a public sector or academic post, this is offset by more “intellectual freedom” along with more control over professional time than persons working for an institution or a health service. Our third party independence, especially in monitoring and evaluation roles, and our ability to “think outside the box”, allows us to speak out and comment on issues as we perceive and understand them, according to our best judgment.


A significant disadvantage however is that, not being part of collective agreements, we must either fund ourselves or be invited as a resource (e.g., to conferences) to access professional development and networking opportunities. Thus, the fourth sector approach demands we deliver on our skills, or go out of business. Happily, as we enter our 11^th year, this has not happened.

Conclusion
This has been a brief and candid account of the experience of Pacific Health & Development Sciences Inc., during its first 10 years of operation. During this period, PacificSci, as a “business venture with a social purpose” has succeeded in delivering on its mission:  “seeking solutions to health and social impacts of economic development”.

Our “fourth sector” model of social enterprise has facilitated flexibility, so that we, as principals, can make choices we are comfortable with and motivated by professionally. As a cautionary note, this model comes at a relatively late stage in our careers, where financial and family responsibilities have receded. For those seeking professional freedom of choice and who are prepared to weather lean inter-contract periods, we can recommend this approach.

Envoi

We close this special 10th Anniversary issue of PacificSci Global Perspectives with the eternal words of Nelson Mandela, a giant of a human being who taught the world so much by example, and left it a better place. 

“…to be free is not merely to cast off one's chains, but

to live in a way that respects and enhances the freedom of others." 

So, with these thoughts and memories, we wish our readers near and far a joyous Holiday Season, and a happy, safe and healthy New Year!

Franklin White & Debra Nanan, Co-Principals,

Pacific Health & Development Sciences Inc.

www.pacificsci.org

REFERENCES:

1. Lamb R. Hybrid Organization. University of Hawaii, Manoa. June 17, 2004. Accessed Dec 15, 2013. http://www.vfh.fh-brandenburg.de/vfh/gastvorlesungen/gastvortrag_05.pdf

2. Ménard, Claude (2004), ‘The Economics of Hybrid Organizations’, Journal of Institutional and Theoretical Economics 160 (3), 345-376. http://www.econ.kobe-u.ac.jp/~yanagawa/Economics_of_Hybrids--JITE-2004.pdf

3. Social Enterprise Council of Canada website.  Accessed December 15, 2013. http://www.socialenterprisecanada.ca/en/learn/nav/whatisasocialenterprise.html

4. Social Enterprise (USA) website. Accessed December 16, 2013. https://www.se-alliance.org/

5. Social enterprise.  Wikipedia.  Accessed December 15, 2013. http://en.wikipedia.org/wiki/Social_enterprise#Canada

6. New Trends in Organizational Forms and Functions – Shifting Sands. Chapter 4, pages 81-82 In: White F, Stallones L, Last JM. Global Public Health – Ecological Foundations. Oxford University Press. New York 2013. For more information about this book, including its contents, visit Oxford University Press at:

http://global.oup.com/academic/product/global-public-health-9780199751907;jsessionid=1629DD204A7E2D4B5EADCD281AB187F4?cc=ca&lang=en&

7. PacificSci GLOBAL HEALTH DATA LINKS website. Accessed December 16, 2013. http://globalhealthdata.webspawner.com/

  ANNOUNCEMENT:  With priority for this issue having been given to the 10^th Anniversary of PacificSci, our Year in Review for 2012 will be the selected topic for the first issue of 2014.