Summary

On July 30, 2008, H.R. 5501, the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria  Reauthorization Act of 2008 was signed into law, authorizing up to $48 billion over the next five years to combat global HIV/AIDS, tuberculosis, and malaria. (Malaria is the fifth leading cause of death worldwide and the second leading cause of death in Africa after HIV/AIDS.)


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Global Washington: A Model for Oregon
GlobalWashington.org provides both a successful model for GlobalOregon™ (GO) and a valuable resource in developing the necessary infrastructure for success. The University of Washington’s Vice Provost of Global Affairs, in collaboration with the Washington State policy team, undertook a survey of the impact of global health on Washington’s economy. The results of the 2005 report were compelling and led to the December 2008 launch of Global Washington. “The Economic Impact Assessment of Global Health to Washington State’s Economy in 2005” established that the global health sector creates and supports over 43,000 jobs in Washington State and generates over $1.7 billion in salaries, wages, and benefits annually. Nearly 14,000 of
these jobs are “direct jobs,” employing people working directly in global health. A secondary economic impact is the additional 30,000 jobs supported by the global health sector state‐wide.
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Right now, neither Global Washington nor GlobalOregon™ is on the radar screen of Oregon leadership. For global health to become an important slice of Oregon’s economic pie, that situation must change. GlobalOregon™ is now positioning to drive that change. Recognition that global health is important to the state’s economy and to the health and security of Oregonians is a crucial first step (http://www.globaloregon.org/GlobalOregon_org.pdf).
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Innovative products and technical expertise to promote development and advance health is the sandbox in which Oregon can play with great success.
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GlobalOregon™ Kick‐Off and Think Tank
Can Global Health play a role as a basis for economic growth in Oregon? The May 8, 2010 GlobalOregonTM kick‐off and think tank brought together approximately 200 participants from multidisciplinary organizations across Oregon. Dr. Tom Potiowsky, Oregon’s State Economist, delivered the keynote address.

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Potiowsky asked the question of the day: “Can organizations in Oregon, be they public or private, help break through the health problems facing developing countries to help lift their standard of living and at the same time promote the Oregon economy?” Oregon is connected internationally through foreign investments, international trade, foreign immigration, tourism, and our university education system. Oregon’s export shipments of
merchandise in 2009 totaled $14.9 billion, up 20 percent ($2.5 billion) from the $12.4 billion exported in 2005. That expansion was the sixteenth largest dollar change among the 50 states over that time period. Oregon’s exports to China increased 26 percent during the first quarter of 2010, reaching a record $1.18 billion. In all, Oregon’s foreign sales in the 2010 calendar year through March exceeded $4.5 billion. This reflects a rebound toward the record high of $5.22 billion set in the third quarter of 2008.
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Oregon has economic and cultural ties with people, businesses, and governments around the world. Our expertise in energy, environment, sustainable building practices, and urban transportation has led to consultants traveling abroad to help national, regional, and local governments and businesses tackle their economic and social problems. Oregon’s academic institutions and non‐profits, such as Medical Teams International and Mercy Corps
International, have a strong research, educational, and civil society supportive presence in lowand middle‐income countries throughout the world.
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Connecting Global Health and Oregon’s Economy
As Oregon recovers from the current recession and struggles with double‐digit unemployment rates, GlobalOregon™ can serve creatively as a clearinghouse to connect non‐profits and business, academe, and government. The economic landscape that existed before the recession
will likely not be the same. Employment levels in wood products, construction, financial services, high tech, and other sectors may not reach pre‐recession levels. Given this reality, efforts to promote global health need to coincide with efforts to grow the economy here at home.
Areas that hold hope for economic growth in Oregon include new businesses in the solar energy field, expanding our expertise in sustainable building practices, and advancing research in alternative energies. Oregon’s international ties have assisted in these early stages of economic recovery. As is apparent in Washington State’s economic report, interest in improving health in low‐income countries is immense. Building on Oregon’s rich and extensive association with other countries in both economic and cultural terms, GO can serve as a conduit to create synergies among non‐profit and for‐profit sectors with the outcomes of improved global health and quality of life.
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GlobalOregon™ provides a network for valuable interaction and synergy across sectors statewide. Witness the current concern of the electronics industry in Oregon over occupational conditions in factories in southern China’s Shenzhen City, where computers and other devices for the U.S. and international market are assembled, and where work practices can promote the risk of psychiatric and neurological illness. The OHSU Global Health Center has strong occupational health research ties with Chinese government institutions in Shenzhen, with the Chinese National Institute of Occupational Health and Poison Control, and with universities and hospitals across China. Such relationships can be invaluable in opening doors that can lead to problem resolution.
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GlobalOregon™ is a sustainable and rational entity poised to participate in improving global health and Oregon’s economy. Oregon needs to be part of the solution and can also benefit from doing so. GO has the potential to help accomplish this win‐win objective.
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Moving Forward: Next Steps for GlobalOregon™

GlobalOregon™ has established a dialogue with GlobalWashington to learn more about their programs, policies, membership development and services, and funding. GO is also exploring avenues for financial support.
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Next steps include informing Salem legislators and Oregon’s Congressional Delegation in Washington, DC (completed May 27, 2010), the broad business community, other non‐profit organizations and additional university partners. An Advisory Committee will be developed for GlobalOregon™ and, as with Global Washington, a GO newsletter and membership will be offered through a statewide email network.
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An Example of the Vision: GlobalOregonTM in Practice
The Global Health Center at OHSU, a public university organized as a statutory corporation, distributed summer travel awards from three Oregon non‐profit organizations to students to work in conjunction with Mercy Corps International and Mercy Corps Colombia to introduce a micro‐hydro project in an indigenous community lacking electricity. The student recipients of the awards will develop the basis to measure the health impact of this
intervention to determine whether the project produces sustainable advances. The outcome of this project will guide future initiatives to maximize the positive sustainable impact of introducing Oregon’s green energy products into comparable communities in low‐income countries. Demonstrable and measurable health impact will lead to an increased demand for Oregon’s products and expertise in this sector.
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May 2010 GlobalOregon™ Launch Discussion Group Brain Storms
Following the morning’s keynote address and expert panel, four cross‐professional discussion groups convened. Each group addressed one of the following questions: What constitutes sustainable development for GlobalOregonTM? How does GO empower a low‐income community to jumpstart measurable development? Can GO empower youth to promote health and reduce disease and injury? How does GO help prevent another generation of HIV orphans?

Overview of the Four Think Tank Discussions
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Discussion Group on Sustainable Development
GO provides a platform for innovating and co‐creating sustainable solutions both globally and locally. The group sought to establish what constitutes sustainable development for GlobalOregon™. Sustainability was defined as being “ecologically sound, financially solid, technologically appropriate, community‐driven, while incorporating education and training.” GO represents a multidisciplinary alliance/network of business, academic, non‐profit, and governmental professionals/stakeholders to market and provide sustainable solutions in the global marketplace to stimulate Oregon’s economy and enhance its reputation. Oregon is unique. Many of our businesses have worldwide brand and lifestyle recognition, which we intend to expand. We share a belief that quality of life merges innovative green business and education with a healthy environment. GlobalOregonTM intends to stimulate and extend our international business presence, thus empowering local economic vitality.

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The group coined a tagline: “GlobalOregon™ –Sustainable solutions for the global marketplace.” It proposed that GO’s mission should be to provide a collaborative network of Oregon businesses, industries, and institutions to market sustainable, ethical, and innovative solutions locally and globally that will promote the reputation of Oregon, compete effectively internationally, and serve as a catalyst for Oregon economic vitality. By serving as a clearinghouse for reputable Oregon businesses and consulting services, GlobalOregon™ will match the export of Oregon‐generated goods, services, education, and technical, research and other professional expertise with entities seeking assistance for local growth and sustainable economic  development. Appropriate technologies and training driven by client “demand” will serve as the basis for local business stimulus. The group felt GO should focus on how it intends to reconcile the competing interests of business, academia, and those interested in development work. GlobalOregon™ will serve as an incubator of ethical ideas, projects, collaborative relationships, and resources that will give Oregon a competitive business edge that will be recognizable in the international marketplace.
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Discussion Group on Measurable Development
A second group addressed the question, “How does GlobalOregon™ empower a low‐income community to jumpstart measurable development? So you want to do a good thing; how do you make sure it’s the best thing?” The group determined that partnerships, determining appropriateness and acceptability, and governance are key factors. They suggested the following areas for GlobalOregon™ measurable development:
• Open‐source technology: GO would coordinate customization of computer applications at a central “location” for all Oregon businesses with an international footprint.
• Recycling: Expand Oregon recycling services to include cell phone and computer waste to generate income.
• Agriculture: Use Oregon expertise to provide exportable, sustainable agricultural practices to maintain nutrient value and economic stability, intercropping, and sustainable irrigation practices.
• Transportation: Hire locals for deliveries, following local traditions. GO with marketable expertise (perhaps in partnership with TriMet) can help improve people transport and access to medical services.
• Education: Promote HIV and disease prevention. The Oregon University System and OHSU have ties internationally to stimulate educational development abroad. This can be a marketable product.
• Jobs clearinghouse: Inquiries would be directed to appropriate industry or expertise listed on the vetted GO registry.
• GO mandate: Coordinate sustainable energy technology and find solutions regarding how technology can best be accessed. Find ways to tie “kick‐off” funds to use Oregon technology and expertise, and then create mechanisms to increase marketability. Create marketable education programs to train others in technology use.
• Best practices: Sustainable, ethical, synergistic projects that combine multidisciplinary expertise from the “hub” of GO. The group also felt that bringing people to Oregon is an important form of economic stimulus. Tourism could be promoted by inviting individuals, groups, or governments to Oregon to market business, stimulate trade, and demonstrate hospitality. Apprenticeships at Oregon firms would allow students to take local technology back home and consider Oregon as their technological consulting resource in the future. GlobalOregon™ could also trigger an idea exchange to develop new products to meet the needs of visitors, drawing on the experiences of recent international immigrants, while  creating new ways to solve problems locally. Finally, developing cell phone technology with applications and training for export for business and medical applications.

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Discussion Group on Empowering Youth to Promote Health

The third discussion group addressed the question, “Can GlobalOregon™ incentivize/empower youth to promote health and reduce disease and injury?” The goal would be to listen to and work with communities, to utilize their local capabilities and assets, and to bring hope through constructive and interactive programs. Youth can serve as both the collectors and distributors of health information, especially in populations where health professionals are rare. Youth can become “little health professionals” and, through this mechanism, not only collect and disseminate health‐related information, butlso be stimulated to consider careers in the biomedical arts and sciences. This would be especially valuable for resource‐poor populations, where 50 percent or more of the population is under 20, where disease prevalence is undocumented, where health care is deteriorating, and where the supply of trained health professionals is decreasing through premature HIVrelated death or through emigration to professionally more attractive positions. The increasingly widespread availability of inexpensive cell phones is a key opportunity both to ‘push and pull’ health information to and from communities. Youth are better equipped than many adults in the use and transmission of data using contemporary communication devices. Youth with GPS‐equipped cell phones can pull (collect) public health data from multiple communities (e.g., crash helmet use, coughing, vaccination, orange‐blonde/brittle hair reflecting malnutrition, pathological head nodding, or goiter) that, with available software (e.g., Datadyne Inc.’s Episurveyor software) , are automatically integrated and plotted geographically. If a ‘high‐cough’ village was identified among one hundred data collection sites showing low cough rates, this could become the specific focus of medical efforts to identify and treat TB (such a program is underway in Pakistan under the auspices of Mercy Corps International). Poor regional use of crash helmets might lead to a geographically focused drive to increase motorcycle head protection and traffic safety education. Cell phone technology could be used to transmit a wealth of health and other information from remote regions of a population, thereby making it a powerful and inexpensive epidemiological research tool. Knowledge of the existence and distribution of illness is a major challenge in resource‐poor countries. Pathological head nodding (as in Sudan and Uganda) could lead to researchers searching for the cause of a newly recognized disease (which it did). Youth with GPS‐equipped cell phones can also disseminate (push) health information that is sent to them from a centralized source. Such information could go beyond health, for example, to include information on nutritional, agricultural, weather forecasts, and income‐generating opportunities.

Progress in dissemination of the information can be tracked in space and time.

  • Existing youth organizations with widespread global penetration are candidates: e.g. Scouts, Rotary youth programs, other, especially youth organizations in Moslem, Buddhist, and other non Judeo‐Christian regions.
  • Youth participating in these program would be rewarded for these efforts, e.g. a “Little Doctor” or “Little Health Researcher” badge that could be worn with pride.
  • Cross‐cultural activities designed by youth for their participation are other valuable mechanisms through which to communicate positive health messages.
  • One example is a soccer program developed for HIV‐positive kids that transformed stigmatized youth into respected peers, sons, and daughters.

Requirements for implementation:

  • Appropriate training (via cell phone or schools) would be required.
  • Cell phone penetration is advancing rapidly on all continents, but full coverage has yet to be achieved and not all phones are GPS‐equipped (nevertheless, a start can be made in many areas where the need is great, as in Kenya, for example).
  • A reliable power source must be available…solar chargers?
  • Data collection and data dissemination content would need to be culture‐customized.
  • Data reliability (pull) and impact (push) would need to be assessed.
  • Cell phones are valuable and subject to misuse.
  • Privacy needs to be considered.

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Discussion Group on Controlling HIV/AIDS

  • “How does GlobalOregon™ help prevent another generation of HIV orphans?” This was the subject of the fourth discussion group, given that HIV represents one of many scourges that compromises health, diminishes productivity, increases health costs, shortens life, and unduly burdens society in so many ways.
  • The group agreed that economic empowerment of women is the central tool for reducing the economic and health burden of HIV. GlobalOregon™ would facilitate export of sustainable Oregon technologies, particularly targeted at women. In addition, GO could support an
    apprenticeship program, bringing those abroad to Oregon to stimulate trade, and also serve as a coordination center for Oregon business & non‐governmental organizations (NGOs). Oregon green energy ideas—such as stoves powered by solar energy or methane gas—can
    target and train women in poor countries, who can then generate income and focus on
    household duties rather than spending hours collecting firewood.

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Other ideas included computer training to create a database for microloans directed to women
and open‐source technologies that create and enhance educational opportunities for women.
Education would include how to use various electronics and an explanation of disease and
injury causes and prevention. Micro‐lending enterprises would promote economic stimulus at
the local level, thus creating a climate for sustainable social and educational progress.

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