Tag Archives: World Health Organization

Views and Voices of Older New Yorkers

Posted on by
Reply

By Mario Rubano, MPH, Center for Healthy Aging, NYAM

Today’s guest blogger is Mario Rubano, Policy Associate at NYAM’s Center for Healthy Aging. Mr. Rubano plays a central role in the Academy’s next Then & Now event, “The Opportunities and Challenges of Healthy Aging in New York City.” He conducted the interviews documenting the experiences of older New Yorkers and will moderate the discussion of those experiences with historians Kavita Sivaramakrishnan, PhD, and David G. Troyansky, PhD. The event takes place online on Tuesday, November 15, 5:00 to 6:00 pm; you can register here.

The NYAM Library’s “Then & Now” series has explored a wide variety of medical and public health issues, bringing experts and researchers into dialogue with the broader NYAM community. As the Academy’s 175th anniversary celebrations wind down, we’re delighted to feature a different set of experts—older New Yorkers.

NYAM has been at the forefront of NYC older adult health and policy since 2006, when it first joined the Global Age-friendly Cities project, an international effort spearheaded by the World Health Organization (WHO). The following year saw the development of Age-friendly NYC, an award-winning partnership that reimagined how the City could meet the needs of its older residents. This shift was rooted in the 8 Domains of Livability, a collection of interconnected categories that captured the most vital aspects of healthy living for older adults in urban centers. Today, the Center for Healthy Aging (CHA) embodies this legacy in its ongoing mission to improve the health and well-being of current and future aging populations.

The 8 Domains of Livability

At present, New York City is home to roughly 1.2 million individuals aged 65+, and we were lucky enough to settle down with five of the busiest of them for personal interviews via Zoom. The participants, drawn from a network of grassroots age-friendly community groups, shared their insights, memories, experiences, and opinions (with classic New York panache) in a discussion structured around the 8 Domains of Livability. Each of the participants has maintained an active relationship with local community-based organizations, community boards, volunteer groups, or, in one case, as a part-time Reservist working with NYAM. What was immediately clear across each of the interviews was the devotion that each participant has to this city. Whether born-and-bred or a transplant, these New Yorkers were as energized by the city as one could possibly be, and it’s this vigor that brought their reflections to life.

Our Interviewees!

If a single takeaway were to be drawn from these five interviews, it would be that “progress” is a constant process rather than a state-of-being or condition that is achieved. The domain of transportation illustrates this idea. The participants all remarked on the tremendous improvements in comfort and capacity that the public transportation system has undergone over their lifetimes. The advent of air conditioning to ease the misery of a summertime, rush-hour commute, the growing fleet of accessible kneeling buses that simplify the boarding process for individuals with mobility challenges, and the creation of station transfers were all viewed as highlights over the years. Yet, we also heard about significant lapses in the management of bus lines that blatantly ignore the needs of older New Yorkers and, in many instances, place undue burdens on communities of color.

Healthcare access also changed in remarkable ways, both positive and negative, over the course of their lifetimes. House calls from family doctors who knew and treated entire communities gave way to newer models of care that, while noted for their efficiency and quality, were seen as impersonal and disconnected. We heard sobering stories of healthcare in the years before desegregation and the ongoing effects of Robert Moses’ infrastructure projects, like the Cross Bronx Expressway. These stories demonstrate the necessity of continued civic and community engagement, even after broad, landmark victories. Legislative progress—such as that initiated by the Americans with Disabilities Act in 1990—must be continuously refined to ensure that the promises of better lives remain intact in an increasingly complex world.

This project has been a thrilling process in itself, and we look forward to sharing these New Yorkers’ stories, and hearing the commentary by our guest historians, Drs. Kavita Sivaramakrishnan and David Troyansky, at the upcoming November 15th Then & Now event.

Item of the Month: Posters from the Special Programme on AIDS, World Health Organization, 1987–1995

Posted on by
8

By Paul Theerman, Associate Director

The WHO Special Programme on AIDS was the first response of the United Nations to the pandemic that had gained world attention by the mid-1980s.1 The offspring of the first two international conferences on AIDS, in Atlanta in 1985 and in Paris the following year, the Programme was founded in February 1987. The Programme’s dynamic director, Jonathan M. Mann, had great hopes and grand plans for combating AIDS through a coordinated worldwide response—the only feasible way to control the virulent and widely spreading disease, he thought. From the beginning he also saw the AIDS outbreak as a focus for engaging global human rights issues. Under Mann, the WHO moved beyond its role of technical advisor to national governments, for it tried to take a directive role, actively engage non-governmental organizations, and promote non-discriminatory policies towards AIDS sufferers. Between 1987 and 1989, the Special Programme—which also came to be known as the Global Programme on AIDS—developed a comprehensive strategy for attacking the virus.

AIDSWorldwideEffortSIDAUnEsfuerzo

These two posters—one design in two languages—come from the heady days of the Programme’s beginning. Produced in 1987, these posters announced its slogan, “AIDS: A worldwide effort will stop it.” The posters’ design inadvertently reveals how difficult it was to talk about AIDS in the 1980s. AIDS seemed different from other diseases. First of all, it was a pandemic experienced in the west, perhaps the first such experience since the polio epidemic in the early 1950s, and before that, the influenza pandemic in 1918–19. With the rise of antibiotics and vaccination, widespread disease outbreaks in the developed world were no longer supposed to happen! As Dr. Gerald Friedland, a doctor on the front lines during the height of the pandemic, said at an event at Columbia University earlier this month, the disease caused the “inverse of the life cycle,” as it mostly impacted young people, leading to parents burying their children. “The only thing comparable was war.”

With AIDS, neither antibiotics nor vaccination worked, so epidemiologists were forced back to classic means of halting pandemics: stopping the means of transmission. Here also AIDS proved difficult. Those means—chiefly sexual contact and sharing needles—provoked strong reactions. Coupled with a long latency and an invariably fatal outcome after a horrific decline, AIDS did not have a simple profile.

The posters display that cultural unease. The UN commissioned noted New York graphic designer Milton Glaser, an internationally known logo and poster designer, with such readily recognizable designs as “I ♡ NY,” Esquire and New York magazines, and Sony, among many others. Certainly Glaser knows about the power of images to convey meaning. For these UN posters, he combined three elements, two hearts and a skull, to make a W—presumably to stand for “world” in the World Health Organization, and to reference the caption, “A worldwide effort will stop [AIDS].” But it’s not clear—and it doesn’t work in the Spanish version of the poster. Even more puzzling is the relationship of the hearts to the skulls. Is it cautionary: in the midst of love—erotic love, that is—lurks death? Is it hopeful: compassionate hearts will combine to crush AIDS? Is it both? Glaser produced a striking image, but he also produced an ambiguous one. By 1991, the red ribbon had been introduced as the predominant AIDS symbol, and it soon the supplanted the “heart-and-skull-W,” even at the UN itself.

The year that this poster came out proved to be the Programme’s high point. In 1988 a new director-general came to the World Health Organization. AIDS could not have two masters. By late 1989, the Programme’s efforts, strategies, and budget were brought up short, and Mann departed in 1990. The Programme limped along for another five years, until replaced by UNAIDS, the locus for United Nations action today. In the words of Mann’s successor,  Michael H. Merson: the Programme “was unable to muster the necessary political will . . . , and its effectiveness was compromised by . . . an increasing preference of wealthy governments for bilateral aid programs.”2 That seems where matters stand now, as we approach World AIDS Day, December 1. The story of the Special Programme on AIDS is a cautionary tale of the difficulties of grappling with a worldwide disease in a disjointed world.

References

1. Much of the history of the Special Programme on AIDS is found in two article by its founding director: Jonathan M. Mann, “The World Health Organization’s global strategy for the prevention and control of AIDS,” in AIDS—A Global Perspective [Special issue] Western Journal of Medicine 1987 Dec; 147:732–734; and Jonathan M. Mann and Kathleen Kay, “Confronting the pandemic: the World Health Organization’s Global Programme on AIDS, 1986–1989,” AIDS 1991; 5 (suppl. 2): S221–S229.

2.  Michael H. Merson, “The HIV–AIDS pandemic at 25—the global response,” New England Journal of Medicine 2006; 354:2414–2417 (June 8, 2006), quotation from page 2415.