Meeting Report

UNDP/World Bank/WHO Special Programme for Research & Training in Tropical Diseases (TDR)
SCIENTIFIC WORKING GROUP - SEB

TDR/STR/SEB/SWG/00.1

Recommendations
Scientific Working Group on Strategic Social, Economic and Behavioural Research
31 May - 2 June 2000 Geneva, Switzerland ti ons
TDR/STR/SEB/SWG/00.1 Original: English

www.who.int/tdr

TDR/STR/SEB/SWG/00.1 This document is not a formal publication of the World Health Organization (WHO), and all rights are reserved by the Organization. The document may, however, be freely reviewed, abstracted, reproduced or translated, in part or in whole, but not for sale or for use in conjunction with commercial purposes. The views expressed in documents by named authors, are solely the responsibility of those authors. TDR 2000
SCIENTIFIC WORKING GROUP ON STRATEGIC SOCIAL, ECONOMIC & BEHAVIOURAL RESEARCH Executive Summary
In June 1999, TDRs Joint Coordinating Board approved the creation of a new Steering Committee on Strategic Social, Economic & Behavioural Research (SEB). A Scientific Working Group (SWG) of experts from a range of social, economic and policy sciences met in Geneva (31 May-2 June) to set the overall direction for SEB and identify priority areas for research for the period 2000-2005. The SWG strongly recommended that the SEB Steering Committee focus its efforts on basic/strategic research that addresses issues and challenges of trans-disease and global concern, and that contributes to increased understanding of the determinants and factors important to the control of neglected infectious diseases.
The SWG recommended that the following underlying principles and concerns guide and provide the basis for future work of the Steering Committee: Globally, infectious and parasitic diseases remain major contributors to morbidity and mortality, and in many settings are the chief causes of suffering and premature death. These afflictions disproportionately affect populations living in poverty.
In most instances, social, cultural, political and economic inequalities are central to the persistence and spread of these diseases. These issues need to be examined within the context of globalization, the changing role of the state, and the emerging role of non-state actors (the private sector, NGOs and civil society). The SWG further recommended that SEB focus its efforts on six priority themes during the period 2000-2005: 1. Understanding the impact of globalization and widening social inequalities on disease persistence, emergence and resurgence (including the socioeconomic impact of disease and the emergence of drug resistance). 2. Understanding and remedying inequality of access to proven therapies, prevention and information. 3. Understanding the linkages between global, national and local level policies and their ability to respond to key health issues. 4. Moving from the epidemiological construct of risk to a social construct of vulnerability (seeing risk in context, and understanding the context of risk). 5. Understanding the implications of changing social, political and civil structures for the health of vulnerable populations. 6. Understanding policy processes, including the role of evidence in policy-making, with the aim of exploring innovative approaches to defining and responding to emerging problems.
The SWG also made a number of recommendations regarding mechanisms for achieving the goals of the Steering Committee:
The Steering Committee should define clear goals and objectives with regard to research outputs. It was felt by some members of the SWG that considerable work had already been done on some topics, and that the Steering Committee should commission comprehensive reviews where necessary, in order to identify gaps in knowledge and develop relevant research agendas.
Basic social, economic and behavioural research will require a different combination of research capabilities, as compared with those needed for more applied research. The SWG felt strongly that SEB research should be carried out by trained social scientists, and that mechanisms need to be developed to both attract and build social science research capacity. Small grants programmes and partnerships between institutions and individuals in developed and resource-poor countries are two potential mechanisms that were discussed. It was also recommended that a web page be developed for SEB, which would provide a forum for exchange of ideas, information and experiences relevant to SEB research.

The SWG recommended that SEB draw on a range of methodological approaches to achieve the goals of SEB. In some instances, this may involve the use of participatory research methodologies, but will ultimately depend on the specific research issues being addressed.
The SWG recommended that SEB develop and support mechanisms to ensure the effective dissemination of research results to different target audiences (policy-makers, public health professionals and academics at both national and international levels). Writing workshops to develop policy briefs and other non-academic reports were suggested as one possible mechanism. The SEB Steering Committee will be formed by July 2000, and a first meeting convened in September 2000 to further develop the research agenda and prepare calls for proposals. A second meeting of the Steering Committee will be held in early 2001 in order to review and recommend new projects for funding.
SCIENTIFIC WORKING GROUP ON STRATEGIC SOCIAL, ECONOMIC & BEHAVIOURAL RESEARCH

BACKGROUND

TDRs new strategy defines the goals and objectives of the programme as:

TDR goals

To alleviate inequity and poverty and foster social and economic development in endemic countries through reduction of mortality, morbidity and disability caused by neglected infectious diseases which affect poor and marginalized populations.
To increase research self-reliance in endemic countries for identifying needs and developing solutions to public health problems caused by neglected infectious diseases.

TDR objectives

To improve existing methods and develop new approaches for preventing, diagnosing, treating, and controlling neglected infectious diseases which are applicable, acceptable, and affordable by developing endemic countries, which can be readily integrated into the health services of these countries, and which focus on the health problems of the poor.
To strengthen the capacity of developing endemic countries to undertake the research required for developing and implementing these new and improved disease control approaches. Knowledge of how social, behavioural, economic, political and health system factors affect and are affected by disease patterns and disease control efforts is clearly important for identifying future needs and opportunities for improved control of TDR diseases. From the outset, TDR recognized the importance of social science research for its mission, and from1979-1994, TDR supported a Steering Committee on Social & Economic Research (SER). Since 1994, however, the focus of social science research in TDR became increasingly applied and disease specific in focus.There has been no structure or budget to allow for more basic social, economic and behavioural research on issues of trans-disease and global importance. In June 1999, TDRs Joint Coordinating Board approved the creation of a new Steering Committee on Strategic Social, Economic and Behavioural Research, to be located with the Basic and Strategic Research Team to emphasize the focus on more basic social science research. The broad mission of SEB is to promote and support research that: l increases understanding of the role and importance of social, economic and behavioural factors for prevention and control of neglected infectious diseases; l addresses issues of multi/trans-disease and global importance; l contributes to identifying needs, opportunities and innovations for improved disease control and prevention; and l contributes to and supports the overall goals and objectives of TDR. In its February meeting,TDRs Scientific and Technical Advisory Committee (STAC) gave the following guidelines for the orientation of SEB research within STR, stating that SEB research should;

l l l l l l l l

focus on strategic, not operational, issues (the latter should continue to be addressed by TDRs Intervention Development and Evaluation Research* (IDE) Team). focus on whole populations (that is, not restrict its focus to sub-populations at risk, but also look at patterns and sources of intra-population variation). be framed within the broad contexts of inequity and poverty. Health sector and systems research should address both demand and supply side issues. take into account perspectives on culture, behaviour and values. consider both non-health sector as well as health sector issues. consider economic perspectives of disease control. contribute to anticipating future problems in control of communicable diseases.

Purpose of the SWG

The aim of the SEB Scientific Working Group was to make recommendations to TDR concerning: l Specific direction for strategic social, economic and behavioural research; l priority research themes to be pursued by SEB during 2000-2005; and l mechanisms for achieving the goals of the Steering Committee. The meeting began with a review of TDRs new strategy in the context of WHOs corporate strategy, and an overview of the history of social science research in TDR from 1979 to the present. Several presentations were also given to familiarize the SWG participants with some related research activities in WHO: l Evidence for Information and Policy (EIP) cluster perspective on health policy and systems research (David Evans). l Alliance for Health Policy and Systems Research (Miguel Gonzalez Block). l Gender mainstreaming in WHO (Claudia Garcia-Moreno). l Department of Health and Sustainable Development (Yasmin Von Schirnding). l Determinants of health and ill-health: non-communicable diseases (Ursel BroesskampStone). Two half-day sessions were then devoted to small working groups. Three groups were formed on the basis of level of factors and actors: (1) family/household/community; (2) health systems and services; and (3) non-health sectors and central government. Each group was asked to use the following questions as a framework for identifying priority research themes and questions: l What are the main challenges of/obstacles to the prevention and control of neglected infectious diseases (focusing on issues of trans-disease or cross-cutting importance)? l What do we know? What dont we know? What do we need to know in order to contribute to addressing these obstacles/challenges? l Which research gaps, if addressed, would have the greatest potential for impact on prevention and control of TDR diseases (and be most useful across diseases, regions and contexts)? l Which research would help achieve TDRs overall goals and objectives? l Which research areas are not already being dealt with adequately by others? l Which would TDR be in a strong position to address (TDRs comparative advantage)?

____________________ * now renamed Intervention Development and Implementation Research
Recommendations: SETTING BOUNDARIES

General

The SWG recommended that the following underlying principles and concerns guide and be the basis for future work of the Steering Committee: Globally, infectious and parasitic diseases are major contributors to morbidity and mortality, and in many settings are main causes of suffering and premature death. These afflictions disproportionately affect populations living in poverty.
In most instances, social, cultural, political and economic inequalities are central to the persistence and spread of these diseases. These issues need to be examined within the context of globalization, the changing role of the state, and the emerging role of non-state actors (the private sector, NGOs and civil society).

Relation to IDE

Since 1994, social science research in TDR has become increasingly applied and diseasespecific in focus. In recognition of this fact, STAC (22) recommended that SEB be located within the Basic and Strategic Research Team (STR) in order to address the need for more basic social science research. The recommendations of the SWG are illustrated in the chart below. It is important to note that while the core types of research to be supported by SEB and IDE are clearly distinguished, there are areas of common interest and potential collaboration, namely research that aims at generating probable ideas for improved disease control. It is clear that SEB will need to communicate and collaborate with IDE (as well as with other TDR teams) to ensure that SEB research contributes to and supports the overall goals and objectives of TDR.
Basic Research Brings understanding of fundamental nature of phenomena
Generates possible ideas for improved control

Type of Research

Develops probable ideas for improved control Determines efficacy of interventions Determines effectiveness of interventions
Applied Research Operational research
Identifies conditions for scale-up

IDE SEB

Specific objectives, outputs, and targets
The SWG strongly recommended that the first task of the SEB Steering Committee should be to develop a focused set of research themes and questions, and define specific objectives, research outputs and targets to be achieved by the end of the period 2000-2005. While the SWG acknowledged the benefit of allowing for some investigator initiated innovative research, the group recommended that this should constitute only a small part of SEB work.The SWG strongly recommended that SEB should not be considered a source of support for social science projects that do not fit within IDE workplans.

Recommendations: RESEARCH TOPICS BY THEME
During the small group deliberations and two plenary sessions, it became evident that there are global issues and trends that have major influences across the different levels and that some of the greatest research challenges relate to these issues and trends. Below are the 6 general research themes identified by the groups, and the results of a relatively brief brainstorming session by each group with regard to possible research topics within each of these general themes. Because the groups did not restrict their brainstorming to the 6 themes, not all of the topics fit neatly under the thematic headings. However, an attempt has been made to list research topics under the most relevant themes. This list should only be considered illustrative of the types of research that SEB might undertake. The SWG recognized that the SEB Committee, once formed, would need to develop a much more focused set of research themes and questions, before calls for proposals can be made.

Theme I

Understanding the impact of globalization and widening social inequalities on disease persistence, emergence and resurgence (including the social and economic impact of disease, and the emergence of drug resistance) l What are the large-scale social and economic determinants of drug use patterns, and what are the implications of these, e.g. for drug resistance? l How can positive aspects of globalization be harnessed to reduce inequality and vulnerability with regard to control and prevention of TDR diseases? l What are the forces and conditions promoting or retarding the development and equitable distribution of effective preventive, diagnostic, and therapeutic technologies? l What are the impacts (positive and negative) of large-scale economic processes and policies (e.g. neo-liberal trade agreements, globalization, and widening social inequalities) on the production and availability of effective drugs and diagnostics?

Theme II

Understanding and remedying inequality of access to proven therapies, prevention and information l What are the barriers to/opportunities for effective dissemination of health information and how could different approaches, e.g. social marketing, be best utilized to contribute to improved disease control and prevention? l What factors influence household decision-making patterns and what are their implications for disease control and prevention? l What are the most effective and equitable models for public-private partnerships for communicable disease control and prevention? What have we learned from existing or past partnerships, and how might we best assess efficacy of such strategies? To what extent are the needs of vulnerable populations being met through such partnerships? Examples might include: Medicines for Malaria Venture Roll Back Malaria River blindness eradication efforts Polio eradication in the Americas How can equitable systems be set up for sharing costs of health care in poor countries?

Theme III

Understanding the linkages between global, national and local level policymaking and their ability to respond to key health issues l What are the underlying values, comparative advantages and implications of different conceptual frameworks (e.g. vulnerability, burden of disease) used in health policy? l What are the characteristics of policies and government actions that effectively address issues of inequity? l What are the characteristics of countries that have policies that promote equity/ equality? l Identifying and differentially weighting the factors responsible for recent public health reversals. Examples might include: Resurgent tuberculosis in eastern Europe and central Asia Schistosomiasis in China Dengue in Latin America Malaria and Sleeping sickness in sub-Saharan Africa.

Theme IV

Moving from epidemiological construct of risk to a social construct of vulnerability (see risk in context and understand the context of risk) l How do households/communities manage their health and well-being? l What factors influence communities capacities to manage and sustain health programmes and interventions? l Does empowerment of communities lead to sustainability of disease control and prevention? l How can the health system be more proactive with regard to intersectoral collaboration to redress vulnerability? What are the barriers and potential? l How do diseases affect fertility, pregnancy, sexuality and violence against women?

Theme V

Understanding the implications of changing social, political and civil structures for the health of vulnerable populations l What are the impacts of economic policies and health sector reform (including trade liberalization, decentralization and privatization of health services, and the introduction of user fees) on infectious disease prevention and control? Example topics include: Impact of such policies on prudent and equitable use of antibiotics and other drugs. Access to basic services by vulnerable populations. Ability of the state to perform its traditional role as guarantor and regulator of services. What are the implications of changing health service delivery systems for health service utilization patterns? (e.g. what are the effects of multiple or vertical government health interventions versus integrated programmes at the community level?) What are the implications of population mobility (such as migration, trans-cultural movements, and circular migration) for the control and prevention of TDR diseases?

Theme VI

Understanding policy processes (including the role of evidence in policymaking) with the aim of exploring innovative approaches to defining and responding to emerging problems l What are the barriers to and opportunities for effective dissemination of research results? l How is the notion of stewardship relevant in the context of communicable disease control? l How can government budgets be channelled to reduce vulnerability and respond to vulnerable circumstances? l How can policy-makers be convinced to see health as a public good? l How can the priorities of health systems and those of poor populations be brought closer together? l How can the notion of healthy public policies be promoted, in contrast to a more narrowly conceived health policy? l What are the assumptions underpinning influential paradigms of communicable disease treatment and control? What are their impacts both globally and locally? Examples might include: Health policies relevant to tropical disease research and control. Formulation, promotion, and dissemination of global health policies. Role of community, local, and state participation in the formulation of policy to control communicable diseases.

Recommendations: HOW TO ACHIEVE THE GOALS OF SEB
Considerable discussion was devoted to issues of research capacity building. It was generally felt that the research to be undertaken by SEB would be difficult and complex to conduct, in particular in light of its inter-disciplinary nature.A long-term commitment will be needed to build adequate research capacity in disease endemic countries. Mechanisms to attract, support and develop such capacity will be key to achieving the goals of SEB. The SWG also discussed the need for SEB to develop criteria for evaluating its efforts (e.g. defining concrete objectives, outputs and targets). Related to this concern, the group felt that the research agenda and priorities to be developed further by the Steering Committee should be clearly relevant to prevention and control of TDR diseases, and support the overall goals and objectives of TDR. Specifically, the group recommended the following: It was felt by some members of the SWG that considerable work had already been done on some topics, and that the Steering Committee should commission comprehensive reviews where necessary, in order to develop relevant research agendas. Basic social, economic and behavioural research will require a high level of research capability.The SWG felt strongly that SEB research should be carried out by trained social scientists, and that mechanisms need to be developed to both attract and build social science research capacity. Small grants programmes and partnerships between institutions and individuals in developed and resource poor countries are two potential mechanisms that were discussed. It was also recommended that a web page be developed for SEB that would provide a forum for exchange of ideas, information and experiences relevant to SEB research. The SWG recommended that SEB draw on a range of methodological approaches to achieve the goals of SEB. In some instances, this may involve the use of participatory research methodologies, but will ultimately depend on the specific research issues being addressed. The SWG recommended that SEB develop and support mechanisms to ensure the effective dissemination of research results to different target audiences (policy-makers, public health professionals and academics at both national and international levels). Writing workshops to develop policy briefs and other non-academic reports were suggested as one possible mechanism.

NEXT STEPS

The Steering Committee will be formed and a first meeting convened in September 2000. The main purpose of this first meeting will be to develop a prioritized research agenda and corresponding calls for proposals for 2000-2001. A second meeting of the Steering Committee will be held in the spring of 2001 in order to review and recommend new projects for funding.

List of Participants

Jens Aargaard-Hansen, Danish Bilharziasis Laboratory, Jaegersborg All 1D, DK 2920 Charlottenlund DENMARK Jah@bilharziasis.dk Dr Celia Almeida, Associate Professor and Senior Researcher in Health Policy and Planning, Dept. de Administrao e Planejamento em Sade-DAPS, Escola Nacional de Sade PblicaENSP/FIOCRUZ, R. Leopoldo de Bulhes, 1480 Manguinhos, 21041-210 Rio de Janeiro, BRAZIL Calmeida@ensp.fiocruz.br Dr Harriet Birungi, Makerere Institute of Social Research, Makerere University,Wandegeya Street, Kampala, UGANDA Misrlib@imul.com Dr Roberto Briceo-Len, Director, Laboratorio de Ciencias Sociales, Universidad Central de Venezuela, Apartado 47-795, Avenida Agustin Codazzi, Quinta LACSO, Santa Monica 1041-A, Caracas, VENEZUELA Lacso@reacciun.ve Dr Paul Farmer, Program in Infectious Disease and Social Change, Department of Social Medicine, Harvard School of Public Health, 641 Huntington Avenue, Boston MA 02115, USA Pefarmer@bics.bwh.harvard.edu Pihpaul@aol.com Dr Suvajee Good, Director, Master Degree Program in Health Social Science (International), Department of Social Sciences and Humanities, Mahidol University, Salaya, Nakornpathom 73170, THAILAND Shsct@mahidol.ac.th Professor Kristian Heggenhougen, Department of International Health, Boston University School of Public Health, 715 Albany Street, T4W, Boston, MA 02118, USA Kheggenh@bu.edu and Lecturer, Department of Social Medicine, Harvard Medical School, 641 Huntington Avenue kris_heggenhougen@hms.harvard.edu Professor Shan-lian Hu, Department of Health Economics, Shanghai Medical University, 138 Yi Yue Yuan Road, 200032 Shanghai, CHINA Slhu@fudan.ihep.ac.cn Dr Gerald T. Keusch, Director, John E. Fogarty International Center, National Institutes of Health, Building 31, Room B2C08, 31 CENTER DR MSC 2220, Bethesda, MD 20892-2220, USA. Keuschg@nih.gov Professor Lenore Manderson, Director, Key Centre for Womens Health in Society, University of Melbourne, 720 Swanston Street, 3053 Carlton, Victoria, AUSTRALIA L.Manderson@KCWH.unimelb.edu.au Professor Anne Mills, Head, Health Economics and Financing Programme, Health Policy Unit Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK Anne.mills@lshtm.ac.uk Dr Sunil Nandraj, CEHAT Research Centre of Anusandhan Trust, BMC Maternity Home, 135 A-E Military Road, Marol, Andheri, Mumbai 400059, Maharashtra, INDIA Sunil@cehat.ilbom.ernet.in Jayashree Ramakrishna, Additional Professor and Head, Department of Health Education, National Institute of Mental Health and Neuro Sciences (NIMHANS), Post Bag 2900, Hosur Road, Banglaore 560 029, INDIA J_ramakrishna@vsnl.com Dr Pilar Ramos-Jimenez, Social Development Research Center, De la Salle University, 2401 Taft Avenue,1004 Manila, PHILIPPINES clafam@mail.dlsu.edu.ph

Susan Rifkin, Tropical Institute of Community Health & Development in Africa (TICH), P.O. Box 2224, Kisumu, KENYA Tich@net2000ke.com : Sbrifkin@compuserve.com Dr Anita Mandrup Ronn, Department of International Health, Centre for Medical Parasitology, University of Copenhagen, Blegdamsvij 3B, 1200 DENMARK Ronn@dadlnet.dk Dr. Maha Mohammed Talaat Ismail, Associate Professor of Public Health, Theodor Bilharz Research Institute & Head of Community & Social Medicine Department, Theodor Bilharz Research Institute, PO Box 30, Giza 12411 EGYPT maha@frcu.eun.eg Dr Viroj Tangcharoensathien, Health Systems Research Institute, Ministry of Public Health, Mental Health Building, Ngamvongvan Road, 11000 Nonthaburi, THAILAND Viroj@hsrint.hsri.or.th Professor Marcel Tanner, Director, Swiss Tropical Institute, Socinstrasse 57, CH-4002 Basel, SWITZERLAND Marcel.Tanner@unibas.ch Dr Joseph K. Wangombe, Department of Community Health, College of Health Sciences, University of Nairobi, P.O. Box 19676 Nairobi, KENYA Wangombe@form-net.com Dr Susan Zimicki, Research Director, the CHANGE Project, Academy for Educational Development, 1825 Connecticut Avenue NW, Washington, DC 20009-5721 Szimicki@aed.org Dr Anthony Zwi, Head, Health Policy Unit, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK Anthony.zwi@lshtm.ac.uk

WHO Secretariat

Dr Miguel Gonzalez-Block (EIP/GPE), Programme Manager, Alliance for Health Policy and Systems Research blockm@who.int Dr David Evans, Coordinator (EIP/GPE/EQC), Effectiveness, Quality, Cost, Gender and Ethics evansd@who.int Dr Andres de Francisco, International Health Specialist, Global Forum for Health Research defranciscoa@who.int Dr Claudia Garcia-Moreno (EIP/GPE/EQC) garciamoreno@who.int Dr Pamela Hartigan (VIP), Director, Violence and Non-Intentional Injury Prevention hartiganp@who.int Dr Dean T. Jamison (EIP/EAS), Director, Economics Advisory Service jamisond@who.int Dr Yasmin Von Schirnding (SDE/HSD), Health and Sustainable Development vonschirndingy@who.int

TDR Staff

Dr Carlos Morel (Director): morelc@who.int Mr Erik Blas (Programme Manager): blase@who.int Dr Paul Nunn (PPM): nunnp@who.int Dr Ayo Oduola (Coordinator STR): oduolaa@who.int Dr Patricia Hudelson (STR): hudelsonp@who.int Dr Jane Kengeya-Kayondo (Coordinator IDE): kengeyakayondoj@who.int Dr Melba Gomes (IDE): gomesm@who.int Dr Odele Kale (IDE): kaleo@who.int Dr Fabio Zicker (Coordinator RCS): zickerf@who.int Dr Ins Azevedo (RCS): azevedoi@who.int Mr Steven Wayling (RCS): waylings@who.int Dr Mark Perkins (PRD): perkinsm@who.int
WHO/TDR Avenue Appia Geneva 27 Switzerland Tel: (+41) 22-791-3725 Fax: (+41) 22-791-4854 E-mail: tdrnews@who.int Web: www.who.int/tdr

Agadez, The Music and The Rebellion

Alberts Winter

Director: Ron Wyman Omara Moctar is one of the great guitar players of West Africa. After years of exile, he returns to his home town, Agadez, at the edge of the Sahara to celebrate their culture and their transition to the modern world. (Niger, USA 65 min)
Director: Andreas Koefoed Eight years old and feeling the pressure of the world. His mother is sick. Albert would rather not talk about it. Meanwhile his parents want him to start choir school. This award winning lm captures the fear and confusion of being a child in an adult world. (Denmark 30 min)
And When I Dim the Lights
Director: Ron Osgood A behind-the-scenes look at the making of a John Mellencamp song. Produced in cinema verite style to t the mood of the music, this documentary short highlights the recording process through observation, music performances and short interviews. (USA 7 min)

Beyond This Place

The Big Uneasy
Director: Kaleo La Belle Whos sacriced on the road to freedom? Director Kaleo La Belle challenges his hard-core hippie dad, proudly stoned for 40 years, to a grueling 500 mile bike trip. On the road, they struggle to reconcile different outlooks and fathom their complicated love. (Switzerland USA 92 min)
Director: Harry Shearer Humorist and New Orleans resident Harry Shearer tells the story of a disaster that he argues could have been prevented. This lm was made to return to the people of New Orleans control over the narrative of their own near-destruction. (USA 98 min)

Boys of Summer

Director: Keith Aumont On a tiny Caribbean island that was once a Dutch slave trade center, one scrappy Little League Baseball team inspires a nation with their incredible winning streak and multiple trips to the Little League World Series in Williamsport, PA. (USA, Curacao 93 min)

Chained!

Director: Betsy Kalin Why are lesbians the biggest consumers of wallet chains in the country? Chained! is a fun, humorous romp through the lives of these quirky lesbians who dene themselves by their chains. (USA 14 min)
Director: Aaron Schock The Ponce familys hardscrabble circus has lived and performed on the back roads of Mexico since the 19th century. Circo intimately portrays the family circus as it struggles to make a living off its artistry, sweat and wit against the backdrop of Mexicos collapsing rural economy. (Mexico, USA 75 min)
Coals to Newcastle: The New Mastersounds

Coming Back for More

Cry Rock
Director: Aaron Dunsay, Marca Hagenstad British funk band, The New Mastersounds, bring their music to the birthplace of funk, New Orleans. Be ready to dance when they take the stage at Hopmonk following the screening. (USA, UK 79 min)
Director: Willem Alkema Funk legend Sly Stone disappeared for more than 20 years. He didnt want to be found or lmed. In 2005, Willem Alkema started searching. Follow the clues and join in the search for one of the most enigmatic characters in pop culture history. (Netherlands, USA 74 min)
Director: Banchi Hanuse A woman wonders whether to record her grandmothers stories or to uphold the oral storytelling tradition by not recording, potentially losing her grandmothers knowledge forever. The beauty of the Bella Coola Valley blends with vivid watercolor animation, illuminating the intersection of story, place and culture. (Canada 28 min)
Danza del Viejo Inmigrante (The Old Immigrants Dance)

Deconstructing Dad

Director: Charlene Music Through moments of sacrice and also of joy, elderly Latinos nd the courage to forge a new life in the United States. (USA 18 min)
Director: Stan Warnow An exploration of composer and inventor Raymond Scott. You know him from classic Warner Bros cartoons and was the rst electronic music pioneer. But from the unique perspective of his lmmaker son, he leaves a more complicated legacy. (USA 98 min)
Ed Hardy: Tattoo The World
Director: Emiko Omori The amazing journey of artist Ed Hardy. From his desire to be a tatto artist at age 10 to his Japanese training to his studio in San Francisco where he initiated the global popularity of tattooing, launched a worldwide brand, and transformed modern culture. (USA 75 min)

The Elephant Bath

Enter the Beard
Director: Aron Gaudet A beautiful look at the intimate relationship between an Indian elephant trainer and his elephant told through the ritual of a morning bath. (India 5 min)

Director: Matt Lawrence & Scott Ballard Anchorage, Alaska: Over 250 men from around the globe compete in The World Beard and Mustache Championships. One such man, Charles Parker Newton, documented his quest. Join Parker on his journey as he navigates through the hirsute. (USA 17 min)
Floating: The Nathan Gocke Story

Goodnight Nobody

Director: Richard Yelland This Saturday started off like every Saturday for thirty-twoyear old surfer Nathan Gocke. But it was a day his life would change forever. Nathans journey is a declaration that we all can endure and overcome. (USA 22 min)
Director: Jacqueline Znd One of the most beautiful lms to play SDFF: A sleepless trip through one night in the unusual lives of four insomniacs. They are night people against their will, oating between a realistic dream world and dream-like reality. (Switzerland, Burkina Faso, China, Ukraine, USA 75 min)

I Bought a Rainforest

Director: Jacob Andrn & Helena Nygren Almost 20 years ago Jacob and his classmates raised money to buy rainforest. But did their effort really make a difference? This amusing lm is a journey to nd out. (Sweden 58 min)

I Hear What You See

Im Just Anneke
Director: Chris Simon Born blind, Kenny Hall, one of the most inuential old-time musicians living today, hears the world that most of us see. With his unique mandolin style & repertoire of songs we hear his inspiring story. (USA 46 min)
Director: Jonathan Skurnik Portrait of a 12-year-old girl. She loves hockey and has a loving family. Shes a hardcore tomboy who everyone assumes is a boy. But puberty has created an identity crisis. Does she want to be a boy or a girl when she grows up? Or something in between? (USA, Canada 11 min)
If These Walls Could Talk
Director: Anna Rodgers If walls can hold memories, and buildings can have ghosts, what echoes linger in old psychiatric institutions? Anna Rodgers returns from Dublin with her new lm about the forgotten people who roamed the corridors of these now-decaying spaces. (Ireland 12 min)
Director: Charles Fairbanks Irma is an intimate musical portrait of Irma Gonzalez, the former world champion of womens professional wrestling. Featuring original music written and performed by Ms. Gonzalez, Irmas story surges with love and deceit, masculine strength, feminine charms, and an extraordinary sense of humor. (Mexico, USA 12 min)

The Kids Grow Up

Lost in the Fog
Director: Doug Block His documentary 51 Birch Street looked at his parents and uncovered a universal story about post-war, suburban families. Focusing on family again, we see his daughter leaving for college, confronting the hardest part of raising a child: letting go. (USA 90 min)
Director: John Corey Owned out of San Francisco with the given name Lost in the Fog, this horse became one of the fastest racehorses in the world. A blue-collar colt up against horse racings royalty - a legend in the making - until fate rewrote the ending. (USA 80 min)

Marwencol

Director: Jeff Malmberg Mark Hogencamps fantasy world. Building a miniature World War II-era town dubbed Marwencol, he photographs action sequences that aid his recovery from a brain injury. When the photographs are discovered by a New York gallery hes forced to choose between the safety of his fantasy life and the real world. (USA 82 min)

Mealtime with Mia

Men Who Swim
Director: Christopher Pavsek Four short lms about Mia and her almost unparalleled passion for food and her near laser-like focus on eating as the world goes on around her. Keep your eyes out for these short lms as they appear in various spots during the festival. (Canada 3 min)
Director: Dylan Williams A warm, humorous look at one mans search for meaning - in a swimming pool. On the brink of turning 40, he joins a mens synchronized swimming team as an escape. An unexpected level of commitment inspires the team to compete at the unofcial World Championship. (Sweden 72 min)

Meter Man

Director: Victor Fanucchi Meter Man is a short, crass, yet compassionate documentary about what its like for three Midwestern parking enforcers to walk the beat while facing constant public hostility. (USA 11 min)

Michael & His Dragon

Director: Briar March A refreshing and poetic look into the experience of posttraumatic-stress disorder told from the perspective of a contemporary veteran. (USA 7 min)

The Most Distant Places

Mothersbane
Director: Michael Seely Dr. Edgar Rodas is an extraordinary doctor dedicated to improving health conditions for underprivileged communities in his native Ecuador. This lm intimately portrays his visionary mobile hospital and rural health care project. (Ecuador, USA 36 min)

Director: Jason Jakaitis Mothersbane is a personal documentary exploring the lmmakers ambivalent relationship to his mothers physical disabilities and chronicling his attempts to be at peace with her suffering and disgurement. (USA 11 min)

My So-Called Enemy

Director: Lisa Gossels Jewish, Muslim, and Christian women meet, argue, and try to bring peace back home to the Middle East. Followed for 7 yrs, see these conicts through the eyes of these 6 intelligent young women. (USA, Israel, Palestinian Territories 89 mins)

Neev (The Foundation)

Director: Wardan Tiple It takes a lot of sweat, blood, patience, pain, labor and a complete metamorphosis to transform soft, natural black mud into hard synthesized red brick. Brick - the base of almost all structures and a silent onlooker of human race, history and society. (India 13 min)

On Coal River

Director: Francine Cavanaugh & Adams Wood Coal River Valley is a community surrounded by lush mountains and a looming toxic threat. On Coal River follows a former coal miner and his neighbors in a David-andGoliath struggle for the future of their valley, their children, and life as they know it. (USA 81 min)

Out In the Silence

Director: Dean Hamer & Joe Wilson Out in the Silence is an uplifting documentary about courageous local residents confronting homophobia and the limitations of religion, tradition and the status quo in their conservative small town in western Pennsylvania. (USA 65 min)
Philip Pearlstein: Naked Vision
Director: Jen Dietrich & Sarah Nitschke Considered the father of New Realism, through his prolic painting, writing, and teaching, Philip Pearlstein has had a tremendous impact on modern and postmodern art. (USA 31 min)

Pianomania

Director: Lillian Franck & Robert Cibis The humorous quest for the perfect sound. Nerves of steel, boundless passion, and extraordinary competence in translating words into sounds dene Stefan Knuepfer of Steinway, Vienna as he works with world-famous pianists to nd the right instrument. (Austria, Germany 93 min)

Plasticity

Director: Ryan Malloy Plasticity reveals three examples of people redening how urban space is used in San Francisco. (USA 5 min)

Shelter

Director: Jason Sussberg Lloyd Kahn says shelter is more than a roof over your head. The author of over a dozen books Lloyd has been grappling with the concept of home for over ve decades. With the housing crisis as backdrop, this lm proles his ideas on DIY construction and sustainability. (USA 6 min)

A Simple Question

Director: Kevin White & David Donnenfield What started in 1992 as a 4th-grade extinction project is now STRAW (Students and Teachers Restoring a Watershed), a program that has restored over 20 miles of habitat connecting teachers & children with nature. (USA 34 min)
Sin Pas (Without Country)
Director: Theo Rigby Sam and Elida Mejia escaped Guatemala during the civil war bringing their baby son to California. For 20 years, they worked hard, raised a family, and lived the American dream until immigration agents stormed their house. (Guatemala, USA 19 min)

Small Wonders

Director: Tally Abecassis Small Wonders is a lm about the disappearance of the small store from the urban landscape. Following three small store-owners over the course of ve years, the lm shows the resilience of human nature and how we bounce back despite the obstacles life puts in our path. (Canada 52 min)

Steam of Life

Director: Joonas Berghll & Mika Hotakainen Its not a therapists ofce where Finnish mens deepest feelings about life and love surface- its the sauna. Listen in as men talk to other men in the sanctuary of the countrys ubiquitous saunas, telling personal and universal stories. (Finland 81 min)

Stolen

Director: Violeta Ayala & Daniel Fallshaw A compelling, modern-day, real-life cloak-and-dagger thriller. The lmmakers stumble on a story about modern slavery. Smuggling footage and fearing for their lives they emerge to tell this important story. (Australia, USA, Algeria, Morocco, 78 min)

Sun Come Up

Director: Jennifer Redfearn The story of some of the worlds rst environmental refugees - the Carteret Islanders. Searching for a new home on Papua New Guinea, we glimpse the beginning of human effects of climate change. Short-listed for Academy Award 2010, Documentary Short Subject. (Papua New Guinea, USA 38 min)

The Time Machine

Tuned In
Director: Mark Kendall A watchmaker in Grand Central Station deconstructs his process and muses about the nature of time. Winner Best Short Documentary, Arizona International Film Festival 2010. (USA 11 min)
Director: Kevin Gordon Natural radio signals surround us all the time. Tuned In goes on a sonic journey into the world of one natural radio pioneer and his efforts to capture these unique and mesmerizing sounds. (USA 5 min)

Two Weddings

Director: Eddie Rosenstein SDFF 08 & 09 award winner Eddie Rosenstein brings us another great lm. By paralleling two weddings in one family, the joys and sorrows of several generations are revealed. (USA 8 min)

Union Maids

Director: Julia Reichert, Jim Klein, Miles Mogulescu 1976 Oscar nominee, Union Maids is the portrait of three women organizers of the rst industrial unions in America. Radicals in the 1930s, they helped shape the country, and connect their movement to the womens movement of the 1970s. (USA 50 min)

Vanishing of the Bees

Director: George Langworthy & Maryam Henein This lm illustrates the critical role of honeybees in our agriculture landscape. An investigative look at the economic, political, and spiritual implications of Colony Collapse Disorder. (USA 87 min)
Voices Unbound: The Story of the Freedom Writers
Director: Daniel Anker From at-risk youths to published authors, see how students and their teacher learn from war diarists Anne Frank and Zlata Filipovic to rise above their circumstances through the power of writing their stories. (USA 90 min)

Wo Ai Ni Mommy

Director: Stephanie Wang-Breal This story of gain and loss is woven together by the bond between a mother and her adopted Chinese daughter. From the rst meeting to life back home, we see the challenges of this new family forging together their lives and future. (USA 76 min)

Wood of Value

Director: Bjorn Bratberg Watch a Christmas trees journey from the forests of Norway to the center of London in an annual tradition thanking the British for aid during World War II. (Norway 16 min)
Yanqui WALKER and the OPTICAL REVOLUTION

The Yellow Bittern

Director: Kathryn Ramey Kathryn Rameys experimental doc is about a now-obscure American expansionist, William Walker, who through coercion and military force became dictator of Nicaragua in 1856. (USA 33 min)
Director: Alan Gilsenan Out-selling The Beatles at their height, and inuencing artists like Bob Dylan and Tom Waits, The Clancy Brothers changed the face of Irish popular music. Watch Liam Clancy weave tales & confessions of his raucous life. (Ireland 108 min)