SAN DIEGO STATE UNIVERSITY
GRADUATE SCHOOL OF PUBLIC HEALTH
PH 780, Global Health I
Fall 2013
Class day/time: Tuesdays 10-12:40 AM
Class location: AH 2134
Schedule number: 22343
Email: tnovotny@mail.sdsu.edu
TA: Raphael Cuomo, MPH
Instructor: Thomas Novotny, MD
Office hours: T & Th 1-2:00 PM
Office location: Hepner Hall 136B
Phone: 619-594-3109, cell 619-206-3656
Email: raphael.e.cuomo@gmail.com
I. COURSE OVERVIEW
This course is an introductory course in global health. It is required for those in the
UCSD/SDSU Joint PhD Degree Program in Global Health and is open to those in the Preventive
Medicine Residency Program, other JDP students with interests in global health, and to others
with permission of the instructor. The style of the course will be very interactive with heavy
emphasis on required reading and case study discussions. Student enrollment is limited to 20.
The course will also involve a number of guest lecturers so that students may gain perspectives
on the research and project activities being conducted by SDSU/UCSD faculty members, NGOs,
and the private sector across multiple disciplines.
II. GENERAL COURSE OBJECTIVES
The content of this course is based on broad arenas: the global burden of disease, including an
analysis of major infectious and non-infectious disease problems; the changing architecture of
global health, including international organizations, philanthropies, and new structures such as
private public partnerships; and health diplomacy---the interface of foreign policy and global
health as well as the interface of culture, politics, and history with global health problems.
Students are also expected to attend the Global Health Seminar Series, held roughly twice per
semester at SDSU. Course objectives include the following:
1. DEFINITIONS: At the end of this course, students will be able to:
a. Explain the term ‘global health’ and what makes it different from ‘international
health.
b. Evaluate the conceptual basis for ‘global’ approaches to major health problems and
the need for new approaches beyond simply ‘disease control.’
c. Explain concepts behind estimates of the global burden of disease, the relative impact
of communicable vs non-communicable diseases, and the political economy that
affects various specific diseases.
d. Compare and contrast measurement methods applied to global health problems and
how these can help set goals and gauge success of interventions.
2. SOLUTIONS:
a. Evaluate the changing architecture of global health including multinational
organizations, philanthropies, private-public partnerships, and government programs.
b. Articulate the main global strategies to prevent and reduce the several critical highburden diseases.
c. Analyze the complexities of pandemic response in a globalized world.
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d. Compare and contrast disease-specific response (vertical programs) versus integrated
approaches (horizontal programs) for globally important diseases.
e. Explain how results-based investments in global health are now implemented.
3. CONTEXT:
a. Evaluate the role of health diplomacy in addressing shared global health problems
among countries.
b. Evaluate cultural, ethical, social, systemic, and anthropological determinants of
global health problems.
III.
COURSE DETAILS
1. Credit: Three (3) semester units
2. Required Text: Merson MH, Black RE, Mills AJ. International Public Health:
Diseases, Programs, Systems and Policies (3rd ed.). Sudbury, MA: Jones and Bartlett
Publishers, 2011.
3. Recommended reading: Novotny TE, Kickbusch I, and Told M. 21st Century Global
Health Diplomacy. Singapore: World Scientific Publishers
4. WEBSITE: All assignments, course documents, news, and changes will be posted to
the PH 780 Blackboard site. Registered students will have immediate access to this site.
5. Web Resources:
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SDSU JDP in Global Health: http://publichealth.sdsu.edu/phd-global-main.php. This
will have announcements, opportunities, and links of interest.
UCSD Global Health Website: http://gph.ucsd.edu/index.shtml, which also will have
descriptions of programs, research, and opportunities on the UCSD campus.
World Health Organization: www.who.int
Social Determinants of Health: http://www.who.int/social_determinants/en/
Office of Global Affairs, Department of Health and Human Services:
www.globalhealth.gov
Consortium of Universities for Global Health http://www.cugh.org/
Center for Global Health, Centers for Disease Control and Prevention:
http://www.cdc.gov/globalhealth/
Fogarty International Center, National Institutes of Health: http://www.fic.nih.gov/
Kaiser Family Foundation Global Health http://globalhealth.kff.org/
UN Millennium Development Goals www.un.org/millenniumgoals/
Center for Strategic and International Studies http://csis.org/
Center for Global Development http://www.cgdev.org
Peoples Health Movement www.phmovement.org
US Global Health Initiative http://www.ghi.gov/
Pan American Health Organization http://new.paho.org/index.php
Council on Foreign Relations www.cfr.org
6. ASSIGNMENTS
a. Read all assigned materials
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b. Class participation: Develop arguments and positions with which to participate
during class discussion (see syllabus topics). This is a doctoral level course and thus
students should be largely responsible for their own learning. The subjects presented
are meant to stimulate your reading and research on these and are not completed in
terms of coverage of the field. It is expected that students will move beyond
assignments and pursue the subjects presented in more depth than found in the
readings.
c. Three exams: We will NOT have midterm or final exams. Instead, we will have a
series of three short, open-book exams that will take place after main sections of the
course. These will be posted on the Blackboard website and you will have 24 hours
to complete the exams. The results will be discussed in class. General topics will
include:
i. Major global health disease challenges
ii. The architecture of global health
iii. Global health and foreign policy
d. Term Paper:
i. Develop a two-page (only) outline for the term paper on a major global health
issue discussed in the course, according to guidelines posted on Blackboard.
This annotated (that means include reference list) outline should be posted on
BB as a Word Document 5 PM, Tuesday, October 16, 2012. Comments will
be provided and returned to students within 2 weeks.
ii. Prepare a 10 page term paper (Please note the guidelines on the instructions
posted on BB assignments for: 1.5 line spacing, margins 1 inch, 11pt Arial
Font, page limit does not including references, charts, or graphs). Term Papers
should be posted as a TURNITIN assignment midnight, December 14, 2012.
Pay close attention to scholarly writing, punctuation, referencing, and clarity.
Also, run your paper through TURNITIN in advance to make sure you don’t
have any excess direct quote.
e. Prepare a team presentation on a group assignment to be provided in class; deliver a
20 minute presentation by the team (2-3 students in each team), using Power Point:
define the problem to be discussed; describe findings as to disease burden, major
interventions, and gap; and make recommendations for new approaches and research.
Group topics should be agreed upon and reviewed in class on 10/25. Some suggested
topics include (but are not limited to):
i. The future of the US Global Health Initiative
ii. The future of the Global HIV/AIDS Epidemic in the era of HAART
iii. The role of the private sector in global health
iv. The global diabetes epidemic
v. The role of BRICS in global health diplomacy: south-to-south collaboration,
political agendas, economic agendas, and solidarity
vi. Biopreparedness: What to make of the new infections such as MERS, Avian
Flu, etc.
7. GRADING: Grading will be based on the following:
a.
Required attendance
10%
b.
Class participation
10%
c.
Term paper outline by October 16
10%
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d.
Group presentation
10%
e.
Monthly exams
30%
f.
Term paper due December 13
30%
(N.B. Papers received after due date will be decreased by 10 point)
g. Letter grades will be based on cumulative scores:
100-95= A
79-75= C+
94-90= A74-70= C
89-85= B+
69-60= D
84-80= B
<60 = F [non-passing grade]
IV.
Date
Week 1
August 27
CLASS SCHEDULE
Topics
Dr. Novotny:
Introductions, course
overview
Discussion: What is
Global Health?
Course Requirements:
The term paper
Group presentation
assignment
Week 2
September 3
Lecture: T. Novotny:
The Global Burden of
Disease
Student-led
Discussion: How do
you measure global
health? (See
discussion questions
on BB)
Week 3
Lecture: T. Novotny
September 10 HIV 30 years later
Case Study: How
Brazil may have
outdone the United
States
1.
2.
3.
4.
5.
6.
Readings and Assignments (Required Reading in BOLD)
Merson, Chapter 18: Globalization and Health - Kelley Lee,
Derek Yach, and Adam Kamradt-Scott
CDC. Ten Great Public Health Achievements — Worldwide,
2001–2010. MMWR / June 24, 2011 / Vol. 60 / No. 24:814-818.
Koplan JP, Bond TC, Merson MH, et al. (2009) Towards a common
definition of global health. Lancet 2009;373(9679):1993 – 1995.
http://www.ghi.gov/newsroom/blogs/2012/194472.htm
De Cock KM, Simone PM, Davison V, Slutsker L. The new global
health. Emerg Infect Dis [Internet]. 2013 Aug [date cited].
http://dx.doi.org/10.3201/eid1908.130121External Web Site Icon
Lidén J. The Grand Decade for Global Health: 1998–2008. Chatham
House, London: April 2013 (Reference material only)
1. Merson, Chapter 1: Measures of Health and Disease in
Populations - Adnan A. Hyder, Prasanthi Puvanachandra, and
Richard H. Morrow Sayer BM, Fliedner TM.
2. The critique of DALYs: a counter-reply. (1997) Bull WHO;75(4):
383-384.
3. Mathers CD, Loncar D (2006) Projections of global mortality
and burden of disease from 2002 to 2030. PLoS Med 3(11): e442.
doi:10.1371/journal.pmed.0030442
4. Discount Rates for Environmental Benefits Occurring in the FarDistant Future. www.iearesearch.com, February 3, 2009
1. Needle R. et al. PEPFAR’s Evolving HIV Prevention
Approaches for Key Populations—People Who Inject Drugs,
Men Who Have Sex With Men, and Sex Workers: Progress,
Challenges, and Opportunities. J Acquir Immune Defic Syndr
2012;60:S145–S151
2. Novotny TE. Excerpts from Two Decades of Action on HIV/AIDS in
LAC –Lessons Learned from World Bank Investments
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3. Gomez E. How Brazil Outpaced the United States When It Came to
AIDS: The Politics of Civic Infiltration, Reputation, and Strategic
Internationalization. J Health Politics, Policy Law, Vol. 36, No. 2, April
201. DOI 10.1215/03616878-1222739
Week 4
Lecture: T. Novotny
September 17 Responding to the
Non-communicable
(chronic) disease
epidemics
Case Study: Global
cancers-- Raphael
Cuomo (See
Discussion Questions
on BB)
Week 5
Lecture: Kimberly C.
September 24 Brouwer, PhD
Associate Professor
Division of Global
Public Health
‘Neglected Tropical
Diseases’
Case Study: Guinea
Worm Eradication in
Sudan
1. Merson, Chapter 7: Chronic Diseases and Risks - Derek Yach,
George A. Mensah, Corrina Hawkes, JoAnne E. Epping-Jordan,
and Krisela Steyn
2. Novotny TE. Preventing chronic disease: Everybody’s business.
In Nolte E and McKee M (eds) Caring for People with Chronic
Conditions: A Health System Perspective. European
Observatory on Health Systems and Policies Series, McGrawHill 2008.
3. Yach D, Kellogg M, Voute J. Chronic diseases: an increasing
challenge in developing countries. Trans R Soc Trop Med Hyg
2005;99(5):321-4.
4. World Health Organization (2013) Draft action plan for the
prevention and control of noncommunicable diseases 2013–2020.
Report by the Secretariat to the Executive Board
5. Maher D et al. Priorities for developing countries in the global
response to non-communicable diseases. Globalization and Health
2012, 8:14 doi:10.1186/1744-8603-8-14
6. Beaglehole et al. Priority actions for the non-communicable disease
crisis. Lancet 2011; 377: 1438–47
1. Merson, Chapter 5 Infectious Diseases - Arthur L. Reingold and
Aubree Gordon
2. WHO. Social Determinants of Health, Chapter 8, page 135-158.
Neglected tropical diseases: equity and social determinants
3. Hotez PJ. Et al. (2007) Control of Neglected Tropical Diseases N
Engl J Med. 357:1018-27.
4. Case Study: Donald R. Hopkins, MD, MPH, and Ernesto RuizTiben, PhD. Case Study on Health Diplomacy: Eradication of
Guinea Worm Disease in Sudan. (2011)
First Exam Due
By midnight on
Sept. 25
Week 6
October 1
Lecture: T. Novotny:
The Architecture of
Global Health
Student-led
Discussion:
1. Frenk J, Moon S. Governance Challenges in Global Health. N
Engl J Med 2013;368:936-42. DOI: 10.1056/NEJMra1109339
2. Ng NY, Ruger JP. Global Health Governance at a Crossroads.
Global Health Governance 2011; 3(2) http://www.ghgj.org
3. Sridhar D, Gostin LO. Reforming the World Health
Organization. JAMA. 2011;305(15):1585-6.
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What are the main
global health
organizations and their
respective roles? (See
discussion questions
on BB)
Week 7
October 8
Lecture: Dr. Tim
Mackey, UCSD
‘International
Pharmaceutical
Policy’
Case Study: Workshop
– Trademark and
Public Health
Considerations in
Tobacco Marketing
Packaging and
Labeling
Week 8
October 15
Lecture Eileen
Natuzzi, MD: Global
Surgery
Term Paper
Outline
Due by Midnight
Oct 15: See
assignment
guidelines for
term paper
Week 9
October 22
Week 10
October 29
STUDENT
PRESENTATIONS I
Lecture: Sam Shin,
Global heath and TB:
Social determinants
and response
Case Study: TB and
4. Zoellick R. Why We Still Need the World Bank: Looking Beyond
Aid (Essay). Foreign Affairs March/April 2012,
5. Bollyky T. Reinventing the World Health Organization. Council on
Foreign Relations, May 23, 2012.
6. Kickbusch I, Hein W, Silberschmidt G. Global Health Governance
Challenges through a New Mechanism: The Proposal for a
Committee C of the World Health Assembly. Global Health
Governance Fall 2010;550-563.
1. Merson Chapter 14. Pharmaceuticals
2. WTO Agreements and Public Health: WTO-WHO Joint
Publication (ONLY NEED TO READ 1-28 AND 38-46).
3. Mackey, T.K., Liang BA. Promoting global health: utilizing WHO
to integrate public health, innovation and intellectual property, In
Press, Drug Discov Today (2012),
http://dx.doi.org/10.1016/j.drudis.2012.06.012
4. Attaran A. How do patents and economic policies affect access to
essential medicines in developing countries? Health Aff (Millwood).
2004 May-Jun;23(3):155-66.
1. Natuzzi ES. Jagilly R, Chu K, Ozgediz D, Ebolu E, Casey K,
Petroze R, Ntakiyiruta T, Novotny T. Surgical issues in
Global Health Chapter 15 in Markle, Fisher, Smego.
Understanding Global Health Second Edition
2. Ozgediz D. et al. The burden of surgical conditions and
access to surgical care in low- and middle-income countries.
Bull WHO 2008; 86(8):577-656.
3. Gosselin R, Ozgediz d, Poenaru D. A Square Peg in a Round
Hole? Challenges with DALY-based ‘‘Burden of Disease’’
Calculations in Surgery and a Call for Alternative Metrics.
World J Surg (2013) Published Online Aug 13. DOI
10.1007/s00268-013-2182-7
4. Bickler SW, Spiegel D. Improving Surgical Care in Lowand Middle-Income Countries: A Pivotal Role for the World
Health Organization. World J Surg (2010) 34:386–390. DOI
10.1007/s00268-009-0273-2
First Group: 20 minutes presentation, 20 minutes discussion each. 10
points each student
1.
1. Murray EJ, Bond VA, Marais BJ, Godfrey-Faussett P, Ayles
HM, Beyers N. High levels of vulnerability and anticipated
stigma reduce the impetus for tuberculosis diagnosis in Cape
Town, South Africa. Health Policy Plan. 2012 Sep 2;28(4):410–8.
2.
Rasanathan K, Sivasankara Kurup A, Jaramillo E, Lönnroth K.
The social determinants of health: key to global tuberculosis
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Smoking
3.
Second Exam due
by Midnight on Oct
4.
30
5.
Week 11
November 5
Lecture: T. Novotny
‘Global Health
Diplomacy:
NGOs, Governments,
Multinationals, and
Foreign Policy’
Case Study: Case
study: Asher Santos,
South-South
Collaborations for
Achieving Global
Health Goals
Week 12
November 12
Week 13
November 19
Guest Lecture: Eric
Stover-Faculty
Director, Human
Rights Center,
Adjunct Professor of
Law and Public
Health, UC Berkeley
Tour of the USNS
Mercy: Car pooling to
30th St Navy Base
Week 14
November 26
Student
Presentations II
Week 15
Guest Lecture: Dr.
control. Int J Tuberc Lung Dis. 2011 Jun 1;15(6):30–6.
Farmer. Story of a poor family in Peru. (excerpt from Farmer P.
Infections and inequalities: the modern plagues. Berkeley [etc.]:
University of California Press; 1999. p.190-193.)
Slama K, Chiang C Y, Enarson D A, et al. Tobacco and tuberculosis:
a qualitative systematic review and meta-analysis. Int J Tuberc Lung
Dis 2007 Oct;11(10):1049-1061.
Van Zyl Smit RN et al. Global lung health: the colliding epidemics
of tuberculosis, tobacco smoking, HIV and COPD. Eur Respir J
2010; 35: 27–33 DOI: 10.1183/09031936.00072909
1. Merson, Chapter 17 Global Cooperation in International Public
Health - Gill Walt, Kent Buse and Andrew Harmer
2. Chatham House (2011) Meeting Summary. Global Health
Diplomacy: A Way Forward in International Affairs
3. Novotny TE, Kickbusch I, Adams V, and Leslie H. Global
Health Diplomacy--a Bridge to Innovative Collaborative
Action. Global Forum Update on Research for Health
2008;5;41-45
4. Kickbusch I, Kökény M. Global health diplomacy: five years on.
Bulletin of the World Health Organization 2013;91:159-159A. doi:
10.2471/BLT.13.118596
5. Daulaire N. The Importance of the Global Health Strategy from the
U.S. Department of Health and Human Services. Am. J. Trop. Med.
Hyg., 87(3), 2012, pp. 382–384 doi:10.4269/ajtmh.2012.12-0400
6. Feldbaum H, Michaud J, 2010 Health Diplomacy and the Enduring
Relevance of Foreign Policy Interests. PLoS Med 7(4): e1000226.
doi:10.1371/journal.pmed.1000226
TBD—this is an open session, so invite your friends!
1. Bonventre E et al. U.S. National Security and Global
Health: An Analysis of Global Health Engagement by the U.S.
Department of Defense A Report of the CSIS Global Health
Policy Center—Working Draft
2. U.S. GLOBAL HEALTH POLICY--THE U.S. DEPARTMENT
OF DEFENSE AND GLOBAL HEALTH September 2012.
Kaiser Family Foundation Report
Second Group: 20 minutes presentation, 20 minutes discussion each. 10
points each student
TBD
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December 3
Holly Shakya, UCSD:
Social Networks
Third Exam Due
by Midnight on
November 30
Week 16
December 10
Wrap up: The US
Global Health
Initiative Going
Forward
December 16
Term Paper Due
at Midnight
1. Alcorn T. What has the US Global Health Initiative Achieved.
www.thelancet.com Vol 380 October 6, 2012
2. http://www.ghi.gov/
3.
30 Points. Make sure this is in accordance with guidelines in course
assignments
V. GENERAL POLICIES
1.
Attendance. Attendance is mandatory. Students are allowed one excused absence during
the semester after which points will be taken from the “Seminar Discussion” grade. In addition,
professional behavior will be expected including arriving to class on time and not leaving early,
not spending excessive time on emails and texting, and not eating in class.
2.
Religious holidays. According to the University Policy File, students should notify the
instructors of affected courses of planned absences for religious observances by the end of the
second week of classes.
3.
Academic misconduct. Academic dishonesty is an affront to the integrity of scholarship
at SDSU and a threat to the quality of learning. Violations of academic integrity are noted in the
SDSU Statement of Student Rights and Responsibilities. Cheating shall be defined as the act of
obtaining or attempting to obtain credit for academic work by the use of dishonest, deceptive, or
fraudulent means. Examples of cheating include, but are not limited to (a) copying, in part or in
whole, from another’s test or other examination; (b) discussing answers or ideas relating to the
answers on a test or other examination without the permission of the instructor; (c) obtaining
copies of a test, an examination, or other course material without the permission of the instructor;
(d) using notes, cheat sheets, or other devices considered inappropriate under the prescribed
testing condition; (e) collaborating with another or others in work to be presented without the
permission of the instructor; (f) falsifying records, laboratory work, or other course data; (g)
submitting work previously presented in another course, if contrary to the rules of the course; (h)
altering or interfering with the grading procedures; (i) plagiarizing, as defined; and (j) knowingly
and intentionally assisting another student in any of the above.
Plagiarism shall be defined as the act of incorporating ideas, words, or specific substance
of another, whether purchased, borrowed, or otherwise obtained, and submitting same to the
University as one’s own work to fulfill academic requirements without giving credit to the
appropriate source. Plagiarism shall include but not be limited to (a) submitting work, either in
part or in whole, completed by another; (b) omitting footnotes for ideas, statements, facts, or
conclusions that belong to another; (c) omitting quotation marks when quoting directly from
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another, whether it be a paragraph, sentence, or part thereof; (d) close and lengthy paraphrasing
of the writings of another; (e) submitting another person’s artistic works, such as musical
compositions, photographs, paintings, drawings, or sculptures; and (f) submitting as one’s own
work papers purchased from research companies.
Academic and Punitive Sanctions: Cheating and plagiarism in connection with the
academic program at The University may warrant two separate and distinct courses of
disciplinary action that may be applied concurrently in response to a violation of this policy: (a)
academic sanctions, such as grade modifications; and (b) punitive sanctions, such as probation,
suspension, or expulsion.
All students in this class are required to complete the online information literacy tutorial,
"Plagiarism: The Crime of Intellectual Kidnapping," a 30-minute tutorial that teaches students
about plagiarism, paraphrasing, and citing sources. Students are to take this tutorial outside of
class time and take the quiz that follows it. They will receive a score on screen that they can
print and this printed score must be submitted as proof of completion by September 15h or they
will be dropped from the course automatically. The tutorial is available at
http://infotutor.sdsu.edu/plagiarism/
4.
Writing Style for Assignments. All assignments are to be MS Word documents and 1.5
line-spaced. Use JAMA style for title page, headings, margins, spelling, grammar, references,
figures, tables, and appendices. Use Ariel 11-pt type, one inch margins. Include your name on
the title page and as a header for each page. Use some sort of reference maker for your
references. (End Note, etc.)
5.
Blackboard. Students are required to check blackboard at least once a week for
announcements and additional required readings. Assignments will be accepted on Blackboard.
“Students agree that by taking this course all required papers may be subject to
submission for textual similarity review to Turninit.com for the detection of plagiarism. All
submitted papers may be included as source documents in the Turninit database solely for the
purpose of detecting plagiarism of such papers. You may submit your papers in such a way that
no identifying information about you is included. Another option is that you may request, in
writing, that your papers not be submitted to Turninit. However, if you choose this option you
will be required to provide documentation to substantiate that the papers are your original work
and do not include any plagiarized material.”
6.
Nondiscrimination Policy. San Diego State University is dedicated to a safe, supportive
and nondiscriminatory environment. It is the responsibility of all students to familiarize
themselves with University policies regarding nondiscrimination, misconduct and academic
honesty. San Diego State University complies with the requirements of Title VI and Title VII of
the Civil Rights Act of 1964, as well as other applicable federal and state laws prohibiting
discrimination. No person shall, on the basis of race, color, or national origin be excluded from
participation in, be denied the benefits of, or be otherwise subjected to discrimination in any
program of the California State University. SDSU does not discriminate on the basis of sex,
gender, or sexual orientation in the educational programs or activities it conducts. More detail on
SDSU’s Nondiscrimination Policy can be found in the SDSU General Catalog, University
Policies.
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SDSU does not discriminate on the basis of disability in admission or access to, or treatment or
employment in, its programs and activities. Students should direct inquiries concerning San
Diego State University’s compliance with all relevant disability laws to the Director of Student
Disability Services (SDS), Calpulli Center, Room 3101, San Diego State University, San Diego,
CA 92128 or call 619-594-6473 (TDD: 619-594-2929).
7.
Student Conduct and Grievances. Instructors at SDSU depend on feedback from
students in order to plan and improve courses. We will ask you to provide objective feedback
after each lecture, and so please do your best to evaluate each presentation professionally and
individually right after class. These evaluations will be shared with each of the lecturers.
SDSU is committed to maintaining a safe and healthy living and learning environment for
students, faculty and staff. Sections 41301, Standards for Student Conduct, and Sections 4130241304 of the University Policies regarding student conduct should be reviewed. If a student
believes that a professor’s treatment is grossly unfair or that a professor’s behavior is clearly
unprofessional, the student may bring the complaint to the proper university authorities and
official reviewing bodies. See University policies on Student Grievances.
8.
Students with Disabilities: If you have any disability which may impair your ability to
successfully complete this course, please let me know during the first two weeks of class.
Accommodations are coordinated through the Student Disability Services and require
documentation. The SDSU office is located at the Calpulli Center, Suite 3101, Phone: (619) 5946473.
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