Global Health Issues

Louis Carrillo, Jerry Cherisen, Stephen Ferber, Robert Guido, Mary Keanrs, Mario Mayes-Romero, Jennifer Pernas, Katiuska Ramierez,

What do you think are some of the most important issues in global health?

Biggest global health issues

Access to health care (cost, location,
poverty, war, socio-economic factors)

Infectious Diseases (HIV, malaria,

pneumonia, TB)

Water (ownership, cost, sanitation) Tobacco use Obesity (beef, sugar etc.)

BIG numbers (some context)

1 million (about half the population of Miami) 8 million (about the population of NYC) 20 million (about the population of Florida) 300 million (about the population of the U.S.) 1.5 billion (about the population of China) 7 billion (about the population of the world)

Access to health care

The establishment of the World Trade Organization imposed US style intellectual property rights around the world. These rights were intended to reduce access to generic medicines and they succeeded.
-Joseph Stiglitz (former World Bank Chief Economist and Nobel Prize
winner for economics)

The access puzzle

Poor country or individual

Drug Patents

Corruption, violence mismanagement

Discrimination

Water
Almost 500 children will die during class due to lack of water 98 cents for clean water for one person for one year 720 million dollars a day were spent the first two years in Iraq

Water
Privatization has priced poor people out of the market Corporate systems bring in about $200 billion annually; they serve only about 7% 12 % of humanity use 85 % of the water

Water
~1.1 billion people have inadequate access to water including 400 million children 2.6 billion people lack basic sanitation 1.4 million children will die each year

Water Price US $ per Cubic Metre (about 250 gallons)

$35/mo*

$264/mo*
If you live in a slum in Manila, you pay more for your water than people living in London.
--UN Human Development Programme

They died because it doesnt pay to keep them alive.

-Ken Silverstein, Millions for Viagra. Pennies for Diseases of the Poor

HIV estimated prevalence among population aged 15-49 years (%), 2007
33.4 million current cases 2.7 million new cases 2 million deaths Spreading in former Soviet States

Estimated TB Incidence by country 2009

9.4 millions cases 1.7 million deaths

Estimated Deaths due to Malaria per 1000 Population, 2006

Over 780,000 deaths

Chronic Respiratory Diseases

4 million deaths annually, 1.4
milloin are lung cancer Increasing prevalence, particularly among children and elderly people

Major risk factors: Tobacco smoke Second hand tobacco smoke Other indoor air pollutants Outdoor air pollutants Allergens Occupational agents

Cardiovascular Diseases and Diabetes

CVD = number one cause of death
globally; 17.3 million deaths Diabetes: affects 346 million people with 3.4 millions deaths

Over 80% of CVD and Diabetes deaths

affect low-and middle-income countries and growing

More risk factors Less prevention initiatives or access More likely to die younger from CVDs Rise of huge middle class in BRIC and other middle income countries

May reduce GDP between 1-5% in lowand middle-income countries

Inequality of access to health care

Stems from the perception that health care is a privilege, not a right. Common misconceptions
Right to health right to be healthy Present obligations Finances relevant but not an excuse

Treatable infectious diseases

 Economic impact:

Tobacco use

Health care expenditure treatment of tobacco-related disease

In Hong Kong (population 6.5 million) the value of direct medical care and long term care was $532 million for active smokers and $156 million for passive smokers. (BMJ)

Effect on the family

Less productive Premature death The poorer the family the greater the impact

Obesity
Serious problem in US, but what about abroad?

Citizens of developing countries are increasingly at risk. Why?

Double burden of disease

Access to water
The real wild card for political and social unrest in the Middle East over the next 20 years is not war, terrorism, or revolution it is water (Alterman & Dziuban, 2010) Finite supply of ground water Primarily being depleted through poor management and reliance on agriculture as an economic basis Consequences
Migration Political alienation

If water appears to be a free resource, it will continue to be treated as an inexhaustible one (Alterman & Dziuban, 2010).

Government

International Agencies

Solutions
Volunteers NGOs

Water Solutions
Clean water changes lives. Girls return to school. Women begin small businesses. Men are no longer too sick to work. Fields are watered and food supply becomes more reliable. Health returns and children grow up to be productive members of their community. The cycle of poverty is broken. Lives change. The Bridge Water project Kenya

Water
The Water Project/ Bridge Water Project partnership Edge Outreach Distribute and install water purification systems in developing countries

Helped over 125,000 people Drip System Irrigation

o

Reduce consumption by 60-80%; more water for nonagricultural purposes

Desalination technology
o

Promising experiments using nanotubes

http://www.edgeoutreach.com

Reducing Lung Disease

Taxation has decreased smoking rates

throughout rich countries
10% price increase 4-8% drop in tobacco consumption; particularly in poor and young

Heart Disease
Millennium Development Goal

Provide support to enhance access to essential medicines and affordable medical technology Patients still face stock-outs or exorbitant price hikes for basic essential CVD medicines

Global Strategy on Diet, Physical Activity and Health Global Noncommunicable Disease Network

Heartbeat International

Pacemaker Program Global network of doctors and hospitals

Access
NGOs, foreign aid and international organizations have often stepped in to provide services, medications and supplies

Global Health Workforce Alliance- address shortage of health workers, response system for epidemics and health emergencies

Project Hope Develop community clinics in

various countries Provide health education, donated medical supplies and drugs Work with USAID to provide TB and HIV control and treatment in Asia and Africa Launched the Diabetes Education Program in Asia and Central America

Delivering health education, medicines, supplies and volunteers where needed.

http://www.projecthope.org/

Foreign Aid: Catch-22

Emphasizing development and sustainability with allies Political instability and loan interest can be barriers Aid is being tied to good governance standards

Catch-22
How do we help those living in countries where governments are failing or corrupt?

What if you know the money will go to waste?

ID Solutions
DOTS (Direct Observed Therapy Short-course) Multidrug pills New shorter therapies Prevention of transmission
AIDS free generation Vaccines for variety of diseases Malaria bed nets

However not everyone is benefiting

How do you treat billions who have no money?

Collective Bargaining
Green Light Committee
Global Fund, UNITAID, WHO Medication bought in bulk sold at reduced prices around the world Programs have to apply, meet requirements
Prevent development of resistance

Affordable Medicines Facility for Malaria; PEPFAR for Aids

Price of TB Drugs in 2002

Future
Social Entrepreneurship Make money saving the world Plenty of ideas
Soccer balls that provide electricity Rats that sniff out land mines

Plenty of opportunities to make a difference

FIU Global Scholars

References
Alterman, J.B., Dziuban, Michael. (2010). Clear gold: Water as a strategic resource in the Middle East. CSIS, District of Columbia. World Health Organization. (2008). The right to health. United Nations, Geneva, Switzerland. World Health Organization. (2012). Why tobacco is a public health priority. United Nations, Geneva, Switzerland. World Health Organization. (2011). Obesity and Overweight. United Nations, Geneva, Switzerland.

References
Prabhat Jha, Rachel Nugent. Challenge Paper Chronic Disease. Copenhagen Consensus 2012. 2012 Dean Jamison, Prabhat Jha, Ramanan Laxminarayan. Challenge Paper Infectious Disease. . Copenhagen Consensus 2012. 2012 World Health Organization. (2012). Why tobacco is a public health priority. United Nations, Geneva, Switzerland. World Health Organization. (2011). World Health Statistics 2011. United Nations, Geneva, Switzerland.

References
World Health Organization. (2009). Global Health Risks: Mortality and Burden of Disease Attributable to Selected Major Risks. United Nations, Geneva, Switzerland. World Health Organization. (2008). The Global Burden of Disease. United Nations, Geneva, Switzerland. World Health Organization Global Map Production: Public Health Information and Geographic Information Systems. 2011

References
"Cardiovascular Diseases (CVDs)." World Health Organization. Sept. 2011. Web. 4 May 2012. "Chronic Respiratory Diseases." World Health Organization. Web. 4 May 2012. "Diabetes." World Health Organization. Aug. 2011. Web. 4 May 2012.

References
McGhee, S. M., and L. M. Ho. "Cost of Tobaccorelated Diseases, including Passive Smoking, in Hong Kong." British Medical Journal. 7 Dec. 2005. Web. 10 May 2012. <http://tobaccocontrol.bmj.com/content/15/2/125 .abstract>. Scollo, M., and A. Hyland. "Tobacoo." World Health Organization, May 2012. Web. 5 May 2012. <http://www.who.int/mediacentre/factsheets/fs33 9/en/index.html>.

References
Shah, Anup. (2009, November 29). AIDS around the world. Global Issues. Retrieved from http://www.globalissues.org/article/219/aidsaround-the-world Shah, Anup. (2010, June 6). Water and Development. Global Issues. Retrieved from http://www.globalissues.org/article/601/waterand-development

References
Shah, Anup. (2010, October 2). Pharmaceutical Corporations and Medical Research. Global Issues. Retrieved from http://www.globalissues.org/article/52/pharmace utical-corporations-and-medical-research Shah, Anup. (2011, Sept 22). Health Issues. Global Issues. Retrieved from http://www.globalissues.org/issue/587/healthissues