Transcript World Bank Seminar Series: Global Issues Facing Humanity

World Bank Seminar Series:
Global Issues Facing Humanity
Diseases without borders
PART I
Slide 1: Presentation Summary
Profile of Major Communicable Diseases
 Factors Driving the Spread of Communicable
Diseases
 What makes Communicable Diseases a Global
Issue?
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Slide 2: Profile of Communicable
Diseases
Steady Progress during the 20th Century in
controlling communicable diseases
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Immunization
Eradication of smallpox, containment of polio
Widespread use of drugs including antibiotics
Impressive advances in medicine
Slide 3: Yet infectious diseases remain
a leading cause of death worldwide
Annually, more than 10 million deaths
worldwide are caused by communicable diseases
 More than half of all deaths due to
communicable diseases are attributed to
HIV/AIDS,TB and malaria
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Slide 4: Magnitude of the Problem
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HIV has infected more than 60 million people
worldwide, more than 20 million of whom have died
TB causes 8.8 million new infections each year and is
responsible for an annual mortality of 1.7 million
HIV-TB co-infection: about a third of HIV positive
people also suffer from TB
Malaria endemic areas cover a third of the world’s
population and the estimated annual mortality is 1.2
million
Slide 5: Emerging Infectious
Diseases
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Zoonotics (diseases caused by infectious agents
that can be transmitted between animals and
humans)
Characteristics include mutation during
transmission, leading to highly contagious
(“superspreader”) or deadly forms
Examples - Severe Acute Respiratory Syndrome
(SARS), Avian Flu, Ebola, Lyme Disease
Slide 6: Factors driving the spread of
communicable diseases
Changes in human demographics and behavior
 Economic development
 Dramatic increase in volume of international
travel and commerce – people, animals, food,
commodities
 Microbial adaptation and change
 Breakdown of public health capacity at all levels
(Source: Institute of Medicine)
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Slide 7: What Makes Communicable
Diseases a Global Issue?
First, the sheer global magnitude of the problem
- a substantial threat to people everywhere
- an obstacle to a nation’s social and economic
development
- worst affected include the poorest households
further impoverish the already poor – loss of
productivity, treatment costs
The poor have a greater share of the burden of
disease and have less access to affordable and
quality care
Slide 8: What Makes Communicable
Diseases a Global Issue?
Second, diseases do not recognize
international boundaries or sovereign states
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Diseases can emerge anywhere on the globe and
spread quickly to other regions
Examples: West Nile virus, SARS, Avian Flu
Slide 9: Transmission Routes of
SARS virus during the 2003 outbreak
Slide 10: Avian Flu- Bird Migratory
Pattern
Slide 11: What makes Communicable
Diseases a Global Issue?
Third, globalization has resulted in a close
link between international economics and
public health.
 Local outbreaks have global implications
because of disruption of travel and trade
- Examples, outbreak of plague in India
- Impact of SARS on East Asian economies
Slide 12: What makes Communicable
Diseases a Global Issue?
Fourth, communicable diseases affect other
global issues discussed in this seminar
series:
 Climate change
 Malnutrition
 Biodiversity
 Access to safe water
 Migration
Slide 13: What makes Communicable
Diseases a Global Issue?
Finally, global action is needed to:
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Identify, control and prevent diseases
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Obtain adequate and predictable funding for
the above
 promote awareness and changes in behavior
and
 accrue global benefits from R&D
World Bank Seminar Series:
Global Issues Facing Humanity
Diseases without borders
PART II
Slide 14: Presentation Summary
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International Cooperation Against Diseases
without Borders
Key Elements of a Global Disease Response
Plan
The Role of the World Bank
Conclusion
Slide 15: International Cooperation
Against Diseases Without Borders
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International Sanitary Regulations (1851)
following cholera epidemic in Europe
WHO International Sanitary Regulations (1951)
WHO International Health Regulations (1969)
Revised WHO International Health Regulations
(2005)
Slide 16: International Cooperation
Against Diseases without Borders
Various forms of Voluntary cooperation amound
international agencies
 Roll Back Malaria
 Stop TB Campaign
 UN Millennium Development Goals
Slide 17: International Cooperation
Against Diseases without Borders
Millennium Development Goal # 6
 Have halted by 2015 and begun to reverse the
spread of HIV/AIDS
 Have halted by 2015 and begun to reverse the
incidence of malaria and other major diseases
Slide 18: International Cooperation
Against Diseases without Borders
An estimated 70 other Global Health
Initiatives
 Global Fund to Fight AIDS, TB and Malaria
 Bill and Melinda Gates Foundation
 Global Alliance for Vaccination and
Immunization (GAVI)
 Multi Country AIDS Program for Africa
(MAPS)
 US Emergency Plan for AIDS Relief
Slide 19: Key Elements of a Global
Disease Response Plan
WHO and the Center for Diseases Control (CDC)
plans for global diseases outbreaks
 Outbreak Management
 Disease Surveillance
 National and Local Public Health Services
 Health Workforce
 Research and Development
 International Legal and Regulatory Framework
 Disease Prevention and Control
Slide 20: The Role of the World Bank
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The Bank’s first Health, Nutrition and Population (HNP)
strategy in 1997, currently under revision.
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Typical activities include:
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Health policy reform
Strengthening of primary health care systems
Health workforce development
Strengthening surveillance systems
Pharmaceutical procurement and planning
Slide 21: The Role of the World Bank
The World Bank is one of the largest financiers of
disease control programs
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About $150 million since 2000 in the fight against
malaria
$560 million for TB prevention and control in
current portfolio in 30 countries
$2.5 billion committed for 106 projects for
HIV/AIDS projects or components for HIV
prevention in health, education, transport projects
Slide 22:The Role of the World Bank
Strong Partnerships now central to Bank work
 Commitment to MDGs
 Partnership for Maternal, Neonatal and Child
Health
 Safe Injection Global Network
 Global Alliance for Vaccines and Immunization
 Global Alliance for Improved Nutrition
Slide 23: Role of the World Bank
Different instruments available to finance
initiatives
 Investment loans
 Adjustment (policy reform) loans
 Grants for pilot or research activities
 Poverty Reduction Strategy Credits
 Avian Flu Fund
Slide 24: The Role of the World Bank
Investments in health through other sectors or
cross-cutting themes
 Infrastructure projects
 Slum upgrading
 Electrification
 Governance
 Human rights
Slide 25: The Role of the World Bank
Bank evaluations of its health projects/portfolio
Bank support has been successful in:
- Expanding health care coverage
- Training health personnel
- Supplying basic inputs
- Influencing health policy
The Bank has been less successful in:
- Sustained, systemic service quality improvement
- Institutional change
Slide 26: Conclusion
High risk that a major pandemic will occur sometime
during the 21st century
 Factors that contribute to spread of diseases will continue
to be at work
 “If we truly want to end the threat of infectious diseases,
we must ..inject into global gatherings the urgency of
working together to defeat infectious diseases; .. Continue
to invest in vaccine research and development.. Work to
ensure that drugs, vaccines and tests are available during an
emergency.. Pool our greatest resources – our imagination
and intellect – to fight this collective fight”
- James Hughes, Director, CDC
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