Transcript International Public Health

International Public Health
Globalization and Disease in history
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Black death in 14th century Europe
Smallpox in the Americas
Great Influenza of 1918
AIDS, etc.
Contemporary Complications in
Global Health
• Globalization
• Humans pushing back jungle frontier
• Drug resistance
• evolution
• antibiotic overuse
• compliance issues
• failing states, war, and inadequate public
health infrastructure
The moral of the story:
• we are all in it together
Infectious disease: the big three-malaria
• parasite spread by mosquitoes
• 500 million cases per year, 1 million die
• cases increasing as pesticides and drugs
become less effective, global warming
expanding range
• Bed nets
• New vaccine?
Malaria
big three--AIDS
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1/3 population of some countries infected
affects the strong and productive
complicated by gender inequality, ignorance
policies and treatment--Thailand, Uganda,
Brazil (vs South Africa, and others)
Life expectancies
Country
Before AIDS 2010
Angola
41.3
35.0
Botswana
74.4
26.7
Lesotho
67.2
36.5
Malawi
69.4
36.9
Mozambique
42.5
27.1
Namiba
68.8
33.8
Rwanda
54.7
38.7
South Africa
68.5
36.5
Swaziland
74.6
33.0
Zambia
68.6
34.4
Zimbabwe
71.4
34.6
Bush Administration on AIDS
assistance
• 2003 pledged $15 billion over over 5 years
• some funding must promote abstinence, not
condoms
Ethical questions behind policy
• Should dollars go where they can save the
most lives?
• To prevention, away from treatment?
The big three--tuberculosis
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bacteria spread through the air
one-third the world latently infected
2-3 million die per year--increasing
requires (sometimes enforced) protracted
treatment
TB
Financial Realities
• 10% of disease research goes to diseases
causing 90% of deaths
Avian Flu
• will it become transmissible person to
person?
Smoking
• still kills more people worldwide than AIDS
• increased marketing and sales in the 3rd
world