World Health Day: Non-Sexy Approaches to Global Health

What Do the Diseases of Poverty Look Like?

Many may think that in the developing world the biggest culprits for death and morbidity are the super-scary things like Ebola outbreaks, but the World Health Organization has estimated that the diseases associated with poverty result in about 45% of their “disease burden.”

These diseases of poverty are so called as it is poverty that is considered the etiological factor. That’s not to say that tropical diseases and malaria are trifles, but this is different. The diseases of poverty include blindness from malnutrition, this impacts about one-half million children annually. The diseases of poverty include death due to diarrhea, killing almost 2 million a year. There is a diabolical cyclical pattern that suggests that vector-borne illnesses can cause or exacerbate poverty.

The diseases of poverty are highly preventable.

Untreated Illness

When minor illnesses go untreated, they can remit, but often lingering disabilities remain. For those less fortunate, chronic or major illness may result, or even death.

When one then includes deaths caused by measles, pneumonia, malaria, and for newborns the child mortality rate quickly spools up to a rate of one child every three seconds. Pause for a moment to take that in.

Deaths from untreated illnesses are highly preventable.

Thankfully these numbers are actually better than they were a decade ago. But this improvement is not evenly distributed throughout the world. The United Nations found that there had been no improvement in the child mortality rate over a period of 16 years for 27 African countries while it had been decreased by 50% since 1970 elsewhere in the developing world.

So What’s Going On?

In a well done study published in the Lancet over a decade ago entitled “How many child deaths can we prevent this year?” Gareth Jones and his colleagues opined that if simple, proven medical interventions were made available to these populations that the effect would result in a 63% reduction in child mortality.

This position seems to find additional support in a more recent World Health Organization report that concluded that this indeed was what was responsible for an 80% reduction in child deaths from 1975 to 2006. Brazil, for example, has a public health system that provides free early treatment and free immunizations. They believe this is what’s resulted in a 60.5% decline in infant mortality and an increase in life expectancy of five years.

So What’s The Problem?

Well, healthcare can be a bit complex. Sometimes solutions can scale and sometimes they cannot. Sometimes they can generalize and sometimes they cannot. There are no silver or magic bullets. But a somewhat provocative of theory is starting to be discussed—that perhaps too much funding is being targeted on AIDS, TB, malaria, and the like—or at least a disproportional amount, and in those countries the result is an unintended diminution in the primary healthcare and/or public healthcare systems. So the argument goes that basic healthcare, or primary care, or public health are not “sexy” or attention grabbing enough for celebrities or foundations or granting agencies to notice. Thus, less funding, less care, higher morbidity and mortality.

As on World Health Day, we may tend to think of health care issues to be more so an international problem.