5.b Flashcards
what are top down national strategies
usually occur in Acs and are government driven on a national scale
Top Down national strategy - Malaria in Mauritius
- became an epidemic here in the mid 19th C - 1867 the pandemic killed 1/8 of the islands pop
- government backed elimination campaign launched between 1948 - 1951
- buildings and breeding sites sprayed with DDT - reducing mortality rates from Malaria
- 1973 - WHO announced Malaria to of been eliminated from the area
- 1975 - cyclone Gervaise - hit and Migrant workers employed in reconstruction reintroduced parasites to the island and destruction caused by this event provided effect breeding opportunities
1982 - new epidemic forced the gov to launch a second vaccination - spraying resumed, predator fish that fed on mosquitos were introduced - since then the government has taken steps tp prevent reintroduction - rigorous passenger screening at international airports which focuses on potential carriers arriving as well as continuous spraying focuses on breeding sites and migrant worker residences
success of top down strategies in Mauritius
the go effort by gov prior to cyclone were highly successful reducing mortality rates form 6/1000 to 0.6/1000 allowing WHO to announce that MAelria was eradicated
- the second campaign to prevent reintroduction also proved highly effective as only one reported case has been seen since the 1990s
- shows top down scenes an successfully eradicate a disease
Limitation of top down national strategies
- these strategies only limit the disease or eradicate on a national scale therefore can still be present globally
- only effective in a stable government that has the resources needed in order to eradicate the given disease
- e.g when it comes to diseases such as malaria - LIDCS may not have the economy that is needed in order to provide vaccinations to help cure the diseases
- in order to maximise the efficiency - collaboration need to also occur with local communities in order to understand what they want from the gov
- only effective if gov able to provide funding and resources to local comm that require support in order to fight against the disease
- resources may not be distributed equally as some areas may require additional support
what sort of places/diseases is top down national strategies more appropriate for?
more important for mobilising resources and coordinating efforts to help eradicate diseases - often taken a lot of reosurces and funding - generally only by offered by AC/EDCs give - LIDCs may not have the spare funding to invest into full eradication
- more appropriate for communicable diseases like covid - implemtmed by gov can often be more effective at combating the diease - like lockdown in the Uk
POLITCAL STABILITY - SL
- easier in urban places - harder in rural pop harder to access
- needs a solution that is easy to implement
Bottom up - Guinea worm - what sort of strategy?
an alternative approach to top down is botomup/grassroot - involves and empowers local communities
- most effective in LLIDCs as they are cheap, easy to supply ( education or changing behaviours) and effective even in countries with unstable governments
Guinea worm eradication programme
- partnered with the Ghana Red Cross women clubs to reduce transmission of guinea women
- this innovation programme involves teaching women volunteers how the guinea worm is transmitted and how transmission can be prevented
- in the past this work was invested in male volunteers which had limited success as men frequently worked outside villages and its mainly the women who are responsible for sourcing water and its use for household consumption
was guinea worm programme successul?
WHO reported that in 1989 there were more than 170,000 case by 2010 the country reported its last indigenous case of the disease
- it is a more longer term solution
- easy to eradicate - as only need to really rely on eradicating communities - cheaper option
limitation of grassroots/bottom up strategies
- insecurity - parts of some affected countries are inaccessible to the program due to internal conflicts that makes these areas unsafe to travel - healthcare worker are less able to trade and prevent infections - SL TO P&B
- there are no vaccines against the disease
- there has been recent cases that it is linked to dogs infected with worms - there needs to be extra effort to help prevent infection dogs
top down international
- this strategy includes vaccinations campaigns, research and development of effective treatments and pharmaceutical drugs
- WHO coordinates health initiatives, surveillance and monitoring on a GLOBAL SCALE - such as flows of people, implementing awareness and education schemes in a GS - providing international aid and financing ti everyone in need
example of top down global
SMALL POX - used global top down strategies such as universal immunisation programmes, mass vaccinations other groups of people, surveillance and commitment strategies to track the speed - by 1980s was fully eradicates
success of top down global
- small pox eradication was very successful - eradicated smallpox across the globe - ensured that recurrent infectivity didn’t occur - they did this by making sire there was no animal reservoir that carried small pot and there was an effective stable vaccine available
- as it was done on a GS - ensured everywhere had the resources and infrastructure t be Abel to eradicate it - of it had not been GS then smallpox wouldn’t of been sussufcully eradicated as not veyhwere would have the same opp to have the equipment to eradicate it (LIDCS
limitation of top down global
- often require a significant financial resource and infrastructure to implement effectively - can strain the resources of both donor countries and international organisations - global campaign to eradicate small pox led by WHO cost $300 million to $500m
- without ongoing efforts there is a risk of insurgence especially if surveillance systems weakened vaccine coverage declines - therefore requiring LT COMMITMENT
- top down strategies may not address the underlying issues of equity and access to healthcare services therefore places with limited resources are left behind - increasing inequalities
- Political instability and conflicts can disrupt eradication - cooperating may be hindered by geopolitical factors therefore affecting the success rate
- countries rely heavily on external aid for disease eradication may struggle to sustain effort once external funding dimensioned
- issues with migrant flows - refugees o very difficult to access all group of people
