//5.b. Top down and bottom up strategies that deal with disease risk and eradication

Question 1

What is a top down stragetu

Answer 1

These often encoutner resistance at local levels and may exclude some groups, especially women

Question 2

Case of the global impact of GlaxoSmithKline (GSK)- a pharmaceutical transnantional- TOP DOWN STRAGETGY- overview

Answer 2

• major pharmaceutical company
• in 2013, the company’s turnover was £23 billion
• 84 manufacturing sites in 36 different countries
• research and development centres in the UK, USA, Spain, Belgium aand China

Question 3

Case of the global impact of GlaxoSmithKline (GSK)- a pharmaceutical transnantional- TOP DOWN STRAGETGY- main information

Answer 3

• GSK vaccines business is one of the largest in the world
• in 2014, it distributed over 800 million doses of vaccine, 80% were to countries in the developing world
• has produced well known medications e.g. bendazole for parasites
• these drugs are on WHO’s list

Question 4

Case of the global impact of GlaxoSmithKline (GSK)- a pharmaceutical transnantional- TOP DOWN STRAGETGY-investment in research and development

Answer 4

• GSK employs 13,000 people in research and development
• it spends more then £3 billion a year researching new medicines
• it is currently researching treatments for WHOs 3 priority diseases: HIV/AIDS, malaria and TB
• 40 vaccines developed for 22 diseases, with 14 more in development.

Question 5

Case of the global impact of GlaxoSmithKline (GSK)- a pharmaceutical transnantional- TOP DOWN STRAGETGY-problem for drugs in LIDCs

Answer 5

• GSK face a demand for new drugs in LIDCs
• drugs are needed in these countries and can bring huge beneifts
• its research centre in Spain focuses primarily on TB, malaria and other tropic diseases
• the company is close to launching the first effective vaccine against malaria
• developing a vaccine for Ebola

Question 6

Case of the global impact of GlaxoSmithKline (GSK)- a pharmaceutical transnantional- TOP DOWN STRAGETY-ethical policy towards the developing world

Answer 6

• a commitment to a small return-5% of each product sold
• providing three HIV/AIDS drugs to LIDCs at significant discount
• granting liscences for the manufacture of cheap generic verstions of its patented drugs
• capping the price of patented drugs to developing countries to 25% of the UK price

Question 7

Explain the stragegy used for Polio- TOP DOWN STRATEGY

Answer 7

Global Eradication Program

• polio was not globally eradicated
• a vaccine was developed in 1952, prior to this Polio killed an estimated 600,000 people a year
• Global Polio Eradication Initiative+Who+UNICEF
• global vaccine rollout in 1988
• 2011-eradicated in all but Afghanistan, Nigeria, Pakistan as they were not welcoming to aid and vaccine worker. 80 workers killed across Nigeria and Pakistan by extremists
• 2013-outbreaks of Polio in Syria after the civil war started

Question 8

Outline a few key facts about Malaria in Mauritius-TOP DOWN STRATEGY

Answer 8

• Malaria became endemic in Mauritius in the mid 19th century
• in 1867, an endemic killed one in eight of the island’s population

Question 9

Outline a few key facts in 1948-1951 about Malaria in Mauritius-TOP DOWN STRATEGY

Answer 9

• government backed campaign to eliminate malaria was launched
• spraying buildings and the breeding sites of mosquitoes with DDT reduced mortality rates from malaria from 6 per 1000 in 1943, to 0.6 per 1000 by 1951
• 1973-malaria eliminated from island woop woop :)

Question 10

Outline a few key facts in 1975 about Malaria in Mauritius-TOP DOWN STRATEGY

Answer 10

• cyclone Gervaise hit Mauritius
• migrant workers reintroduced malarial parasites
• cyclone provided new breesing opportunities for mosquitoes

Question 11

Outline a few key facts in 1982 about Malaria in Mauritius-TOP DOWN STRATEGY

Answer 11

• malaria epidemic forced government to embark a second elimination campaign
• spraying on breeding sites, mass administration of choroquine (anti malaria drug)

Question 12

Outline a few key facts in 1988 onwardsabout Malaria in Mauritius-TOP DOWN STRATEGY

Answer 12

• rigorous passanger screening impleneted at airport
• 175,000 passengers per year screened
• people kept under surveillancd by health workers for up to 4 months
• blood samples taken
• insecticide spraying
• residences of migrant workers

Question 13

What are grass root strategy

Answer 13

• Small, community based projects that focus on the needs of people and are often favoured by NGOs such as Oxfam -Education, assistance and engagement of local people are key features
• foucs on empowering local communities

Question 14

Explain the Guinea Worm Eradication Programme

Answer 14

• in Ghana, the Guinea worm eradication programme has partnered with Ghana Red Cross women’s clubs to reduce the transmission of Guinea worm
• this programme involves teaching women volunteers how the Guinea worm is transmitted and can be prevented
• the volunteers then vists villages and educate local communties

Question 15

Why were men first used for the Guinea Worm Eradication Programme and not women?

Answer 15

• in the past, this work was invested in male volunteeres and met with limited success
• men frequently work outside villages and it is mainly women who are responsible for sourcing water and its use for household consumption
• women were able to drink filtered water and avoid contamination of water sources by people already infected with the parasite

Question 16

What does the eradication strategy involve

Answer 16

• monitoring, identifying and reporting all new cases of the Guinea worm
• ensuring that those infected did not contaminate water sources
• distibuting, checking and replacing water filters that remove water fleas from drinking water
• identifying water sources used by the community and requiring treatment with larvicides

Question 17

What the Guinea Worm Eradication Programme effective?

Answer 17

• yes it has proved effective
• the worm has been eradicated from Ghana
• in 1989, there were 179,000 cases
• by 2010, the country reported its last indigenous case of the disease