5b- Top down and bottom up strategies that deal with disease risk and eradication. Flashcards
GlaxoSmithKline (GSK) scientific breakthroughs
produced medicines like amoxicillin to fight bacterial infections, and bendazole to combat parasitic infections
research and development (R&D) employs 13,000 people and spends more than £3 bill a year on R&D of new medicines
GSK patents
patents on over 300,000 medicines- they decide the price and this gives them lots of power
GSK is capping the price of patented drugs to developing countries to 25% of the UK price
GSK manufacturing and distribution
in 2014 distributed over 800 million doses of vaccine- 80% to the developing world
GSK devotes R&D resources to the needs of the developing world, they have a research centre in Spain which focuses on TB, malaria, and Ebola which all disproportionately affect the developing world
expected to give £15 mill to Save the Children partnership which means medicines can be developed to tackle child mortality in Africa
what is needed for disease eradication
need to be easy to diagnose and detect cases
no major animal reservoir
an effective intervention to interrupt transmission
3 types of strategies for disease eradication
top down; global, national
grassroots
top down global strategy for small pox
vaccination program was able to eradicate small pox in 1980 when the WHO declared it eradicated. However small quantities of small pox virus officially exist in two research laboratories in Atlanta and Russia
why was the strategy to eradicate small pox so successful
recurrent infectivity didn’t occur- if someone had had the disease they were unable to get it again due to the body’s immune response
There was no animal reservoir- which means that the disease once eradicated from humans isn’t still present in animals so won’t spread any more
an effective stable vaccine was produced- reliable, easy to use and accessible vaccine could be rolled out wherever it was needed so the transmission was ceased
large scale, lots of funding, knowledge from lots of people
limitations of top down global strategies
if there is a conflict or natural disaster this can limit the effectiveness of the eradication strategy as it makes it difficult to get to areas - e.g polio is still present in Iraq and Syria despite the Global Polio Eradication Initiative
political unrest in places like Nigeria means that workers won’t want to go there due to the danger
logistics make it hard
religious beliefs limit vaccination programmes - resistance to western medicines e.g MMR vaccine said to cause autism
top-down national strategy for disease eradication
Mauritius eradication of Malaria. Malaria killed 1/8 of the island’s population when it became an epidemic in 1867. Gov campaign to eliminate malaria between 1948-1951 by spraying buildings and breeding sites with DDT
2 years later cyclone Gervaise hit Mauritius and migrant workers were employed in reconstruction which reintroduced the malarial parasites onto the island and the destruction offered new breeding grounds
second elimination campaign - spraying indoors and breeding grounds, predatory fish that feed on mosquito larvae were introduced, bed nets, and anti-malarial drug, screening of passengers at the airport with 175,000 screened a year and people who were showing symptoms were monitored by health workers for up to 4 months
the success of top down national strategy
reduced mortality rates from 6 per 1000 in 1943 to 0.6 per 1000 in 1951
only one imported case of malaria since 1997
declared malaria-free in 1998
small countries able to do it more effectively than bigger ones
islands able to control who enters and exits the country
limitations of top-down national strategy
community engagement is crucial
political will is needed
money is needed- limits which countries are able to do it
drug resistance may occur
harder to do in places that aren’t islands as you cant as easily control who comes into the country
grassroots strategy for disease eradication
Guinea worm in Ghana- in 1989 there were more than 179,000 cases in Ghana
the disease is spread by drinking stagnant water a foot-operated pump with water filtration was installed which was adopted in other regions by the government’s programme
educating people about the disease and how to prevent getting it is an effective way of eradicating it
success of grassroots strategy
by 2010 Ghana reported its last indigenous case of guinea worm
empowers local communities
limitations of grassroots strategy
small scale- hard to implement at a large scale as would need lots of volunteer workers and resources
using male volunteers was unsuccessful as women weren’t receptive to them
role of women in combating disease
for Guinea worm it’s normally women who are collecting the water so it’s most important to educate them about it, they tend to respond more to female volunteers - link to low status of women in LIDCs
