Global Health Flashcards
Define global health:
An area for study, research, and practice that places a priority on improving health and achieving health equity for all people worldwide
What are communicable diseases?
Any disease that passes between people or animals - i.e. transmissible or infectious
e. g. COVID-19 (viruses spread faster due to global transport links etc)
eg. Polio Global Eradication Initiative
What is the issue with communicable disease in modern society?
Interconnected world
Faster spread of disease
New rules placed in one country = major impacts on others
What does this mean for controlling communicable diseases e.g. in a pandemic?
Therefore cannot control disease by solely acting on a national level
Why is COVID different from e.g. polio?
COVID = hitting home front of the WEST = more financially secure countries with higher incomes, more resources etc.
Polio mainly in third world countries
What are some non-communicable disease that global health needs to address?
e.g. mental health
Influenced by many large corporates e.g. fb, mcD, ig, etc.
Polio Global Eradication Initiative
How is global health currently regulated?
WHO - world health organisation
Specialised agency of the UN
Intergovernmental organisation aiming to uphold international peace and security
What are the aims of the WHO?
Attainment of all peoples at the highest possible level of health
Info from all countries passed onto WHO, this info is collated and organised appropriately
Appropriate measures taken
Governance
WHO – aim is ‘the attainment by all peoples of the highest possible level of health’
International Health Regulations – describes role of national governments too
Is able to declare a ‘Public Health Emergency of International Concern’
How can countries be grouped together?
Wealth
Infrastructure
Standard of Living
Whats the Human Development Index (or HDI)?
What is it comprised of?
Approach used by the United Nations (UN) to quantifying development (in general) and is a composite continuous value between 0.001 and 0.999 (usually provided to three decimal places).
HDI comprises 3 measures of development:
Knowledge - based on education and literacy
Healthy life - life expectancy
Standard of Living - income adjusted for local circumstances - based on Purchasing Power Parity (PPP)
Group countries into Very High, High, Medium, and Low
Used when drawing statistical comparisons
After each country is given an HDI value, how can they be grouped?
Very high = Norway, Ireland and Switzerland
High = Seychelles, Trinidad and Tobago and Albania
Medium = Kyrgyzstan, Morocco and Guyana
Low = Mauritania, Benin and Uganda
Why is the HDI so useful?
HDI is used widely when drawing statistical comparisons.
What is also used, other than HDI?
HIC - high income country
LMIC - low and middle income countries
These are more objective
Delineates between settings based on an objective measure of wealth
What is meant by the global south?
Refers to countries where income tends to be low and economies are recently industrialising
Geographically = are around the tropics
Many of these countries have a colonial history
What is meant by the terms:
Third World =
Less economically developed countries =
Emerging markets =
Third World = In the era of the Cold War, countries that were aligned with NATO were deemed first world. Countries aligned with the USSR were considered second world. This term was originally intended to denote non-aligned national state actors
Less economically developed countries = A term that has been vaguely used to categorise countries on then basis of their gross national income (GNI). This term has now been removed from routine use by the World Bank
Emerging markets = An economic term suggesting that a country is about to engage with global markets. This term remains commonly used in business with pharmaceutical companies often using it to describe multiple countries where business opportunities are ancipated
What is WASH?
Water, sanitation and hygiene
Water - safe water for drinking, washing, and domestic activities ( 30% of world lacks)
- Fundamental human right (UN)
- Water that does not have a significant threat to health over a lifetime of consumption
- Infectious disease: water-borne, water-washed, water-based, water-related, diseased caused by poor sanitation
Sanitation - safe removal of waste (toilets and waste disposal) - (60% of world lacks)
Hygiene - health promotion activities that encourage protective healthy behaviour practices
Benefits greater together than implemented separately
What are some examples of globally prevalent WASH-related diseases?
Diarrhoea Malaria Schistosomiasis Trachoma Intestinal helminths Japanese encephalitis Hep A Other types of poisoning
Why is diarrhoea an issue?
Leading cause of mortality and morbidity in children under 5 - in low-middle income supply
Associated with lack of WASH
How does WASH improve diarrhoea?
Improved water supply = improvement of 6-25%
Improved sanitation = improvement of 32%
What are hygiene interventions?
Hand washing
Hygiene promotion
= lead to decrease is diarrhoea by 45%
What is a fundamental human right in WASH?
Right of access to safe drinking water and sanitation by UN
What is safe drinking water?
Water that does not set a significant risk to health over a lifetime of consumption - each person required 50-100L of clean, safe water / day to cook, clean, drink and bathe
How does poor quality drinking water impact people?
Health
Livelihood
Education and employment opportunities - lead to wider economic and political challenges
What are the 5 water-related infectious diseases?
Water-borne = disease spreak wehn people drink / eat in food contaminated water e.g. cholera
Water-washed = infections caused by poor personal hygiene
Water-based = transmitted by aquatic species
Water-related = insect vector diseases
Diseases caused by poor sanitation
What is Sustainable Development Goal (SDG)?
Package of 17 goals launched by UN inn 2015
To be achieved by 2030
Each goal is dependent on the other goals
Universal for all countries
What are the 17 SDH universal goals?
GOAL 1: No Poverty
GOAL 2: Zero Hunger
GOAL 3: Good Health and Well-being
GOAL 4: Quality Education
GOAL 5: Gender Equality
GOAL 6: Clean Water and Sanitation
GOAL 7: Affordable and Clean Energy
GOAL 8: Decent Work and Economic Growth
GOAL 9: Industry, Innovation and Infrastructure
GOAL 10: Reduced Inequality
GOAL 11: Sustainable Cities and Communities
GOAL 12: Responsible Consumption and Production
GOAL 13: Climate Action
GOAL 14: Life Below Water
GOAL 15: Life on Land
GOAL 16: Peace and Justice Strong Institutions
GOAL 17: Partnerships to achieve the Goal
What is maternal death?
Death of a woman while pregnant or within 42 days of termination of pregnancy - from any cause by the pregnancy or its management but not from accidental or incidental causes
Why is maternal mortality important in global health?
Indicators of a country’s health and wellbeing - almost 300,000 women die each year from maternity related causes - – over 95% from LMICs
What is the maternal mortality ratio (MMR)?
Maternal mortality ratio is the epidemiological indicator commonly used. It is calculated as the number of deaths divided by the number of live births (in the same period) per 100,000 live births.
MMR = Maternal Mortality Ratio (no. of deaths/no. of live births per 100,000 live births)
Also a measure of how accessible/responsive/effective a health system is
Using the UNICEF website above, what is the MMR in Norway?
Very low - <100
2
What is the MMR in the United Kingdom?
Very low - <100
7
What is the MMR in Sierra Leone?
Extremely high - >1000
1120
Why is MMR important?
Important indicator of human and social progress
Measure of how accessible, responsive and effective a health system is
The degree to which a health system is responsive to women’s health is a measure of how politically invested a country is in achieving equal health outcomes for men + women
What affects MMR?
Income
Privatised healthcare
Health system inequalities
What is the modern world called in planetary health and sustainability?
The Great Acceleration
Humans = exponential increase in consumption of:
Human consumption
Fresh water
Proliferation of motor vehicle
Production and use of synthetic fertilisers
Paper production
Plastic production
Extraordinary acceleration since 1950s
Huge impact across natural ecosystems
Human consumption and needs exceeds planetary capacity, what is this leading to?
Improvements of humans
But decrease in natural ecosystem functioning
Also HUGE driver of burden of disease today
Wealthy tend to consume whereas the poor tend to suffer the consequences
What is planetary health?
an emerging discipline that recognises our coexistence as human beings with the world around us
- Balance between human consumption and planetary sustainability
What is one health?
Conceptual paradigm:
To improve health and well-being through the prevention of risks and the mitigation of effects of crises that originate at the interface between humans, animals, and their various environments
INCLUDES animal health, environmental health and human health
animal health - Wild animals, agriculture, aquaculture, companion animals = farmers, vets, food consumers and pet owners
Environmental health - vegetation, soil, water = industry, farmers, waste water management
Human health - individual, local, global = patients, prescribers, pharma
What is AMR (antimicrobial resistance)?
Where antibiotics, antivirals, antifungals and antiparasitics become less effective overtime as pathogens evolve
What are the risks, impacts and consequences of AMR?
Poor treatment options in the future Risks of future pandemics Longer hospitalisations Increased mortality Greater infection rates
Increasing incidence of multi-drug resistant bacteria
If nothing is done – may become almost impossible to do routine surgery
Will hit those who have the least resources the hardest
What can we do about AMR?
More controlled prescribing in hospitals
Lessened use in farming
Discovering more antimicrobials
Large proportion of antibiotics are used in agriculture - reduce this
Understand science behind resistance
Reduce availability of all antibiotics + introduce more safeguards for broad spectrum Abx
Issues with AMR solutions?
Interdependent around the world, everyone globally needs to follow these = unlikely
NEED PEOPLE INVOLVEMENT
Not just human health - veterinarians, agriculture, business, politicians
Global effort
How might climate change in the tropics influence human health in London?
Increased average temp - environmental degradation - agricultural failure - crime and disorder - fear of crime - global supply chains - malnutrition - economic migration - infectious disease - pressure on services - increasing health inequalities - structural racism and inequity - political instabilities - armed conflict
What is The ‘tragedy of the commons’
an economic analogy that describes how people degrade a common good for personal consumption, in spite of the consequent overall societal loss.
Other than humans, who are antibiotics also given to
A large proportion of antibiotic is used in agriculture: in countries including the US they are used to promote animal growth. Although disputed, some figures estimate in the region of 50-80% of antibiotics by volume are given to animals in the US.
