History of Global Health and Development Flashcards
When did US engagement in global health begin?
- the stage was set by domestic health programs, many during the 1930s/Great Depression like maternal and child health programs in US South and malaria control programs
- lessons and models for delivery of care from these programs were applied to global health programs after WWII
What were the public health conditions like in the Southern US from the 1920s to 1940s?
- the conditions in the rural south were like those of disadvantaged populations in rural Africa and Asia now
- operating under continuing conditions of segregation and disenfranchisement, ph programs were launched
- pioneered approaches to delivery of health services to rural populations that later were replicated in global health programs
What were the conditions of public health like in Africa and Asia from the 1920s to 1940s?
- much of Africa and Asia was under control of European colonial powers
- tropical medicine / tropical public health; this was the dominant global health perspective, concern often was protecting health of colonial administration, rather than improve health of local populations, also they approached health more categorically by focusing on one disease at a time
How did WWII affect global health?
- strengthened American interest in PH (soldiers were getting sick while not in US from parasitic and tropical diseases, things like that, US realized they needed vaccines and treatments for these or soldiers would keep dying when going to war; in WWII more soldiers died from disease than Japanese bullets)
- many public health intervention had their origins during this war like penicillin, chloroquine, ddt
Describe penicillin and WWII.
- discovered by Alex Flemming in 1928 so had it before the war but was only available in small quantities
- there was pressure to mass produce penicillin for troops, identified the chemical structure by 1945
Describe chloroquine and WWII.
- discovered at Bayer laboratories by Hans Andersag and coworkers in 1934, discovery ignored because they thought itwas too toxic for routine use
- WWII: US government sponsored trials of different potential antimalarial drugs, cloroquine identified as among the most promising
-1947: introduced into clinical practice for prevention of malaria
Describe DDT and WWII
- 1874: first synthesized, but insecticidal action unknown
- 1939: Insecticidal properties identified by Swiss chemist Paul Herman Müller
- 1942-45: Used to control malaria and typhus among both civilians and troops (3M died after WWI)
- 1948: Müller awarded Nobel Prize for discovery of insecticidal properties
Name two factors that affected US engagement in global health after WWII.
- US military established as a major force in tropical medicine and tropical public health during WWII
- US experience with public health and malaria control programs in southern US prior to WWII
Describe the postwar period and global health.
Name some challenges in newly-independent countries.
- artificial borders
- legitimacy of national government not established
- no administrative structures, ministries, civil service in place
- no service provision in place
- rebel movements
Describe the postwar activities of WHO.
- establishing health systems in newly independent countries
- eradication programs i.e. malaria from 1955-1969 and smallpox from 1958-1980)
What is the Dawson of Penn Report?
- published in 1920, outlined way of organizing health services with a colonial and missionary focus
- later taken as model for health systems in newly-independent countries
In 1955 when the world began the eradication of malaria, why didn’t they include sub-Saharan Africa?
- Many of the countries like Angola and Mozambique we still under colonial control (had view that colonies should support themselves)
- many countries recently independent, still establishing basic functionality of their health services
- lack of roads and infrastructure in rural areas
(later malaria rebounded though so it sort of balanced out for Africa vs. other places)
What was the state of global health in 1970?
- Most health interventions had been centrally planned and executed like medical and nursing schools, hospital construction, and eradication campaigns
- notable successe: yaws, smallpox, etc.
- limited or no improvement in overall health status in rural areas in many countries
- failure to sustain successes of malaria eradication, except where transmission was weak to begin with like Latin America
- there was a demand for new model for improving the health of populations because disease control programs and hospitals and clinics weren’t enough
What is a categorical breadth/scope of a health program?
one disease, health problem, or intervention
What is a selective breadth/scope of a health program?
a few high-priority diseases or interventions
What are the two WHOs?
Describe decolonizing global health
What is the “save lives now” school of decolonizing global health?
What is the “reform power asymmetries” school of decolonizing global health?
What is the “burn it all” school of decolonizing global health?
What is the triangle of criticism in decoloniaing global health?
Gives some examples of factors affecting the incidence and prevalence of malaria at each level.
Give some examples of factors affecting initiation of cigarette smoking by adolescents.
Give some examples of factors affecting life expectancy and quality of life for people living with HIV.
