Class Lecture #6

state of complete physical, mental & social well-being and not
merely the absence of disease or infirmity (WHO definition)

promotes health of a political territory (e.g., USA, Virginia)

promotes health of all of Earth's population

Rather, global health is comprehensive & inclusive because it promotes improved & more equitable health throughout the entire globe. It seeks to reduce threats to health for all people worldwide regardless of political territory

- Increased international interactions
- Increased global population & population concentrations
Climate change further impacts health, food security, water, disasters, disease vectors, etc.
Humans & ecologies are interconnected & interdependent, so health improvements to one
benefits all humans, all states & the entire global socio-ecological system ('one health')
Meanwhile, right now we possess unprecedented technologies, knowledge, medicine,
wealth & resources to address these problems

List a few

disease exists & is maintained within a population without external inputs (e.g., shingles in USA, but not guinea worm disease because USA lacks conditions for it to persis

disease outbreak of local or regional proportion that is confined to a geographic area (e.g., cholera in Haiti after 2010 earthquake, Ebola in West Africa)

disease outbreak that spreads worldwide (e.g., Black Death w/ ~100 M deaths, 1918 Spanish Flu w/ ~50 M deaths, Covid-19 w/ 6.9 M deaths, HIV-AIDS)

a population interacts with a disease they have previously never encountered; the at-risk population is essentially immunologically defenseless, which can result in a 'virgin soil epidemic' (e.g., smallpox in the Americas due to Colombian Exchange

an agent (e.g., mosquito, fly, tick, mammal) carries & then transmits a disease from one host to another (e.g., malaria, Lyme disease, dengue, West Nile, chikungunya)

an animal infection that can spread directly from animals to humans (e.g., rabies, anthrax, Ebola, leptospirosis, avian flu, salmonellosis, plague)

60% infected are women
Millions of children orphaned
Loss of productivity & human capital (e.g., DALYs), impacting local & national economies
Accelerated by low condom use, violence against women & social stigma of HIV-AIDS as an STI
Treatment is expensive & difficult to reach rural areas
Malnutrition renders medicines less effective
Meanwhile, HIV-AIDS only one of many issues challenging the region

- Virgin soil epidemic
- occurred after colonization of new world
- massive loss of life in native populations.

- vector born disease
-denoted by Hippocrates in 4th c bc
-Globally, the world's most deadly vectored disease (230 M infected &
410,000 deaths annually)
Transmitted by female Anopheles mosquito
Mosquito eradication & mosquito nets have had limited success
Projected to become endemic in higher elevations & higher latitudes due
to climate change

Theory / Fact that disease infections are caused by pathogens

- Previously believed diseases emanated from miasmas (noxious nodes of stinky, rotting, decaying matter) & that breathing in the poisonous, polluted air made you sick
- Also based on ethnicity, nationality, religion, socioeconomic status, values & morals (i.e., racism & 'othering' through the medium of health)

until recently (i.e., ~100 yrs. ago)

research helped prove miasmas false & germ theory true by linking London cholera epidemic to "invisibly tiny parasites" in the water supply

Source of cholera pandemic, discovered by John Snow.

Louis Pasteur

Robert Koch

Alexander Fleming

Edward Jenner

WHO's Smallpox Eradication Program eradicated smallpox in 1980—to this day, the only disease to be eradicated!

Jonas Salk

99% eradicated—but long, tough road remains
Only 2 countries remaining w/ endemic polio (Afghanistan
& Pakistan)
Global efforts led by WHO & Rotary International
Unvaccinated pops. threaten others, especially in
neighboring countries that have achieved eradication
Eradication hampered by physical geographies (e.g.,
mountains, isolation & remoteness) & cultural resistance
(e.g., religious, social, political & general skepticism)

- NGOs & supranational institutions are critical actors in global health due to their ability to work with constituents, reach hard to reach areas, bottom up approach
-

Securing steady funding & donor fatigue, especially in economic downturns
Financial solvency, scalability & sustainability of programs
Beholden to donor agendas
Securing, motivating & retaining a volunteer base
Accountability, transparency, corruption, missing funds (e.g., Red Cross)
Perceived as 'outsiders'
Prototypical, technocratic & culturally insensitive programs and approaches
Can be an extremely taxing & dangerous for little pay (e.g., polio eradication)
Poor employee conduct (e.g., Red Cross, Oxfam, UNICEF & Save the Children, Plan International)