Global Health, Faith and Human Rights

So What? Why should we in wealthy developed countries care about the world’s least healthy people in developing countries? Three primary reasons : 1.) national security 2.) economic 3.) ethical/moral (Matthew 25:31-46)

National Security Interests "It is axiomatic that infectious diseases do not respect national borders. Pathogens migrate great distances to pose health hazards everywhere… This constant cycle of congregation, consumption, and movement allows infectious diseases to mutate and spread across populations and boundaries. These human activities have profound consequences for people in all parts of the world and no country can insulate itself from their effects. The world’s communities are interdependent and reliant on one another for health security." L. Gostin, “Why Rich Countries Should Care about the World’s Least Healthy People,” Journal of the American Medical Association, Vol. 298 (July 4, 2007):89-90

Drug-resistant TB seen at record levels globally Wed 27 Feb 2008

Life expectancy at birth, males

Infectious diseases

Biggest Killers: AIDS TB (Tuberculosis) Malaria Diarrheal Diseases

The “Lazarus” Effect

fertility rate

Rosenfield A et al. N Engl J Med 2007;356:

Three (of 4) Critical Foundations for Public Health and Personal Development -Reliable and effective sewage systems -Safe drinking water -Enough nutritious food

Implementation bottleneck + Vaccines Primary Health Care Drug therapies Maternal Child Health Care Basic Surgery Gates Foundation develops: Microbicides and other preventive tools New malaria and TB drugs, diagnostics New combination therapies Drugs for neglected diseases >10 new vaccines Slide courtesy of Jim Kim, MD/PhD

Poverty & Health Trap For many poor countries, poverty itself is a trap. Main Reasons: 1.) Physical geography: many of the world’s poorest countries are landlocked, situated in high mountain ranges and lack navigable rivers, long coastlines or natural harbors = high transportation costs & low agricultural productivity 2.) Fiscal issues: if population is poor, taxation is not feasible; governments can be corrupt/inept/incapacitated; debt overhang to IMF = insufficient $ resources 3.) Governance failures: good government is not natural or easy = corruption 4.) Cultural barriers: unequal rights for women, lack of viable futures, high fertility rates = no hope

Critical and Inexpensive Interventions 1.) safe drinking water & sanitation (hygiene) 2.) extended breastfeeding (beyond 6 months) 3.) increased access to prenatal, neonatal and postnatal care 4.) increased rate of vaccinations & immunizations 5.) increased access to antibiotics 6.) increased access to bed nets to prevent malaria transmission 7.) improved nutrition 8.) improved education and family planning * Expanded economic opportunities, micro-credit operations, and equal rights for women (Kiva, Grameen Bank, BRAC)

Spring Break trip to Peru

A rural public health clinic

A public clinic An urban public health clinic

CSI medical mission trip to Haiti

Take-Home Message & “To Do” List 1.) Read “Mountains Beyond Mountains” 2.) Recognize your privileges in life (I didn’t) 3.) Achieve fluency in a foreign language 4.) Pursue opportunities to visit developing countries 5.) Start now: don’t wait ‘till college or later…