Prevention versus Cure:
Model Essay 1: (Agreement)
In this world, many people are dying from various types of health related problems due to the lack of appropriate health education and preventive actions. That is why a government should expend a huge amount of money from health budget for health education as well as preventive measure. It is agreed that this policy has a great number of benefits and this will be proven by analysing economical point of view of a country and the health aspects of people.
Firstly, many Countries spend an enormous amount of money in order to treat their people who are suffering from different types of serious diseases. This expense can be easily reduced when state commences of healthcare educational system by spending money to the health teaching system. As an example, if the administration perceives to their slums that smoking, drinking, and so on is bad things for human body through this educational program, many people will be not attacked by the severe sickness. This could save a large amount of money of the state. As can be clearly seen from this illustration that the idea may bring colossal economic benefit to the government.
Secondly, many governments fight against several types of diseases, especially diabetes and the heart diseases. Before these health problems assault the people, it can be ceased by taking some preventive measure. For example, exercise, sports, entertainment etc. can decrease the chances to become these patients. Making parks, playground, and cinema hall can influence people to do exercise, which can protect the people from these intense sicknesses. This can be achieved by investing the money in preventive measures from health budget.
In conclusions, this idea is indispensable not only to the people but also to the governments. However, the tremendous amenities of this policy fortify my argument. Therefore, a government should spend money for health education and preventive measure from health budget.
[ Written by – Ayub Ali ]
Model Answer 2: (Agreement)
It goes without saying that prevention is better than cure. That is why, in recent years, there has been a growing body of opinion in favour of putting more resources into health education and preventive measures. The argument is that ignorance of, for example, basic hygiene or the dangers of an unhealthy diet or lifestyle needs to be combated by special nationwide publicity campaigns, as well as longer-term health education.
Obviously, there is a strong human argument for catching any medical condition as early as possible. There is also an economic argument for doing so. Statistics demonstrate the cost-effectiveness of treating a condition in the early stages, rather than delaying until more expensive and prolonged treatment is necessary. Then there are social or economic costs, perhaps in terms of loss of earnings for the family concerned or unemployed benefit paid by the state.
So far so good, but the difficulties start when we try to define what the ‘proportion’ of the budget “should be, particularly if the funds will be ‘diverted from treatment’. Decisions on exactly how much of the total health budget should be spent in this way ‘ are not a matter for the non-specialist, but should be made on the basis of an accepted health service model.
This is the point at which real problems occur – the formulation of the model. How do we accurately measure which health education campaigns are effective in both medical and financial terms? How do we agree about the medical efficacy of various screening programmes, for example, when the medical establishment itself does not agree? A very rigorous process of evaluation is called for so that we can make an informed decision.
Model Answer 3: (Disagreement)
Present a written argument or case to an educated reader with no specialist knowledge of the following topic.
A government has various responsibilities to its citizens, perhaps the most important would be the health care. There are different approaches to this, namely prevention versus cure. This essay will explain why treatment is superior, using the case of tobacco as a clear example.
Firstly, health education has its limits. Over the last twenty years, various western governments have attempted to discourage smokers by placing surgeon’s warnings and revolting pictures. Yet smokers still want to light up, therefore seriously questioning government endeavours of prevention rather than cure. Nevertheless, through the same period cancer treatment has improved considerably even producing beneficial spin-off discoveries for asthma suffers. Therefore treatment is not only more effective, it has also bettered other sectors of society.
Secondly, even if prevention has solid evidence of being effective there is the common case of patients suffering by pure chance. For example, it is known that people can suffer from lung cancer having never smoked anything whereas someone smoking twenty a day can escape such illness. Therefore, even having followed government guidance, there would still be a need for treatment. In addition, if funds had been diverted from research for cures to education there would be little to help ‘chance victims’.
To conclude, all though smoking has addictive elements, drawing from observations over various years it is clear that prevention has failed considerably. Furthermore, treatment can help those afflicted by pure chance, and even benefit patients with related challenges.
Third essay on Prevention is Better than Cure
Article shared by Manish Rajkoomar
Prevention implies ‘to stop doing something’. Cure means ‘to find a solution’. Man is prone to commit mistakes. Prevention is the shield which saves mankind from many disasters, chaos and destruction. Man can foresee the happenings of the future. He checks himself from doing anything wrong.
We must measure very step we take. Cure involves much more effort and pain than what would needed to prevent a problem from affecting us. A cure is a blessing, but prevention is more than a blessing. It is better than cure. A wise act of cautious mind can check us from stepping into something wrong or dangerous. The act of right living makes everything possible. Living in the right sense means living judiciously, wisely and cautiously.
Man has the knowledge of distinguishing between the right and the wrong, the good and the evil,. the safe and the dangerous. He can judge them and escape from dangers and difficulties before thy engulf him. Many fail to distinguish between them and find themselves trapped. Then they seek a cure.
Prevention halts or obstructs the danger or evil etc, from the person before it overpowers him. It makes the person escape from it completely. Cure is a solution for the danger or evil which has already engulfed him. Hence, prevention is better than cure.
A man is judged by his character and manners. His character can be easily polluted. Sometimes people happen to come in contact of bad people. This affects their life badly. They can become a slave to bad habits like smoking, drinking, gambling etc. They may create problems in his family affairs, health and finances. They can lead a healthy life if they avoid them and prevents themselves from falling into such habits.
Prevention can be ensured by planning ahead. An unfortunate act can be avoided if planning is done well in advance. If you want to lose some weight, have a plan, if you want a new job, have a plan. Everything usually goes systematically if we plan for it earlier. The planned programme of vaccinating children well in time has led to the decrease of the incidence of diseases like polio, measles, tetanus etc. Thus, vaccination can prevent in time will help in the . prevention of these diseases in time will help in the eradication of the same.
It is also correct when it is said that we have to take risk or listen to our instincts at some level, but it is also a fact that we cannot take risk in some aspect of like education, finance, health etc. Any kind of carelessness in these aspects may cause destruction. So it is better to take all necessary precautions beforehand.
FUNDING FOR HEALTH:
Every country faces funding challenges
For poorer countries, the challenge is to increase the funding available for health so that they are able to provide and make accessible the needed set of health services of sufficient quality – namely treatment, prevention, promotion and rehabilitation.
Currently many countries are still under the levels of health expenditure that have been defined as critical minimums for providing at least a minimal set of health services. For richer countries, the challenge is to protect the current levels of health expenditure while responding to the challenge of ageing populations (with implications for both revenues and costs) and cost pressure from technological advances (a challenge facing poorer countries as well).
Many options to increase funding
Every country could raise additional domestic funds for health or diversify their funding sources if they wished to. Options include governments giving higher priority to health in their budget allocations, collecting taxes more efficiently, including compulsory insurance contributions, and raising additional funds through various types of innovative funding mechanisms. Taxes on harmful products such as tobacco and alcohol are one such option. They reduce consumption thereby improving health, and increase the resources governments can spend on health.
A ministry of health cannot, on its own, implement measures to increase funding, but it has the responsibility to try and influence the rest of government. This calls for more and better dialogue between the health policy makers and those that control public spending – the ministries of finance and the wider political actors and institutions (such as the parliament and the heads of state).
International funds for health are vital
Even with substantial increases in domestic health expenditure, increased external financial flows will be necessary for many of the low-income countries for a considerable period of time. Development partners can raise more funds to channel to poorer countries in innovative ways, but they should also focus on providing more predictable, harmonized and long-term aid flows.
Health education is a profession of educating people about health. Areas within this profession encompass environmental health, physical health, social health, emotional health, intellectual health, and spiritual health.
Health education can be defined as the principle by which individuals and groups of people, learn to behave in a manner conducive to the promotion, maintenance, or restoration of health. However, as there are multiple definitions of health, there are also multiple definitions of health education. The Joint Committee on Health Education and Promotion Terminology of 2001 defined Health Education as “any combination of planned learning experiences based on sound theories that provide individuals, groups, and communities the opportunity to acquire information and the skills needed to make quality health decisions.”
The World Health Organization defined Health Education as “compris[ing] [of] consciously constructed opportunities for learning involving some form of communication designed to improve health literacy, including improving knowledge, and developing life skills which are conducive to individual and community health.
The Role of Health Education Specialists
From the late nineteenth to the mid-twentieth century, the aim of public health was controlling the harm from infectious diseases, which were largely under control by the 1950s. By the mid 1970s it was clear that reducing illness, death, and rising health care costs could best be achieved through a focus on health promotion and disease prevention. At the heart of the new approach was the role of a health educator .
A health educator is “a professionally prepared individual who serves in a variety of roles and is specifically trained to use appropriate educational strategies and methods to facilitate the development of policies, procedures, interventions, and systems conducive to the health of individuals, groups, and communities.
In the United States some forty states require the teaching of health education. A comprehensive health education curriculum consists of planned learning experiences which will help students achieve desirable attitudes and practices related to critical health issues. Some of these are: emotional health and a positive self image; appreciation, respect for, and care of the human body and its vital organs; physical fitness; health issues of alcohol, tobacco, drug use and abuse; health misconceptions and myths; effects of exercise on the body systems and on general well being; nutrition and weight control; sexual relationships and sexuality, the scientific, social, and economic aspects of community and ecological health; communicable and degenerative diseases including sexually transmitted diseases; disaster preparedness; safety and driver education; factors in the environment and how those factors affect an individual’s or population’s Environmental health (ex: air quality, water quality, food sanitation); life skills; choosing professional medical and health services; and choices of health careers.
Health Care around the world
Health provision varies around the world. Almost all wealthy nations provide universal health care (the US is an exception). Health provision is challenging due to the costs required as well as various social, cultural, political and economic conditions.
The main ways universal health care is achieved in wealthy nations include:
Government run (tax funded) systems, e.g. Britain’s NHS
Privately run but the government pays most of it, e.g. Canada and France
Private insurance companies but with regulation and subsidies to ensure universal coverage and non-discrimination by insurance companies (can’t deny based on medical history or existing conditions), e.g. Switzerland
Structure of a health service
At a high level, health services fall into different categories of health care:
Primary health care
Secondary health care
Tertiary health care
(Some systems may also have additional levels of separation.)
Primary health care
Primary care is usually the first point of contact for a patient. Primary care is typically provided by general practitioners/family doctors, dentists, pharmacists, midwives, etc. It is where most preventative health can be achieved and where early diagnosis can be possible, which may prevent more expensive hospital treatment being required.
By its nature, primary care involves communicating with patients, developing personal connections with patients, going out into the community, using outreach programs for promoting good health and preventative strategies, and more. As such, it can often be extremely cost-effective.
For example, the World Health Organization estimates that better use of existing preventive measures could reduce the global burden of disease by as much as 70%. In addition,
Secondary health care
In most countries this is usually when a primary care person such as a doctor refers a patient to a specialist.
Secondary care providers typically do not have the type of continuous contact with patients that primary care providers do, but help address more complex conditions.
Tertiary health care
This is specialized consultive care, often hospital care.
People often talk about building schools and hospitals, especially when it comes to aid and charity for poorer regions and countries. While hospitals are no doubt important, they give politicians and organizations more credence as they offer visible and tangible results (to their stake holders, such as tax payers and donors).
However, sometimes strengthening and improving primary care can often provide more effective health care (while also easing the burden on secondary and tertiary care). While this may be better for recipients, especially in poorer countries, it is also harder to measure and so often gets neglected.
The WHO, in the above-noted report, has tried to reiterate the importance of primary health care in health care systems.
Health care in developing countries
Many developing countries also strive to provide universal health care. However, most struggle to do so, due to lack of sufficient resources, or inappropriate use of existing funds. Health inequality, therefore, is quite common.
Poverty is a major problem. In some developing countries health facilities have improved considerably, creating a health divide where those who can afford it can receive good quality care. Health gaps typically mirror equality gaps. For the enormous numbers of people without access to health, there is a terrible paradox: poverty exacerbates poor health while poor health makes it harder to get out of poverty.
As detailed further on this site’s global health overview page, policies such as the IMF and World Bank’s Structural Adjustment Programs through the 1970s and 1980s have reduced the ability of many poor countries—many African nations in particular—to provide health services for their populations.
The same ideology encouraging those inappropriate health policies have continued to this day and privatization has often been preferred by these international financial institutions even if they have been shown over and over to be inappropriate for developing countries.
Corruption is an ever-present problem (sometimes in wealthy countries too). Corruption not only makes the problem worse, but some policies have encouraged corruption, too, as has the lack of health resources.
Another issue that plagues some poor countries is brain drain whereby the poor countries educate some of their population to key jobs such as in medical areas and other professions only to find that some rich countries try to attract them away. The prestigious journal, British Medical Journal (BMJ) sums this up in the title of an article: Developed world is robbing African countries of health staff. (Rebecca Coombes, BMJ, Volume 230, p.923, April 23, 2005.)
In many poorer countries, the number of health workers such as doctors and nurses in proportion to the population can be small and in many rural settings, it can be very difficult for people to access services.
The issue of user payment at point of use is perhaps more important in poorer countries than the wealthier ones. In wealthy ones, other than the US, universal health care works such that even where people have to pay at point of use, in many cases it is affordable.
Health Aid to Developing Countries
Foreign aid for health care is directly linked to an increase in life expectancy and a decrease in child mortality in developing countries, according to a new study by Stanford University School of Medicine researchers.
The researchers examined both public and private health-aid programs between 1974 and 2010 in 140 countries and found that, contrary to common perceptions about the waste and ineffectiveness of aid, these health-aid grants led to significant health improvements with lasting effects over time.
Countries receiving more health aid witnessed a more rapid rise in life expectancy and saw measurably larger declines in mortality among children under the age of 5 than countries that received less health aid, said Eran Bendavid, MD, an assistant professor in the Division of General Medical Disciplines and lead author of the study. If these trends continue, he said, an increase in health aid of just 4 percent, or $1 billion, could have major implications for child mortality.
“If health aid continues to be as effective as it has been, we estimate there will be 364,800 fewer deaths in children under 5,” he said. “We are talking about $1 billion, which is a relatively small commitment for developed countries.”
The study was published online April 21 in JAMA Internal Medicine. The study’s co-author, Jay Bhattacharya, MD, PhD, is an associate professor of medicine. Both authors also are core faculty members at Stanford’s Center for Health Policy and Center for Primary Care and Outcomes Research.
Does it work?
Bendavid noted that there is much debate around foreign aid. Critics question whether it’s used effectively and reaches its intended recipients. They often argue that it discourages local development and displaces domestic resources that might otherwise be devoted to health. So the researchers devised a statistical tool to address the basic unanswered question: Do investments in health really lead to health improvements?
Bendavid said there are many reasons to suspect the answer would be no, though the findings proved just the contrary, with health-related aid leading to direct, beneficial outcomes.
“I think for many people, that will be surprising,” he said. “But for me, it fits with other evidence of the incredible success of public health promotion in developing countries.” In a previous study, for instance, he found that hundreds of thousands of lives were saved through the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR, in which the U.S. government invested billions of dollars in antiretroviral treatment and other AIDS-related prevention and treatment initiatives.
In the latest study, the two investigators used data from the Creditor Reporting System of the Organization for Economic Cooperation and Development, the world’s most extensive source of information on foreign aid. While aid programs for health grew during the 36-year study period, the largest period of growth occurred between 2000 and 2010, they found.
It was during this decade that many governments and private groups stepped up their investments in health, including PEPFAR; the World Bank; the Global Fund to Fight AIDS, Tuberculosis and Malaria; the Gates Foundation; and the GAVI Alliance, among others, he said.
As a result, while health aid in 1990 accounted for 4 percent of total foreign aid, it now amounts to 15 percent of all aid, he said. And it’s become an important part of health budgets in recipient countries, accounting for 25-30 percent of all health-care spending in low-income countries, Bendavid said.
The researchers found that these funds were used effectively, largely because of the targeting of aid to disease priorities where improved technologies — such as new vaccines, insecticide-treated bed nets for malarial prevention and antiretroviral drugs for HIV — could make a real difference.
They observed the greatest health impacts between 2000 and 2010, when donor investments were at their peak. During the decade, under-5 child mortality declined from a mean of 109.2 to 72.4 deaths per 1,000, or 36.8 fewer deaths among those children in the countries that received the most health aid, the researchers found (a 34 percent reduction). In the countries receiving the least, under-5 mortality fell from 31.6 to 23.2 deaths per 1,000, or 8.4 fewer deaths per 1,000 live births (a 26 percent reduction), the researchers reported.
Life expectancy increases
During that period, life-expectancy figures also grew faster in countries with a greater infusion of health aid, Bendavid said. Life expectancy rose from 57.5 to 62.3 — an increase of 4.8 years — among the countries receiving the most aid. Among the countries receiving the least health aid, life expectancy increased by 2.7 years, from 69.8 to 72.5 years.
Bendavid said previous experience has shown that, on average, life expectancy has increased by nearly one year every four years in developed countries. But health-aid programs literally cut in half the time it took to reach this goal in developing countries. “In that same four-year span, they increased life expectancy by two years, rather than one year,” he said.
He said the results are not surprising if one considers some of the new health technologies made available to developing nations as a result of foreign aid. Childhood vaccines, including those for diphtheria, tetanus, polio and measles, have all but wiped out what used to be among the top killers of young children in the developing world. Health aid directed to providing insecticide-treated malarial bed nets also has been credited in recent studies with reducing malarial deaths among young children, he noted.
Among both adults and children, aid that has expanded the availability of antiretroviral drugs in the developing world has had a major impact on reducing deaths and improving overall life expectancies, he said. For instance, in a study published in 2012, Bendavid and colleagues found that PEPFAR’s health aid resulted in more than 740,000 lives saved between 2004 and 2008 in nine countries.
The researchers also found that the benefits of aid have a lasting effect: The telltale signs of aid’s relationship to reducing under-5 mortality were detectable for three years following the distribution of aid. The correlation between health aid and longer life expectancy overall was detectable for five years after the aid was distributed.
With aid commitments flattening amid the economic downturn, Bendavid said donors will have to be that much smarter in how they invest future dollars, focusing on the most cost-effective interventions and technologies.
“To date, there has been little consideration of how to use development aid in the most cost-effective manner,” he said. “That will have to change now that the funding level has reached a plateau.”
The study was funded by the George Rosenkranz Fellowship for Health Policy Research in Developing Countries and by the National Institutes of Health (grant K01AI084582).
Dealing with Global Epidemics with Technology
Following the recent Ebola outbreak, there have been a number of investigations to ensure that we learn the lessons from this epidemic and use them to prepare for the next. This has included noted philanthropists such as Bill Gates and Paul Allen calling for governments and NGOs to use the epidemic as a wake-up call, as the next outbreak may be even more widespread.
One sector that is likely to provide a significant impact in future outbreaks is technology. With recent innovation in converging technologies such as mobile computing, mobile communications and broadband internet, it has been possible to trial a number of innovative approaches to epidemic response. Although technology has been used to assist in the fight against epidemics in the past, the recent Ebola outbreak has led to a step change in the level of focus from the technology sector.
Many are now suggesting we need to prepare for the next epidemic through the use of germ war games. A number of technical trials are already underway that could form part of this early response. By building on these technologies as suggested and initiating appropriate war games, we can validate our readiness for the next epidemic.
Technology cannot stop the spread of the epidemic but it can educate, warn and empower those on the ground and those that need to be aware of the situation to significantly reduce the impact.
There are four areas where technology has been used in trials during the Ebola outbreak that can be accelerated.
During an outbreak, clear messaging to the local population is vital to ensure they are informed and reminded to use appropriate precautions, getting clear information to the point most required. Thanks to Africa’s technological push for mobile phones, several NGOs have been able to spread the message highlighting the hazards of Ebola and how to avoid contracting the virus.
In a recent project, Text To Change was able to work in conjunction with Airtel, sending more than 1 million text messages to inform the Sierra Leonean population of ways to prevent the spread of Ebola. Programmes such as this are able to utilize the available technology to quickly reach the population with up-to-date information and, more importantly, quickly update it as the hazards change. It is through the use of these tools that we are able to reach a disparate population to make them aware of the issues and treatments for some of these diseases. It is important to note that, although technology and mobile phones are becoming more prevalent in Africa, the widespread use of smartphones is limited. The TTC and other programmes focus on using SMS texts to spread the message.
Technological advances in mobile computing are used to train health workers in the field. Tools such as the Oppia browser and e-buddi from the MMEI have been able to provide training directly to health workers on the ground. The benefit of tools such as this is that they can quickly deliver standardized learning, with the ability to be updated in the field as new procedures are validated. This replaces potentially conflicting training that is not widely disseminated or tested. Additionally, by using established communications links, training material can be tailored and tested with the health workers on site.
By using these tools, we are able to focus efforts on training the existing staff, health workers and local population to treat themselves long after the emergency support has ended. This will also have an appropriate knock-on effect on the general medical infrastructure in the region. At present, the penetration rate for mobile devices is much lower in the rural areas most in need of such advice and treatment, but this will change.
Much has been written about the growing connectivity capabilities within Africa and the developing world. Improved connectivity facilitates a number of technological advances and is a key enabler of the technical capabilities discussed in this article. There have been significant advances in this area, but access in rural locations is still limited. From our work in the region, this is the key tool that can bring both economic and health benefits.
During an epidemic, communication is a critical tool to ensure we can both spot the virus spreading early and make attempts to contain it by educating the local population. From an NGO perspective, it also provides a means of maintaining medical services through the use of telemedicine. In the recent outbreak, a number of facilities were effectively shut down as staff were evacuated, creating a secondary and potentially more damaging issue, as basic healthcare was no longer available.
Anything we can do now to ensure a stable communications network in region will have a significant impact in a future epidemic. The legacy these solutions provide to the beneficiary hospitals is also significant. As evidence that such capabilities can be provided in harsh environments, recently VSEE provided telemedicine access to refugees in Syrian refugee camps. By utilizing this technology in situ, remote areas will have the capability to continue providing health services following an outbreak.
Traditional means of providing bandwidth to remote areas using satellite technology are being augmented by Wi-Fi and 3G or 2.5G technologies. This is not the traditional solution in the Western world but, due to the expense of satellite-based solutions, these technologies are economically viable. Hardware solutions such as the BRCK have been developed and deployed in Africa specifically to provide mobile internet capabilities in situations with limited power supplies. This device provides internet access when the power is out, utilizing any remaining 3G communications links.
Real time monitoring
Several innovative solutions such as Epi-info VHF and EVDNet have been trialled to assist in the monitoring of any new virus outbreak. This is an area that has seen real innovation in using the available mobile capabilities in the region. The viability of these approaches will only grow with the increase in mobile penetration.
Innovations that are being trialled include examining data from mobile phone towers to track users who have been close to a known case of the virus. Other initiatives are being trialled that allow staff to electronically enter patients’ details as they are received at a medical facility, thus helping to provide a clear picture of the outbreak itself. These technologies leverage the communication capabilities others are trialling to allow clinics to be linked together and tracked centrally. Data from these tools are now being analysed with at least one hackathon being aimed at using the data.
These trials highlight the potential usage of technology, and the results are starting to show promise. With the next epidemic potentially just around the corner, it is imperative to continue pursuing these technical evaluations to ascertain which tools can be effectively used in the next outbreak. Technology will not stop the outbreak alone but, as has been shown, it can be an effective force multiplier that can be leveraged to aid in the detection and treatment of the next epidemic. We must continue pushing ahead with these evaluations, holding war games to validate which approaches are the most successful if we are to avert widespread casualties in the future.
Are we ready to face an epidemic:
Too often, the conventional wisdom in diplomatic or scientific circles is that the general public doesn’t know what’s good for them when it comes to foreign policy or tackling global threats. It’s too complicated, the experts say; the public wouldn’t understand. Yet new polling suggests that many in the public understand very well how global infectious disease outbreaks pose a serious threat to their lives and economic security – and they know what should be done about it.
An opinion research survey commissioned by the World Bank Group with 4,000 respondents across five industrialized countries – France, Germany, Japan, the United Kingdom, and the United States – found that most people are not convinced the world, or their own country, is prepared for the next global epidemic. Twice as many respondents think the world will experience another global epidemic in the next decade as will not, and fewer than half are convinced that their own country is prepared. They rank “global health and epidemics” as one of their top global concerns, after terrorism and climate change.
These findings come nearly a year since the World Health Organization (WHO) declared the Ebola epidemic a “public health emergency of international concern,” its highest level of alert. This triggered a massive global response, but only eight months after the first identified case in West Africa. Yet after more than 11,000 deaths, millions of lives disrupted and billions of dollars in lost income, the threat is not over; new Ebola cases continue to emerge. We’ve also seen the recent spread of the highly infectious MERS virus to the Republic of Korea, which has contributed to a decline in the country’s GDP growth to a six-year low.
Both the Ebola and MERS viruses have been largely confined to a few countries because they are transmitted through close contact. But what would happen if the world faced a fast-moving, airborne disease such as the Spanish flu outbreak of 1918-19? Modelling suggests a Spanish flu-like outbreak today would kill more than 33 million people in 250 days. And the cost of such a severe outbreak has been estimated at 4.8% of global GDP – or more than $3.6 trillion.
The public is right: The world is not prepared for the next epidemic. We’re no better equipped to respond quickly to an outbreak than we were a year ago. But we can be – and at a fraction of what it would cost if we don’t act urgently. Here are three things we need to do:
First, let’s ensure that all countries invest in better preparedness. This starts with a strong health system that can deliver essential, quality care; disease surveillance; and diagnostic capabilities. We should expand successful efforts such as those by Ethiopia and Rwanda to train cadres of community health workers, who can expand access to care and serve as the frontline response to future disease outbreaks. The goal must be universal health coverage – both to ensure everyone can get the care they need, and also because those areas without adequate coverage put everyone at risk.
The public gets this: Strong majorities believe that investing in doctors, nurses, and clinics in developing countries helps prevent epidemics from breaking out in their own countries and saves lives and money. But Korea’s experience shows that even the most advanced health systems need to step up their epidemic preparedness.
Second, we need a smarter, better coordinated global epidemic preparedness and response system that draws upon the expertise of many more players – including a better-resourced WHO. The early months of responding to the Ebola epidemic fell disproportionately upon the heroic Médecins Sans Frontières. Outbreaks will happen, but they can be contained before they turn into much more deadly and costly global epidemics. This requires pre-set arrangements and close coordination between national and local governments, international bodies, the private sector, and non-governmental organizations, with a supply chain that can be up and running in no time. The private sector, which was largely shut out of the initial response to Ebola, can bring market discipline, innovation, and additional resources to the fight.
Third, we must be able to get emergency funding out the door and deploy rapid response teams at the first sign of a crisis. If a fast-moving epidemic hits, the traditional approach of issuing fundraising appeals just isn’t good enough. The World Bank Group is working with the WHO and other institutions on one part of the solution – something we call a pandemic emergency financing facility. Endorsed by the leaders of the Group of 7 in Germany in June, the facility aims to make sure adequate and timely financing is available to countries and international responders to effectively contain a pandemic threat. The facility is developing innovative financing arrangements such as private sector insurance and public sector contingency pools that can disburse rapidly to support a surge in health workers or the setting up of emergency response operations centers. Governments have already used this model to successfully manage climate and natural disaster risks.
Two years ago, a survey of 30,000 insurance executives showed that a global epidemic was their greatest worry. But the executives’ alarm was ignored – as were the previous warnings from SARS and avian flu. Today, with the painful reminder of the latest epidemic and public support strongly in favor, it’s time to tackle epidemic prevention and response. We must break the cycle of talk and no action.
Hospitals and Treatment
A hospital is a health care institution providing patient treatment with specialized medical and nursing staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emergency department to treat urgent health problems ranging from fire and accident victims to a heart attack. A district hospital typically is the major health care facility in its region, with large numbers of beds for intensive care and additional beds for patients who need long-term care. Specialised hospitals include trauma centres, rehabilitation hospitals, children’s hospitals, seniors’ (geriatric) hospitals, and hospitals for dealing with specific medical needs such as psychiatric treatment (see psychiatric hospital) and certain disease categories. Specialised hospitals can help reduce health care costs compared to general hospitals.
A teaching hospital combines assistance to people with teaching to medical students and nurses. The medical facility smaller than a hospital is generally called a clinic. Hospitals have a range of departments (e.g.: surgery and urgent care) and specialist units such as cardiology. Some hospitals have outpatient departments and some have chronic treatment units. Common support units include a pharmacy, pathology, and radiology.
Hospitals are usually funded by the public sector, by health organisations (for profit or nonprofit), by health insurance companies, or by charities, including direct charitable donations. Historically, hospitals were often founded and funded by religious orders, or by charitable individuals and leaders.
In the 2010s, hospitals are largely staffed by professional physicians, surgeons, and nurses, whereas in the past, this work was usually performed by the founding religious orders and members of their order or by volunteers.
n the modern era, hospitals are, broadly, either funded by the government of the country in which they are situated, or survive financially by competing in the private sector (a number of hospitals also are still supported by the historical type of charitable or religious associations).
Modern hospital buildings are designed to minimise the effort of medical personnel and the possibility of contamination while maximising the efficiency of the whole system. Travel time for personnel within the hospital and the transportation of patients between units is facilitated and minimised. The building also should be built to accommodate heavy departments such as radiology and operating rooms while space for special wiring, plumbing, and waste disposal must be allowed for in the design
Treatment or Medical case management is a collaborative process that facilitates recommended treatment plans to assure the appropriate medical care is provided to disabled, ill or injured individuals. It is a role frequently overseen by patient advocates.
It refers to the planning and coordination of health care services appropriate to achieve the goal of medical rehabilitation. Medical case management may include, but is not limited to, care assessment, including personal interview with the injured employee, and assistance in developing, implementing and coordinating a medical care plan with health care providers, as well as the employee and his/her family and evaluation of treatment results.
Medical case management requires the evaluation of a medical condition, developing and implementing a plan of care, coordinating medical resources, communicated healthcare needs to the individual, monitors an individual’s progress and promotes cost-effective care.
What are overweight and obesity?
Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health.
Body mass index (BMI) is a simple index of weight-for-height that is commonly used to classify overweight and obesity in adults. It is defined as a person’s weight in kilograms divided by the square of his height in meters (kg/m2).
Overweight and obesity are linked to more deaths worldwide than underweight. Globally there are more people who are obese than underweight – this occurs in every region except parts of sub-Saharan Africa and Asia.
What causes obesity and overweight?
The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended. Globally, there has been:
an increased intake of energy-dense foods that are high in fat; and
an increase in physical inactivity due to the increasingly sedentary nature of many forms of work, changing modes of transportation, and increasing urbanization.
Changes in dietary and physical activity patterns are often the result of environmental and societal changes associated with development and lack of supportive policies in sectors such as health, agriculture, transport, urban planning, environment, food processing, distribution, marketing, and education.
What are common health consequences of overweight and obesity?
Raised BMI is a major risk factor for noncommunicable diseases such as:
cardiovascular diseases (mainly heart disease and stroke), which were the leading cause of death in 2012;
musculoskeletal disorders (especially osteoarthritis – a highly disabling degenerative disease of the joints);
some cancers (including endometrial, breast, ovarian, prostate, liver, gallbladder, kidney, and colon).
The risk for these noncommunicable diseases increases, with increases in BMI.
Childhood obesity is associated with a higher chance of obesity, premature death and disability in adulthood. But in addition to increased future risks, obese children experience breathing difficulties, increased risk of fractures, hypertension, early markers of cardiovascular disease, insulin resistance and psychological effects.
Facing a double burden of disease
Many low- and middle-income countries are now facing a “double burden” of disease.
While these countries continue to deal with the problems of infectious diseases and undernutrition, they are also experiencing a rapid upsurge in noncommunicable disease risk factors such as obesity and overweight, particularly in urban settings.
It is not uncommon to find undernutrition and obesity co-existing within the same country, the same community and the same household.
Children in low- and middle-income countries are more vulnerable to inadequate pre-natal, infant, and young child nutrition. At the same time, these children are exposed to high-fat, high-sugar, high-salt, energy-dense, and micronutrient-poor foods, which tend to be lower in cost but also lower in nutrient quality. These dietary patterns, in conjunction with lower levels of physical activity, result in sharp increases in childhood obesity while undernutrition issues remain unsolved.
How can overweight and obesity be reduced?
Overweight and obesity, as well as their related noncommunicable diseases, are largely preventable. Supportive environments and communities are fundamental in shaping people’s choices, by making the choice of healthier foods and regular physical activity the easiest choice (the choice that is the most accessible, available and affordable), and therefore preventing overweight and obesity.
At the individual level, people can:
limit energy intake from total fats and sugars;
increase consumption of fruit and vegetables, as well as legumes, whole grains and nuts; and
engage in regular physical activity (60 minutes a day for children and 150 minutes spread through the week for adults).
Individual responsibility can only have its full effect where people have access to a healthy lifestyle. Therefore, at the societal level it is important to support individuals in following the recommendations above, through sustained implementation of evidence based and population based policies that make regular physical activity and healthier dietary choices available, affordable and easily accessible to everyone, particularly to the poorest individuals. An example of such a policy is a tax on sugar sweetened beverages.
The food industry can play a significant role in promoting healthy diets by:
reducing the fat, sugar and salt content of processed foods;
ensuring that healthy and nutritious choices are available and affordable to all consumers;
restricting marketing of foods high in sugars, salt and fats, especially those foods aimed at children and teenagers; and
ensuring the availability of healthy food choices and supporting regular physical activity practice in the workplace.
Exercise and Health:
The benefits of exercise extend far beyond weight management. Research shows that regular physical activity can help reduce your risk for several diseases and health conditions and improve your overall quality of life. Regular physical activity can help protect you from the following health problems.
Heart Disease and Stroke. Daily physical activity can help prevent heart disease and stroke by strengthening your heart muscle, lowering your blood pressure, raising your high-density lipoprotein (HDL) levels (good cholesterol) and lowering low-density lipoprotein (LDL) levels (bad cholesterol), improving blood flow, and increasing your heart’s working capacity. Optimizing each of these factors can provide additional benefits of decreasing the risk for Peripheral Vascular Disease.
High Blood Pressure. Regular physical activity can reduce blood pressure in those with high blood pressure levels. Physical activity reduces body fat, which is associated with high blood pressure.
Noninsulin-Dependent Diabetes. By reducing body fat, physical activity can help to prevent and control this type of diabetes.
Obesity. Physical activity helps to reduce body fat by building or preserving muscle mass and improving the body’s ability to use calories. When physical activity is combined with proper nutrition, it can help control weight and prevent obesity, a major risk factor for many diseases.
Back Pain. By increasing muscle strength and endurance and improving flexibility and posture, regular exercise helps to prevent back pain.
Osteoporosis. Regular weight-bearing exercise promotes bone formation and may prevent many forms of bone loss associated with aging.
Self Esteem And Stress Management. Studies on the psychological effects of exercise have found that regular physical activity can improve your mood and the way you feel about yourself. Researchers have found that exercise is likely to reduce depression and anxiety and help you to better manage stress.
Disability. Running and aerobic exercise have been shown to postpone the development of disability in older adults.
Keep these health benefits in mind when deciding whether or not to exercise