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Chapter 1

MDG Report 2011. MDG Report 2011. Chapter 1. The Principles and Goals of Global Health. Richard Skolnik. HEALTH. “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”. Medicine versus Public Health.

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Chapter 1

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  1. MDG Report 2011 • MDG Report 2011 Chapter 1 The Principles and Goals of Global Health Richard Skolnik

  2. HEALTH “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”

  3. Medicine versus Public Health Table 1.2: Approaches of Public Health and Medicine Modified from Harvard School of Public Health. About HSPH: Distinctions Between Public Health and Medicine. Available at: www.hsph.harvard.edu/about.html#publichealth . Accessed May 27, 2006.

  4. Public Health • “…the science and art of preventing disease, prolonging life, and promoting health through organized community efforts; • the control of community infections; • the education of the individual in principles of personal hygiene; • the organization of medical/nursing service for the early diagnosis and treatment of disease; • the development of the social machinery to ensure to every individual in the community a standard of living adequate for the maintenance of health.”

  5. Table 1.1: Selected Examples of Public Health Activities

  6. Public Health Initiatives • In Maine? • In United States?

  7. Global Health • “…an area for study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide. “ • emphasizes transnational health issues, determinants, and solutions • involves many disciplines within and beyond the health sciences, and promotes interdisciplinary collaboration; • synthesizes population based prevention with individual-level clinical care.”

  8. Table 1.3: Selected Examples of Global Health Issues

  9. Figure 1.2: Distribution of Dengue Fever, 2009 Data from Centers for Disease Control and Prevention. Dengue Fever (DF) and Dengue Hemorraghic Fever (DHF). Available at: http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-5/dengue-fever-dengue-hemorrhagic-fever.aspx#1647. Accessed February 1, 2011..

  10. SARS Outbreak • 2002, 1st cases seen in China, local gov’t bans press from writing about • By early 2003, 305 cases and 5 deaths, outbreak said to be under-control by local officials • ‘03, 64 yr old doctor in China with respiratory complaints, Hong Kong for vacation with his brother-in-law, stay at a hotel • Symptoms get much worse, goes to hospital • Warns hospital he has a virulent disease • Dies 10 days later

  11. SARS • He infects: • Brother-in-law …dies soon after • 2 nurses • 16 hotel guests, carry disease to 3 more countries • Canada, Singapore, and Vietnam • 1 hotel guest  hospital and infects • 88 health workers, 18 medical students, ?#patients • Infected patient goes home and infects 200+ residents of housing complex • Within 5 months 8096 known infected in 30 countries, 774 deaths

  12. SARS Outbreak Lead to Much Research • Identity, new coronavirus – not expected! • Origin • Live animal market suspected, many exotic animals • Many workers had antibodies to SARS virus, not sick • Conclude pre-cursor to SARS present in animal market • Find SARS-like virus in civets for sale in market, but not civets in the wild (not natural reservoir) • Find virus close to SARS in wild bats - ?natural reservoir

  13. SARS Outbreak Lead to Much Research • Sequenced DNA in bat, civet and human SARS virus • found mutation in spike protein allowed binding to human receptor • Transmission, 1st cases animal to human, rest human to human • Found human begins to spread virus 7-10 days into infection, sick at this point • Lead to quarantining of patients to avoid spread

  14. Classifying Countries • Developed vs. developing • By income • World Bank sets criteria • By region • World Bank regions • World Health Organization (WHO) • Millennium Development Goal (MDG)

  15. World Bank Income Categories • Low-income : $1035 or less • Lower middle-income : $1,036 to $4,085 • Upper middle-income : $4,086 to $12,615 • High-income : $12,616 or more Based on gross national income per person SB: Updated 1/14

  16. Table 1.4: Examples of Low, Middle, and High-Income Countries, Following World Bank Classification Data from the World Bank. Country and Lending Groups. Available at: http://data.worldbank.org/about/country-classifications/country-and-lending-groups. Accessed September 4, 2010.

  17. World Bank Regions • Countries are separated into 6 regions, with high-income countries as a 7th group: • High Income • East Asia and Pacific • Europe and Central Asia • Latin America and the Caribbean • Middle East and North Africa • South Asia • Sub-Saharan Africa.

  18. World Bank Regions

  19. WHO Regions

  20. MDG Regions • Developed regions • Northern Africa • Sub-Saharan Africa • Latin America and the Caribbean • Caucasus and Central Asia • Eastern Asia • Southern Asia • South-eastern Asia • Western Asia • Oceania

  21. Table 1.5: Millennium Development Goals and their Related Targets Source: Data from Millennium Project: Goals, Targets, and Indicators. Available at http://www.unmillenniumproject.org/goals/gti.htm. MDG

  22. Table 1.5: Millennium Development Goals and their Related Targets (cont)

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