Jana Blumenthal Michael Dillon Kacy Negethon Abby Law

1. Jana BlumenthalMichael DillonKacy NegethonAbby Law

2. Infections and Inequalities THE MODERN PLAGUES written by paul farmer

4. Introduction We know most things about it, but TB still kills more people than any other pathogen, far more than alcoholisms, AIDS, malaria, tropical diseases and Ebola combined, and nobody seems to care….Where is the shame? Where is the outrage? Lee Reichman, 1997

5. Introduction Farmer discusses social inequalities that contribute to the spread of Aids, tuberculosis, and other diseases among the poor and hinder their treatment. Farmer has battled AIDS in rural Haiti and deadly strains of drug-resistant tuberculosis in Peru. In his stories of sickness and suffering. Farmer challenges the accepted methodologies of epidemiology and international health.

6. Farmer shows that society has put a net worth on human life. Diseases That are treatable in the United States but not in Haiti or Peru, unfortunately poverty has devalued Human life. “Peru’s government has deemed MDRTB not cost effective, but $350 million for a dozen fighter jet’s a terrific deal.” With better access to information, the poverty stricken now know that MDRTB can be treated with second-line drugs. But with a six month supply of TB drugs many times costing a Haitian more than a years salary. No one wants to treat the most Susceptible to risk, the poor.

7. Societal conditions determine biological realities for poor and powerless people by simultaneously putting them at risk for disease and denying them access to care.

8. Emerging Infectious Disease • Social Inequalities • “We live in a world where infections pass easily across borders--social and geographic-- while resources, including scientific knowledge, are blocked at customs.” (54) • Transnational Perspective • Inequality in developing countries may cause medical emergencies in developed countries when borders are crossed • Critical Epistemology • Rhetoric and perceived human value perpetuate disease in oppressed groups

9. What is Tuberculosis (TB) ? • Bacterial disease that is spread through the air • Usually attacks lungs, but can affect any part of the body • TB is curablewith treatment • TB can lead to death if untreated

10. Multi Drug Resistant TB (MDR-TB) • Lack of access fuels drug resistance • Most TB patients do not complete their full 6-9 month regimen. The TB bacillus becomes resistant due to incomplete, erratic or inadequate treatment. • MDR-TB could be growing as rapidly as 400,000 cases each year

11. Poverty and TB • Treatment requires taking several medications regularly for at least six months • Small living spaces expose and re-expose infectious bacteria • Family members, homeless shelters, prisons • Unable to take time off of work, hindering recovery and exposing co-workers

12. Intersection of Two Global Epidemics • Approximately 2 billion people (one-third of the world's population) are infected with Mycobacterium tuberculosis, the cause of TB. • TB is the cause of death for one out of every three people with AIDS worldwide. • The spread of the HIV epidemic has significantly impacted the TB epidemic - one-third of the increase in TB cases over the last five years can be attributed to the HIV epidemic

13. What are HIV and AIDS? • HIV is a virus that kills CD4 cells(T-cells) which help body fight off disease • Transmitted through blood, semen, vaginal secretions, and breast milk • AIDS is the most advanced stage of HIV

14. Poverty and HIV/AIDS • Treatment requires: • a personalized selection of medications for remainder of life • constant tests of viral levels and T-counts • Infected person must be adaptable to sudden needed rest, unexpected illness, etc.

18. Reality • Annual per person cost of TB treatment medication: - min $500 • Per capita income in Peru -$5000 • Annual per person cost of HIV treatment medication: • $4000 • Per capita income in Haiti • $400

19. AID’S came from Africa then traveled to United States and Europe, subsequently was introduced into Haiti by either tourist or returning Haitians, 33% of all AID’S patients live in suburb’s of Port Au Prince. Complications to HIV infections in rural and suburban Haiti are leading cause of death

20. Factors of AIDS in Haiti • 70 % unemployment rate • Transnational homosexual contact • Pursuit of trade and tourism • Crowded demographics, population pressures • Economic pressure • Patterns of sexual unions • Gender inequality • Concurrent disease • POVERTY

21. Voodoo, Sorcery and Superstitions • Haitian voodoo priest routinely conduct rituals where blood of animals is consumed • Many Haitian voodoo priest are homosexual men • Many Haitians believe infections are caused by sorcery • Many Haitians believe AIDS is a U.S. experiment gone wrong • Infections can be sent by someone who willfully inflicts death upon the afflicted.

23. Three decades after the surgeon general claimed that “its time to close the book on infectious diseases,” these pathogens, most of them treatable, remain the world’s number one killers. • TB will be the 4th leading cause of death overall in the developing countries by the year 2020

24. Good Aspects • Passionate and engaging anecdotes • Extensive, well-documented research • Tangible language; easy read • Copious information • Room for finger painting at end of book

25. Bad Points • Redundant at times, unfortunately same story, ex. patient gets TB, then die’s • Farmer assumes the reader is familiar with all terminology associated with infections and diseases • No real clear solution to fix the problem • Idealistic way of looking at the world thru pragmatism