We, the People of Faith and the Diseases of Poverty: Understanding our Role

1. We, the People of Faithand the Diseases of Poverty: Understanding our Role Devotions at Medical Teams International – 28 Aug 2007 Milton B. Amayun, MD, MPH (iaimilton@aol.com)

2. Greetings and Introductions • Greetings and thank you! • It is with great pleasure to be here in the name of Christian Connections for International Health (or CCIH)… • I would like to briefly introduce the members of our Board and staff who are here. • Laura (our new Vice-President), Vicky, Bob, Jacqui, Douglas, David • Ray (our Executive Director) and Sharon (our Program Associate)

3. CCIH is… • A network of 100 organizations and affiliates committed to the promotion of health and wholeness from a Christian perspective. • We are focused on global health issues. • We are a forumfor sharing and discussion. • We connect organizations, people, communities. • Please visit www.ccih.org.

4. Seven Principal Causes of the Global Disease Burden • In 2001, nearly two-thirds of all diseases in children and young adults (0-44 years) were caused by a few diseases, mostly infectious. • Close to 60% were due to AIDS, Maternal and Perinatal Conditions, Acute Respiratory Infections, Diarrheas, Malaria, Measles, TB. • The combined death toll for AIDS, TB and Malaria alone was six million! • Most of these deaths were in the developing world. India contributes significantly to morbidity/mortality due to the seven diseases each year .

5. Major Causes of Death and Disease, 0-44 years, in 2003

6. Death is only Part of the Story • For every death, there are many more cases. • Disability can be disfiguring for life – e.g., leprosy, polio, lymphatic filariasis. • Stigma is associated with AIDS, TB. • Millions of carriers do not know their status. • Orphans – innocent victims by the millions. • Costs of treatment and/or burial worsen levels of poverty. • Large-scale missed opportunities towards meaningful and productive lives.

7. Implications to Society • Loss of human capital: Millions dying due to AIDS • Unmotivated work force: Lower productivity due to illness. • Increased costs of production: Budget for health increases. • Loss of markets: Less buying power of an impoverished population. • Heightens role of prevention • Result: MANY POOR PEOPLE REMAIN POOR BECAUSE OF POOR HEALTH

8. Implications to Christians • Millions missing the abundant life due to illness. • Major opportunities for Christian witness with Jesus as our model. • Complementary role of healing ministries to the mandate to preach the Word. • Need to train Christian health professionals in public health issues and programs. • Re-emphasis of prevention strategies. • Resources needed for reduction of global disease burden.

9. Challenges and Opportunities • Christians have been slow in embracing HIV/AIDS as a responsibility. • Funding for health ministries has been on the decline; many Christian health institutions have been unsustainable. Some have had to close. • Although the situation is changing, many medical missionaries are still focused on clinical medicine. • In creative access countries, health is a good entry point. • Few resources invested in M&E and documentation; fewer still in policy debates.

10. Focus on AIDS, TB, Malaria

11. TB: Basic Facts • Infects many organs; pulmonary form common. • 2 billion carriers worldwide; India (especially N India) has very high concentration of TB cases. • Globally, 8.8 million cases become active TB each year. • 1.9 million deaths each year, mostly young adults in productive stages of life. • Between 2000 and 2020, 35 million deaths projected – nearly 20x current population of Greater Portland. • Increasing rates of co-infection with HIV/AIDS. • 10 million TB-HIV co-infections today.

12. Malaria: Basic Facts • Transmitted by mosquitoes. • Falciparum malaria is most virulent strain. • One million deaths per year, mostly in young children 0-5 years. • That is 3000 child deaths per day! • Pregnant mothers can become anemic, or have stillborn and stunted babies, in addition to abortions. • Surviving babies may have impaired growth and development.

13. What is lacking? • We know the treatment and we have the technology to fight the diseases of poverty. • TB and Malaria medicines can cure. • We have ARVs to prolong and improve the quality of lives of PLWHAs – up to 20 years! • We will soon have the resources equal to the magnitude of the problem. • We lack the political will to implement the task. • Goal: 100% coverage of the need. • Civil society (includes the Church) and private sector must share leadership with government!

14. Costs of Interventions

15. Goals for the New Millennium • Deadline for the following goals is 2010. • HIV/AIDS: to reduce the number of newly infected young people (15-24 years) by 25%. • TB: to reduce by 50% current level of TB deaths and prevalence. • Malaria: to reduce the malaria disease burden by 50%.  

16. Global Program Initiatives • Stop TB Initiative • Roll Back Malaria • PEPFAR: President’s Emergency Plan for AIDS Relief • Global Fund to fight AIDS, TB and Malaria • Massive Effort Campaign • Global TB Drug Facility and the Global Alliance for TB Drug Development • International AIDS Vaccine Initiative

17. GFATM: Example of a New Paradigm • Involves all sectors of society, including communities affected by the diseases, government, donor community and the private sector. • High levels of transparency required. • Performance on first two years determine funding for remaining three years • Checks and balances in place. • Private sector participation needs to increase at all levels.

18. Challenges to the Church • Investing in health is a good missions strategy! • Church is uniquely positioned to respond to the diseases of poverty. • Scaling-up traditional programs needing new paradigms. • Stigma and discrimination can be reduced through the Church. • Collaboration with government, private sector and civil society is the way of the future.

19. Conclusions Jesus: “I have come that they might have life…more abundantly.” (John 10:10-11) “Poor people will only be able to emerge from poverty if they enjoy better health. Health should be at the heart of our struggle for sustainable development.” Gro-Harlem Brundtland, Director-General, WHO, 1998-2003 The story of Lazarus’ resurrection.