ICM - Global Health Initiative
| Why Global Health?|
| - (a) Global economy (increased exchange)|
- (b) Disease knows no boundaries
- (c) Hotbeds of infection lead to resistance
- (d) A healthy populace is a better workforce
- (e) A healthy populace produces more consumers
- (f) A grateful populace is likely to prove a better
| Why Global Health?|
| • It's the ethical thing to do!|
• It re-energizes the passion for
becoming (and remaining) a
| specific goals to be achieved by 2015|
|• Reducing by half the proportion of the world's people living in extreme poverty (living on less than a dollar a day)|
• Ensuring that all boys and girls complete a full course of primary schooling
• Reducing by two thirds the death rate among children under five
• Halting and reversing the incidence of AIDS and other major diseases, especially TB and malaria
• Halving the proportion of people without sustainable access to safe drinking water and basic sanitation.
|The BIG FIVE|| 1. diarrhea|
|drop in trends in child mortality primarily due to||1990 Primarily due to greater use of insecticide treated mosquito nets, better rehydration for diarrhea, and better access to clean water, sanitation and vaccines|
|causes of death for children under age 5|| 42% neonatal|
| __trails only pneumonia as the|
biggest killer of small children in the
world, greater than tuberculosis, AIDS or malaria, in numbers equivalent to a jumbo jet crashing every hour. Death is due to dehydration and inanition!!
• Deaths from diarrhea in the USA number in hundreds.
|__is usually taken to mean a deficiency in caloric intake —any person whose daily diet gives fewer than the defined minimum of 2,100 kcal is considered suffering from hunger, or undernourished. The typical response to hunger is food aid that supplements a person's daily caloric intake.||Hunger|
|__however is not merely the result of too little food. It is a pathology caused principally by a lack of essential nutrients. Most food aid is an inadequate response to malnutrition as it either delivers insufficient amounts of essential nutrients or delivers them in a way that they are destroyed by cooking , storage, or not taken up properly by the body.||Malnutrition|
(Physicians Without Borders, 1999)
| Peanuts blended with unsaturated fats; rich in|
macro-and micro-nutrients; 4 week course;
~$1/day. Avoids hospitalization
|Preventive Interventions|| • Breast feeding* (0-6 mos; 7-11 mos)|
• Measles vaccine
• Vitamin A (vision, growth & development)
• Zinc (immune system, growth)
• Insecticide-treated materials (netting)
• Complementary feeding (incl. micronutrients)
• Water sanitation, hygiene
>if HIV mom on HAART > she can still breastfeed
|Treatment Interventions|| • Oral rehydration therapy|
• Zinc (decreases diarrhea duration & severity))
• Vitamin A
• Complementary feedings
|"How many child deaths can we prevent this year?"||About 2/3rds of child deaths could be prevented today by interventions that are feasible for low income, high population coverage, costing less than $1 a day!|
|Dr. John Snow (1813-58)|| • Pioneer in inhalation anesthesia (ether, chloroform).|
• Father of epidemiology.
• Pioneer in medical cartography.
|In 2005, the globe silently celebrated the 150th anniversary of the second edition of Dr. John Snow's landmark publication "On the Mode of Transmission of Cholera". In that book he||implicated contaminated water as the culprit in the pathogenesis of Asiatic (or Spasmodic) Cholera during the 1848-49 and 1853-54 outbreaks in London, England|
| Friday 8 September 1854:|
A Historic Moment!
|Removal of Broad Street Pump handle was accompanied by sharp drop in cholera cases in that area.|
|Vibrio Cholerae pacini|| Discovered in intestinal tract of patients with cholera in 1854 by Filipo Pacini, but the paper he published, in an Italian journal, went unnoticed.|
Rediscovered in 1884 by Robert Koch to great acclaim.
Discovery finally credited to Pacini in 1965.
|Demonstration that sodium/sugar/ amino acid absorbing cells are not impaired by cholera toxin.|| The "denudation" and|
"poisoned pump" theories
|Adding __to the lumenal solution, markedly decreases volume of secretion by small intestinal elicited by cholera toxin||glucose|
| Oral Rehydration Preparations|
>for vomiting & diarrhea
| 8 teaspoons of sugar|
1 teaspoon of salt
1 liter of water
|"The discovery that sodium transport and glucose transport are coupled in the small intestine so that glucose accelerates absorption of solute and water is potentially the most important medical advance this century."||dr. shultz did this >> he is up for the Nobel peace prize|