Chronic Diseases, Innovations in Health Systems and Data for Decision Making

September 22, 2010

The participants in this session all reinforced the need for using innovative approaches to address global health issues. In describing the problem of rising cancer incidence in developing countries, Sofia Merajver quoted the gospel of Matthew, “The harvest is plentiful, but the workers are few.” She pointed out that the vast burden of cancer deaths is borne by low and middle-income countries, which have the fewest resources to deal with cancer and other chronic diseases. Recognizing that strategies for addressing cancer deaths in high income countries are not appropriate for low income countries, her team developed local cancer registries, which allowed them to better understand the types of breast cancer affecting women in North Africa and the Middle East. This in turn led to dramatic reductions in stage 4 breast cancer.  

In a similar way, Pamela Andreatta and colleagues were able to use cell phone technology to show that use of bimanual uterine compression can reduce deaths from post-partum hemorrhage. Her team trained illiterate traditional birth attendants in rural Ghana to collect data and report it via SMS messaging. A spinoff of this research was the growing sense of empowerment of the traditional birth attendants.

Woutrina Miller provided another example of ways in which technology can be borrowed from one arena and used to meet global health challenges. She described an innovative and cost-effective way of detecting water-borne pathogens which uses the principles of hemodialysis technology to concentrate pathogens from large water sources. 

Two of the panelists reported on efforts to address chronic diseases in Brazil. Beatriz Carlini spoke about a study on the impact of telephone counseling for those wishing to quit smoking in Brazil, and James Macinko presented some work showing that Brazil’s roll-out of a strong, universal primary health system was associated with a dramatic reduction in hospitalization rates.

Finally, Erika Arteaga, from the People’s Health Movement, gave some provocative comments on how policy decisions based on the principle of economic growth can actually lead to worsening health, and gave the example of the 3-fold increase in cancer incidence among indigenous people impacted by the Texaco Oil Spill in the Amazon. She alluded to the need for stronger advocacy for the rights of vulnerable populations, and promoted a political ecology framework for looking at global health issues.

Prepared by David Roesel

The Effects of Climate Change and Global Health

September 21, 2010

To get to one of the last sessions on Monday, I had to walk through a maze of hallways thinking I would end up in a room that no one could find. This was not the case. People eager to learn more about the effects of climate change on global health occupied every chair as well as every inch of carpet space. Michal Brauer was speaking on air pollution, Jenna Davis on sanitation and water, Thomas Hinckley and Joshue Tewksbury on food security, and Kristie Ebi on the general effects of climate change.

Kristie Ebi immediately grabbed the crowd’s attention with very sobering statistics — the rate of climate change that we are experiencing today is faster than over the past 10,000 years combined. There are already places in the world that we can categorize as biologically extinct. These very rapid changes are likely to have significant health impacts as well.

The biggest health challenges result from the increase in frequency and intensity of weather events. We have seen this recently with the flooding in Pakistan and the aftermath that resulted. The most notable health effects from climate change can be seen in increases in malnutrition, deaths from extreme weather conditions, cardio-respiratory deaths from air quality, and higher rates of diarrhea related diseases. Climate change can also have an effect on the MDG goals. For example, extreme weather can lead to unpredictable agricultural seasons, which increases the likelihood of malnutrition. Furthermore, when aid programs shift funding around to assist in climate change events, this may result in less assistance for already established programs on the ground.

To conclude her talk, Ebi reminded the audience that we must understand the individual dynamics of a country to address global health issues arising from climate change disasters. She showed us a picture of flooding in Mozambique in 2000. Thousands of people were rescued from trees and the entire country seemed to be covered in water. As aid groups came in, they focused on immediate rescue efforts. However, by not understanding the countries individual nature, they did not know of land mines scattered all over the country. This resulted in hundreds of deaths, mostly children, who came across these land mines after the flooding. Climate change and global health are very complicated issues that we must approach cautiously and strategically in order to achieve the greatest impact for all.

Prepared by Jori Saeger

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