Thursday, August 21, 2014

Selected Readings on Human Health, Disease, and the Environment

The following are responses and summaries of various readings related to Human Health, Disease, and the Environment. 
Rx for Survival: The Forgotten Link Between Health and Wealth
Globally nations have begun to promote an increase in aid beginning with the Millennium Development Project, though little action has actually been taken since.  According to Adam Smith the government has three main duties: providing for its own defense, development of a justice system, and the construction and maintenance of public facilities and services.  Britain was the first to really get the building of public works aspect with its construction of the sewage and water system, which put a stop to the cholera epidemic that swept the European continent and Britain in the 19th century.  The Asiatic cholera had decimated the port towns of Germany and Russia, having proceeded up the Caspian from India in previous years.  Cholera was a disease alike none other than had been seen before in the Isles; it was a quick killer, acting at a furious pace and spreading quickly.  During the epidemic nearly half of those who became infected died.  It first appeared in the port town of Sunderland, which would later order the port closed and the city quarantined.  Locals, denying its existence, revolted against the quarantine.  Only six months later more than 20,000 throughout England had died from the cholera that had spread from Sunderland.  It took much time and work, but thanks to the efforts of Edwin Chadwick and John Snow it was proven to the powers that be that the disease was transmitted through the water, specifically the water which was becoming contaminated by the sewage.  They proposed to Parliament the construction of a great water and sewage system.  Though they had sufficiently proven that source of the illness was not that the people were poor and bad off, it was that the conditions they were forced in to – poor housing and sanitation – was only making things worse, Parliament did not act until the stench of the open sewers forced them to evacuate the Parliament building.  The construction of the system was perhaps the most expensive public works project in the world’s history at the time, but the results were instantaneous with the cholera epidemic ceasing.  After this the rest of the industrial world soon followed suit in their public works efforts.  The wellness of the nations created a huge economic boom.  The link between health and disease prevention and the economy was lost after the Second World War.  After WWII the World Bank was created with the motif that if a company is going to grow economically, then it is required to have great capital for investment in industry, transportation, and business.  From this idea it was expected that the leading nations would aid the poorer nations with copious capital enabling them to pull themselves up.  The idea of human capital, the health and wealth of the people, was overlooked in the formation of these development projects.  Too much money had been dedicated to building roads and factors and not enough to the health of the population. 

Investing in Health
With the 1993 publication of Investing in Health by the World Bank, the idea of investing in the health and education of the people as a way to stimulate economic growth in the poor nations of the world was relit.  Much of the progress which humanity has made is due to the creation and distribution of wealth, but health and wellbeing plays a large part as well.  The easiest way for governments of poor nations to improve the health of its citizens is to spend less money on the bigger, more ineffective measures like hospitals and to focus more on smaller services such as immunizations and prevention combined with clinics.  The economic-health link has been restated with data collected that shows, all other things being equal between similar nations, the country with a longer life span will have an economic increase of .3 to .5 percent in addition each year.  A healthier population is more productive and misses less time from work due to illness, often strive for higher education or knowledge, save and invest money for old age, and has less children as a whole.  Recently a trend has developed to shift from the old ways of analysis, the Gross Domestic Product, to newer statistics such as full income and DALY.  The full income includes a figure for life expectancy to the data set, while the DALY is the disability-adjusted life year, which allows for a measure of those between health and death, where before there was none.  The central issues for why investment into human capital is necessary are that without assistance these poorer countries could become trapped in a situation that they could not revive themselves from, disease is the greatest barrier to economic growth, and the simplest or most easily treated diseases are the ones which wreak the most havoc.  The failure of poorer nations is best forecasted by partial democracy regimes and most notably high rates of infant mortality.  Human health is a great issue for national and international security and stability and as such needs to be addressed financially in order to avoid catastrophe. 

If Not Now, When?
The Global Fund, recently created, is a new type of aid organization: it collects funds from donor nations and private parties and gives them out as grants, not as loans which can cause a burden on the receiving nation.  It analyzes the proposal projects, developed within the nations themselves, monitors the spending of the project’s funds, and measures the efficiency of the projects.  The Global Fund is what new aid organizations should use as a template for their activity.  Since the end of World War II, specifically the end of the Marshall Reconstruction Plan, foreign aid given by the United States has fallen from 3 percent of the GDP to .16 percent, though many U.S. citizens believed that we were spending much more.  According to a 2001 study by the WHO currently the world is spending about $6 billion on aid, while it sees that $27 billion is the minimum to cover the most basic of necessities.  This increase would only be about .1 percent of the GDPs of the world’s wealthier nations.  The nations of the world have agreed that more money is needed, but have not acted as such.  The major nations need to commit to large sums of money for aid purposes and the world’s aid agencies need to be reformed and made more transparent.  The most recent globalization is at a point of strife; if action is not taken soon against the plagues of the poorer nations, it could spell disaster just as the globalizations of the 19th century led to World War I and the failure to address those same issues led to the re-ignition of the European fire that was World War II.
Conclusion
Studies and research has shown that health aid projects can be successful.  The projects must be large, national or global in scale, address major public health problems, with the effects being obvious, be very cost-effective over a long time period.  It is possible to achieve success in even the most poor of nations, regardless of the corruption in government.  The governments, while poor, are still very important in the utilization and creation of health means.  Technology and modern medicine is great, however the simplest of ideas can create a great change in people’s wellbeing.  The governments of poor nations and nongovernmental organizations can work together on projects of their own without the assistance of donor nations. 

 Readings above may have been drawn from the following sources:
Six Modern Plagues and How We are Causing Them, Mark Jerome Walters; Shearwater Books, 2003, ISBN 155963992X
Life Support, The Environment and Human Health, Michael McCally, editor, MIT Press, 2002, ISBN 0-262-63257-8
Rx for Survival,  Philip Hilts, Pengquin Books.  ISBN 0-7394-6974-6
Emerging Infectious Diseases,  Stuart A. Hill, Pearson Eductation Inc., publishing as Benjamin Cummings.  ISBN 0-8053-3955-8
Under the Weather:  Climate, Ecosystems and Infectious Disease, National Research Council, National Academy Press.  ISBN 0-309-07278-6

This article originally written December 8th, 2008 for OU IPE 3913 - Human Health, Disease, and the Environment.

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