Confronting The Realities of Global Health

A conversation recently about how people in
the U.S. feel about the need for fighting poverty and disease causes me to
reflect on misperceptions of the risks facing the world.


Poverty is the single
most important reason
for ill health. And
ill health is the
single most important
reason for poverty.
–Newsroom Guide
to Global Health
WGBH and
Vulcan Productions

I was in a conversation about health and poverty recently and someone said neither health nor poverty is high in the priorities of individuals or governments because we don’t perceive them to require urgent attention. In fact, some in the developed world don’t see the threat of epidemics as an urgent issue at all, despite recent grave warnings about avian flu.

That set me to thinking about the inaccuracy of this perception. It’s inaccurate from many angles. Hunger creates instability. Hunger is born of poverty. We know this from experience. It really doesn’t take a written study by the World Bank or Bread for the World to make this case. It’s readily apparent.

The economic disruption that comes in tandem with political unrest can explode into a crisis that affects global relationships overnight. We are more interconnected than ever and what happens in one part of the world has consequences in another almost immediately. Poverty, hunger and instability go hand-in-hand.

Globalization makes
us all vulnerable
to any new
disease, no matter
where it originates.
–Newsroom Guide
to Global Health
WGBH and
Vulcan Productions

Couple this to another piece of reality. Outbreaks of infectious disease are only a day away from any place in the world. In RX for Survival, Philip Hilts notes that “…if we count only travel between nations with a heavy burden of disease and those with less disease more than a million people a week are making the trip.” (p. 3) One infected person on one flight can carry an infection around the world in a single day.

The AIDS pandemic is enough to demonstrate the easy movement of infectious disease but because the disease is related to sexual behavior and the sharing of syringes for intravenous drug use, it’s been easier for some to focus on these behaviors and to think that the risks are associated with those who practice risky behaviors. This is a dangerous diversion for which millions of innocent people, including many women and children, are paying with their lives. AIDS remains an urgent concern.

Hilts also makes a case that the decline of public health services and monitoring, begun when President Reagan declared government the problem and not the solution, leaves the U.S. less prepared for risks that continue to arise. Consider these potential infectious diseases and their capacity to spread: hantavirus, Lyme disease, West Nile virus, Rift Valley Fever, Ebola, Marburg virus, Nipah virus, SARS and H5N1.

Daily we hear how ill-prepared the world is for H5N1. Many epidemiologists are looking at the virus’ capacity to make the crossing from bird-to-human and then from human-to-human. An outbreak could take millions of lives around the globe. We live in a bubble of false security if we think these diseases won’t cross borders, geographic and otherwise. The reality of globalization is that when one of us is sick, all of us are at risk. We would do better to recognize that prevention and treatment are matters for all of us as well. When it comes to disease transmission, there is no longer an “over there.”

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