Background

At CSIS on October 14^th, Sir Richard Feachem gave a presentation on what the Global Health priorities should be for the 21^st century.  He divided his presentation into four distinct sections.  These sections were; Mind the Gap, Sex and Chickens, Eating more and eating less, and the World’s Biggest Muddle.

Mind the Gap

Mind the gap refers to wide disparity in life expectancy depending on where one is born.  Life expectancy in wealthy, developed countries reaches approximately 80 years as opposed to underdeveloped countries where life expectancy hovers around 40 years.  The second statistic Sir Richard used was 65q0 which refers to the percent chance one has of reaching 65 years of age.  A woman in an underdeveloped country has a less than 20% chance of reaching 65 as opposed to an 80% chance in developed countries.  For Sir Richard, this is unacceptable, shameful and tragic as this is largely preventable. 

This is also the section that Sir Richard mentioned malaria most thoroughly.  He referred to malaria as a compelling success story.  He cited a map of malaria-endemic countries in 1945, 2009 and a projected map of 2025.  The maps indicate past and projected future success.  Sir Richard’s main point is that we can be successful when focused on the right priorities. 

Sex and Chickens

Sex and chickens refers to the fact that the manner of transmitting pandemics has been reduced to two main avenues, sexual and respiratory.  Sir Richard then discussed various pandemics including HIV/AIDS and the fact that it is the greatest in human history.  He mentioned XDR TB as one to watch and H1N1 as the pandemic receiving the most media attention.  What is crucial for the Global Health community is the globalization of the world has put us all at risk for any pandemic.  This means drastic social and economic consequences, global vulnerability and the need for a global control program to effectively respond. 

Eating More, Eating Less

Simply put, this section refers to the dual health threat of obesity and starvation.  Typically, poorer countries struggle with hunger and more developed countries struggle with obesity.  Interestingly, and disturbingly, some nations, such as India struggle with both hunger and obesity. 

The World’s Biggest Muddle

Sir Richard’s presentation ended with a look at Healthcare systems and the surrounding debate.  Health systems have problems in both poor and rich countries.  In poor country, the bottom line is there is limited access to poor quality healthcare.  In the developed world, healthcare is the world’s largest industry.  In the U.S., 8% gdp is spent on defense as opposed to 16% on health care.  The problem is there is no agreement on where to take health systems and furthermore, there is no shining example of what healthcare should be. 

Sir Richard suggests the answer must be multi-sectoral, integrated and be a joint global action.  Sir Richard also addressed the debate between horizontal and vertical spending in health.  His point was that we need both.  Targeted funding has had great success for diseases such as malaria, polio and other dieases and we cannot afford to lose that.  At the same time, health systems must be built up so what we must focus on is polyvalent investments when possible.  For instance, Sir Richard mentioned the work he does on malaria in Africa.  One of the investments they made was in laboratories for malaria diagnostics.  When malaria ends, these laboratories will not disappear, but be reapportioned for other uses.  It is these types of cross cutting investments that will work both on a targeted level and at a broader systems level.

Tags: Pandemic, Sir Richard Feachem

Tags: Pandemic, Sir Richard Feachem
Categories:Global Health Community