Informing the Future Critical Issues in Health, Fifth Edition (2009) / Chapter Skim
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Stretching Across International Borders
Stretching Across International Borders
Pages 53-66
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From page 53... ...
examines different aspects of this responsibility. The IOM looks at how the nation can best protect its own residents from global health threats and also at how the nation can help other countries with limited resources to tackle health problems within their own borders.
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, the first installment of the new report, calls for highlighting health as a pillar of U.S. foreign policy and backing this up with significant funding increases for global health efforts over the next 4 years.
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0.43 0.43 0.43 0.42 0.41 0.39 0.38 U.S. 0.4 0.34 0.32 0.30 0.27 0.3 0.20 0.20 0.18 0.18 0.2 0.1 0.0 en g ay k Ir e s Be nd Fi m d n m i t z t r ia Fr d er e y lia Ze d a Po d G al e ly St n es an ar nd ur ai n an te p a an c ec Ita g iu do ra w at an la ew n a ed la Sp r tu m Sw us bo m lg rla re ni Ja nl al or er st ng N Ca Sw en A m N Au he Ki d G D xe et d Lu N te U ni U Net official development assistance (2008)
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Many countries face critical health workforce deficits that directly affect efforts at combating disease and death.
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The IOM, together with the nonprofit group Global Violence Prevention Advocacy, convened a workshop to examine how a public health approach might be applied in lessening the pressing dangers. Among their goals, workshop participants -- drawn from an array of fields related to health, criminal justice, public policy, and economic development -- set out to discuss specific opportunities for the U.S.
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Both government and private efforts are needed to span this knowledge gap. Top 0 Causes of Death, Ages -44 Years, Both Sexes, 00 rank -4 Years - Years 0-44 Years 1 Childhood cluster HIV/AIDS HIV/AIDS 200,139 855,406 855,406 2 Road traffic injuries Road traffic injuries Tuberculosis 118,212 354,692 368,501 3 Drowning Tuberculosis Road traffic injuries 113,614 238,021 354,692 4 Respiratory infections Self-inflicted injuries Ischemic heart disease 112,739 216,661 224,986 5 Diarrheal diseases Interpersonal violence Self-inflicted injuries 88,430 188,451 215,263 6 Malaria War injuries Interpersonal violence 76,257 95,015 146,751 7 HIV/AIDS Drowning Cerebrovascular disease 46,022 78,639 145,965 8 War injuries Respiratory infections Cirrhosis of the liver 43,671 65,153 135,072 9 Tuberculosis Poisonings Respiratory infections 36,362 61,865 102,431 10 Tropical diseases Fires Liver cancer 31,845 61,341 84,279 NOTE: Bold, italic figures highlight deaths or disability due to violence.
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With an estimated billion people crossing international borders every year, the shipment of animals and animal products over great distances to reach their final destinations, and rampant population growth in countries where poverty rates are high and people by necessity live in close proximity to animals, new outbreaks could emerge with devastating health, economic, environmental, agricultural, and sociopolitical results. The IOM and the National Research Council jointly convened a workshop to examine how well the United States and the world are prepared to deal with the threats of zoonotic diseases over the long term.
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For example, it will be critical to develop a greater understanding of the interaction of climate with other major factors, such as the globalization of travel and trade, population growth, urbanization, land-use patterns, and habitat destruction, that play a role in disease emergence and resurgence. Governments also will need to establish long-term monitoring programs to simultaneously track climate and infectious disease dynamics, and to optimize measurement instruments (many of which were designed for other purposes)
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Stretching Across International Borders obsered Changes in North American extreme eents, Assessment of Human Influence for the obsered Changes, and Likelihood That the Changes Will Continue Through the Twenty-first Centurya Likelihood of Where and When Linkage of Continued Phenomenon These Changes Human Activity Future and Direction Occurred in to Observed Changes in of Change Past 50 Years Changes This Century Warmer and fewer Over most land Likely warmer Very likelyd cold days areas, the last 10 extreme cold and nights years had lower days and nights numbers of severe and fewer frostsb cold snaps than any other 10 year period Hotter and more Over most of Likely for Very likelyd frequent hot North America warmer nightsb days and nights More frequent Over most land Likely for certain Very likelyd heat waves and areas, most aspects, e.g., warm spells pronounced over night-time northwestern temperatures; two-thirds of and linkage North America to record high annual temperatureb More frequent Over many areas Linked indirectly Very likelyd and intense heavy through downpours and increased water higher proportion vapor, a critical of total rainfall in factor for heavy heavy precipitation precipitation events eventsc Increases in No overall average Likely, Southwest Likely in area affected change for North USA.c Evidence Southwest by drought America, but that 1930s and USA, parts of regional changes 1950s droughts Mexico, and are evident were linked to Carribeand natural patterns of sea surface temperature variability continued
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The committee relied heavily on work conducted by the Intermittent Preventive Treatment in Infants Consortium, comprising 17 leading organizations involved in malaria research in Africa, Europe, and the United States. Assessment of the Role of Intermittent Preventive Treatment for Malaria in Infants: Letter Report (2008)
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Because malaria kills so many people and is an enormous public health problem, health experts around the world are searching for new ways to fight the disease. While the recent IOM report discusses intermittent preventive treatment, that is only one option among many.
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Immunocompromised and not 2 million candidates for vaccine Unique and specialized infrastructure workers 2 million Household contacts of cases 88 million The summary of the proposed guidance, dated November 20, 2008, revises the preliminary position on household prophylaxis: "No national recommendation is made at this time for PEP [post-exposure prophylaxis] of household contacts of an influenza case or for workers in sectors other than healthcare and emergency services." Total estimated number of courses 285 million for treatment and prophylaxis Total excluding household post- 197 million exposure prophylaxis SOURCE: Antivirals for Pandemic Influenza: Guidance on Developing a Distribution and Dispensing Program, p.
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While malaria and influenza remain everyday threats to human health, in the late 20th century the global health community eradicated one of the most devastating diseases ever to plague humanity: smallpox. Today, all known stocks of the disease's causative agent, variola virus, are stored in two repositories sanctioned by the World Health Organization -- in the United States at the federal Centers for Disease Control and Prevention, and in Russia at the State Centre for Research on Virology and Biotechnology.
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finds that developing medical countermeasures against this deadly pathogen remains an essential need because of the potential for an accidental or deliberate release, and that having access to stocks of live variola virus will critically aid researchers in reaching their goals. The report singles out four areas for particular attention: development of improved therapeutics; development of new or improved vaccines; genomic analysis to improve the fundamental understanding of the virus and identify new strategies for therapies; and "discovery research" that can yield fundamental insights about human biology as well as lessons on how to improve smallpox prevention and treatment.
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