Transcript Document

We, the People of Faith
and the Diseases of Poverty:
Understanding our Role
Devotions at Medical Teams
International – 28 Aug 2007
Milton B. Amayun, MD, MPH
([email protected])
Greetings and Introductions
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Greetings and thank you!
It is with great pleasure to be here in the name
of Christian Connections for International
Health (or CCIH)…
I would like to briefly introduce the members of
our Board and staff who are here.
Laura (our new Vice-President), Vicky, Bob,
Jacqui, Douglas, David
Ray (our Executive Director) and Sharon (our
Program Associate)
CCIH is…
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A network of 100
organizations and affiliates
committed to the
promotion of health and
wholeness from a Christian
perspective.
We are focused on global
health issues.
We are a forum
for sharing and discussion.
We connect organizations,
people, communities.
Please visit www.ccih.org.
Seven Principal Causes of the
Global Disease Burden
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In 2001, nearly two-thirds of all diseases in
children and young adults (0-44 years) were
caused by a few diseases, mostly infectious.
Close to 60% were due to AIDS, Maternal and
Perinatal Conditions, Acute Respiratory
Infections, Diarrheas, Malaria, Measles, TB.
The combined death toll for AIDS,TB and
Malaria alone was six million!
Most of these deaths were in the developing
world. India contributes significantly to
morbidity/mortality due to the seven diseases
each year .
Major Causes of Death and
Disease, 0-44 years, in 2003
Disease
AIDS
Maternal/Perinatal
ARI
Diarrhea
Malaria
Measles
TB
All others
Total
Proportion of
Deaths
13%
11%
9%
9%
6%
5%
4%
43%
100%
Population
Affected
Young adults
Mothers/Children
Children, 0-5 years
Children, 0-5 years
Children, 0-5 years
Children, 0-5 years
Mostly young adults
All ages
Developing countries
Death is only Part of the Story
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For every death, there are many more cases.
Disability can be disfiguring for life – e.g.,
leprosy, polio, lymphatic filariasis.
Stigma is associated with AIDS, TB.
Millions of carriers do not know their status.
Orphans – innocent victims by the millions.
Costs of treatment and/or burial worsen levels
of poverty.
Large-scale missed opportunities towards
meaningful and productive lives.
Implications to Society
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Loss of human capital: Millions dying due to
AIDS
Unmotivated work force: Lower productivity due
to illness.
Increased costs of production: Budget for health
increases.
Loss of markets: Less buying power of an
impoverished population.
Heightens role of prevention
Result: MANY POOR PEOPLE REMAIN POOR
BECAUSE OF POOR HEALTH
Implications to Christians
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Millions missing the abundant life due to illness.
Major opportunities for Christian witness with
Jesus as our model.
Complementary role of healing ministries to
the mandate to preach the Word.
Need to train Christian health professionals in
public health issues and programs.
Re-emphasis of prevention strategies.
Resources needed for reduction of global
disease burden.
Challenges and Opportunities
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Christians have been slow in
embracing HIV/AIDS as a
responsibility.
Funding for health ministries has
been on the decline; many Christian
health institutions have been
unsustainable. Some have had to
close.
Although the situation is changing,
many medical missionaries are still
focused on clinical medicine.
In creative access countries, health
is a good entry point.
Few resources invested in M&E and
documentation; fewer still in policy
debates.
Focus on AIDS, TB, Malaria
Disease
Deaths/yr
New cases/yr
No. affected
AIDS
3.1 million
5.3 million
42 million
TB
1.9
8.8
2 billion
Malaria
1 million
300 million
300 million
Totals
6 million
315 million
2.3 billion
TB: Basic Facts
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Infects many organs; pulmonary form common.
2 billion carriers worldwide; India (especially N
India) has very high concentration of TB cases.
Globally, 8.8 million cases become active TB
each year.
1.9 million deaths each year, mostly young
adults in productive stages of life.
Between 2000 and 2020, 35 million deaths
projected – nearly 20x current population of
Greater Portland.
Increasing rates of co-infection with HIV/AIDS.
10 million TB-HIV co-infections today.
Malaria: Basic Facts
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Transmitted by mosquitoes.
Falciparum malaria is most virulent strain.
One million deaths per year, mostly in young
children 0-5 years.
That is 3000 child deaths per day!
Pregnant mothers can become anemic, or have
stillborn and stunted babies, in addition to
abortions.
Surviving babies may have impaired growth and
development.
What is lacking?
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We know the treatment and we have the
technology to fight the diseases of poverty.
TB and Malaria medicines can cure.
We have ARVs to prolong and improve the
quality of lives of PLWHAs – up to 20 years!
We will soon have the resources equal to the
magnitude of the problem.
We lack the political will to implement the task.
Goal: 100% coverage of the need.
Civil society (includes the Church) and private
sector must share leadership with government!
Costs of Interventions
Disease
Intervention
Costs
Remarks
AIDS
-Abstinence
-Being Faithful
-Condoms
ARV/HAART
-Free
-Free
-US$14/year
-US$350 for
one year (less
in the future)
-ABC approach
reduced Uganda’s
AIDS prevalence
-Prolongs life for up
to 20 years
TB
DOTS:
Multidrug
therapy
US$10 for sixmonth
treatment
Cure rate up to 95%
Malaria
Anti-malarials
Insecticidetreated nets
US$0.12/tablet
US$4 per net
Cure rate up to 95%
Goals for the New Millennium
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Deadline for the following goals is 2010.
HIV/AIDS: to reduce the number of newly
infected young people (15-24 years) by 25%.
TB: to reduce by 50% current level of TB deaths
and prevalence.
Malaria: to reduce the malaria disease burden
by 50%.
Global Program Initiatives
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Stop TB Initiative
Roll Back Malaria
PEPFAR: President’s Emergency Plan for AIDS
Relief
Global Fund to fight AIDS, TB and Malaria
Massive Effort Campaign
Global TB Drug Facility and the Global Alliance for
TB Drug Development
International AIDS Vaccine Initiative
GFATM: Example of a New
Paradigm
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Involves all sectors of society, including
communities affected by the diseases,
government, donor community and the private
sector.
High levels of transparency required.
Performance on first two years determine
funding for remaining three years
Checks and balances in place.
Private sector participation needs to increase
at all levels.
Challenges to the Church
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Investing in health is a good missions strategy!
Church is uniquely positioned to respond to the
diseases of poverty.
Scaling-up traditional programs needing new
paradigms.
Stigma and discrimination can be reduced
through the Church.
Collaboration with government, private sector
and civil society is the way of the future.
Conclusions
Jesus: “I have come that they might have
life…more abundantly.” (John 10:10-11)
“Poor people will only be able to emerge from
poverty if they enjoy better health.
Health should be at the heart of our struggle for
sustainable development.”
Gro-Harlem Brundtland, Director-General, WHO, 19982003
The story of Lazarus’ resurrection.