The Global Impact of Infectious Disease: Unit 2Economics and Infectious DiseaseLink to PovertyThe Tragedy of Malaria film clip provided a good case study of the links between poverty and infectious disease. (handout was provided with focus questions)Fred Soper control Malaria in Brazil?- Target=Mosquitos ; Total eradication ; DDT, Draining Swamp, EnfumigationDevelopment status and factors used to measure that status. GDP, GDP per capita, sectors of the economy, Human Development Index, types of capitalDoes development spur better health? NO or Does better health spur economic growth? YES- What factors could be analyzed to make a case?Healthy people= more people able to work, save money, make money - Case study from 19th Century England and the Industrial RevolutionIndustrialization let to steady economic growth, increase GDP, migration of people tocities for better wagesNo improvement to health was seen, life expectancy same or worseInfectious diseases became worse= Infant diarrhea, typhoid, cholera, typhusRural poor moved in, upper class moved outRapid economic growth resulted in disruption, deprivation, disease and death - How do you think this compares today?Better public health todayWas 4 fold difference in per capita GDP, now 20 fold. Jeffrey Sachs= thinks wiping out malaria in sub-Saharan Africa could increase the per capita growth rate by as much as 2.6% a year. - What is the Poverty Trap? What contributes to staying in the trap? What allows you to escape the trap? Forces poor people to stay poor.Taxes, public investment, public growth depreciation, consumption What is the demographic transition? A shift from high fertility and mortality to low fertility and mortality with population growth- What is the link to development? Piped water, modern cooking fuels, educations of women, urbanization, access to health care- To health? Investing in human capital could be as important as investing in physical capital- What is the epidemiologic transition?How do developed countries help the developing world?- Who invests and how do we assess those investmentsIMF- international monetary fund= provide loans to countries facing downturnsWorld Bank= development of poor countriesMillennium goal #6- combat HIV, Malaria and other diseasesHelping developing countries combat disease should create economic growthEconomists are studying in real time- Has the focus of investments changed over time?- Study of the Economics of Drug Production Pharmacies don’t want to spend money on tropical diseases because they make no profit. Erectile dysfunction, weight loss, wrinkles make most money.Governance and Infectious DiseaseGovernment, Politics and Policy – definitionsGovernment- body within any organization that has the authority to make, and the power to enforce laws, regulations or rulesPolitics- the process by which groups of people make decisionsPolicy- a deliberate plan of action to guide decisions and achieve rational outcomesWhat are the functions of government according to Adam Smith? (Wealth of Nations-1776) said government has 3 functions:1) Provide protection2) Dispense justice3) Build necessary public works (hospitals, schools) How does this include the realm of health?Health needs gov. for-- Non- profit - Collective action is needed- Government has policing powerDirect and Indirect protection of the health of citizens.- Direct- medicare (over 65, disabilities); medicade (low income, HIV, nursing homes) ; FDA ; Public Health systems- Indirect- prevent poverty (welfare); unemployment insurance ; transportation systems ; SNAP (food) ; Military; FEMADoes this also pertain to citizens of other countries? YES- Help others- Infectious diseases travel- Good will = security for countryQuarantine: a government actionIsolation vs quarantineWhen is quarantine most effective?SARS in Taiwan case studyCulture/Society/Religion and Infectious DiseaseVaccination as a public health measureHistory of vaccination Small Pox Varolation- 6th century china- Early 1700s lady montagueSmall pox:- Increased vaccination rates thru 1800s- Epidemics still occurred- tho rare and small in US in 1900- Proof of vaccination was obviousPolio eradication campaign film segmentLaws regarding vaccines in USVaccination Assistance Act 1962- Federal support for state purchases of vaccines- CDC adopted the role of federal overseer of vaccine issues- States adopted compulsory vaccination laws 0 to 50 states between 60s and 80sNational Childhood Vaccine Injury Act of 1986- Written in collaboration with DPT group and American Association of Pediatricians- Vaccine Adverse Event Reporting System (VAERS)- National Vaccine Injury Compensation Program- Vaccine Court- Institue of Medicine to review safety of all vaccinesConcern or Opposition to vaccines-what is real, what is misinformation?ExemptionsPertussis vaccine- 1982 Vaccine Roulette- reported adverse side effects of Pertussis vaccinationThimerosol- mercury-containing preservative in some vaccines (DPT, HepB, HIB)- FDA recommended that manufacturers remove thimerosal from vaccines, was done by 2002. MMR vaccine – Andrew Wakefield- 1998 The Lancet- described 12 children with severe diarrhea, constipation and immunological deficiencies (GI complications common with autism)- Notes that 8 parents associated the onset of symptoms with MMR at 15 mths- At a news conference he suggested it would be good to offer spate measles andrubella shotsFilm clip of vaccination issues (polio and small pox vaccine)STIs 20 million new stds occur each yr. $16 billion yearly for treating stds. 50% of all new stds are among youth each yr. General info about Chlamydia, Gonorrhea, Syphilis, HPV, Herpes and Hepatitis VirusBacterial or viralIs there a treatment?Is there are vaccine?In general, what are some complications with STIs?- Stigma- Pregnancy issues- Birth defects- Some don’t go away- Some deadly Surveillance: what kinds of statistics are important? - Griswold vs Connecticut (1965 Supreme Court)- the Court identified a constitutionally protected right to privacy, which the court reasoned prohibited states from denying birth control to married couples.- Eisenstadt vs Baird (1972 Supreme Court)- On 22 March 1972 the Massachusetts law forbidding the distribution of contraceptive articles to unmarried persons was struck down in a 6–1 majority decision by the Supreme Court- Stonewall riots 1969- people would be harassed in gay bars because being gay was illegal What societal