POL 4410Health and Scarcity

Structure

1.Global Health Overview

2.Specific Diseases and Treatments (Lomborg)

3.Civil Wars, Violence, and Disease (Ghobarah)

4.NeoMalthusians vs. NeoClassicals (Kahl)

Global Health Measures

•Life Expectancy

•Infant Mortality

•Spread of Disease

•Public Health Spending

•Private Health Spending

Some Health Jargon

•Disability Adjusted Life Expectancy

•Disability Adjusted Life Years

•Communicable vs. non-communicable diseases

Economics of Health

•Direct costs (lost hours of work)

•Indirect: fertility, coping strategies, higher discounting of the future, higher dependency ratio

Politics of Health

•Who receives public health care? Political decision.

•Likely to be limited in poor countries, dictatorships, countries with high GINI coefficients, and in war-torn states.

Map of Risks

Life Expectancy

Life Expectancy and GDP

Infant Mortality

Spending on Health

Spending on Health

Effects of Globalization

• Improved access to foregin drugs and technology.

• Shift of production into manufacturing leads to urbanization and possibly disease

• Substitute foreign investment for local investment

• Impact of migration

• Spillover resource wars

Specific Issues

•Malaria

•AIDS

•Public Health Spending

Malaria•Carried by Anopheles

mosquito.

•Stable malaria vs. severe malaria

•Severe: respiratory and cerebral

•Other effects on anemia and pregnancy

Malaria Map

Treatments

•Insecticide Treated Nets (ITNs) especially to protect under 5s. BCR 10.4

•Intermittent Presumptive Treatment of Pregnant Women (IPTp). BCR 13.7

•Artemisinin-based Combiantion Therapies (ACT). BCR 38.6

HIV/AIDS•HIV is transmitted through intravenous drug

use (IDU), sexual intercourse, and medical procedures.

•HIV is the virus. AIDS is the condition that develops, which undermines immune system.

• 2.5-3.5m people died from AIDS in 2003: over five percent of ALL DEATHS.

• Between 35 and 45 million people have HIV/AIDS

HIV in under 25s

Treating HIV/AIDS

•CONDOMS: Thailand 100% condom campaign helped avert 200,000 infections. BCR of up to 466!

•Blood safety. BCR 11-466.

•Prevent mother-child transmission

•TB care 29-233.

•Antiretroviral (ARV): BCR 0.3-0.4

Public Health Development

•Strengthening Basic Health Services: BCR 2.1-2.6

•Public Health programs (tobacco, alcohol, STDs, education, immunization)

•Clinical programs (chemo for TB, pre-natal care, treatment of STDs, sick child management)

Impact of Globalization

•Malaria

•AIDS

•Public Health Spending

Ghobarah et al

•Effect of civil wars on health outcomes using WHO dataset.

•Refugees, brain drain, homicide, orphans, deindustrialization

•WHO estimate that 269,000 deaths and 8.44m DALYS from civil wars.

Political Impact on Health

1.Extent to which populations are exposed to conditions increasing the risk of death, disease, and disability.

2.Financial and human resources available for addressing the public health needs of pop.

3.Level of resources actually allocated to public health needs by private and public sectors.

4.The degree to which resources are actually allocated efficiently.

Effects of Civil Wars

Impact of Globalization

•On civil wars

•On Ghobarah et al’s four conditions

Grades

.5

1

1.5

2

2.5

Density

.2 .4 .6 .8 1Score

Kahl

•How does demographic and environmental stress (DES) affect violence and war?

•DES means population growth, depletion of renewable resources (timber, soil, water) and of non-renewable resources (oil, minerals)

Malthus

•Population increases at a geometric rate but resources increase only linearly

Neo-Malthusians•Pressure of DES on society: renewable

resource scarcity; economic marginalization; demographic shifts

•Pressure of DES on state: new demands (dams), lower productivity (capital shallowing and low savings), undermine coercive power

•Deprivation: absolute and relative

•State weakness vs. state exploitation

Neo-Classicals

•Adaptation prevents collapse: through market (prices) and institutions

•Not scarcity but abundance that causes problems

•Honey pots: greed not grievance

•Resource curses

Dutch Disease• Imagine three sectors: traded minerals,

traded manufactures, non-traded services

•Resource boom in minerals means massive international demand for minerals

•Money from minerals forces up prices in non-traded sector - currency appreciation

•Currency appreciation plus shift out of manufactures causes collapse in that sector

Kahl’s Criticism

•Neoclassical hypothesis better applies to non-renewables

•NeoMalthusian over-predicts crises

•Think of them as applying to different time frames.

Impact of Globalization

•Does globalization make population growth more or less likely

•Does globalization make resource curse stronger or weaker?

•How about ability of state and market to adapt?