EQ4: How can the impacts of health risks be managed?

Aims: To recognise which health risks can be managed effectively and which cannot

To fully understand the role of sustainability

What to do!!

• Read the following slides.• Make notes on what they are saying.• Can you give other examples of health

issue success / failure from your notes.• Visit the 2 sites on the last slides and

make brief notes on what they show.

Key Terms

• Healthcare sustainability – healthcare systems which have the funding to maintain levels of human and physical resources over the long term in the fight against a particular disease or disease in general

• Preston Curve – a graph showing the relationship between a country’s life expectancy (used as a measure of its health) and its real per capita income

Key Terms

• Vertical health programmes – concentrate on tackling a single disease e.g. Mobilize Against Malaria

• Horizontal health programmes – aim to prevent and treat all forms of illness e.g. NHS UK

Read PA pages 375- 376. This looks at the management of the pollution causes health risks and those caused by lifestyle.

This PowerPoint will add to that by looking at the sustainability of long and short term programmes and consider success on a wide and small scale.

Overview• Shorter term planning is VITAL when

unexpected circumstances happen (see Asian Tsunami example in 4.3)

• The emphasis for health-management needs to be on longer-term sustainable planning for a better health environment

• Can be easier said than done!– Small-pox eradicated globally shows that health

planning can be successful– Current battle against HIV/AIDS is proving more

difficult

Overview• World Health Report, 2008, “Higher spending on

health is associated with better outcomes, but with large differences between countries”

• The Preston curve is often used the show the relationship between health and wealth

• The curve has shifted upwards over time as can be seen @ Gapminder – An income of $1000 in 1975 gave a life expectancy of

48.8 years (average)– 2005 an income of $1000 gave a life expectancy of 52

years (average)– This suggests that improvements in nutrition,

education, health technologies and management now allow for the greater production of health for the same level of wealth

HIV/AIDS

• Longer-term planning required– In a country– Across the globe (WHO co-ordinated)

• UNAIDS and other major organisations agree that– Best prevention is education and testing– Best treatment for long-term survival is anti-

retrovirals– Key to success is reliable data collection– You have seen that prevention and treatment

are VITAL to economic development

Funding

• In 2002 $2 billion were available fight HIV/AIDS

• In 2007 $10 billion were available

• If there is to be universal access to drugs FOR ALL then $42 billion will be needed by 2010

• How sustainable is this targeting of HUGE funds towards one disease?

Sub-Saharan Africa• Hit by medical, social and economic burden of

AIDS• Funding is VERTICAL and so funds are taken

from other, also pressing, health needs• 1/5 of ALL global health aid is to HIV

programmes BUT accounts for 1/20 of the burden of disease in low-middle income countries. Costly because:– Sophisticated equipment– Expensive medicines– Heavy demands on medical staff

• Compared with more modest resources which could seriously fight trachoma and bilharzia

Vertical Programmes – good or bad?• WHO Vertical Programmes assessment –

on Moodle• GOOD – measurable results like with

small-pox• BAD - Often funded by individual donors

– This can create wasteful administrative costs– Draw much-needed medical expertise away

from weak state health systems

• BUT:– Few studies to illustrate which model works

best– Few studies to illustrate which organisations

are best able to distribute and spend money

Other reading

• http://www.ncbi.nlm.nih.gov/pubmed/6670002

• www.theglobalfund.org