TLDR on Global Health
A beginner’s guide to pandemics, global health, and WHO
As a public health major, I found it ironic that the only time the world cares about public health is when this discipline has failed to protect us. For those of you who just discovered what public health is because of the coronavirus pandemic, you came to the right place! I had the opportunity to take a Global Health course over the summer at UC Berkeley, and I’m thrilled to share my takeaways.
TLDR on Public Health Terminology
Public Health: NOT merely the absence of disease, but the prevention of disease at the population level, and the utilization of institutions and policies to ensure positive health outcomes for all
Epidemic: Widespread occurrence of an infectious disease in a community or population in a given time
Pandemic: Epidemic occurring worldwide over a very wide area, crossing international boundaries and usually a large number of people
Outbreak: Occurrence of disease cases in excess of normal in a community or population in a given time period
Communicable Disease: Disease that spreads from one person to another which include contact with bodily fluids, airborne virus, or being bitten by an insect. Examples: Coronavirus, HIVs, AIDs, flu.
Non-Communicable Disease: Disease not caused by infectious agents and progress slowly. Examples: diabetes, Alzheimer’s, stroke.
Quarantine: Separation and restriction of movement of healthy people who may have been exposed to the virus in order to contain the virus
Counts: Number of death cases from a disease
Prevalence: Proportion of a population that is diseased
Prevalence Ratio: Prevalence in the exposed over prevalence in the unexposed population
Incidence: Occurrence of new cases of disease in a candidate population over a period of time
Incidence Rate: Occurrence of new cases of disease that arise during person-time observation
Disease Frequency: How often a disease arises in a population
Antigen: Foreign substance that induces an immune response in the body
Antibody: Proteins the body creates that help fight against antigens
Herd Immunity: When a high proportion of individuals in a population is immune to a disease, usually due to a vaccine, the spread of a contagious disease within a population halts
As Human Civilizations Evolved, So Did Diseases
Hunter and Gatherer Society (Before 1400s)
Society based on small groups living from place place
- Humans were primarily affected by disease related from animal and slow acting, non-fatal diseases like rabies and hookworm
- Because human society was dispersed and consisted of small groups, humans did not have immunity to these diseases and died from them
Agrarian Society (1400s to 1800s)
Society based on small farms, agriculture, and feudal systems
- Humans lived in closer proximity to animals because of animal breeding and livestock production, so measles, influenza, and viruses transferred from animals to humans more easily.
- Humans also lived in closer proximity to other humans as indoor living manifested during this era. Living closely among humans led to increases in influenza and tuberculosis.
- Humans tending to the land would clear out land and wildlife populations for crops, which would lead to smallpox and bubonic plague.
- Humans created aqueducts and irrigation systems to water their crops, which would lead to opportunities for mosquitoes to breed in these new water sources — malaria and dengue arose.
- However, despite all of this, the human population grew because of improved conditions for food storage and increased stability of food sources.
Early Industrial Society (1820s to 1950s)
Society based on organized labor systems and early industry
- Humans lived in very close proximity to each other and would often work in polluted settings.
- Poor sanitation, poor infrastructure, little health access, and horrid working conditions of the poor in cities often led to outbreaks.
- The development of penicillin and antibiotics in the 1920’s treated bacterial infection and contributed to herd immunity.
Globalized Society (1960s to 2020)
Society based on technology, transportation, and systems around the world
- Increases in human population density, urbanity, and travel have enhanced exposure to a variety of diseases
- Sedentary lifestyles, diet, and social isolation are factors that increase the rise in non-communicable diseases
- The speed of modern airfare can transport people — as well as viruses — to multiple nations in a matter of hours
What does the WHO do?
WHO is the World Health Organization, part of the United Nations
- WHO was founded on April 7, 1948. It is based in Geneva with 6 regions around the world.
- WHO does not have direct authorization over countries. They can make recommendations and coordinate efforts but must rely on countries to enforce their suggestions.
- Programs that WHO operates include polio eradication, increased access to health services, nutrition services, vaccine preventable death, HIVs and hepatitis eradication, tuberculosis alleviation, maternal and child health, and the prevention of outbreaks.
- Funding for WHO stems from financing from countries and foundations.
- WHO can declare a worldwide public health emergency.
About a week ago, the United States withdrew from the WHO. The U.S. is the single biggest contributor to WHO, which accounts for over 15% of its total funding. The services that WHO provide for the world are now at risk, and the infrastructure for pandemic detection will soon be heavily defunded — all while during one of the greatest humanitarian crises the world has ever seen.
