{"id":879,"date":"2009-11-11T11:11:26","date_gmt":"2009-11-11T10:11:26","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=879"},"modified":"2009-11-11T11:11:26","modified_gmt":"2009-11-11T10:11:26","slug":"richard-smith-rethinking-priorities-in-global-health","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2009\/11\/11\/richard-smith-rethinking-priorities-in-global-health\/","title":{"rendered":"Richard Smith: Rethinking priorities in global health"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.bmj.com\/home\/icons\/bmjh7648e.jpg\" alt=\"Richard Smith\" width=\"160\" height=\"110\" align=\"left\" \/>Last week\u2019s <a href=\"http:\/\/www.globalhealthacademy.ed.ac.uk\/\">conference to launch Edinburgh University\u2019s Global Health Academy<\/a> left me thinking that priorities in global health may be very wrong.<\/p>\n<p>David Molyneaux from Liverpool said that an alien observing earth for the first time would think that it had only three diseases: AIDS, TB, and malaria. He is one of the \u201cthree dinosaurs of neglected tropical diseases (NTDs)\u201d who spoke at the meeting, pointing out that sums that are very small by the standards of AIDS could make a huge difference in alleviating the suffering of the world\u2019s poorest people from schistosomiasis, onchocerciasis, sleeping sickness, elephantiasis, and the other neglected tropical diseases. Some of these diseases can be treated very effectively and cheaply. Deworming people\u2014as animals have long been dewormed\u2014for 60 cents a year could make huge differences to child growth and development and levels of disability.<!--more--><\/p>\n<p>Neglected tropical diseases have received some funds and had successes with treatment and eradication, but why have they not received the attention and funding of AIDS when much more could be achieved with much less money?<\/p>\n<p>Molyneaux thought that one problem was that most people in rich countries had never heard of these diseases and had no idea of the extent of harm they can cause. Broadcast media are reluctant to make programmes on the diseases because people don\u2019t know what they are\u2014and the pictures of people severely affected by the diseases they judge to be just too horrible. Then health ministers in the affected countries\u2014mostly in SubSaharan Africa\u2014are highly unlikely to get the diseases themselves because they are the diseases of the poorest people living away from the capitals and often away from any health services at all.<\/p>\n<p>The preoccupation with AIDS, TB, and malaria may well be creating harm, argued the Lancet\u2019s Rhona McDonald, a passionate advocate for global health and social justice. She described first hand experience of intense political battles over whether the \u201cvertical programmes\u201d for treating AIDS, TB, and malaria\u2014the \u201cglobal health initiatives\u201d\u2014had done harm by diverting attention and resources from basic health systems.<\/p>\n<p>Then she emphasised the importance of clean water, sanitation, food security, and human rights. Health is impossible without these basics, and preoccupation with the medical model can be a distraction.<\/p>\n<p>Allyson Pollock from Edinburgh built on this theme, reminding the audience that the huge advances in life expectancy and quality in the developed world in the past 150 years came mainly from public health not from drugs and vaccines. She also emphasized the importance of the collection of routine data on births, deaths, and the like and feared that data on the global burden of disease may be misleading because so many countries do not collect routine data.<\/p>\n<p>If the alien that observed that the earth had only the three diseases of AIDS, TB, and malaria had found its way into the meeting it would have emerged thinking that the earth needed to rebalance its priorities.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Last week\u2019s conference to launch Edinburgh University\u2019s Global Health Academy left me thinking that priorities in global health may be very wrong. David Molyneaux from Liverpool said that an alien [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2009\/11\/11\/richard-smith-rethinking-priorities-in-global-health\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":66,"featured_media":38364,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[955],"tags":[],"class_list":["post-879","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-richard-smith"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Richard Smith: Rethinking priorities in global health - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2009\/11\/11\/richard-smith-rethinking-priorities-in-global-health\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Richard Smith: Rethinking priorities in global health - The BMJ\" \/>\n<meta property=\"og:description\" content=\"Last week\u2019s conference to launch Edinburgh University\u2019s Global Health Academy left me thinking that priorities in global health may be very wrong. 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