Global Health Policy for Tuberculosis - Research Paper Example

Global health policy for tuberculosis Due to increased globalization in the recent years, the spread of infectious diseases across the borders has become much easier and facilitated than in the past, so that public health administrators and health policy makers have now to think of adopting measures that cover the whole world when aiming to counterattack an epidemic. One such disease that has global implications is Tuberculosis, or TB (Raviglione, Snider, & Kochi, 1995). This paper purports to discuss the reason for the global nature of the disease by presenting epidemiological statistics, the nature and availability of the health care services in relation to this disease across the world, and an examination of the applicability of the human rights approach towards solving this global health problem. Global nature: In 1997, the World Health Organization called for an international panel of experts and epidemiologists from forty countries worldwide to address the issue of the global threat of tuberculosis in 212 countries (Dye, Scheele, Dolin, Pathania, & Raviglione, 1999). It was calculated that the existing cases of tuberculosis worldwide were around sixteen million (Dye et al., 1999), with about eight million new cases that year (Dye et al., 1999). This meant that the disease was prevalent in thirty two percent of the global population (Dye et al., 1999), effecting 1.86 billion people across the globe (Dye et al., 1999). To this end, the global fatality rate of TB was estimated at twenty three percent (Dye et al., 1999), although on a country to country basis, it different greatly, with some African countries experiencing a fifty percent death rate due to the disease (Dye et al., 1999). Moreover, the highest incidence rate per capita of the disease was also in the African countries (Dye et al., 1999), reaching a ratio of nine out of ten (Dye et al., 1999). This could be linked to the high prevalence of the AIDS in those African countries (Raviglione et al., 1995), therefore, increasing the fatality rate of TB to a greater percentage (Raviglione et al., 1995). The correlation between AIDS and TB and the fatality rate of the latter disease is beyond the scope of this paper. Although a global problem, this disease was found to be concentrated in a handful of countries worldwide, as eighty percent of the prevalence was found in twenty two countries (Dye et al., 1999), with 5 Southeast Asian countries housing the majority of those cases (Dye et al., 1999). These statistics clearly show that TB is, indeed, a global health issue (Raviglione et al., 1995), and needs to be addressed as such. Global healthcare services: The nature of the global healthcare services with regard to the prevention and cure of tuberculosis have changed in their approach and structure worldwide in light of the ineffectiveness of the initial approach adopted by the WHO (Grange & Zumla, 2002). It should be noted that the treatment and prevention of tuberculosis is cheap and affordable (Grange & Zumla, 2002), and is considered quite effective when applied properly (Grange & Zumla, 2002). Nevertheless, the overall incidences of tuberculosis have been increasing globally, including in the developed countries (Grange & Zumla, 2002). However, the disease is considered a ‘disease of poverty’ (Grange & Zumla, 2002), as it is most prevalent in the economically unstable and poverty-stricken nations of the world (Grange & Zumla, 2002), with ninety five percent cases occurring in those countries (Grange & Zumla, 2002), and ninety eight percent of deaths from the disease (Grange & Zumla, 2002). The WHO has launched a ‘Stop TB Strategy’ (Lonnroth & Raviglione, 2008) in an effort to wipe out the disease by 2050 (Lonnroth & Raviglione, 2008). The biggest issue to this regard the accessibility and availability of improved vaccines and drugs to the general public (Lonnroth & Raviglione, 2008), especially those living below the poverty line, which is quite limited (Lonnroth & Raviglione, 2008). There is a need to develop better drugs (Lonnroth & Raviglione, 2008) to combat the incidence of multi-drug resistant strains of the disease (Grange & Zumla, 2002), which increase the cost of treatment exponentially (Grange & Zumla, 2002), thereby reducing the ratio of the public who can afford the treatment. The campaign of ‘the Massive Effort Against Diseases of Poverty’ (Grange & Zumla, 2002) has launched several initiatives to increase the effectiveness of the program by guarantying the availability and administration of curative measures (Lonnroth & Raviglione, 2008) even in the far flung areas. The healthcare sector now relies heavily in the private practitioners and GDPs for combating the disease (Raviglione & Pio, 2002). Human rights approach: The fight against the global threat of tuberculosis cannot be won simply through the biomedical model of prevention and treatment (Hurting, Porter, & Ogden, 1999). This has become evident by the failure of the ‘vertical approach’ (Raviglione & Pio, 2002) of WHO towards TB in the underdeveloped countries (Raviglione & Pio, 2002). This period lasted from ‘1948-1963’ (Raviglione & Pio, 2002). The approach was then modified to introduce the directly observed therapy, short course, DOTS, (Hurting, Porter, & Ogden, 1999) technique by WHO to cater to the developing countries (Hurting, Porter, & Ogden, 1999), where the incidence of the disease is the highest (Grange & Zumla, 2002). However, the current technique still relies heavily on a medical approach, whereas there is a need to introduce aspects of social, economic (Hurting, Porter, & Ogden, 1999), and political sectors in order to endure the availability of TB preventative and curative services to all the strata of society (Hurting, Porter, & Ogden, 1999). This means the issue of TB has become more of a public health issue than a medical issue (Raviglione & Pio, 2002), and this human rights approach (Hurting, Porter, & Ogden, 1999) is not only applicable but is crucial for the success of the ‘Stop TB Strategy’ (Raviglione & Pio, 2002) of WHO. There is also a need to address the social problems such as smoking, economic disparity, pollution, crowded shelters, and malnutrition (Lonnroth & Raviglione, 2008), among others, which form the risk factors of TB (Lonnroth & Raviglione, 2008). References Dye, C., Scheele, S., Dolin, P., Pathania, V., & Raviglione, MC. (1999). Consensus statement. Global burden of tuberculosis: estimated incidence, prevalence, and mortality by country. WHO Global Surveillance and Monitoring Project. Journal of American medical association, 282(7), 677-686. Grange, J. M. & Zumla, A. (2002). The global emergency of tuberculosis: What is the cause. Perspectives in public health, 122(2), 78-81. Hurting, A. K., Porter, J. D. H., & Ogden, J. A. (1999). Tuberculosis control and directly observed therapy from the public health/human rights perspective [Counterpoint]. The international journal of tuberculosis and lung disease, 3(7), 553-560. Lonnroth, K. & Raviglione, M. (2008). Global epidemiology of tuberculosis: Prospects for control. Semin Respir Crit Care Med, 29(5), 481-491. Raviglione, M. C. & Pio, A. (2002). Evolution of WHO policies for tuberculosis control, 1948-2001. The Lancet, 359(9308), 775-780. Raviglione, M. C., Snider, D. E., & Kochi, A. (1995). Global epidemiology of tuberculosis: Morbidity and morality of a worldwide epidemic. Journal of American medical association, 273(3), 220-226. Read More