Francis Collins is director of the National Institutes of Health. This is the fourth in a series of articles from the World Economic Forum on the key challenges facing the world in 2015 as part of their Outlook on the Global Agenda. The views expressed are the writer’s own.
There’s a well-understood correlation that as the economy of a country improves, so the health of its citizens improves. What may be less obvious is that the opposite is also true – improving the health of a nation’s citizens can directly result in economic growth, because there will be more people able to conduct effective activities in the workforce.
Health presents a challenge for all nations; in a study by the Pew Research Center, a median of 85 percent of respondents believe it was a problem in their country. Effective public health systems are essential for providing care for the sick, and for instituting measures that promote wellness and prevent disease. Tobacco, for instance, is one of the greatest scourges we face. In working to combat diseases such as lung cancer and heart disease, we have to fight the causes; there’s a clear need for educational campaigns and other mechanisms to discourage people from smoking in the first place. If the plan to improve health in a nation is to simply build a few more hospitals, that won’t solve the problem.
For developed economies, ageing populations place a heavy strain on healthcare networks. In developing nations, a lack of resources or inadequate infrastructure present separate challenges. Currently, NIH is wrestling with the Ebola crisis in West Africa. When you see the devastation this disease has wrought upon the region, it’s clear that healthcare systems in this part of the world were totally unprepared for the enormous challenge. FULL POST
Fareed speaks with Peter Piot, director of the London School of Hygiene and Tropical Medicine, who co-discovered the Ebola virus.
You worry about the fact that this could spread in the very large, very congested cities in Africa, for example, in Nigeria. And at that point, this could really spread like lightning.
Well, first of all, the three countries that are affected are being totally destabilized, not only in terms of people who are killed by Ebola, their families, the orphans that now are coming up because the parents die, but the economy has come to a standstill. People are massively dying from other diseases that are normally treatable, like malaria, or women die while giving birth because hospitals are abandoned or are full with Ebola patients.
So that’s a very, very destabilizing factor. And that's going to go in its impact beyond Ebola.
Now the big question will be, will this spread to surrounding countries? The good news is that both Nigeria and Senegal have been able to contain a number important cases. In Senegal, there wasn’t even any secondary case. In Nigeria, there were a number of people who were infected and died, but it has not given rise to an outbreak in Lagos, after all, a city of more than 20 million people, or in Port Harcourt. FULL POST
Fareed speaks with former U.S. President Bill Clinton about the outbreak of Ebola in West Africa. Watch the full interview on "Fareed Zakaria GPS," this Sunday at 10 a.m. and 1 p.m. ET on CNN.
You’ve worked a lot on issues like disease prevention. What lesson do you think we should draw from this outbreak of Ebola and the speed and kind of pace with which it’s spread? When you look at it, can you tell us about maybe the potential for pandemics or anything?
Well, first, like anybody else who's involved, we have a big presence in Liberia and three of our people, our top people, have stayed in Liberia to help organize the response. So we've all got to figure out, you know, how to coordinate it better. We're going to have a special session on it at CGI (Clinton Global Initiative).
But the lesson we should draw, the lessons are twofold. One is we have to do a much better job in building the health care infrastructure in these countries. We have to increase their capacity, including the capacity to have community health workers go out in these villages and have credibility with people. You know, this tragic story of the health workers being killed in Guinea, it's just terrible. But if we have more capacity, we can deal with it quicker. So that’s the first thing.
The second thing is we're going to have to get quicker and nimbler at developing biomedical responses, you know, the vaccines or whatever, or cures.
And the third thing is the wealthy countries have got to reexamine how we fund the World Health Organization, because I think they do a marvelous job. But increasingly, as development ministries get more expertise in given areas, they want to fund specific projects in specific countries. And it's clear that the World Health Organization needs a pot of money that can be mobilized in a hurry for emergencies while we wait for the inevitable time delay when America and the U.K. and France and Scandinavia, we all kick in money.
Watch "Fareed Zakaria GPS," Sundays at 10 a.m. and 1 p.m. ET on CNN
Fareed speaks with CNN Chief Medical Correspondent Sanjay Gupta about recent research on the risks of high sugar consumption. Watch the video for the full interview.
For 20 years, people have been assuming that fat was the enemy because it produced cholesterol, which was blocking arteries. That's not quite right.
I could talk about this all day long, because I think it highlights some very important things in terms of how we sometimes misinterpret science, or at least exaggerate it.
It was in the late '70s – in fact, there was a Senate commission, Senator McGovern, who actually looked at this issue and found that people who had very high levels of cholesterol tended to die early of heart disease. And there was also other studies that showed if you ate a diet high in fat, it raised your cholesterol. But those were two different studies. And they got really, really linked, not only by the Senate, but also in the scientific community and then by everybody else.
And what happened over the last 30 years, it got codified. It became the way that we eat low fat in this country. And nothing changed. In fact, things got worse. Cardiovascular disease remains the biggest killer of men and women. Diabetes rates are higher than ever before. Childhood obesity. So it didn't work. And I think that's what sort of prompted all this analysis. FULL POST
By Tracey Guise and Laura Piddock, Special to CNN
Editor’s note: Tracey Guise is CEO of the British Society for Antimicrobial Chemotherapy. Laura J.V. Piddock is Director of Antibiotic Action and Professor of Microbiology at the University of Birmingham. The views expressed are their own.
It’s not surprising that international attention has been focused on the ongoing outbreak of Ebola that has struck West Africa. After all, there are few treatment options for the disease, which has a case fatality rate of up to 90 percent, and the current outbreak has been described as the deadliest outbreak in history. Indeed, Britain’s government recently held an emergency meeting to discuss the possible threat to the country, although the foreign secretary said he believes Britain has the expertise to deal with the threat.
But while Ebola is getting the headlines, another health threat has been growing across the globe, one with implications every bit as serious: the rapid rise of antibiotic resistant bacteria.
There are few of us alive in developed countries that can remember living without the unprecedented health benefits that antibiotics bring. Within a few decades of Alexander Fleming’s discovery of the antibacterial powers of Penicillium, back in 1928, healthcare had progressed more than it had in the two millennia prior to their discovery. Fast forward to today, and antibiotics are a mainstay of human health – lifesaving, life enhancing, life extending and enabling agents without which medicine as most of us know it would not exist.
As consumers, we have high expectations for our well-being, including life extending treatments for those with chronic conditions such as cystic fibrosis, successful cancer chemotherapy regimens, and organ transplant and joint replacement surgeries – we expect to receive these treatments when required and without exception. But imagine a world in which a simple scratch could prove fatal? Or even minor surgery became risky to perform? One recent study, reviewing 43,000 patients undergoing abdominal surgeries, showed that about 40 percent of patients having operations on the large intestine suffered an abdominal wound infection if they were not given antibiotics. FULL POST
Fareed speaks with Sanjay Gupta, CNN’s chief medical correspondent, about the recent outbreak of Ebola. Watch the full interview on "Fareed Zakaria GPS," this Sunday at 10 a.m. and 1 p.m. ET on CNN.
Sanjay, how has this been blocked in the past? Why does this seem unprecedented? Is there something different right now?
You know, in a morbid way, it's because it killed so quickly – it would just burn out. You imagine these remote villages. People weren't moving around as quickly. And the Ebola virus – they would die and before they could start to spread it…it's awful to think about, but that's what was happening.
Now, you have a more mobile group. You have more roads between some of these smaller villages, such as in Guinea, where this originated, and the capital city of Conakry. There are roads. There are all these good passageways now back and forth. And so I think that part of it is certainly contributing. There’s also this idea that there’s a mistrust – I think a little bit of distrust, maybe – even of health care professionals. In part, that's fueled by the fact that there’s no good anti-viral, there’s no good vaccine. So we need to see health care workers show up, they're not offering some panacea to what is happening here.
And so there's not a lot of trust. And a lot of the people who are getting infected aren't hearing the right messages. And you also have several epidemics sort of starting in different points almost simultaneously now. Usually, it was one place you could target. FULL POST
Fareed speaks with New York Times columnist Paul Krugman about the Affordable Care Act.
You’ve written recently that Obamacare is working. Explain very simply why you make that claim.
There were a bunch of things that Obamacare was supposed to do in its first year. It was supposed to sign up a lot of people through the exchanges, through people buying, essentially, private insurance, but through the government-run exchanges. It was supposed to insure a bunch of additional people through Medicaid. It was supposed to do this without causing a spike in health care costs. It was supposed to substantially reduce the number of people who are uninsured. All of those things have happened.
If you put just about any of the numerical targets for the first year, it's done better than that. It's the most amazing thing that people don't know that, but, you know, after the big problems last fall, everyone was assuming that year one would come in short of expectations. In fact, it's come in ahead of expectations. And it looks very clear that this is a workable policy. FULL POST
By Martin Cetron and Davide Mosca, Special to CNN
Editor’s note: Martin Cetron MD is director of the Centers for Disease Control’s Division of Global Migration and Quarantine. Davide Mosca is director of the Migration Health Division, International Organization for Migration. The views expressed are their own.
Today’s ease of travel means more people are on the move than ever before – more than 232 million people across the globe are considered migrants, playing an important role by filling jobs in sectors that face a shrinking national workforce. In the process, they frequently enrich societies with their skills, entrepreneurship, and cultural diversity.
Unfortunately, many also originate from countries that have high rates of tuberculosis and fewer health resources. World TB day, being marked today, offers an important moment to take stock of where we stand – and why this is a problem not just for developing countries, but also for rich nations including the United States.
Of the nine million people around the world who get sick with tuberculosis each year, a third do not get treatment. It is this reality that forms the basis of this year’s theme – reaching the “three million,” through a TB test, treatment and ultimately a cure for all.
The challenge, of course, is that many of the missing three million live in the world’s poorest, most vulnerable communities, nations that often don't have the resources to fight TB. These migrants frequently face high exposure to TB infection because of overcrowded and unhealthy living and working conditions in their home countries. As a result, tuberculosis rates are high among foreign-born groups in many industrialized countries, including here in the U.S.
By Global Public Square staff
What was this week's most important economic story? No, it was not Obama's State of the Union speech. Nor the stock markets. And no, it has nothing to do with the U.S. Federal Reserve. We are talking about a decision made in Beijing this week to ban smoking in schools across China – all the way from kindergarten through middle school.
Why is this economic news? Well, consider these numbers.
China is said to have 350 million smokers – more than the entire population of the United States. We bring up the U.S. for comparison because the Surgeon General coincidentally released a report last month that really caught our eye. The fallout of tobacco use, the report says, costs Americans $289 billion a year – about four times as much as the U.S. federal budget for education combined. Twenty million Americans have died in the last 50 years as a result of smoking – more than the tally from all of our wars put together, of course. This year, nearly 500,000 Americans will die prematurely because of smoking.
These numbers are just staggering. And in China, the numbers are much, much worse.
By Tom Frieden, Special to CNN
Editor’s note: Dr. Tom Frieden is the director of the Centers for Disease Control and Prevention. The views expressed are his own.
Today marks the Lunar New Year – and the world’s largest annual migration. There will be more than 3.6 billion transit trips within China, in addition to countless international trips. Yet this celebration comes at a time of growing concern about the H7N9 avian influenza virus. And this concern is not unfounded – should this virus change into a form that easily spreads between people, the world’s next pandemic could occur in the next three weeks.
This combination of mass travel and an emerging virus such as this should underscore the connectedness of health security between countries. Of course, H7N9 influenza is just one example of how the health security of all nations, including the United States, depends on the health security of each individual nation. And regardless of where outbreaks occur, stopping them at the source is the most effective and cheapest way to save lives at home and abroad.
By Sir Richard Feachem and Dr Gavin Yamey, Special to CNN
Editor’s note: Sir Richard Feachem is director of the Global Health Group at the University of California, San Francisco. Gavin Yamey is an associate professor at the University of California, San Francisco and leads the Evidence to Policy Initiative in the Global Health Group. The views expressed are their own.
It’s been nearly 100 years since San Francisco was hit by the flu epidemic that swept the world and eventually claimed 50 million lives. In February 1919, the United States Public Health Service released data showing that San Francisco suffered the most of all major American cities, with a death rate approaching 30 deaths per 1,000 people.
In today’s era of mass, rapid international transit, and in the face of rising rates of “spillover” of animal infections into humans, concern is growing that the world could soon face an even deadlier global flu pandemic. The terrifying reality is that the world is shockingly under-prepared.
The 1918 flu pandemic reminds us how interconnected we are as a planet. The only way that we can adequately prepare for public health emergencies like a flu pandemic is through international collective action. With global health threats, we all win together, or we all lose together.
By Tom Frieden, Special to CNN
Editor’s note: Dr. Tom Frieden is the director for the Center for Disease Control. The views expressed are his own.
The Center for Disease Control’s more than 12,000 public health experts have a simple goal: to help people live healthier, longer lives. This will increase productivity and reduce health care costs.
We as a country are fortunate there are so many dedicated specialists working 24/7 to protect us from threats. The skill and hard work of CDC staff allows me to sleep well at night.
Of course, there were those 16 nerve-wracking days in October when most of CDC’s experts weren’t here because of the government shut-down. The uncertainty of that time makes me appreciate CDC’s achievements in 2013 even more. Our work with partner organizations and individuals in the government and private sector – doctors, nurses, pharmacists, and laboratory experts – in this country and around the world made this progress possible. And our progress this past year enables even more progress in 2014. FULL POST