Better Health for All

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Ensuring basic health care for people in low-income countries is critical to the Plan B goal of eradicating poverty and stabilizing population. While heart disease and cancer (largely the diseases of aging), obesity and smoking dominate health concerns in industrial countries, in developing countries, infectious diseases are the overriding health concern. Besides AIDS, the principal diseases of concern are diarrhea, respiratory illnesses, tuberculosis, malaria and measles. Child mortality is high.

Progress in reaching the United Nations (U.N.) Millennium Development Goal of reducing child mortality two thirds by 2015 is lagging badly. As of 2005, only 32 of 147 developing countries were on track to reach this goal. In 23 countries child mortality has either remained unchanged or risen. And only two of the World Bank’s 35 fragile states are on track to meet this goal by 2015.

Along with the eradication of hunger, ensuring access to a safe and reliable supply of water for the estimated 1.1 billion people who lack it is essential to better health for all. Now the realistic option in many cities may be to bypass efforts to build costly water-based sewage removal and treatment systems and instead opt for water-free waste disposal systems that do not disperse disease pathogens. This switch would help alleviate water scarcity, reduce the dissemination of disease agents in water systems, and help close the nutrient cycle — a win-win-win situation.

One of the most impressive health gains has come from a campaign initiated by a little-heralded nongovernmental group in Bangladesh known as BRAC, which taught every mother in the country how to prepare oral rehydration solution to treat diarrhea at home by simply adding salt and sugar to water. BRAC succeeded in dramatically reducing infant and child deaths from diarrhea in a country that was densely populated, poverty-stricken, and poorly educated.

Seeing this great success, UNICEF used BRAC’s model for its worldwide diarrheal disease treatment program. This global administration of a remarkably simple oral rehydration technique has been extremely effective — reducing deaths from diarrhea among children from 4.6 million in 1980 to 1.6 million in 2006. Few investments have saved so many lives at such a low cost.

The war against infectious diseases is being waged on a broad front. Perhaps the leading privately funded life-saving activity in the world today is the childhood immunization program. In an effort to fill the gap in this global program, the Bill and Melinda Gates Foundation invested more than $1.5 billion through 2006 to protect children from infectious diseases such as measles. Additional investment can help the many countries that cannot afford vaccines for childhood diseases and are falling behind in their vaccination programs. Lacking the funds to invest today, these countries pay a far higher price tomorrow. There are not many situations in which just a few pennies spent per youngster can make as much difference as vaccination programs can.

One of the international community’s finest hours came with the eradication of smallpox, an effort led in the United Nations by the World Health Organization (WHO). This successful elimination of a feared disease, which required a worldwide immunization program, saves not only millions of lives but also hundreds of millions of dollars each year in smallpox vaccination programs and billions of dollars in health care expenditures. This achievement alone may justify the existence of the United Nations.

Similarly, a WHO-led international coalition has waged a worldwide campaign to wipe out polio, a disease that has crippled millions of children. Since 1988, Rotary International has contributed an extraordinary $600 million to this effort. Under this coalition-sponsored Global Polio Eradication Initiative, the number of polio cases worldwide dropped from some 350,000 per year in 1988 to fewer than 800 in 2003.