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Global Health Issues, Tuberculosis

For a long time, tuberculosis (TB) has been a disease of concern for global health. Caused by the bacteria Mycobacterium tuberculosis, it spreads through aerosol droplets, meaning that people breathe in the bacteria from infected persons. Tuberculosis is often latent and reveals itself when the immune system is weak. Risk factors include overcrowded living quarters, HIV infection, undernutrition, smoking, alcohol and drug abuse, diabetes, and others. Two billion people worldwide are infected with TB but do not have the active form (Skolnik, 2012). Tuberculosis can affect all organs of the body, but in 80 percent of cases, the lungs are infected. A chronic cough, weight loss, and fever are the main symptoms of TB.

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The TB incidence rates in Southeast Asia and Africa remain the highest in the world (Skolnik, 2012). In 2010, there were 8.8 million new TB cases worldwide (Migliori & Lange, 2014). As for treatment measures, Directly Observed Therapy Short Course (DOTS) is the main strategy provided by local care professionals. The therapy consists of four drugs: “isoniazid, rifampin, pyrazinamide, and ethambutol for the first two months, and then isoniazid and rifampin for the following four months” (Skolnik, 2012, p. 255). In the long term, it is necessary to develop more effective vaccines and affordable diagnostic tools for all forms of TB. Since TB treatment is largely provided by the private sector, it should be linked with national TB control programs. In addition, more informational and educational initiatives about TB are vital to combat this significant public health issue.

Diabetes mellitus is subdivided into three main types: type I, type II, and gestational diabetes. The risk factors for these types differ. Type I normally begins before the age of 30 and is evident by a pancreas that does not make insulin. The exact cause is still unknown, but a family history of diabetes is important: if a person’s parents or siblings suffer from this type of disease, the risk increases. Other significant factors include the person’s environment, weight and height development, infections, and illnesses (Skolnik, 2012). With type II, insulin is either produced in deficient quantities or is used improperly by the body. The most common form of diabetes, type II is also connected with family history. Obesity, lack of physical activity, high blood pressure, insulin resistance (in which the pancreas must work more to produce the necessary amount of insulin), aging, and ethnic background constitute the risk factors for type II diabetes. Moreover, in wealthy countries, less-educated people with lower income levels have diabetes more frequently than better-educated and more prosperous individuals (Skolnik, 2012). The third type, gestational diabetes mellitus (GDM), is diagnosed during pregnancy and usually goes away after delivery. Still, the risk of developing type II diabetes increases. The risk factors for GDM are family health history, age, and being overweight and of a nonwhite race (Petry, 2014).

The human costs and consequences of tobacco use are alarming. An onerous social and economic burden is imposed worldwide as productivity decreases due to tobacco-related disease and death. Around 1.1 billion individuals all over the globe smoke, and tobacco use accounts for about 5 million deaths per annum (predominantly of men aged 35 to 69) (Skolnik, 2012). Moreover, those living with tobacco-related diseases caused by smoking or secondhand smoke (the process of inhaling tobacco smoke from someone else) have to seek medical attention including hospitalization, nursing, medication, healthcare services, transportation, and caregiving by non-professionals such as family members. Thus, the direct costs of treating tobacco-related cardiovascular disease, cancer, diabetes, and other diseases are huge. From 1997 to 2001, these costs were equivalent to 1.71% of the U.S. GDP—while the indirect costs were estimated to reach as high as 55.09% (Stuckler & Siegel, 2011).

Although there is no perfect measure that would prevent everyone from smoking, some measures have proven to be quite effective: higher cigarette taxes, warning labels on packaging, bans on smoking in public places, and help for those who would like to quit. For example, smoking has become less popular in Norway; in 2004, the government took the first step and introduced a smoking ban in public places (Stuckler & Siegel, 2011).

Sub-Saharan Africa is known as one of the most problematic regions in the world in terms of HIV/AIDS rates. The region has about 68% of all HIV infections in the world and 72% of all AIDS-related deaths. At the same time, it is one of the poorest areas (Skolnik, 2012). Under such circumstances, preventive measures should meet two requirements: be immediate and cost-effective. Focusing on the prevention of further infections in sub-Saharan Africa, it is necessary to prioritize the population most at risk for HIV/AIDS infection: young women, children, sex workers, men who have sex with men (MSM), and drug users.

HIV testing and counseling (HTC) and mobile HIV screening are two possible strategies that are easy to implement even in remote villages. When people are aware of their health, they are more likely to avoid high-risk sexual behavior and undergo treatment. Condom use and distribution, prevention of mother-to-child transmission, voluntary medical male circumcision (VMMC), and harm reduction (plans focusing on reducing harm caused by drugs) are suggested as key preventative measures (HIV and AIDS, 2016). However, there are several hindrances. Some test-positive people never enroll in treatment.

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Moreover, relationships with family and partners, poverty, lack of HIV knowledge, and personal or traditional beliefs often limit condom use. Although progress is being made in antiretroviral treatment for pregnant women, there has been a decrease in the number of patients accessing it. In 2007, the World Health Organization (WHO) and UNAIDS recommended VMMC as a component of HIV prevention, since it reduces the possibility of sexual transmission of HIV from women to men (HIV and AIDS, 2016). However, any preventative or treatment actions should be taken in accordance with each specific country. In South Asia, the approach will be slightly different because the key risk groups to focus on are MSM, transgender people, and drug users (HIV and AIDS, 2016). In other words, the preventative activities in Africa and South Asia will depend on their respective populations.

Millions of Americans inject drugs on a regular basis. Apart from the destructive power of drugs, drug use significantly increases the number of HIV-infected people. Because clean needles are not affordable for the overwhelming majority of the drug-addicted population, people often imperil their health by using the same needles as blood-borne infected people. About half of all new HIV infections occur among IV drug users; hepatitis C and hepatitis B are also transmitted via drug use (Pates & Riley, 2012).

As a means of harm reduction, needle exchange programs (NEPs) aim to minimize the risk of infection through the sharing of infected equipment. WHO recommends providing 200 sterile needles per drug user (HIV and AIDS, 2016). Many programs distribute not only clean needles but also a wide variety of equipment including mixing containers, filters, and sterile water. Although these programs are controversial, it would be wrong to prohibit them because they do not encourage drug use and may actually help those users who are unable to quit. The idea is to secure IV drug users who may contact persons living with HIV or hepatitis and prevent further contagion. Two advantages of this method are evident: it is cost-effective and powerful. Compared to the cost of treating HIV-infected persons, NEPs are less expensive; they are often combined with advice on reducing the harmful effects of drugs, managing overdoses, HIV testing, condom provision, and other services (HIV and AIDS, 2016). Therefore, the U.S. government should support needle exchange programs.

Solving health problems is one of the significant tasks that the world is facing today. The following global health organizations are largely considered to be the most important (Skolnik, 2012). The World Health Organization (WHO) is a United Nations intergovernmental agency. Its principle goal is to promote “the attainment by all peoples of the highest possible level of health” (WHO as cited in Skolnik, 2012, p. 338). In general, WHO engages in providing and advocating knowledge and plays an important role in setting various global norms and standards. The United Nations Children’s Fund (UNICEF) addresses the sphere of children’s health and welfare. It tackles the issues of antenatal care, maternity, and childhood. In order to help children and mothers, UNICEF provides financing, generates and shares knowledge, and works to enhance nutrition and childhood development. The United Nations Population Fund (UNFPA) pays attention to the improvement of reproductive health. UNFPA is widely known for its campaigns to end obstetric fistula and female circumcision. Finally, the United Nations Development Program (UNDP) is designed to help people all over the world, particularly in developing countries, eradicate poverty and build a good life. In this respect, the organization seeks to share experience, expertise, and resources. Sustainable development, democracy, peacebuilding, and climate and disaster resilience are of primary importance for the organization (UNDP, 2016).

Natural disasters occur frequently, as evidenced by the flooding and monsoon rains in India (2007), cyclone Nargis in Myanmar (2008), the 8.0-magnitude earthquake and subsequent tsunami in Samoa and American Samoa (2009), and the earthquake in Haiti (2010) (Skolnik, 2012). The impact of natural disasters on global heath is devastating: natural disasters lead to increased death rates, diseases, and economic costs. Depending on the type of disaster, the health impact may vary, but there are some generally shared features.

Some deaths are directly caused by natural disasters; however, complex humanitarian emergencies—such as water and food shortages, unsanitary conditions, poor health services, and special health problems associated with camp life—result in more problems. For example, the rates of violence against women increase in camps and temporary housing. When people are displaced from the damaged region and become refugees, the most common causes of death are diarrheal diseases, respiratory infections, measles, and malaria (Skolnik, 2012). After emergency care, medical treatment focuses on recovery and rehabilitation. Violence-related injuries, TB, respiratory infections, sexually transmitted infections, and pediatric issues are of concern, as well as longer-term mental health issues, especially post-traumatic stress disorder (PTSD). Moreover, it is often necessary to rebuild medical facilities after a natural disaster. All in all, the health effects of natural disasters range from inconvenient to disastrous, and plans must be put in place to effectively handle the potential problems.

References

Averting HIV and AIDS. (2016). Web.

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Migliori, G. B., & Lange, C. (2014). Tuberculosis. Sheffield, UK: European Respiratory Society.

Pates, R., & Riley, D. (2012). Harm reduction in substance use and high-risk behaviour. Oxford, UK: John Wiley & Sons.

Petry, C. (2014). Gestational diabetes: Origins, complications, and treatment. Boca Raton, FL: CRC Press.

Skolnik, R. (2012). Global health 101. Burlington: Jones & Bartlett.

Stuckler, D., & Siegel, K. (2011). Sick societies: Responding to the global challenge of chronic disease. Oxford, NY: OUP Oxford.

United Nations Development Program. (2016). Web.

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