Week 11: Heathcare Financing and Health Outcomes in the Global Context

After considering the case study analysis, I really do think that cost effectiveness analysis is the way forward for deciding where resources should be allocated. There are only so many resources available and it makes most sense to use them in the most effective way possible. Though the discussion of this type of analysis brought up many criticisms, I do not think that there is a better way thus far for stakeholders and those providing the resources to analyze where their money would be best spent. It was interesting in class, that the point was brought up by Dr. Shahi that we don't have to worry about this type of thing in the US on the scale that developing nations do. We basically can have everything in regards to healthcare, if we wanted. But these other nations cannot, and until they are economically viable enough to reach a level where they can provide for all their healthcare needs, their needs to be some system that is effective at prioritizing what issues merit funding. I was curious about one of the articles 10 "best buys," the provision of insecticide treated bednets, because for some reason I was under the impression that there were more effective ways of addressing malaria in these regions, such as building up land on the swampy areas. I am not sure, maybe I just made this up. However, the discussion question that asked if the World Bank should require cost effectiveness analysis before they allocated funds seems to be an interesting one. I do not think that this can be the only measure they use when determing allocation of resources, however, I do think it should be incorporated and taken seriously.

An NPR article titled: Study: 634 Million People at Risk from Rising Seas

I found this article on the NPR website and thought it was an interesting addition to what we discussed in this lecture, "Monitoring, Surveillance and Rapid Response Capabilities." The article was about how it is known that sea levels are expected to rise in the next century perhaps by as much as a foot, and with the rise of the ocean will come more flooding of low-level cities and it has even been hypothesized that with global warming hurricanes might become more intense. However there has not been much data about who exactly this will affect. Using satellite data and census information, the researchers discovered that that low-elevation areas are home to 634 million people, which is about 1 in 10 people in the world. Those countries with the most people in these low-elevation coastal areas are China, India, Bangladesh, Vietnam, Indonesia, Japan, Egypt, United States, Thailand, and the Philippines, and the countries with the largest share of their population living in these areas are the Bahamas, Suriname, the Netherlands, Vietnam, Guyana, Bangladesh, Djibouti, Belize, Egypt, and Gambia. In addition, two thirds of the world's largest cities are in these low-elevation levels, which is a huge deal considering populations will continue to shift to urban areas throughout this next century. This article highlights the need to look to what is going to happen in the future and how well prepared we are and should be to handle the future effects of global warming on weather patterns. The people in these areas will be greatly affected by these weather changes and hopefully governments will work to achieve good monitoring and effective strategies to deal with the inevitable weather disasters that will strike in their homes in the future.

The idea brought up in class of telemedicine was so neat in my opinion. I think that the possibilities for how helpful that could be for patients are endless. Imagine not having to go through all the hastle when you have something like the flu or a cold, and need an antiobiotic, to just be able to e-mail or speak with your physician on the phone to obtain the appropriate antibiotic or whatever treatment is necessary. It seems that the cost of primary care could greatly be decreased through the use of this strategy. I have a story somewhat related to this. When I first got to Greece I was taking an antibiotic for an infection I had, and had used this antibiotic many times and had gotten to the point where I could recognize exactly when I had an infection and what I needed to take to get rid of it. A few weeks later, the infection came back and I knew that I needed to get the antibiotic again, only this time take it for a longer period of time to ensure the infection went away completely this time. Well, being the American I am, I went immediately to the local doctor and explained my symptoms and what medication I needed, and he wrote my prescription and I paid him 50 Euros. Well, then I went to the pharmacy and got this prescription (with much hastle because he didn't speak English and the doctor hadn't written down what I needed in Greek). When I came back and talked to the directors of the program (who were themselves Greek) they laughed that I had went to the doctor at all. Apparently in Europe, you do not need a prescription to go to the pharmacy to get drugs. If you know what you need, you just go there and get it. Thus, all those times we Americans know exactly what we have and know exactly what they are going to prescribe to us, we have to sit there anyway, wasting all that time and money, where in Greece they just skip that unnecessary step. This telemedicine idea just seemed like a move towards the system in Greece, and it just makes sense to me. Of course this system in reliant on the fact that trust has been established between you and your primary physician.

Week 8: Technology Innovation and Global Health 1: Biomedical Sciences

Though I have very little background in what this lecture discussed, I found it interesting and quite insightful. I think the thing that stuck with me most was when Dr. Shahi discussed the current situation of the US being at the "top of the hill." He described, in a very illustrative way, how once a country feels that they are secure in their developments, and do not have anymore mountains to climb and conquer, that they are already beginning to slide down the hill, allowing other countries who continue to strive to be always be better to begin to overtake it. Though the US does an enormous amount of research in every field and has come out with more then its share of innovative and progressive technologies, it seems as if the US has grown almost lazy and expectant that its reign over technology development will not be surpassed. Other countries, specifically in Asia, seem so much hungrier to make the big leaps that will eventually lead them to be leaders in technology development. It is my hope that researchers and developers in the US will realize that in order to stay on top we must continue to strive to be the first and the best at coming up with innovative and effective ideas.
Furthermore, I enjoyed the discussion about the biobusiness innovation landscape. I know the professor said that developers should focus on the summit opportunities, but I didn't understand why they should not focus on the cloud opportunities. I guess that part was over my head or something. I also thought the slide about the technology adoption challanges was neat, because it highlighted for me that I am so on the wrong end of the spectrum of where I should be in terms of accepting and incorporating new technologies into my life. I have always shied away from technology, and it has become quite apparent from this class that that is not a smart or viable strategy at all if I want to succeed in the 21st century.

I watched the video about Ethiopia for today, and it reminded me a lot of what we discussed in week 5 concerning global hunger. There is such a desperate need for people in developing countries to be trained in how to properly farm their lands so that they do not overuse it and destroy its fertility. If organizations and governments could recognize and take aggressive actions to address these land issues and realize that addressing these issues could help to alleviate many of the other problems that develop as a result of them, then I think that a huge step forward could be made. I also thought the video called UNDP HDR Water and Environment was interesting. The main recommendations of getting the government to make sincere policy change, however, didn't really seem realistic. The policy changes concerning sanitation and water in Western Europe and the US that were so effective in lowering the child mortality rates in recent history were instituted by governments that cared about the social welfare of its people because it was the people who were running the governments. In a lot of these African countries, there is so much corruption and so little power for the people to have any say in policy that these reforms are just not going to happen unless the international community puts more pressure on the governments to do something about it.

Interesting ariticle in Newsweek about men and depression in the US

I just read an interesting article in Newsweek titled "Men & Depression: Facing Darkness." I was really surprised to learn about some of the new therapies the NIMH is developing to treat depression. The article explained that the focus for treating depression was shifting in their research from boosting neurotransmitters (which is what antidepressants such as the SSRI's like Zoloft and Prozac do) to focusing instead on the endocrine system. They believe that perhaps if they can block overproduction of stress chemicals they can reduce damage to healthy nerve cells. I think that this is really interesting, because for so long researchers have been focusing on the brain and its neurotransmitters, and now they seem to be looking at depression more holistically and realizing that hormones (particularly stress hormones) most likely play an important role in the development of this disorder. Furthermore, they are trying to find fast-acting antidepressants that would relieve depression symptoms in a matter of hours, instead of weeks like the older antidepressants. They have tested one of these drugs named ketamine, which is apparently an animal tranquilizer, and so far in tests it has been shown to have both short and long-term effectiveness. It will be interesting to see if they can actually develop these extremely fast acting antidepressants. I think that though psychopharmacology is an extremely important part of treatment for depression, it is important no to lose sight that cognitive therapy is just as important. The article made an important point when it pointed out that antidepressant treatment is still more of an art then a science, and people can't expect drugs to always work exactly how they want them too, which is why cognitive therapy is such an integral part in treating depression.