Dealing with Global Health Crises

North Americans tend to think of things like SARS and Bird Flu, but in fact, the most critical pandemic facing the world today is probably AIDS -- not to mention TB and Malaria. There is, however, another group of chronic diseases that are beginning to create a double burden on countries. These are led by cardiovascular diseases (exacerbated by the growing obesity epidemic), followed by mental illness and injuries.

One simple answer would be money, but in reality, it takes much more. It takes vaccine research and distribution, prevention education programs (e.g. mosquito nets in endemic malaria regions), adequate numbers of health care personnel, surge capacity in health care systems, good two-way communication systems between governments/public health and front line professionals, adequate quarantine legislation and public health personnel with the authority to enforce them, intergovernmental and international cooperation in terms of data collection, and the sharing of containment approaches. In other words, adequate and thoughtful preparation.

I guess it really depends on the definition of a pandemic. In terms of my own personal definition the most serious challenge related to pandemics facing the world now is AIDS. It's not H5N1. H5N1 is something that could become a major issue, but in terms of what we have today, I would say that AIDS is a much more serious challenge.

The number priority in my own mind--and I guess this relates specifically to what we can be doing in Canada-- would be development assistance.

HIV/AIDS. The World Health Organization estimates that in 2005, approximately 3 million people died of this pandemic worldwide.

First, prevention through education and condom use. Second is the supply of antiviral drugs. Third, government support for the development of an effective vaccine. There have been reports of 'testing' of experimental drugs on humans in Third World countries, which are conducted without adequate safety measures on a vulnerable population.

One of the worst crisis-facing pandemics is the fact that people don't believe that there will be one. In the medical community they believe because they do a lot of work stockpiling, but I truly believe that the general public doesn't believe this will happen. Clearly, some work has to be done which is the education and convincing people that we really do have to be doing work because it's going to happen. Beyond this, I think Avian flu has the potential to be the most critical pandemic facing the world.

The whole issue of education. How do people get this? What do we do about farm controls?

The most critical pandemic we are facing from a global health perspective is the maldistribution of resources and the resulting human resource deficit. The international global health community has recognized the need to address the gross inequities of poverty and social development with solutions such as the Millennium Development Goals, and large global programs such as the Global Fund for HIV/AIDS, TB, and Malaria.

The most important measure we have to deal with this is good evidence, based on the development and support of solid and comprehensive information systems from the national to local level, that will allow decision-makers to understand and address the interplay between a sustainable public health system and the critical attention to resources that is required for adequate and appropriate human resources for global health and development.

The most critical pandemic facing the world today is poverty and inequities.

One has to reduce the inequities between groups of people, within and between countries.

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