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AIDS 8, 493 deaths per day 3.1 million deaths per year (2004 WHO estimates) • More than 90% of those infected with HIV/AIDS live in developing countries and contracted the disease through heterosexual activity • About 70% of the global total of 42 million HIV infected people live in Sub-Saharan Africa, although the region contains only 11% of the total global population Malaria 2,959 deaths a day worldwide 1.1 million deaths in 2000 (WHO estimates) • 40% of the world’s population or 2.2. billion people, in over 100 countries with warm, humid climates are at risk • 90% of malaria deaths occur in Sub-Saharan Africa, mostly among young children Tuberculosis 4,384 deaths a day worldwide 1.6 million deaths in 2000 (WHO estimates) • • • • Poorly supervised health services, the spread of HIV/AIDS and the emergence of multi-drug resistant TB have adds to the impact 2 billion people worldwide are carriers of the bacterium that can lead to active TB. Left untreated, each person with active TB infects an average of 10 to 15 people a year. 99% of TB suffers live in developing countries and 80% of these cases occur in 22 countries, including India, China, Indonesia, Nigeria, Russia, Peru, and Ethiopia Global trade, air travel and movement of refugees have contributed to the spread of disease. In the US, 40% of cases occur in foreign-born people The Case of Cuba • Population: 11.2 million • HIV prevalence rate: .05% • Socialist, single-party state lead by Fidel Castro • Universal health coverage, well defined and well-funded public health sphere • Development of generic drugs (provided free of charge) • Talk about prevention!National AIDS Program created in 1983, 3 years before it’s first detected AIDS case Classic Public Health Response to Epidemic • HIV patients quarantined indefinitely • Contact testing and tracing • Routine testing of Cubans who visited Africa or who were pregnant • Close medical surveillance • Comprehensive education and outreach programs Success or human rights violators? • At what point should the right to privacy and secrecy leave off and the assumption of larger social responsibilities begin? • Individual liberty, privacy, free speech, and free choice are cherished values in any democratic society but they are sometimes invoked to obstruct social policies that favor universal healthcare, social welfare, and equal opportunity. AIDS- what can be done $14 Condoms A year’s supply per person • Reported use of condoms in Thailand’s brothels increased to more than 90% in 1994 from 14% in 1989; the same period STDs among men dropped by more than 90% Community Education • Experts believe that health education messages were a factor in Zambia’s reduction of HIV-infected females (ages 15-19) from 28% in the last 5 years Malaria- What can be done $4 Bed nets 6-month supply • In coastal Kenya, mass distribution of bed nets in 1999 decreased malaria cases by more than 80% from 1998 12 ¢ Anti-malarial tablet Per tablet • 1 in 2 deaths could be prevented TB- What can be done $10 TB medicine 6-month supply • In Peru, 94% of TB patients received full treatment in 1998 compared with 50% in 1990, preventing an estimated 70,000 deaths $1 Sputum-smear exam per exam • Cost-effective way to detect infectious TB and prevent the spread of the disease