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The human problem on Earth

The human problem on Earth. Anne Marie Chomat. “ Biomedical interventions ” vs. “ The environment ”. BCG. Sulfa. Streptomycin. Vaccine. United States. Vaccine. PCN. PCN. Achieving the MDGs ???. Significant variation WITHIN countries. Significant variation BETWEEN countries.

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The human problem on Earth

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  1. The human problem on Earth • Anne Marie Chomat

  2. “Biomedical interventions” vs. “The environment” BCG Sulfa Streptomycin Vaccine United States Vaccine PCN PCN

  3. Achieving the MDGs ??? Significant variation WITHIN countries Significant variation BETWEEN countries HDR 2005

  4. State of the world’s health • 1/2 million/yr women die from pregnancy/childbirth (hemorrhage > infection > other causes) • Child mortality = 9.2 million/yr (1/2 due to diarrheal illness, 2/3 from underlying malnutrition) • 195 million children < 5 are stunted (1/3 developing world children) • 1 billion people undernourished • Malnutrition responsible for >36 million deaths/yr • 0.8 billion without cleanwater access • 2.5 billion without sanitation • Land degradation, deforestation, falling water table levels, climate change, risk of decreasing crop productivity UNICEF 2009 FAO 2009 WHO 2009 Von Glebmer 2010

  5. Loss of annual net primary productivity 1991-2003 Child Mortality Poverty Poor human health Poor environmental health Prevalence of undernourished Risk to cyclones, floods, earthquakes, landslides Threat to human water security and biodiversity Prevalence of people without sanitation

  6. Health solutions & unintended consequences

  7. Malnutrition in Guatemala Free Market / Global Economy Climate change Export/Import pressures ↑ food/fuel prices Fuel insecurity Droughts Heavy rains Altered livelihoods Food insecurity ↓subsistence agriculture ↑cash crops Flooding Difficult travel/transport Poor agriculture yields Erosion Poor governance Land Overuse Poor sanitation Infections Overpopulation Poor health care access Poverty Malnutrition High fertility rate ↑morbidity ↑mortality Indigenous ethnicity No education

  8. Globalization Local economics Climate Environment Determinants of health Livelihoods Access to resources Farming Production costs Yields Population pressures Social capital Community cohesion Food security Nutrition status New exposures to infectious diseases Sanitation Economic security Water security Physical security Social support Knowledge Underlying health/illness Social determinants of health (wealth, education, gender, age, ethnicity, rural/urban) Vulnerability Susceptibility to illness/infection Local governance Local resources Local infrastructure Health

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