BIOE 260: Intro to Global Health Issues

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BIOE 260 Intro to Global Health Issues

• Spring 2007

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Course Overview

• Syllabus
• Four Units
• Major global health issues
• Health systems economic development
• Design of successful interventions
• Case studies
• Readings
• Millions Saved
• The End of Poverty
• Banker to the Poor
• The Spirit Catches You and You Fall Down

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Course Overview

• Project oriented course
• Design challenges from TMC-affiliated
  international programs
• Mentors from TMC and developing countries
• Summer internships available to implement
  solutions
• Outcomes
• Prototype manual
• Project report
• Project poster presentations

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Project Handout

• Read the entire document
• Task 1 Project selection form (due next class)
• Task 2 Restate problem, team contract
• Task 3 Lit review
• Task 4 Design criteria
• Task 5 Brainstorming
• Task 6 Brainstorming evaluation
• Task 7 Reiteration of brainstorming
• Task 8 Design proposal
• Task 9 Design analysis
• Task 10 Ethical and cultural considerations
• Task 11 Project presentation
• Task 12 Prototype
• Task 13 Final report

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Project Overview

• Pictorial dosing guide software
• Botswana Baylor Intl. Pediatric AIDS Initiative
• Hematocrit point of care tester
• Malawi Baylor Intl. Pediatric AIDS Initiative
• Vented stove design and assembly kit
• Baylor Shoulder to Shoulder Foundation
• Middle school BIOE club
• Houston Independent School District
• Lesotho Baylor Intl. Pediatric AIDS Initiative

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Pictorial Dosing Guide Software

• Problem
• Drug regimens for HIV are often complex and
  demanding
• Adherence may not always be optimal, especially
  for children
• http//www.npr.org/templates/story/story.php?story
  Id5074228
• Solution
• Software to print pictorial dosing guide which
  illustrates daily ARV drug regimen

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Hematocrit Tester

• Problem
• AZT may cause anemia
• Many labs do not have the capability to measure
  hematocrit
• Solution
• Inexpensive, dependable, portable tool to measure
  hematocrit which does not require external power

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Vented Stove

• Problem
• Traditional cooking practices which rely on
  indoor, unventilated stoves lead to high levels
  of respiratory illnesses
• Solution
• Simple, inexpensive, vented, energy efficient
  stove that can be made from locally available
  materials and accommodate round bottom pots

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After School BIOE Club

• Problem
• Decreasing interest in careers in science and
  engineering
• http//www.nap.edu/execsumm_pdf/11463.pdf
• Increased education highly correlated to gains in
  health
• http//www.nytimes.com/2007/01/03/health/03aging.h
  tml?incamparticle_popular_2
• Solution
• Interactive activities for middle school students
  that promote understanding of and interest in
  science and engineering

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Want to propose your own project?

• Talk to Dr. RRK ASAP!!

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Speed Dating Exercise

• You will have one minute to talk with each person
  in class

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Millions Saved

• Center for Global Development
• 15 experts in international health, development
  economics, public policy and other relevant
  fields
• Goal
• Identify and examine experiences of large scale
  successes in international health
• Collaborated with DCPP, solicited nominations
  from worlds leading health authorities
• Book
• Chronicles 17 success stories
• Identifies common features of successful
  interventions

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Gains in Health

• Life expectancy in developing countries
• 1950 40 years
• 2000 65 years (increase of 60)
• Most improvements are from reduced risks to young
  children
• What is responsible for these gains?
• Economic growth only partially explains these
  health improvements (probably less than half)
• Public health programs are responsible for large
  part of gains

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Criteria for Success

• Scale
• National, regional or global scale
• Importance
• Public health significance measured in DALYs
• Impact
• Changes in morbidity and mortality
• Duration
• At scale for at least 5 years
• Cost-effectiveness
• Threshold of 100/DALY saved

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Millions Saved

• Reducing guinea worm in Asia and sub-Saharan
  Africa
• Controlling Chagas disease in South America
• Reducing fertility in Bangladesh
• Curbing tobacco use in Poland
• Preventing iodine deficiency in China
• Eliminating measles in southern Africa
• Preventing dental caries in Jamaica
• Preventing Hib in Chile The Gambia

• Eradicating smallpox
• Preventing HIV in Thailand
• Controlling TB in China
• Eliminating polio in Latin America
• Saving mothers lives in Sri Lanka
• Controlling river blindness in sub-Saharan Africa
• Preventing diarrheal deaths in Egypt
• Improving health of the poor in Mexico
• Controlling trachoma in Morocco

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Six Lessons Learned

• Success is possible even in the poorest countries
• Governments in poor countries can do the job and
  in some cases are the chief funders
• Technology, yes but behavior change, too
• International coalitions have worked
• Attribution is possible
• Success comes in all shapes

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Common Elements of Successes

• Political leadership
• Technological innovation only works when there is
  an effective system to deliver it at and
  affordable price
• Agreement among technical experts strengthens
  signal, reduces noise
• NGOs complement and keep a vigilant eye on public
  action
• No technology, funding or champion takes the
  place of good management on the ground

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Common Elements of Successes

• Information is power
• Raise awareness
• Shape design
• Motivates
• Community participation creates a two-way street
• More predictable funding, at adequate levels,
  permits the system to work

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Challenges Ahead

• Each year
• 3 million children die of immunization-preventable
  diseases
• 2 million children die of dehydrating effects of
  diarrheal disease
• 500,000 women die in pregnancy or childbirth
• 3 million people in sub-Saharan Africa contracted
  HIV
• Major challenges for the future
• AIDS
• High child mortality in Africa
• Inequality
• Cardiovascular and chronic diseases

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HW Due Next Time

• Task 1 Project selection form