TAILIEUCHUNG - Chapter 002. Global Issues in Medicine

Examining specific problems—notably AIDS (Chap. 182), but also tuberculosis (TB, Chap. 158), malaria (Chap. 203), severe acute respiratory syndrome (SARS; Chap. 179), and key noncommunicable diseases—helps to sharpen the discussion of barriers to prevention, diagnosis, and care as well as means of overcoming them. We next discuss global health equity, drawing on notions of social justice that once were central to international public health but have fallen out of favor over the past several decades. . | Chapter 002. Global Issues in Medicine Examining specific problems notably AIDS Chap. 182 but also tuberculosis TB Chap. 158 malaria Chap. 203 severe acute respiratory syndrome SARS Chap. 179 and key noncommunicable diseases helps to sharpen the discussion of barriers to prevention diagnosis and care as well as means of overcoming them. We next discuss global health equity drawing on notions of social justice that once were central to international public health but have fallen out of favor over the past several decades. We close by acknowledging the importance of costeffectiveness analysis linked to national economic data while at the same time underlining the need to address disparities of disease risk and access to care. History of Global Health Institutions Concern about health across national boundaries dates back many centuries predating the Black Plague and other pandemics. Before the advent of germ theory when epidemic disease began to be understood to be the result of microbes rather than of miasmas or the wrath of a divine being the chief social responses to such epidemics often included accusations that this or that human group was responsible for propagating the affliction in question. Similarly inaccurate and ineffective beliefs abounded when the arrival of European colonists led to catastrophic outbreaks of communicable diseases among indigenous populations in the Americas and these viewpoints continued to hold sway during subsequent pandemics of cholera. Many historians trace modern public health and epidemiology to the day in 1851 when Dr. John Snow having discerned the link between cholera outbreaks in London and water sources used by the afflicted populace removed the handle of the Broad Street water pump. Thus one cholera epidemic was stopped but it would still be years before the etiology of cholera was discovered. A proper understanding of etiology was necessary to the birth not only of epidemiology but also of efforts to apply public health .

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