HEALTH GATEWAY 3: Challenges

HEALTH GATEWAY 3: Challenges

1. Reemergence of Malaria

   • Air Travel
     • Increased air travel -- disease-causing organisms are also transported around the world due to globalisation and air travel -- caused re-emergence of malaria is some countries as people with surviving malaria parasites enters a country -- outbreak in a spread. // Airplane & Malaria in France
   • Climate change
     • Climate gets warmer -- temp at higher altitudes increases -- glaciers melt and become favourable breeding sites. // Central highlands in Kenya increase temp, additional 4m affected w Malaria.
   • Resistance to antimalarial drugs
     • Use of counterfeit or incomplete doses of antimalarial drugs -- Allow surviving malaria Anopheles parasites to build resistance to the drug and continue to thrive. // Migrant workers worked in Mekong, Thailand - contracted, brought back to India.
   • Insecticide-resistant mosquitoes
     • According to WHO, mosquito resistance to insecticides has been detected in 64 countries ard the world. If situation worsens, it could potentially place 120k children under 5 years old at risk of Malaria and in turn shorten their Life Expectancy, higher death rates.

2. Challenges in Managing Malaria

   • Socio-Economic
     • Limitation to health care
       • Absence of an approved malaria vaccine and ability of Anopheles mosquitoes to develop resistance of antimalarial drugs - incomplete treatment allow mosquitoes to survive and spread.
     • Mobility
       • Large population - difficult to monitor. // Border Control - Greater Mekong subregion on SEA control spread of drug-resistant malaria across border // Travel Advisories - inform specific risks of travelling to a particular destination so as to reduce travel to infected places and reduce the spread to own country - however may not reach everyone
   • Environmental
     • Climate Change
       • Global Warming causes higher temperatures and rainfalls. // High temp increase speed of mature and growth of female anopheles mosquitoes / High rainfalls allow formation of stagnant water for most to breed and thrive. // tropical Africa reduce malaria bc high temp but reduced rainfall.
     • Monsoon Rain
       • creates puddles of stagnant water that are left exposed on low-lying land and construction sites. // Urban India have heavy rain during monsoon season - create lasting pools of stagnant water that mosquitoes are able to breed and thrive and transmit the disease

3. Challenges in managing HIV/AIDS

   • Socio-Economic
     • Lifestyle Choices
       • Difficult to manage as individuals have own opinion whether or not they want to engage in risk taking activities such as sharing needles, unprotected sex, polygamy, breastfeeding to kid. // Due to cultural beliefs which may not be accurate - Zambai and Kenya Africa believe in polygamy and having more than 1 wife.
     • Difficulties in HIV Detection
       • no visible signs of HIV for most period of the infection - People carry and spread disease // Survey by WHO 2010, 35.2% of women in Congo with HIV knew they had HIV before the test. The rest of the women who had HIV were unaware of their HIV status.
     • Social Stigma
       • Discrimination - ostracised - not accepted - remain silent until infection full blown // Doctors refuse to treat due to fear of contacting HIV while treating. // UNAIDS 2008 -27% Americans prefer not to have close contact w those w HIV.
     • High cost of antiretroviral therapy
       • Antiretroviral treatment controls disease, improve life quality, reduce risk of transmission. // High cost, thus people untreated and increase spread. // Botswana 25% adults have HIV but long waiting of 4-12 hours - reduce productivity - thus not treated.
     • Population Mobility
       • Populations with High mobility have high vulnerability to spread of diseases. // Kinshasa/AIDS Highway (Uganda and Kenya) -- High prevalence of HIV as many from low dev travel to more dev for job opportunities, away from family, polygamy.

4. Emergence: SARS 2003

5. Reemergence: Dengue Fever