how can we improve healthcare in emerging countries-world-medical-fund
TRANSCRIPT
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Outline
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Global inequalities in health
• Everyone has the right to a
standard of living adequate
for health and well-being
- Article 25, Universal
Declaration of Human
Rights
• Many people worldwide lack
access to even basic
healthcare
United Nations; UC Atlas of Inequality
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Global inequalities in health
• A child born in Swaziland is nearly 30 times
more likely to die before the age of five than a
child born in Sweden
UC Atlas of Inequality
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Global inequalities in health
UC Atlas of Inequality
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Malawi
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Countries at a glance
CDC, World Bank, Swiss Federal Statistical Office
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Main causes of death
CDC, Swiss Federal Statistical Office
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Malaria
Swissinfo 2003 WHO 2014
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HIV and AIDS
UNAIDS
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How can we address these
problems?
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Suggestions?
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Supply
• Many healthcare conditions predominantly affect
the world's poorest populations
Medicines
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Storage
Few facilities
Very hot conditions
Modern facilities
Cold storage
Medicines
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Electricity
“In an average week we will only have
electricity for 4 days and water for 3”
Medicines
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Dosage
• Correct dosage needed for patients
• Trials for drug may not have been in these
populations or for the types of patients most
affected
• 9 of 10 children infected with HIV/AIDS live in sub-
Saharan Africa
• Most clinical trials are conducted using doses and
dosage forms designed for adults
IFPMA
Medicines
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Rationale use
• Overuse, underuse or misuse of medicines
harms people and wastes resources
• In developing countries, less than 40% of
patients are treated according to clinical
guidelines
WHO; World Bank
• Less than 60% of children with acute diarrhoea
receive necessary oral rehydration therapy yet more
than 40% receive unnecessary antibiotics
• Only 50% of people with malaria receive the
recommended first-line antimalarial
Medicines
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Delivery
Medicines
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Hospital/clinic
Infrastructure
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Waiting room
Infrastructure
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Pharmacies
High tech Low tech
Infrastructure
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Laboratories and testing
Infrastructure
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Equipment
Infrastructure
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Terrain
Infrastructure
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Corruption
Malawi
• Economy depends on substantial
inflows of economic assistance from
donors
• Many of these cut off because of
suspected corruption
DRC
• Despite rich natural resources, poor
management has left it with second
lowest GPD on the planet
• listed among the 20 most corrupt
countries in the world, which has
resulted in low education and poor
health systems
• Around 80 per cent of African people live on less than US$2 a day. Corruption is one
factor perpetuating poverty
• Poverty and corruption combine to force people to make impossible choices like “Do
I buy food for my family today or do I pay a bribe to get treated at the clinic?”
Transparency International; WMF
Infrastructure
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Prevention
• Intestinal parasites spread in areas with poor sanitation
• Children are most frequently infected with these
parasites as hygienic practices are often forgotten or not
used or taught
Education
and prevention
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Education
Education
and prevention
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Support
• It is essential that those caring for the children do not feel alone
• In 2013, WMF began a Support Group for those caring for the
children receiving HIV/AIDS treatment, care and support
• Parents and guardians now attend Health Education sessions on
how they can best care for their children who are living with
HIV/AIDS as well as for themselves
Education
and prevention
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Nutrition
• Good nutrition is vital so children to gain the full benefit from the
powerful medicines they receive
• Parents and guardians are learning how to prepare the right meals
for their children and for themselves
• A popular initiative has been a demonstration garden where they
learn how to grow soya beans and other plants.
Education
and prevention
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Staffing and training
World Bank; OECD
The College of Medicine (CoM) was
established in 1991. It is the only
medical school in Malawi
Education
and prevention
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Technology
Education
and prevention
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World Medical Fund
WMF’s UK registered charity number: 1063756
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Key initiatives
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Children's mobile clinic
• 4 x 4 vehicle carrying a clinical team
and medicines
• Mobile clinic visits villages and
remote locations
• WMF also has a Mobile Surgical
Unit to perform minor surgery deep
in the African bush
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Children’s mobile clinic 2013
Source: WMF Annual report 2013
Note: A total of 25,637 cases were treated by the
Children’s Mobile Clinic in the Nkhotakota district
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Electives for medical students
• Enable medical students to
learn first-hand how health
care delivery operates in a
developing world setting and
the challenges involved
– Gain practical, clinical training
in tropical medicine in a
unique cultural environment
• Usually spend 4 to 8 weeks
working with the WMF team
in Malawi
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Many factors
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