Global Health Challenges Responses and Health Determinants Global

Global Health Challenges, Responses, and Health Determinants Global Health Training Package Office of Global Health and HIV (OGHH) Office of Overseas Programming & Training Support (OPATS)

Session Learning Objectives § LO 1: Participants will identify at least two examples of determinants of health. § LO 2: Using case studies, participants will identify at least 3 ways in which determinants of health contribute to health inequities and develop at least 2 strategies appropriate for Volunteers to use in addressing determinants of health.

Global Health Challenges COMMUNICABLE DISEASES NONCOMMUNICABLE DISEASES POPULATIONBASED AND OTHER CHALLENGES

Definitions COMMUNICABLE DISEASES • An infectious disease that can be transmitted from one person to another or via a vector (a carrier like a mosquito or tick) NONCOMMUNICABLE DISEASES • A disease which is not contagious • Usually of long duration and generally progresses slowly POPULATIONBASED & OTHER CHALLENGES • Challenges, besides communicable and noncommunicable diseases, facing populations and communities

Global Health Challenges: Communicable Diseases § HIV/AIDS is the most prominent communicable disease. § Almost all (97%) of those living with HIV reside in low- and middle-income countries, particularly in sub-Saharan Africa. § HIV/AIDS is the leading cause of death among women of reproductive age (15 -44 years old) in developing countries

Global Health Challenges: Communicable Diseases • About 3. 3 billion people – half of the world's population – are at risk of malaria. • Approximately 86% of malaria deaths occur in children under 5 years of age and the majority of cases are in sub. Saharan Africa.

Global Health Challenges: Non-Communicable Diseases § Non-communicable diseases represent more than 60% of deaths in the world. § The four main noncommunicable diseases are – cardiovascular diseases – diabetes – cancers – chronic respiratory diseases. § Nearly 80% of all deaths caused by noncommunicable diseases occurred in low- and middle-income countries.

Global Health Challenges: Population-Based § 99% of all maternal deaths occur in developing countries. § Every 2 minutes, a woman dies of pregnancy-related complications, the four most common causes being: severe bleeding after childbirth, infections, high blood pressure during pregnancy, and unsafe abortion. Source: WHO, et al. , Trends in maternal mortality: 1990 to 2008, 2010, http: //www. who. int/reproductivehealth/publications/monitoring/9789241500265/en/index. html.

Key Players in Global Health Multilateral, Bi-Lateral & International Organizations • • • Global Fund to Fight AIDS, TB and Malaria USAID, DFID, Aus. AID, NORAD UN Agencies, such as WHO • UNAIDS • UNFPA GAVI Stop TB Roll Back Malaria Academia and Research Organizations • Universities • Research institutions • Think tanks Developing Country Governments • Ministries of Health • Ministries of Social Welfare • Ministries of Finance Civil Society • Non-governmental organizations (NGOs) • Community organizations Private Sector • Businesses, including pharmaceutical companies • Foundations Individuals • Affected individuals • Family members • Community members

Major Global Health Initiatives Global Alliance for Vaccines and Immunisation (GAVI) Abuja Declaration 2000 Millennium Development Goals (MDGs) United Nations General Assembly on HIV/AIDS 2000 2001 International Health Regulations Global Fund to Fight AIDS, Tuberculosis, and Malaria U. S. President’s Emergency Plan for AIDS Relief (PEPFAR) World Health Organization 3 x 5 Initiative 2002 2003 International Health Partnership Plus (IHP+) 2007 2005/2007 United Nations Millennium Development Goals’ Review Summit 2010

Millennium Development Goals

What are the social determinants of health? Factors that cannot be modified and can influence the health of individuals: Biological Factors e. g. Age, sex, genetic make-up Factors that can be modified and can influence the health of individuals: Socio-economic Factors Cultural Factors e. g. Income, class, education, race e. g. How people eat, work, conduct themselves, and seek care Environmental Factors e. g. Access to clean water, level of air pollution, existence of safe workplaces and homes Individual Lifestyle Factors e. g. Handwashing, sexual activity, use of tobacco and/or alcohol, and diet Social and Community Networks Health Services e. g. Relationship with friends and family, social relations, involvement in community networks e. g. Quality of health services, access to health services, availability of medicine

Health Inequity Unfair and avoidable differences in health status seen within and between countries. Between countries: § A child born in Japan has a chance of living 43 years longer than a child born in Sierra Leone. – A Cambodian woman’s lifetime risk of dying due to pregnancy related causes is 1 in 48 compared to 1 in 110 in Myanmar, 1 in 280 in Vietnam and 1 in 500 in Thailand Within a country: § Life expectancy at birth for men in the Calton neighborhood of Glasgow is 54 years, 28 years less than that of men in Lenzie, a few kilometers away. § In Moldova, children from the poorest urban quintile are 3 times more likely to be chronically malnourished than children from the wealthiest urban quintile

Reflection Questions 1. What are some ways that you, as a Volunteer, could work with your community to address this problem? 2. What are some possible solutions you will explore and possibly implement with your community to address these influencing factors or determinants?