[02.11b] Global Health and Screening Part 2 V2.pdf

Special United Nations agency (est. 1948) dedicated to monitoring and improving world health

What is the World Health Organization (WHO)?

Geneva, Switzerland

Where is the global headquarters of the WHO located?

No, they do not necessarily follow geographical continents; division is supposedly political

Do WHO regional offices strictly follow geographical continents?

Western Pacific, Southeast Asian Region Office (SEARO), Eastern Mediterranean Regional Office (EMRO), AFRO, EURO, PAHO

Name at least three of the WHO's regional offices.

Philippines, Japan, Korea, Malaysia, Vietnam

Name specific countries included in the WHO Western Pacific region.

Indonesia, India, Thailand

Name specific countries included in the WHO Southeast Asian Region Office (SEARO).

Each country has a country office, depending on the need for WHO services

Does every country have a WHO country office?

Inside the Department of Health (DOH)

Where is the WHO country office in the Philippines located?

Dr Rui Paulo De Jesus

Who is mentioned as the current head of the WHO country office, acting as the WHO representative?

To promote and protect global health, well-being, and equity in healthcare access for all people worldwide

What is the mission of a WHO regional office?

Health as a basic human right

What did the WHO establish as a basic human right, declared by nations part of the UN?

Sets global health standards and norms; Monitors and assesses international health trends and emergencies; Provides technical assistance and capacity building to countries; Conducts research and evidence-based guidance; Coordinates international responses to health crises

Name three key functions of the WHO.

Country office acts as direct communication between the DOH and the WHO

How does a WHO country office facilitate communication between the WHO and a country's Department of Health?

Suggesting tackling non-communicable diseases or developing Universal Health Care (UHC) within the country

Give an example of technical assistance and capacity building provided by the WHO to countries.

Standards and advice on COVID vaccine efficacy

What is an example of research and evidence-based guidance provided by the WHO during a health crisis?

No, the WHO cannot impose its will onto countries

Can the WHO impose its will or regulations onto member countries?

Annual World Health Assemblies

Where do countries agree to principles presented by the WHO and show cooperation for implementing projects?

Strengthening laboratory and regulatory systems

Give an example of a WHO recommendation that a country might decline if not prepared for implementation.

Disease prevention and control; Health systems strengthening; Access to essential medicines and vaccines; Maternal and child health; Nutrition; Mental health; Environmental health; Health equity

List five key areas of focus for the WHO.

Specific infectious diseases (e.g., HIV/AIDS, malaria, COVID-19), non-communicable diseases, and health emergencies

What types of diseases and health events does WHO address under its key area of focus for disease prevention and control?

Supports countries in developing and improving healthcare infrastructure and services

What is the purpose of WHO's focus on health systems strengthening?

Disease specific

What characterizes a "vertical approach" in health systems?

Campaigns, monitoring and evaluation, and clinics for DOTS (Directly Observed Treatment, Short-course)

What services are typically focused only on TB in a vertical approach, such as a national tuberculosis program?

Making sure a health facility not only covers TB, but other possible needed services (anti-malaria, mental health, etc.)

What is an example of a "horizontal approach" to health systems?

An ideal facility and system

How does the WHO describe a health facility that provides all key areas of focus being stipulated by the organization?

Advocates for equitable access to medicines, vaccines, and healthcare technologies

What is the goal of WHO's focus area on access to essential medicines and vaccines?

Reduce maternal and child mortality

What is the primary objective of WHO's focus on maternal and child health?

Promotes proper nutrition and food safety, and addresses non-communicable/vascular diseases

What are the two main aspects of WHO's focus on Nutrition?

Advocates for mental health awareness and services

What is the WHO's objective in its Mental Health focus area?

Addresses environmental factors that impact health

What does WHO's Environmental Health focus area deal with?

Strives to reduce health inequalities globally

What is the aim of WHO's Health Equity focus area?

Smallpox eradication

What is considered a global health success story?

Before vaccines, smallpox was a deadly virus that killed many people

How was smallpox described before the development of vaccines?

Jenner and Pasteur

Who developed the first vaccines from cowpox, contributing to smallpox eradication efforts?

Milkmaids exposed to cowpox were immune to smallpox

What observation by Jenner led to the development of the smallpox vaccine?

1967-1980

What was the timeframe for the historic smallpox eradication campaign?

Global effort by numerous countries and organizations, led by WHO

Who led the smallpox eradication campaign?

Intensive vaccination campaigns, effective surveillance, and isolation

What were the key strategies of the smallpox eradication campaign?

1977 in Somalia

When and where was the last known case of smallpox reported?

May 8, 1980

When did the World Health Assembly declare the eradication of smallpox?

World Health Assembly

Which assembly is attended by health secretaries, distinguishing it from the UN Assembly?

One of the greatest achievements in public health history

How is the eradication of smallpox regarded in public health history?

Mpox vaccines

Which current vaccines are mentioned as using similar technology to what was used during smallpox vaccinations?

The vaccine was stable, cheap, and easy to manufacture

What characteristic of the smallpox vaccine significantly contributed to its successful eradication campaign?

Dengue has 4 strains, and vaccinating a child without previous infection can increase the chance for hemorrhagic fevers during secondary infections

Why is it difficult to produce an effective vaccine for dengue, unlike smallpox?

Requiring previous dengue infection in order to avoid hemorrhagic fevers

What requirement for some dengue vaccinations, like Dengvaxia, highlights a challenge in vaccine development?

United Nations Children’s Fund (UNICEF)

Which international agency focuses on the well-being of children, addressing child health, nutrition, immunization, and access to clean water?

Water, Sanitation, and Hygiene (WASH) projects

What type of project is UNICEF involved with in the Philippines to prevent contamination of drinking water?

World Bank

From which organization does UNICEF receive monthly funds to oversee nutrition projects?

Copenhagen

Where does UNICEF have a large warehouse for vaccinations?

United Nations Population Fund (UNFPA)

Which agency focuses on reproductive health and rights, family planning, and reducing maternal and child mortality?

USAID

With which organization does UNFPA work, focusing on population control for food security?

Joint United Nations Programme on HIV/AIDS (UNAIDS)

Which agency leads and inspires the global effort to end HIV/AIDS?

Medecins Sans Frontieres (Doctors Without Borders)

Which international humanitarian organization provides emergency medical care in conflict zones, natural disaster areas, and regions with endemic diseases?

Multiple disciplines, including the provision of supplies, not just doctors

What range of professionals and services does Medecins Sans Frontieres include?

Centers for Disease Control and Prevention (CDC)

Which U.S. government agency has a significant international role in disease control, prevention, and emergency response, and is tied to the DOH in the Philippines?

Responsibility for the Philippines’ good field epidemiology strength

What significant contribution is attributed to the CDC's ties with the DOH in the Philippines?

National epidemiology center and Regional epidemiology center in Centers for Health Development (CHDs)

What are the two main types of epidemiology centers in the Philippines that benefit from CDC ties?

Bill and Melinda Gates Foundation

Which major private foundation funds global health initiatives, particularly in infectious diseases, vaccines, and maternal and child health?

Questions as to their ulterior motives as businessmen

What common critique or concern is sometimes raised about the philanthropy of the Bill and Melinda Gates Foundation?

Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM)

Which international financing organization mobilizes resources to fight these three major diseases?

Gavi, the Vaccine Alliance

Which public-private partnership aims to increase immunization in poor countries, funds vaccines, and strengthens health systems?

Where Covax vaccines were obtained

What notable connection does Gavi, the Vaccine Alliance, have regarding vaccine distribution?

Asian Development Bank (ADB)

Which institution, focused on the Asia-Pacific Region, provides financial and technical support for economic growth, infrastructure, and health initiatives, often through loans?

World Bank Group

Which primarily financial institution invests heavily in health initiatives, providing funding and expertise for health programs in low- and middle-income countries?

Philippines Multisectoral Nutrition Project (PMNP)

What specific project in the Philippines is funded by the World Bank, involving DOH and NEDA?

DOH and National Economic and Development Authority (NEDA)

Which two Philippine government agencies are involved in the Philippines Multisectoral Nutrition Project (PMNP)?

Medical missions and volunteer work; Partnerships and collaborations; Advocacy and policy engagement; Research and innovation; Medical education and training; Telemedicine and telehealth; Disaster response and preparedness; Global health leadership roles; Public health campaigns; Advocating for health equity; Health systems strengthening; Research and development of low-cost solutions; Cultural competency and respect; Continuous learning

List five potential roles of physicians in global health.

Taking an internship (in WHO) and advancing to consultant and technical officer

How can a physician begin a career in global health leadership within the WHO?

Master of Arts in Health Policy to advocate for management and governance of epilepsy

Give an example of a specific area of advocacy a physician can pursue with further education.

Research Institute for Tropical Medicine (RITM)

Name an institute where physicians can collaborate for global health research and innovation.

Red Cross and Medecins Sans Frontieres

Which two organizations are specifically mentioned for physicians to engage in disaster response and preparedness?

Building a local organization and going international

Besides working for the WHO, what is another way a physician can become a global health leader?

Studying abroad for masters and doctorate degrees, and engaging in networking and collaboration

How can physicians achieve continuous learning for global health?

Impact of health problems, injuries, and risk factors on a population’s overall health and well-being

What is the Burden of Disease (BOD)?

Sum of mortality and morbidity measured by DALYs (and QALYs)

How is the Burden of Disease (BOD) quantified?

Disability-Adjusted Life Years (DALYs)

What is the standardized metric that allows for direct comparisons of disease burdens across different diseases, countries, populations, and over time?

Measured in years

How are DALYs measured?

No, it is a collective of years in a given country’s population

Are DALYs applicable only for one person?

Policymakers, other decision-makers, and investors

Who does the DALY indicator primarily guide in prioritizing health interventions?

1 lost year of healthy life

What does 1 DALY represent?

YLL + YLD

What is the formula for DALYs?

Years of Life Lost (due to premature death)

What does YLL stand for in the DALY formula?

Years Lost due to Disability (or Years Lived with Disability)

What does YLD stand for in the DALY formula?

Quantification of the global burden; Inclusion of non-fatal health outcomes; Providing independent objective evaluations; Measurement unit should be normative; Measurement unit should be used for cost-effectiveness studies

Name three overall goals of the Global Burden of Disease (GBD) study.

Any health outcome should be reflected; Treating like health outcomes as like; Time as a unit of measure

What are the general assumptions underlying DALY calculations?

Based on standard cohort life expectancies (82.5 years for females, 80 years for males)

What is the basis for calculating Years of Life Lost (YLL)?

Generally, people who die younger have greater YLLs

How does age influence the magnitude of Years of Life Lost (YLL)?

Discounting future with a 3% rate

What time preference rate is applied when calculating both YLL and YLD?

Non-fatal health outcomes

What does Years Lost due to Disability (YLD) primarily measure?

Disease-specific epidemiology of disabilities; Disability weights between 0 and 1; Health state valuation via person trade-off questions

What factors are considered when calculating Years Lost due to Disability (YLD)?

In the productive age group (schooling and working ages)

In YLD calculations, whose disability would result in a higher YLD?

Infectious Diseases; Non-Communicable Diseases (NCDs); Injuries; Risk Factors

List the four main causes of the Burden of Disease (BOD).

Malaria, HIV/AIDS, and tuberculosis

Which infectious diseases are cited as significant contributors to the burden of disease in many developing countries?

Heart disease, cancer, diabetes, and mental health conditions

Which non-communicable diseases (NCDs) are major contributors to the burden of disease in developed and increasingly developing countries?

Accidents, violence, and other injuries

What types of events contribute to injuries as a cause of BOD?

Lifestyle factors (e.g., smoking, poor diet, lack of physical activity) and environmental factors

What risk factors can increase the burden of disease?

Global distribution; Impact on Healthcare Systems; Health Inequalities; Measurement Challenges; Changing Patterns; Prevention and Intervention; Global Initiatives

Name three challenges associated with the Burden of Disease (BOD).

Low- and middle-income countries

Which countries typically face a greater burden of infectious diseases and maternal and child health issues?

High-income countries

Which countries generally have greater burdens of non-communicable diseases (NCDs)?