disease – Alex B. Hill

Death, donations, and doing good

The ice bucket challenge was undoubtedly a media and fundraising success for the ALS Association. For many people this was an opportunity to “do good” and call out their friends on social media to do the same. Skepticism mounted as social media feeds were inundated with ice bucket participant videos.

Plenty Consulting looked at the data and found that daily donations to the ALS Association (ALSA) remained the same even as the number of ice bucket challenge participants grew exponentially. Donations to the ALS Association were 35% higher than last year, but were all the non-donating participants missed fundraising opportunities or simply “do good” imposters? Perhaps it is helping to foster a culture of giving?

Vox published a widely shared bubble chart (above) that demonstrated which diseases kill the most people compared to which diseases get the most donations. This chart is flawed in the sense that comparing one-time fundraisers, such as a Breast Cancer Walk, isn’t enough to capture which diseases get the most overall funding.

Others took a more statistical approach to their skepticism. One individual (redditor SirT6) chose to look at NIH funding and disability-adjusted life years (logarithmic) to compare some of the top diseases that get funding compared to their impact on lifespan.

I think both measures in the above chart are flawed in that NIH funding is a poor indicator of where the general public is donating and also it is nearly impossible to compare the suffering and impact of each individual disease through adjusted life years.

Instead I chose to identify the largest charity for each of the top 15 diseases that kill people in the US (excluding #5 unintentional accidents) based on the 2011 National Vital Statistics Report from the Centers for Disease Control (CDC). A few charities took on multiple diseases, such as the American Heart Association (AHA) working on heart disease (#1) and stroke (#4) or the American Lung Association (ALA) covering lower respiratory disease (#4), pneumonia (#8), and lung inflammation (#15). By searching the most recent IRS Form 990 from each charity I looked at their Total Revenue (fiscal year) as well as the percent of the Total Revenue that came from Contributions (fundraising, grants, etc.). I figured this gives the best indication of where both individuals and other foundations or nonprofits are giving their donations. I then compared each disease/ cause of death in its “per 100,000” prevalence rate.

The size of the bubble represents the percentage of total revenue that comes from donations. The big take away here is that some of the most deadly diseases are getting larger amounts of funding. However, there are a handful of diseases that definitely aren’t getting enough (i.e. Septicimia), but are three times as deadly as ALS. Lung diseases really aren’t getting a lot of donations, but seem to remain highly funded regardless. In my research for this I was surprised to find that HIV/AIDS per 100,000 rate is less than ALS at 2.5. In particular areas, such as Detroit, HIV/AIDS is a much larger problem, but it is good to see that advances in treatment and prevention have lowered the national rate.

The majority of charities depend on contributions and donations to fund their efforts, pay salaries, and cover expenses. It is difficult to say what percentage is used for prevention activities or for finding a cure, but very obviously not all diseases are funded equally. Likewise, not all diseases contribute to the deaths of people at the same rates. Does that mean some should get more funding over others?

the impact of conflict on health

Health

The correlation between violent conflicts and health may seem to be very obvious, but there is more to the issue than what crosses the mind. Everyone can make the simple connection that there is direct impact of conflict on being unbenefittal for the betterment of health. For example it is easy to read this <a href="http://news.bbc.co.uk/2/hi/africa/6590965.stm
“>article and see the obvious connection to artillery shells hitting a hospital in Mogadishu. Internal clashes and conflict creates a more difficult situation for humanitarian operations all over Africa.

Africa represents the highest rates of internal conflict and disease, especially HIV/AIDS. This disease has been used as a weapon in conflict. Many times infected soldiers are sent to the front lines to spread disease and infect the opposition, which generally turns out to be the innocent population. Populations affected by armed internal conflicts end up experiencing severe public health consequences from food insecurity, displacement, and combat. All this ends in a collapse of basic health services which are essential to the survival of the population.

I could not find the article again, but the BBC had reported on the difficulties faced by those bringing humanitarian aid to Darfur, Sudan. They constantly faced issues with the government shutting areas down or denying them entrance. infrastructures for basic health, or created systems for basic health become neglected or destroyed. In many cases the impact of conflict can be felt at the very lowest levels of a population; women are unable to protect their families, fathers just might not be present anymore, children have no access to schooling, and everyone suffers from an absence of basic health – no food, no medications, no stable doctors, and no way to deal with the injury inflicted by the violence of conflict.

With the renewed peace talks for Uganda, the twenty year civil war seems to be coming to a close and the health of the northern Ugandan population may be improving. The rebuilding effort is going to be long and difficult, but there is hope. Many organizations are beginning efforts to improve the health situation and support hospitals and health centers that have been impacted by the conflict.

There are so many topics that can be covered as a result of conflict in a country and its correlation to health. However, I am not here to expound all of the information available, but know that it is out there: sexual violence, psychological impact on children, and especially the toll on health workers. Conflict impacts health plain and simple, but there is so much more as the impact trickles down to the population, the families, and the children. The future of a country in conflict lies in its ability to rebuild and provide aid to their populations after conflict.

a phamaceutical not bent on profit?

Health

Do you see it there on the horizon? Hope is dawning and the situation seems to be less grim in this radiating light. Diseases run rampant in Africa, plan and simple, there is no health infrastructure to deal with the burden of preventable diseases. Meningitis for example can kill a child in Africa in less than six hours, while we can sit here in our ‘developed’ world knowing that the vaccination is right around the corner office.

The largest drug company in Europe, GlaxoSmithKline (GSK) announced a new drug for sole use in Africa to fight meningitis. The drug will be introduced with prices that will never have potential to cover the research or production costs. Experts and critics see this as a huge change in big companies changing their business practices to be more compassionate. Some critics say it isn’t enough, but I’d say this is an enormous and important positive step in the right direction. The company does not expect to make a profit. In a quote from the BBC article: “We have found a pretty clever way to fund therapeutic solutions for the developing world without essentially sacrificing the more traditional research we do on diseases around the world,” said the GSK chief executive Jean-Pierre Garnier.

This new approach comes about as last year big companies tried to sue South Africa over its purchase of cheaper, generic drugs to combat diseases. From the public outcry the big companies decided to back down amidst a PR disaster and the knowledge that their current practices were not going to cut it. They had to come to the realization that the old way of conduction business had to change. Now big firms are partnering with smaller firms in India and China and they are researching the ‘neglected diseases.’

This is an amazing positive in the way of saving lives. Changing the way companies do business can save lives. Currently four out of the twelve major companies have centers focusing on major diseases like HIV/AIDS, Tuberculosis, and Malaria. This is seen as the first big step following a number of small steps in the direction of doing something more for the ‘developing’ world.