Thinking Citizen Blog — Tuberculosis, Polio, Leprosy

Thinking Citizen Blog— Thursday is Health, Health Care and Global Health Policy Day

Today’s Topic: Global Health Milestones II: Tuberculosis, Polio, Leprosy

Last week smallpox, cholera, and malaria. Today, three more scourges whose toll has been drastically reduced from what it was in the 1950s when I was growing up. Experts — please chime in. Correct, elaborate, elucidate.

TUBERCULOSIS — Data for Western Europe, 1740–1985

  1. “By the beginning of the 19th century, tuberculosis, or “consumption,” had killed one in seven of all people that had ever lived.”

2. Globally, still 1.5 MM deaths per year — 95% in developing countries.

3. Factors behind decline in Western Europe and America: better living conditions, pasteurization, sequestration in hospitals and sanatoria (1890s -1954), the Bacille, Calmette, Guerin (BCG) vaccine, streptomycin (discovered 1943, Nobel Prize 1952), “triple therapy” (combines streptoymycin with isoniazid and PAS (para-aminosalicylic acid).

A Century of Tuberculosis | American Journal of Respiratory and Critical Care Medicine

Tuberculosis

https://www.pbs.org/wgbh/americanexperience/features/plague-gallery/

Tuberculosis vaccines

POLIO: “Apart from the atomic bomb, America’s greatest fear was polio” (in 1952)

1. US: in 1952, 60,000 children infected, 3000 died. By 1979, eradicated.

2. Vaccines: The Jonas Salk vaccine (1955) — a “dead version” by injection. The Albert Sabin (1956) — a “live version” taken orally. Superior in terms of ease of use and effectiveness. Both Salk and Sabin refused to patent their vaccines.

3. The movement for eradication of polio in the US was fueled the March of Dimes, founded by FDR in 1938, which raised more money than all other US charities combined (with the exception of the Red Cross).

NB: “A global effort to eradicate polio began in 1988, led by the World Health Organization, UNICEF, and the Rotary Foundation. These efforts have reduced the number of cases diagnosed each year by 99.9% from and estimated 350,000 cases in 1988 to a low of 483 in 2001…” There are an estimated 10 to 20 MM polio survivors worldwide.

Polio

https://en.wikipedia.org/wiki/History_of_polio

March of Dimes

LEPROSY — “Hansen’s Disease” — once feared as super contagious and devastating is now curable

1. The above map charts disability-adjusted life years per 100,000 inhabitants. Yellow is 1.5 or less. Red is 20 or more.

2. “In 2018, there were 209,000 leprosy cases globally, down from 5.2 million in the 1980s.” Current cases concentrated in India (60%), Brazil (13%), Indonesia (8%)

3. The cure: three drugs combined in a multi-drug therapy (MDT): dapsone, rifampicin, and clofazimine.

NB: The BCG vaccine (for tuberculosis) offers a “variable amount” of protection against leprosy.

Leprosy

YOUR TURN

Please share the most interesting thing you learned in the last week related to health, health care or health care policy — the ethics, economics, politics, history….

Or the coolest, most important thing you learned in your life related to health are or health care policy that the rest of us may have missed. Or just some random health-related fact that blew you away. This is your chance to make some one’s day.

Or to cement in your mind something really important you might otherwise forget. Or to think more deeply than you otherwise would about something that matters.

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