What’s the good news about global health?

1: This week we’ve been exploring the incredible medical advances against infectious diseases and the incredible increase in human health. Yesterday we looked at diseases which have been eradicated or are on the verge of eradication, including small pox, rinderpest, polio, elephantiasis, river blindness, and blinding trachoma.

But there’s more good news.

“Even diseases that are not obliterated are being decimated,” writes Steven Pinker in Enlightenment Now. “Between 2000 and 2015, the number of deaths from malaria (which in the past killed half the people who had ever lived) fell by 60 percent. The World Health Organization has adopted a plan to reduce the rate by another 90 percent by 2030… The Bill and Melinda Gates Foundation has adopted the goal of eradicating it altogether.”

2: In the 1990s the prevalence of HIV/AIDS reversed humanity’s progress in lengthening life spans. “But the tide turned in the next decade, and the global death rate for children was cut in half, emboldening the UN to agree in 2016 to a plan to end the AIDS epidemic (though not necessarily to eradicate the virus) by 2030,” Steven observes.

Beginning in the year 2000, there has been a massive reduction in the number of children dying from the four most lethal infectious diseases, including pneumonia, diarrhea, malaria, and measles. “In all, the control of infectious disease since 1990 has saved the lives of more than a hundred million children,” writes Steven.

3: As spectacular as the conquest of infectious disease in Europe and America, the continuing advances among the global poor is even more amazing. “Part of the explanation lies in economic development, because a richer world is a healthier world,” Steven observes.

The other driving factor?

“The expanding circle of sympathy, which inspired global leaders such as Bill Gates, Jimmy Carter, and Bill Clinton to make their legacy the health of the poor in distant continents rather than glittering buildings close to home,” Steven notes. “George W. Bush, for his part, has been praised by even his harshest critics for his policy on African AIDS relief, which saved millions of lives.”

The Nobel laureate, Angus Deaton “notes that even the idea that lies at the core of the Enlightenment—knowledge can make us better off–may come as a revelation in the parts of the world where people are resigned to their poor health, never dreaming that changes to their institutions and norms could improve it.”

More from Steven Pinker in weeks to come.

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Reflection: Take a moment to be grateful for the advances in medical care and resulting increase in human life

Action: Share this information with a friend or colleague.

Wealth and power are no match for what?

1: Many people believe we live in the “worst of times.”  The data shows otherwise.  

Today we continue our exploration of the many and momentous ways life has improved over the past 200 years by looking at our health.  

“For most of human history, the strongest force of death was infectious disease, the nasty feature of evolution in which small, rapidly reproducing organisms make their living at our expense and hitch a ride from body to body in bugs, worms, and bodily effluvia,” writes Steven Pinker in Enlightenment Now: The Case for Reason, Science, Humanism, and Progress.

Millions of people died because of epidemics, which wiped out entire civilizations and brought misery to local populations.  One example?  Yellow fever, a viral disease transmitted by mosquitoes, was named because its victims turned yellow before dying in misery.

Steven shares an account of an 1878 epidemic in Memphis, where those infected by yellow fever “crawled into holes twisted out of shape, their bodies discovered later only by the stench of their decaying flesh. . . . [A mother was found dead] with her body sprawled across the bed . . . black vomit like coffee grounds spattered all over . . . the children rolling on the floor, groaning.”

Wealth provided no protection against infectious disease: The wealthiest man in the world, Nathan Mayer Rothschild, died of an infected abscess, in 1836.

Nor did power: different British monarchs died from dysentery, smallpox, pneumonia, typhoid, tuberculosis, and malaria.  

American presidents were not immune: William Henry Harrison died of septic shock in 1841, thirty-one days after his inauguration.  James Polk died from cholera three months after leaving office in 1849.  In 1924, the sixteen-year-old son of a sitting president, Calvin Coolidge Jr., died of an infected blister he got while playing tennis.

2: “But starting in the late 18th century with the invention of vaccination, and accelerating in the 19th with acceptance of the germ theory of disease, the tide of battle began to turn,” Steven writes.  “Handwashing, midwifery, mosquito control, and especially the protection of drinking water by public sewerage and chlorinated tap water would come to save billions of lives.

“Before the 20th century, cities were piled high in excrement, their rivers and lakes viscous with waste, and their residents drinking and washing their clothes in putrid brown liquid,” Steven notes.

Then, in 1854, John Snow figured out that cholera-stricken Londoners were getting their drinking water from a pipe that was downstream from an outflow of sewage.  His findings brought about changes to the water and waste systems of London, which led to changes in other cities and an overall significant improvement of public health around the world.

3: The other silent killer?  Medical care itself.

Prior to the discovery of anesthesia, antisepsis, and blood transfusions, “surgery was a source of torture and mutilation as opposed to a cure,” Steven writes.

“Doctors themselves used to be a major health hazard as they went from autopsy to examining room in black coats encrusted with dried blood and pus, probed their patients’ wounds with unwashed hands, and sewed them up with sutures they kept in their buttonholes,” Steven writes.  

Then, Ignaz Semmelweis and Joseph Lister proved the importance of sterilizing hands and equipment.  The world would truly never be the same.  Doctors and nurses were transformed from taking lives to saving lives.   

More tomorrow.

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Reflection: Take a moment to be grateful for the advances in medical care and resulting increase in human life.     

Action:  Share this information with a friend or colleague.

A triumph of human well-being

1: Consider this fact: Well into the 19th century, in Sweden, one of the world’s wealthiest countries, between a quarter and a third of all children died before their fifth birthday.  And, in some years the death toll was close to 40%, Steven Pinker shares in his powerful book Enlightenment Now.

This week we are continuing our review of the incredible progress human beings have made following the Industrial Revolution.  Many people believe we live in the “worst of times.”  The data tells us otherwise.  Today, we look at infant mortality.

Our chart shows the decline in child mortality in five countries in from different continents.  What Steven refers to as the “spikiness” of the curve before 1900 shows the difficulty of life for most of human history: ” An epidemic, war, or famine could bring death to one’s door at any time.”

Tragedy struck all parts of society.  Charles Darwin lost two children in infancy and his beloved daughter Annie at the age of 10.

2: Then, something incredible happened.  “The rate of child mortality plunged a hundredfold, to a fraction of a percentage point in developed countries, and the plunge went global,” Steven notes.  The greatest innovation of the Industrial Revolution was innovation itself.  

“In sub-Saharan Africa, the child mortality rate has fallen from around one in four in the 1960s to less than one in ten in 2015, and the global rate has fallen from 18 to 4 percent–still too high, but sure to come down if the current thrust to improve global health continues.”

One counter-intuitive result of this trend is when fewer children die, parents have fewer children because they do not have to “hedge their bets against losing their entire families,” Steven writes.  

“So contrary to the worry that saving children’s lives would only set off a ‘population bomb’ (a major eco-panic of the 1960s and 1970s, which led to calls for reducing health care in the developing world), the decline in child mortality has defused it,” notes Steven.

3: And, on a more personal note: when fewer children die, human happiness increases exponentially.  “The loss of a child is among the most devastating experiences,” Steven notes.  “Imagine the tragedy; then try to imagine it another million times.  That’s a quarter of the number of children who did not die last year alone who would have died had they been born fifteen years earlier.  Now repeat, two hundred times or so, for the years since the decline in child mortality began.”

The lines on our graph represent “a triumph of human well-being whose magnitude the mind cannot begin to comprehend.”  Amen.

More tomorrow.

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Reflection:  What surprises me about the data shared above?  Why does it surprise me?

Action:  Share this information with a friend or colleague who is convinced we live in the “worst of times.”