We are not immune - a public health problem

Ronald Glasser has written an article in this month's issue of Harper's magazine on the problems with public health, mainly in the US context. The full text is available at World Health News a weekly update from Harvard.

It is an interesting read, highlighting major problems with the public health system. One paragraph is telling, "Few advances were as important as the realization that merely washing one's hands could prevent the spread of disease. Life expectancy in the eighteenth century for an average male was about thirty years; by the early 1970s, it was seventy-five years. And as Garrett points out, most of that progress occurred prior to the invention of antibiotics, and "less than 4 percent of the total improvement in life expectancy since the 1700s can be credited to twentieth century advances in medical care." Ironically, the medical revolutions of the twentieth century have contributed to our overconfident and complacent neglect of the public-health infrastructure. We spend vast sums to lengthen the lives of terminally ill patients by a few days and refuse to make modest investments that would prevent millions of needless illnesses and deaths."

Garrett refers to Laurie Garrett. "The United States has no single agency responsible for public health and thus no coherent policy. As Laurie Garrett suggests in her monumental study, Betrayal of Trust: The Collapse of Global Public Health, it is no exaggeration to say that we simply lack a public-health system per se; what we do have is best described as "a hodgepodge of programs, bureaucracies, and failings.""

Sounds so much like India, though we are much worse off.