Famous blog discusses GLOBAL HEALTH CARE - Challenges and solutions

USA has spent 17.9% of its GDP in the year between 2009 and 2013.

13 FEBRUARY 2014, PARK AVENUE, NEW YORK
Summary
In term of percentage of Gross Domestic Product spent on health globally, each countries has spent a tremendous amount of money on health, just mention few, ranging from Afghanistan which had spend 9.6% of her GDP on health, Austria 10.6%, south Africa 8.5%,spain 9.4%, UK 9.3% and USA 17.9% in the year between 2009 and 2013 just to mention few countries.

Introduction

Global health care is talking about the health of the world population and this transcends the perspectives and concerns of individual countries. In global health, problems that surpass national borders or have impact globally on politics and economic, are often emphasized. This has been defined as the area of study, research and practice that places priority on improving health and cheaving equity in health for all people in the world. Therefore, global health is all about worldwide improvement of health, reduction of disparities, and protection against global threats that has no respect for national borders.

The main or major international agency for health is the world health organization (WHO). There are other important agencies that has impact on global health activities are UNICEF, world food program (WFP), and the world bank.

The history of global health care can be dated far back as in the 19th century, when the major discoveries were made in medicine and public health that has come to influence the field of global health. The broad street cholera outbreak of 1854 was the central to the development of modern epidermiology. The microorganisms responsible for malaria and tuberculosis were discovered in 1880 and 1882 respectively. The 20th century witnessed the development of preventive and curative treatments for numerous diseases, among are the BCG vaccine and penicillin in the 1920s. The eradication of smallpox, with the last naturally occurring case recorded in 1977, hope was raise that other diseases could be eradicated as well.

Important moves were put in place towards global cooperation in health with the birth of United Nations (UN) and World Bank Group in 1945, after World War II.

In 1948, the member states of the infant United Nations then gathered together to form the World health organization (WHO). 20,000 lives were taken in Egypt in 1947 and 1948 as a result of a cholera epidemic help to catalyst the international community to action. The WHO published the concept of essential medicines in 1977 and it was also mentioned in the 1978 Alma Ata declaration which underlined the importance of primary health care.

Year 2000 witnessed another declaration by the United Nations summit, member nations declared eight (8) millennium development goals (MDGs) reflecting major challenges facing human development globally, to be achieved by 2015. Three of the eight MDGs focus explicitly on health, while others address wide social conditions. Across all goals, there are eighteen targets, supported by 48 health indicators. The declarations have matched by unprecedented global investment by donor and recipient countries. The UN reported on July 2, 2012 that several MDG targets have been met ahead of 2015 timeline.

Measurement of global health includes the collection of health indicators proceed by analysis of same to draw conclusion. Several measures exist: disability-adjusted life year (DALY), quality-adjusted life year (QALYs), and mortality measurements. The choice of measures can includes practical and ethical considerations.

Life expectancy is a statistical measure that measures the average life span (average length of survival) of a specified population. Sometimes refers to as the expected age to be reached before death for a given human population (by nation, by current age, or by other demographic variables). It may also be refer to as the expected time remaining to live, and it can be calculated for any age or for any group.

The measure which is the summary that combines the impact of disability, illness and mortality on population health is refer to as disability-adjusted life year (DALY). The time lived with disability and the time lost due to premature mortality was combines together in one measure by the DALY. A single DALY can be thought of as one lost year of healthy life and the burden of disease as a measurement of the gap between an ideal situation where all lives into old age free of disease and disability and the current health status. Let take for example, DALYs for a disease are the sum of the years of life lost due to premature mortality (YLL) in the population and the years lost due to disability (YLD) for incident cases of the health condition. One full year of full health equivalent is represented by one DALY.

QALYs are a way of measuring disease burden including both the quality and the quantity of life lived, as a means of quantifying in benefit of a medical intervention. The QALY model needs utility independent, risk neutral, and constant proportional tradeoff behavior.QALYs attempt to combine expected survival with expected quality of life into a single number: if an additional year of healthy life expectancy is worth less than a year. QALY calculations are based on measurements of the value that individuals place on expected years of survival. Measurements can be made in numerous ways: by methods that duplicate gambles about preferences for alternative states of health, with surveys or analyses that deduce willingness to pay for alternative states of health, or through instruments that are based on trading off some or all likely survival time that is medical intervention might provide in order to have less survival time of higher quality. QALYs are useful for utilitarian analysis, but does not in itself incorporate equity considerations.

Of the 57 million global deaths in 2008, 36 million, or 63%, were due to NCDs, principally cardiovascular diseases, diabetes, cancers and chronic respiratory diseases. As the impact of NCDs increases, and as populations’ age, annual NCD deaths are projected to continue to rise worldwide, and the greatest increase is expected to be seen in low- and middle-income regions. While popular belief presumes that NCDs affl ict mostly high-income populations, the evidence tells a very different story. Nearly 80% of NCD deaths occur in low-and middle-income countries and NCDs are the most frequent causes of death in most countries, except in Africa. Even in African nations,

NCDs are rising rapidly and are projected to exceed communicable, maternal, perinatal, and nutritional diseases as the most common causes of death by 2030.

Child and infant mortality

Life expectancy, DALYs and QALYs represent the average disease burden well. Although, infant mortality and under-five child mortality are more specific in representing the health in the poorest parts of the population. Therefore, any changes to the classic measure are especially very useful when focusing on health equity. When it comes to advocates of children’s rights they are also important. About 56million people died in 2001. Of these, 10.6 million were children under 5 years of age, 99% of these children resides in low-and middle-income nations. These means roughly 30,000 children dies every day.

Morbidity

Morbidity refers to measures that include incidence rate, prevalence and cumulative incidence. Incidence rate is the risk of developing some new condition within a specified period of time. However, sometimes loosely expressed simply as the number of new cases during some period, it is much better expressed as a proportion or a rate with denominator.

Mortality and morbidity data reveal the growing and disproportionate impact of the epidemic in lower resource settings. Over 80% of cardiovascular and diabetes deaths, and almost 90% of deaths from chronic obstructive pulmonary disease, occur in low- and middle-income countries. More than two thirds of all cancer deaths occur in low- and middle-income countries. NCDs also kill at a younger age in low- and middle-income countries, where 29% of NCD deaths occur among people under the age of 60, compared to 13% in high-income countries. The estimated percentage increase in cancer incidence by 2030, compared with 2008, will be greater in low- (82%) and lower-middle-income countries (70%) compared with the upper-middle- (58%) and high-income countries (40%).

Cancer: Cost-effective interventions are available across the four broad approaches to cancer prevention and control: primary prevention, early detection, treatment and palliative care. Early diagnosis based on awareness of early signs and symptoms and, if affordable, population-based screening improves survival, particularly for breast, cervical, colorectal, skin and oral cancers. Some treatment protocols for various forms of cancer use drugs that are available in generic form. In many low- and middle-income countries, access to care, oral morphine and staff trained in palliative care are limited, so most cancer patients die without adequate pain relief. Community- and home-based palliative care can be successful and cost effective in these countries.

Diabetes: At least three interventions for prevention and management of diabetes are shown to reduce costs while improving health. Blood pressure and glycaemic control, and foot care are feasible and cost-effective interventions for people with diabetes, including in low- and middle income countries.

Health conditions

The major diseases and health conditions prioritized by global health initiatives are sometimes group under the term “diseases of affluence” versus “disease of poverty”, although the impact of globalization are increasingly blurring any such distinction.

Respiratory infections

Infections of the respiratory tract and middle ear are the main causes of morbidity and mortality worldwide. Some of the respiratory infections of global significance include measles, tuberculosis, influenza and pneumonias caused by pneumococci and Haemophilus influenza. Crowded conditions assist the spread of respiratory infections, and poverty is associated with more than 20-fold increase in the relative burden of lung infections.

Diarrheal diseases

Diarrhea is the second most common cause of child mortality worldwide; it is responsible for 17% of under-5 deaths worldwide. The transmission of bacterial and virus through water, food, utensils hand and flies are increased by poor sanitation. Oral rehydration therapy (ORT) can be use effectively to treat dehydration due to diarrhea with dramatic reduction in mortality. Major cause of severe diarrhea is rotavirus and death is children. Hygienic measure alone may not effectively prevent rotavirus diarrhea, the use of safe and potentially cost-effective vaccine is advised.

Maternal health

Pregnancy complications and childbirth are the leading causes of death among women of reproductive age in numerous developing nations. It is reported that one woman dies as a result of complication from childbirth approximately every minute. According to world health organization’s world health report 2005, poor maternal conditions are the fourth leading cause of death for women globally, after HIV/AIDS, malaria, and tuberculosis. Majority of maternal deaths and injuries are preventable and have been largely eradicated in the developed nations.

Cutting back on the vital health and educational services ----structural adjustment

Some economics policies. Such as structural adjustment programs (SAPs), enforced by the International Monetary Fund’s and World Bank for decades on poor countries of the world had a disastrous implications on health. SAPs were designed as an economics measure to promote fiscal austerity for poor countries that was burdened with heavy debts repayment to the rich countries. Economies were restructured to ensure debt repayment to the rich countries, but this meant reducing the standard of living for the people. Cost of food, health services, education and other critical functions went up as important subsidies and other such programs were removed

In terms of health, services were reduced or totally removed, and now health care was either unavailable for the poor in many parts of the world, or is too expensive. As at then 1 billion people lack access to health care.

One study in Bangladesh found that a child whose mother dies has only a 24% chance of living to age 10, while a child whose mother survives has an 89% chance of remaining alive; indeed, neonatal conditions are by far the leading cause of death for children under five years old. There is a direct correlation between country infrastructure and maternal mortality rates. Nearly all maternal deaths (99%) occur in developing countries, 87% occur in sub-Saharan Africa and South Asia, and 65% occur in 11 countries – Afghanistan, Bangladesh, the Democratic Republic of the Congo, Ethiopia, India, Indonesia, Kenya, Nigeria, Pakistan, Sudan, and Tanzania.

HIV/AIDS

Human immunodeficiency virus (HIV) is transmitted by having unprotected sex with an infected person, unclean needles and blood transfusions or from mother to child during birth or during breastfeeding. Globally, HIV is primarily spread through heterosexual intercourse. The infection damages the immune system; as a result it leads to acquired immunodeficiency syndrome (AIDS) and finally, death. HIV is minimized and life is prolonged and delays the onset of AIDS by the administration of antiretroviral drugs.

A cure for HIV/AIDS has not been found for almost 30years of research. First treatments focused attention on antiretroviral drugs that were effective to a certain degree. The US approved The first drug, which is zidovudine, in 1987, this leads to approval of a total of 25 drugs to date, numerous of them are available in fixed-dose combinations and generic formations for use in resource-limited settings (only zidovudine and didanosine are available as true generics in the USA).HIV/AIDS treatment were revolutionized in the mid- 1990s when the class of drugs known as protease inhibitors and the introduction of triple-drug therapy was introduced. The era of active antiretroviral therapy (HAART) was launched, and three or more combinations of different classes of drug are administered simultaneously. Tremendous success was recorded especially in the developed world as a result of using HAART regimen in improving the expectancy and quality of lives for patients. However, there was some serious side effect with the HAART regimens and in all cases, HAART has to be taken for a lifetime, with daily dosing of one or more pills. Failure of the treatment was also recorded due to some patients developing resistance to certain combinations of drug. Due to the absence of complete cure under the current treatment, great need for continued efforts in seeking innovative approaches for HIV/AIDS treatment.

Vaccines are the most effective agents in addition to treatment for the preventive strategies for the best way to fight the global infections. Historically, vaccines had been the most effective at controlling other major infectious diseases like measles, rubella, polio, mumps and smallpox which had been completely eradicated. There have been enormous efforts to develop a safe and effective vaccine for HIV/AIDS.

Although, the task has been very daunting so far, with the recent failure of clinical trials for major candidate vaccines. This has prompted a debate over which way to take in HIV/AIDS vaccine research. Despite the debate, it is very convincing that a novel approaches for identifying new antigens and adjuvant as well as better system of delivery are important. The development of effective intravaginal microbicides that can be used by women is another preventive strategy that has been under investigation. The understanding and the design of technologies for microbicide development had been witnessing a remarkable progress. However, recent clinical trials failed to show efficacy, indicating the need for more research and development to design better systems.

The new discipline of science and engineering that is advancing many areas of medicine is the nanotechnology. It has to do with the understanding, design, engineering and fabrication of materials at the atomic and molecular level. Nanotechnology was defined as the study of structure with roughly 1-100 nm in size at least one dimension but structures up to several hundred nanometers are also considered under nanotechnology application by the national nanotechnology initiative. The application of nanotechnology to medicines, which are commonly referred to as nanomedicine, involves the use of nanoscale materials for preventive, therapeutic and diagnostic purposes. Over the last few decades, there have been major advances in nanomedicine, particularly in cancer diagnosis and therapy. At an earlier stage, application of nanotechnology for the prevention and treatment of HIV/AIDS have also gained attention in recent years. There exist emerging novel approaches in which nanotechnology can enhance present treatment as well as advance new therapeutic strategies, such as gene therapy and immunotherapy. There exist some nanomaterials with therapeutics effect by themselves.

The major role in preventive strategies for developing vaccines and microbicides can be play by nanotechnology. The discussion of potential of nanotechnology in improving the current treatment, advancing new therapeutic strategies as well as providing alternatives in the quest for vaccine and microbicied development for HIV/AIDS is carried out in this review.

The treatment of HIV/AIDS currently

The treatment of HIV/AIDS currently is HAART, Where three or more antiretroviral drugs are administered to patients simultaneously. The drugs used in combination are in most cases from different classes that work based on different mechanisms. Despite the tremendous success with the current HAART treatment for the deadly virus, there are still numerous challenges remaining. The major obstacle has been the failure of the treatment, typically due to poor patient compliance. Patients usually failed to adhere to the constant schedule of the treatment, resulting to ineffective drug levels in the body and rebound of viral replication this is as a result of the need for the daily intake of the medication for a lifetime. There are cases of virus developing resistance to a particular combination of drugs even with good adherence. The high genetic diversity of HIV-1 and the continuous mutation it undergoes are the main causes of drug resistance. The problems is being tackle with individualized therapy, each patients undergo the resistance testing and a selection of a combination of drugs that is best effective for them are performed. In addition, toxicities of the drugs are parts of the concerned side effects. There are reports that patients undergoing the treatment of HAART experiences increased rates of heart diseases, diabetes, liver disease, cancer and accelerated aging. Most experts agree that these effects could be due to HIV infection itself or co-infection with another virus, like hepatitis C virus resulting in liver disease. It could also be as a result of the toxicities from the drugs used in HAART. The eradication of the virus from the body has not been possible under the current treatment. The major argument or causes of this is that the virus resides in “latent reservoirs” with memory CD4+ T cells and cells of the macrophage-monocyte lineage. A major study recently found that, in addition to acting as latent reservoirs, microphages significantly contribute to the generation of elusive mutant viral genotype by serving as the host for viral genetic recombination. The cells that harbor latent HIV are typically concentrated in specific anatomic sites, such as secondary lymphoid tissue, testes, liver, kidney. Lungs, gut and the CNS. The eradication of the virus from such reservoirs is very critical to the effective longterm treatment of HIV/AIDS patients. It is very pertinent to explore new approaches for the developing of nontoxic, lower dosage treatment modalities that will provide more sustained dosing coverage and effectively eradicate the virus from the reservoirs, avoiding the need for lifetime treatments completely.

The treatment of HIV/AIDS with nanotechnology

Nanotechnology for antiretroviral drug delivery

The adoption of nanotechnology platforms for the delivery of drugs is revolutionizing medicine in numerous aspect of disease treatment. Patients who suffer from cancer related have been the biggest beneficiaries of this revolution so far, with significance advancement in the last few decades. Numerous nanoscale systems for the systemic cancer therapy are either FDA approved or in clinical trials. The tremendious success has been due to the unique features that nanotechnology impact on drug delivery systems. The use of nanotechnology has made it possible to achieve improved delivery poorly water-soluble drugs, targeted delivery of drugs to specific cells or tissues and intracellular delivery of macromolecules.

There could be similar advantages for nanotechnology- based platform for systemic delivery of antiretroviral drugs. Controlled-release delivery systems can enhance their half-lives, keeping them in circulation at therapeutic concentrations for longer periods of time. This could possess major implications in improving adherence to the drugs. Nanoscale delivery systems also enhance and modulate the distribution of hydrophobic and hydrophilic drugs into and within different tissues because of their small size. This particular characteristic of nanoscale delivery systems appears to hold the most promise for their use in clinical treatment and prevention of HIV.

HIV/AIDS prevention and Nanotechnology

Vaccine delivery

Since the discovery of the disease which is going to about three decades now, the search for safe and effective HIV/AIDS vaccine has been challenging. Recently, high- profile clinical trial failures have prompted great debate over the vaccine research, with some suggestion that the need for a major focus on fundamental research, with fewer efforts on clinical trials.

The major obstacle in the development of a preventive HIV/AIDS vaccine have been the extensive viral starin and sequence diversity, viral evasion of humoral and cellular immune responses, coupled with the lack of methods to elicit broadly reactive neutralizing antibodies and cytotoxicT cells. For the generation of T cells responses, protein must be enter into APCs(like DCs) where peptides are processed and loaded into MHC molecules for presentation to CD4+ T cells(extracellular antigen in MHC class II) and CD8+ T cells(intracellular antigen in MHC class I). the requirement of the exogenous antigen specialized ‘cross- presentation’ in order to be presented by MHC class I and CD8+ cytotoxic T cells are the challenges associated with any exogenous antigen (such as nanoparticles) to APCs. HIV intracellular vaccine also face yet another obstacle as a result of the requirement for cytosolic delivery of the antigens and cross presentation, potentilally an advantages of nanodelivery. Humoral responses (neutralizing antibodies produced by B cells) are generated to intact antigen available on the surface for the virus, or nanoparticles, but these humoral responses typically require “assistance” from CD4+ T cells, and thus the challenge is not to achieve either a single cellular or humoral response, but rather both.

WHO and global health care

Global health coverage is one of the new strategic priorities for WHO. Its combines two fundamental components: access to the services (promotion, prevention, treatment and rehabilitation) is needed to achieve good health: with financial protection that prevents ill-health from leading to poverty. Global health coverage is very importance from a health governance perspective in two ways. At nationals level it represents a goal that is relevant to all nations as they seek to strengthen or reform their health systems. Also, in the debate about how to position health in the post 2015 agenda, it provides the potentials to be a unifying goal, combining concerns about completing the work on the current Millennium Development Goals, and during the same period accommodating the need to address non communicable diseases and other causes of ill health.

WHO’s role in health governance, also take the form of negotiation of international instruments needs to be linked to capacity building in countries. An international health regulation (2005) is an evidence of such role. The key legal instrument required to achieve collective health security is provided by the regulation. The impact of the regulation depends on all the nations to be able to meet the capacity requirement needed to detect report and take necessary action on any new or emerging threat of international public health concerns. In the same vein, WHO also work on increasing access to medical products which had been influenced by several international agreements which include the Doha declaration on agreement on trade-related aspects of intellectual property rights and public health, also the subsequent global strategy and plan of action on public health, innovation and intellectual property. Other governance processes are still ongoing on substandard/falsely-labeled/spurious/counterfeit/falsified medical products, and also the report of the consultative expert working group on research and development: financing and coordination are been follow up. As in the aspect of the regulations, the full impact of governance decisions will depend largely on building or strengthening the institutions at country and regional level are required in order to practicalise the agreements.

The WHO is financed by contributions from member states and outside donors. As of 2012, the largest annual assessed contributions from member states came from the United States ($110 million), Japan ($58 million), Germany ($37 million), United Kingdom ($31 million) and France ($31 million). The combined 2012–2013 budget has proposed a total expenditure of $3,959 million, of which $944 million (24%) will come from assessed contributions. This represented a significant fall in outlay compared to the previous 2009–2010 budget, adjusting to take account of previous underspends. Assessed contributions were kept the same. Voluntary contributions will account for $3,015 million (76%), of which $800 million is regarded as highly or moderately flexible funding, with the remainder tied to particular programmes or objectives.

In recent years, the WHO's work has involved increasing collaboration with external bodies.As of 2002, a total of 473 NGOs had some form of partnership with WHO. There were 189 partnerships with international non-governmental organization (NGO) in formal "official relations" – the rest being considered informal in character. Partners include theBill and Melinda Gates Foundation and the Rockefeller Foundation.

Tackling global health challenges

Around Dec. 2013, world leaders and policy makers gathered in Doha and discussed on innovative solutions to the most pressing global health challenges at the inauguration of World Innovation Summit for health (WISH).

The summit showcased a practical range of recent innovations from around the world which includes technological advances, new business models and design-based solutions covering health issues as diverse as mental health, obesity, accountable care, big data and healthcare, antimicrobial resistance, end of life care, road traffic injuries and patients engagement.

Delegates at the summit heard from distinguished keynote speakers including Simon Stevens, global health division president, united health group; Daw Aung San Suu Kyi, Chairperson of Myanmar’s National League for Democracy; Mayor of London in person of Boris Johnson; and John Dineen, CEO and President of GE Healthcare.

Boris Johnson Mayor of London at the summit said that “there are numerous health issues that are of global significance, but every nations around the world also faces its own set of challenges. Bringing together key international leaders is a great opportunity to exchange ideas and learn from excellent and innovative work elsewhere”.

Research and Sciences (Multinational Pharmaceutical and The Poor)

Thebig pharmaceutical companies have created enormous uproar in recent years when they tried to block poorer nations attempt to deal with various health crises. One of such is the case of South Africa and cheaper generic drugs. The big pharmaceutical association, PhRMA (Pharmaceutical Research and Manufacturer of America), and other large companies had intensely lobbied the, then US Vice President, Al Gore, in 1999, to threaten South Africa with trade sanctions for trying to develop cheaper, generic drugs to tackle AIDS. It was claimed that world trade organization (WTO) have power regarding patents and intellectual property if violated.

There was no violation. As problematic as the WTO rules have been in this area, provision was made available in the rules allowing generic drugs to be created for emergency situations and public, non-commercial use.

When CIPLA, an India‘s leading generic company offered the dose of anti-retroviral drugs for AIDS at $350 yearly, compared to $10,000 from the multinational companies, the situation sent a shockwave in two ways . The poor countries realized they could have more affordable means to tackle their massive health crises that afflict them the most; and the multinationals saw their monopolized prices are in danger and are severely threatened, and exposed.

The patents laws in India allowed the production of cheap generics. For example, CIPLA offered the low-cost price for their AIDS drug at a loss for itself, because they said, it made profits from other drugs, and at the same time their phenomenon was not about profit and loss. Although, India’s patent law has been under pressure from the rich countries for a long time now. Their patents laws were tightened up in the early 2005, to inclined with WTO laws, and creating cheaper alternatives less production. It is not only India that will benefit from this but also a large majority of the world that depend on India for generic industry.

There are numerous cases of such where the big multinational will be pressurizing the poor and smaller countries when the issues of cheaper generic drugs are concerns. From Brazil in 1999 to Canada, Britain, and African nations as well just to mention a few.

Global health initiatives

Right from year 2000, a great number of global initiatives have been set up to deal with various global health crises. To their credit, the big pharmaceutical companies have been actively involved in those initiatives too.

A lot of mega- rich individuals, like Bill gates, Warren buffet have all shown incredible charity spirit by donating hundreds of millions of dollars to numerous initiatives across the world. However, some of the donations from people like Bill Gates are not without their own criticisms for other motives.

“Private charity is an act of privilege, it can never be a viable alternative to state obligations” said Dr James Obrinski, of the organization Medicens Sans Frontieres, in Dhaka at the people’s Assembly…….. In a nutshell, industry and private donations are good, short-term interventions and no substitute for the vastly larger, and essentially political, task of bringing health care to more than a billion poor people worldwide.

The creation of global fund to fight AIDS, TB and Malaria at the urging of UN Secretary General, Kofi Annan, in 2001. It was supposed to be the largest fund set up to deal with these global health issues. However, it has suffered greatly from poor funding, slow distribution, and other political hindrances, from some of the richest nations like US that would prefer to have their own initiatives so that they have more control over where the money goes.(the global fund is supposed to be a fund where nations donates without any strings attached). The PEPFAR (President’s Emergency Plan for AIDS Relief) was prefer as the international HIV and AIDS charity AVERT criticize.

Technology and global health care

An investment of £7.5 million will be carried out by the technology strategy board in the development on in vivo clinical imaging and non-invasive detection technologies which will enable the detection of characterization of human diseas to stratify patient subgroups for treatment selection and improved treatment outcomes. The competition addresses key objectives from the UK stratified medicine roadmap to advance the use of biomarkers and related technologies for earlier detection of disease that will meet regulatory standards.

The Technology Strategy Board's Stratified Medicine Innovation Platform (SMIP) seeks to build on the UK's strength within the global healthcare industries and put it at the centre of the next generation of medicine. Its seven partner organisations will together invest around £200m over 5 years in the area of stratified medicine.

To support its vision of eradicating cancer in the United Kingdom, cancer research UK,the world’s largest not for profit cancer research organization, will be working with oracle health science translational research center as the foundation for a new analytical environment that will assist the charity combine the genetic and clinical data from it stratified medicine programme. Together with AstraZeneca, Pfizer and the UK government's Technology Strategy Board, Cancer Research UK is working to demonstrate a national service that will provide standardized, high-quality and cost-effective genetic testing of tumors linked to clinical data

Also the mission to research, teach, and heal, charite Berlin, the biggest university hospital in Europe, provides 150,000 inpatient and 600,000 outpatient treatment per year. The hospital’s 3,800 doctors and scientists are committed to the highest levels of healthcare and research – and the organization is equally committed to providing the accurate, timely reports and analysis required for success

Charité already has a mature analytics program. This enables them to think creatively about how they use patient data, medical records, and study results within their business. Researchers wanted to look at millions of data points and ask questions in a flexible reporting environment – and they wanted to make their in-house analytics systems as fast and easy to use as a Google search. To make this possible, the hospital invested in SAP in-memory technology designed to harness the big data associated with medical records. Already, more than 600 users are taking advantage of the technology.

HEALTH INFORMATION FLOWS

Improving data collection is a good first step in creating health systems with data that flows to appropriate points in the network and informs effective decision-making. Peter Byass argues that better data collection will lead to better health policies and health outcomes. 15 In particular, the use of ICTs creates efficiencies in data collection as well as improves health information flows and data quality. This allows timely and accurate depictions of disease burdens and resource flows, enabling policy makers to effectively allocate limited resources.

Rapid identification of clinical trial candidates

Charité now uses the SAP HANA Oncolyzer to analyze data merged from its cancer and medical admin databases to find the best candidates for each new trial. The Oncolyzer searches and examines information such as tumor types, gender, age, risk factors, treatments, and diagnoses – to find the best candidates based on the study criteria. In the future, when DNA is added to the data set, the Oncolyzer will analyze up to 500,000 data points per patient. Both structured and unstructured data is analyzed, accelerating the identification process greatly – and giving Charité a competitive advantage over other prospective research partners.

Oracle has also a forum discussing flight against cancer.  Moffitt Cancer Center has gone live with its next-generation health and research informatics (HRI) platform, built on Oracle Health Sciences solutions. In early deployment, the new platform enables Moffitt to accelerate clinical trial patient recruitment and advance personalized medicine. This is a great article to read. Oracle health science solution is a good topic to read. Also SAP healthcare solution is a  good read. 

Further the CIO.com posted an interesting article around " How Wi-Fi and Wireless Data-Sharing Cures Patients’ Ills" 

Global Health care data

In term of percentage of Gross Domestic Product spent on health globally, each countries has spent a tremendous amount of money on health, just mention few, ranging from Afghanistan which had spend 9.6% of her GDP on health, Austria 10.6%, south Africa 8.5%,spain 9.4%, UK 9.3% and USA 17.9% in the year between 2009 and 2013 just to mention few countries.

CONCLUSION

Conclusively, in 1990, communicable diseases caused 59% of death and disability among the world's poorest 20%. Among the worlds richest 20%, on the other hand, noncommunicable diseases caused 85% of death and disability. A raised baseline rate of communicable disease decline between 1990 and 2020 would increase life-expectancy among the world's poorest 20% around ten times as much as it would the richest 20% (41 vs 04 years). However, the poorest 20% would gain only around a quarter to a third as much as the richest 20% from a similar increase in noncommunicable diseases (14 vs 53 years). As a result, a faster decline in communicable diseases would decease the poor-rich gap in 2020, but under an accelerated rate of overall decline in non-communicable diseases, the poor-rich gap would widen.

There is always the need to carry out researches and more spending globally and the need for the government of each countries of the world to focus and create more enabling environment and policies also the implementation of these policies especially in the low income countries which have the higher prevalence rate and are prone to these diseases. Also there is need to invest heavily on the production and invention of technology that will assist in the area of global health care and make those technologies available to the final users at reduced prizes.

About the Author

Antonio Bhardwaj is a one of the top 50 successful leaders. Antonio Bhardwaj is a great follower of President George H.W Bush & President Martin Luther King. Jr

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Quotes
" "Cancer is not a death sentence, but rather it is a life sentence; it pushes one to live."" -Marcia Smith
""When it comes to global health, there is no 'them'... only 'us.'"" -Global Health Council
""So if there is a purpose to the suffering that is cancer, I think it must be this: it's meant to improve us." " -Lance Armstrong
""Investment in AIDS will be repaid a thousand-fold in lives saved and communities held together." " - Dr. Peter Piot, Executive Director, UNAIDS
""Medical science has proven time and again that when the resources are provided, great progress in the treatment, cure, and prevention of disease can occur." " -Michael J. Fox
""There is no medicine like hope, no incentive so great and no tonic so powerful as expectations of something better than tomorrow."" Orioson Swett Marden
" "The longer I live, the more convinced I become that life is 10 percent what happens to us and 90 percent how we respond to it."" -Charles Swindall
""The moral test of government is how it treats those who are in the dawn of life . . . the children; those who are in the twilight of life . . . the elderly; and those who are in the shadow of life . . . the sick . . . the needy . . . and the disabled." " -Hubert H. Humphrey