Goal 3: Health and Well Being

Several health issues such as mortality rate, epidemics of diseases, drug abuse, sexual and reproductive health have been existed throughout the decade. Goal 3 of UN Sustainable Development Goals states “Ensure healthy lives and promote well-being for all at all ages” (UN, 2016). Multi-centric health improvement model has been necessitated to unravel existing health issues at different levels.

A number of neglected tropical diseases including buruli ulcer, chagas disease, cysticercosis, dengue fever, dracunculiasis, echinococcosis, fascioliasis, leishmaniasis, leprosy, lymphatic filariasis, onchocerciasis, trachoma and others are prevalent in low to middle income countries of Asia, Africa and Latin America (CDC, 2011; Global Network, 2015; londonntd, 2016). Intervention measures such as mass treatment, individual treatment and cure, water, sanitation and hygiene (WASH), vector control and veterinary public health have been taken against neglected tropical diseases and national elimination of NTDs was achieved by 50 countries in 2014(WHO,2016). More than 5.9 million children under 5 years old died in 2015 and target 3.2 of UN sustainable development goals aims to achieve under 5 mortality rate as low as 25 per 1000 live births by 2030 (WHO,2016).

Road traffic accidents and associated deaths and injuries has alarming trend worldwide and global health observatory (GHO) data suggests 1.25 million road traffic deaths  globally in 2013 (WHO, 2016). Minimization of road traffic accident related deaths and injuries have been taken as urgent priority by UN Sustainable Development Goals.

Environmental hazards and pollution are causing significant health damages. Water, air, and soil pollution caused about 40 percent deaths worldwide (Lang, 2007). Anderson (2015) identified carbondioxide, ammonia, chlorine, hydrochloric acid and sulfuric acid as top five hazardous chemicals causing injuries from acute chemical incidents. Approximately 6.5 million deaths have been attributed to household and ambient air pollution in 2012 (UN, 2016). Infectious diseases are likely to occur from faecal contamination of water and soil and poor environmental conditions. Reducing the deaths and injuries caused by hazardous chemicals and environmental pollution by 2030 is one of the key targets of UN Sustainable Development Goals.

Information and empowerment of sexual and reproductive health and safe reproductive system has been considered as centre of development. Universal access to sexual and reproductive health care and knowledge and education of family planning and reproductive health is addressed by target 3.7 of SDG Goals. Prevention of unintended pregnancy and reduction of adolescent childbearing has been prioritized to improve women, children and adolescent’s health (UN, 2016). Joint actions from international agencies and national governments with appropriate policy measures and actions are required to combat health sector challenges.

  

 References

Anderson, A. R.  (2015) Top Five Chemicals Resulting in Injuries from Acute Chemical Incidents- Hazardous Substances Emergency Events Surveillance, Nine States, 1999-2008. Surveillance Summaries, 64(SS02); 39-46. 

Centre for Disease Control (CDC) Neglected Tropical Diseases [Online] Available at http://www.cdc.gov [Accessed on 2016].

Lang, S.S. (2007) Water, Air and Soil Pollution Causes 40 Percent of Deaths Worldwide, Cornell Research Survey Finds. [Online] Available at http://www.news.cornell.edu [Accessed on 08 October 2016].

London Centre for Neglected Tropical Diseases Research (2016) About NTDs [Online] Available at http://www.londonntd.org [Accessed on 08 October 2016].

The Sabin Vaccine Institute (2015) The Most Common NTDs [Online] Available at http://www.globalnetwork.org [Accessed on 08 October 2016].

United Nations (2016) Sustainable Development: Knowledge Platform [Online] Available at http://www.sustainabledevelopment.un.org [Accessed on 08 October 2016].

World Health Organization (2016) Global Observatory Data [Online] Available at http://www.who.int [Accessed on 2016].

World Health Organization (2016) Water Sanitation Hygiene [Online] Available at http://www.who.int [Accessed on 2016].

Health Effects of Cadmium

Presence of cadmium in drinking water is hazardous to human health. Renal, cardiovascular, respiratory and skeletal effects have been found to be induced by cadmium exposure. Cadmium can induce renal tubular dysfunction leading to renal lesion and irreversible impairment of reabsorption capacity of renal tubules. Combine concentration of metallothionein, a cadmium binding protein, and cadmium can be found in the renal cortex of Kidneys (Queensland Health, 2002). Increased excretion of low molecular weight proteins such as B2-microglobulin and alpha1-microglobulin and enzymes such as N-acetyl-B-D-glocosaminidase (NAG) or tubular proteinuria may be caused by exposure to cadmium (Jarup, 2003; WHO, 2011). Destroyed arrangement of mineral metabolism and nutritional deficiencies are associated with accumulation of cadmium in the Kidneys (Queensland Health, 2002).

Kidney stones have been associated with cadmium. Renal damage and conditions such as hypercalciuria and hyperphosphateuria may result kidney stone (CDC, 2013). Skeletal damage, osteomalacia or osteoporosis might occur as a result of long term exposure to Cadmium (Jarup, 2003; WHO, 2011). Many cases of skeletal disease also known as itai-itai disease was reported in Japan in the 1950s due to long term exposure to cadmium in drinking water (Jarup, 2003; WHO, 2011).

Respiratory disease and bone disease could be resulted due to long term (20-30 years) accumulation of cadmium in Kidney (ICdA, n.d.). Stomach irritation, vomiting and diarrhoea could be resulted from drinking water with high levels of cadmium (Illinois Department of Public Health, n.d.; Queensland Health, 2002). Illinois Department of Public Health (n.d.) suggested the probability of low birth weight babies for women exposed to cadmium. Suppression of testicular function could be induced by Cadmium toxicity (Queensland Health, 2002).

References

Centres for Disease Control and Prevention (CDC) (2013) Cadmium Toxicity: What Diseases are Associated with Chronic Exposure to Cadmium [Online] Available at www.cdc.gov [Accessed on 09 January 2015].

Illinois Department of Public Health (n.d.) Environmental Health Fact Sheet [Online] Available at www.idph.state.il.us [Accessed on 5 January 2015].

International Cadmium Association (ICdA)(n.d.) Cadmium Exposure and Human Health [Online] Available at www.cadmium.org [Accesses on 5 January 2015].

Queensland Health (2002) Cadmium [Online] Available at www.health.gld.gov.au [Accessed on 5 January 2015].

World Health Organization (WHO) (2011) Cadmium in Drinking Water: Background Document for Development of WHO Guidelines for Drinking Water Quality [Online] Available at www.who.int [Accessed on 5 January 2015].

Ebola Virus Disease

Handling of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines has been believed to be the cause of Ebola virus infection to human population (WHO, 2014). Five identified subspecies of Ebola virus includes Ebola virus (Zaire Ebola virus), Sudan virus (Sudan Ebola Virus), Tal Forest Virus (Tal Forest Ebola virus), Bundibugyo virus (Bundi bugyo Ebola virus) and Reston virus (Reston Ebola virus), latter causing disease only in non-human primates (CDC, 2014; Paho, 2014). Ebola virus has enveloped, helical, cross striated nucleocapsid, filamentous or pleomorphologic shape that are flexible with extensive branching, 80 nm in diameter and 970-1200 nm in length (AABB, 2009).

Contact with infected person with the soiled clothing, handling of unsterilized needles or medical equipment and other physical contact with infected person are possible ways of Ebola virus infection (NHS, 2014). Virus Transmission between two persons can occur through direct contact with the blood or secretions of an infected person and exposure to contaminated objects (CDC, 2014). Virus can replicate themselves quickly to cause harmful health effects (NHS, 2014).

Sudden fever, weakness, muscle pain, headache and sore threat followed by vomiting, diarrhoea, rash, impaired kidney and liver function are common signs of Ebola virus disease (NHS, 2014; Paho, 2014; WHO, 2014). Internal bleeding from ears, eyes, and mouth may occur (NHS, 2014). Specific treatment of Ebola virus disease is not available yet however supportive care, rehydration and maintenance of oxygen status and blood pressure has been recommended (CDC, 2014; WHO, 2014). Ebola virus disease has a fatality rate up to 90%.

References
Advanced Transfusion and Cellular Therapies Worldwide (AABB) (2009) Ebola Virus [Online] Available at http://www.aabb.org [Accessed on 13 September 2014].
Centres for Disease Control and Prevention (CDC) (2014) Ebola Haemorrhagic Fever [Online] Available at http://www.cdc.gov [Accessed on 16 August 2014].
National Health Service (NHS) (2014) Ebola Virus Threat to the UK is Very ‘Low’ [Online] http://www.nhs.ac.uk [Accessed on 13 September 2014].
Pan American Health Organizations (PAHO) (2014) Ebola Virus Disease (EVD), Implications of Introduction in the Americas [Online] Available at http://www.paho.org [Accessed on 16 August 2014].
World Health Organization (WHO) (2014) Frequently Asked Questions on Ebola Virus Disease [Online] Available at http://www.who.int [Accessed on 16 August 2014).

Diabetes

Diabetes is one of the leading causes of death. According to WHO (2013), 347 million people have diabetes in the world and 80% of the disease is prevalent among populations of low and middle income countries. Twenty nine million people in UK are affected by diabetes and 850,000 people are undiagnosed patients (NHS, 2013).

Glucose, produced from carbohydrate, is used in human body cells as a source of energy. Insulin produced by pancreas, is needed in the glucose metabolism process. Cells absorb glucose from the blood in the metabolism process to produce energy stimulated by insulin [BBC, 2013]. When body cannot metabolise high amount of glucose, a condition develops known as diabetes [diabetes.org, 2012; NHS, 2013].

Diabetes can be divided into two, Type I and Type II diabetes, Type I diabetes is insulin-dependent condition where body stops producing insulin and Type 2 is insulin resistant condition where body do not produce enough insulin or cells do not react to insulin (diabetes.org, 2012; NHS, 2013]. Frequent urination, increased thirst, extreme tiredness and weight loss are common symptoms of Type I diabetes [JDRF, 2013; NHS, 2013]. Third type of diabetes is gestational diabetes.

Diabetes treatment includes reducing blood glucose levels by using medicines and subcutaneous injection of insulin. Medications such as Bignanide, Sulphonylureas, Alpha glucosidase inhibitor, prandial glucose regulators, thiazolidinediones, incretin, mimetics, and DPP-4 inhibitors are used to lower blood glucose levels [diabetes.org, 2012]. WHO (2013) suggested maintaining body weight, physically active healthy diet and avoiding tobacco use can reduce the risk of diabetes.

References

British Broadcasting Corporation (BBC) What is Diabetes? [Online] Available at www.bbc.co.uk [Accessed on 28 October 2013].

Diabetes UK (2012) Diabetes UK: Care Connect. Campaign [Online] Available at www.diabetes.org.uk [Accessed on 28 October 2013].

Juvenile Diabetes Research Foundation Ltd (JDRF) (2013) What is Type I Diabetes? [Online] Available at www.jdrf.co.uk [Accessed on 28 October 2013].

National Health Service (NHS, 2013) Diabetes [Online] Available at http://www.nhs.ac.uk [Accessed on 28 October 2013].

World Health Organization (WHO) (2013) Diabetes [Online] Available at www.who.int [Accessed on 28 October 2013].

Universal Health Coverage (UHC)

Universal Health Coverage (UHC) has been defined as a policy approach enabling easy access to health services for people of all ages, groups and financial strength. WHO (2013) explained the UHC concept as development issue where people’s ‘right to health’ is protected allowing them to access to quality health services. Financial hardship is an important issue which prevents poor people from accessing health services. According to WHO (2013), 1.4 billion people on earth are not receiving the required health services. UHC policy covers the people who cannot access health services due to their poor financial circumstances.

WHO(2013) outlined low levels of national income, weaker health systems, changing disease patterns, aging populations and high economic and social inequalities as the challenges to implement UHC. Financial weaknesses which include poor economy and poor households adversely affect health sector particularly influencing nutrition, sanitation and environmental exposure of individuals (Eloviano, n.d.; Sachs, J.D., 2012). Coverage of health services, financial coverage and population coverage has been outlined by WHO (2010 cited in Sherry et al., 2012).

Implementation of UHC in middle and low income countries has a number of barriers. However, successful implementation of UHC in Thailand was studied by Ghislandi et al (2013) where 99.5% of the population has at least one type of health insurance. Expanding and strengthening public health systems and increasing taxation power of government to create health funding  are necessary to achieve UHC goals (Eloviano, n.d.) which is supported by Sengupta (2013 ) in his study on health care system of India where private health care accounts for 80% of outpatients and 60% of in-patient care.

References

Elovainio, R. (n.d.) Improving Health Outcomes by Gearing Health Systems towards Universal Health Coverage. [Online] Available at http://www.proparco.fr [Accessed on 20 August 2013].

Ghislandi, S., Manachotphong, W. and Perego, M.E.V. (2013) The Impact of Universal Health Coverage on Healthcare Consumption and Risky Behaviours: Evidence from Thailand. [Online] Available at www.healthsystems2020.org [Accessed on 20 August 2013].

Haas, S., Hatt, L., Leegwater, A., El-Khoury, M. and Wong, W. (2012) Indicators for Measuring Universal Health Coverage: A Five-Country Analysis (DRAFT). Bethesda, MD: Health Systems 20/20 project, Abt Associates Inc.

Sachs, J. D. (2012) Achieving Universal Health Coverage in Low-Income Settings. The Lancet. Vol. 30(9845), pp. 944-947.

Sengupta, A. (2013) Universal Health Care in India: Making It Public, making It a Reality [Online] Available at www.municipalprojectservices.org [Accessed on 20 August 2013].

World Health Organization (WHO)/ The World Bank (2013) Towards Universal Health Coverage: Concepts, Lessons, and Public Policy Challenges. [Online] Available at www.who.int [Accessed on 20 August 2013].