Banishing the burden

Reducing the burden of disease globally and in the United States will require a shift from spending vast amounts treating preventable diseases to actually preventing those diseases in the first place, according to Monday morning’s special session “Reducing the Global Burden of Disease,” where the U.S. surgeon general and health minister of Taiwan discussed the challenges and opportunities in embarking on such an endeavor.

Panelist Chris Murray, professor of global health at the University of Washington, noted that large increases in global health funding is now leading to slow progress in achieving health priorities, which vary greatly among developed versus developing nations. Still, around the world the proportion of noncommunicable disease is growing.

“This epidemiological transition is much further along than even some in global health realize,” Murray said.

Acting U.S. Surgeon General Rear Admiral Steven Galson outlined his education and health promotion priorities for reducing underage drinking, eliminating health disparities, and preventing and reducing childhood obesity. Galson called on his fellow public health workers to improve the environments that contribute to obesity, saying that one way we can do so is via “nontraditional public health practitioners” who work on agriculture and transportation policies.

“We really need to change the way we think about public health…chronic disease prevention should be our number-one priority in the United States,” Galson said.

Improving our health care system to make it value-driven and accountable is also an important goal. Americans have more information about the cars they purchase than about their health care plans, Galson said.

Ching Chuan Yeh, minister of health in Taiwan, spoke about the successes of Taiwan’s national health insurance program, which was implemented in 1995. Offering subsidies to lower-income residents is a significant feature of the program, which stresses equity and accessibility. Yeh noted that despite far less spending and resources than the United States, life expectancies and infant mortality rates are comparable to those in America.

Clearly, there is still much to be done worldwide to improve the health status of populations with diverse risk factors. Luckily, Murray outlined four approaches to reduce the global burden of disease: (1) develop new diagnostics, vaccines, drugs and procedures; (2) increase investments in public health and medicine, and increase health system efficiency; (3) improve ways to measure progress; and (4) expand interventions to treat and prevent infectious diseases such as HIV, TB and malaria.

— P.T.