1. Global health
Global burden of disease
Millennium goals
NAME: Shashwat Awasthie
GROUP:154A
DEPARTMENT: Public health
TEACHER: Dyusetayev didar
ASTANA MEDICAL UNIVERSITY

2. 1.Understanding Global Health
Defining Health and global health
Social Determinants of Health
The Top 10 Countries Funding the World Health
History and evolution of global health, United Nations
World health Organisation, Health for all ( Kazakhstan )
Current day reality (first, second and third worlds)
HDI, Life expectancy, Physicians/1000,Literacy rate
Poor nations, problems in global health, health gap
2.Understanding Global burden of Diseases
Why should we care ?
How to calculate GBD ?
Comparisons, Chronic Disease, Mortality statistics
Major Risk factors
3.Leading causes of Deaths (Globally)
Global Projection
Cardio vascular Diseases
Global prediction for 2004 to 2030
Index -
4.Millennium Goals
Millennium goals
report.
5.My Conclusion

3. What is Health
“A state of complete physical, mental,
and social well-being and not merely
the absence of disease or infirmity.”
WHO definition of health

4. Global Health
Refers to health problems that transcend
national borders.
• Problems such as infectious and insect-borne
diseases that can spread from one country to
another. It also includes health problems that are
of such magnitude that they have a global
political and economic impact..
Refers to health problems that are best
addressed by cooperative actions and
solutions
• global health problems can move across
national borders, Cooperation across countries is
essential to addressing those health problems
that transcend borders. This includes helping
other countries address their particular health
care crises.

5. Social Determinants of Health
Conditions of their Enviromen
Conditions in people grow, live,
work and age have powerful
influence on health
Economics
Economy can be a huge factor as
it decides “education” and
“Food”
Medical facilities
Health facilities are places that
provide health care. They include
hospitals, clinics, outpatient
care centres, and specialized
care centres, such as
birthing centres and psychiatric
care centres.

6. Top 10 Countries Funding the World Health
1. U.S.: $116M (24% of total)
2. China: $57M (12% of total)
3. Japan: $41M (8% of total)
4. Germany: $29M (6% of total)
5. U.K.: $22M (4% of total)
6. France: $21M (4% of total)
7. Italy: $16M (3% of total)
8. Brazil: $14M (3% of total)
9. Canada: $13M (2% of total)
10. Russia: $12M (2% of total)

7. Short Tour of Global health History
1978
Declaration of
Alma Ata
1970s+80s
World Health
organisation
UDHR
1945
United Nations
1948 Global
economic
recession and
structural
adjustment
2000
2001
2000
Global Fund
Drop the Debt
Campaign
Millennium
Goals
Declaration

8. The United Nations
Created in
1945
01 02
Purpose was to
maintain
international peace
and security
05
USA is the top
Contributor
04
50 nations
signed Charter
of the United
Nations
03
International
economic and
social
cooperation

9. World Health Organisation
Successes
• Smallpox
• Polio
• Tobacco
convention
Agenda
• Promoting development
• Encourage health security
• Strengthening health
systems
• Encouraging research,
information & evidence
• Enhancing partnerships
• Improving performance of
health developing
organizations
History
• First global health
organization. In later half of
19th century
• The League of Nations
established a health
organization in 1920
Work
Development and
distribution of
vaccines, medicines
and diagnostics
Aim
International efforts
to monitor/combat
infectious diseases

10. Health for All by 2000
Involves related sectors:
• Agriculture
• Animal husbandry
• Food
• Industry
• Education
• Housing
• Public works
• Communications
Alma Ata | Kazakhstan | September 1978 | Declaration of Alma Ata:
“Primary health care is essential health care…made universally
accessible…at a cost that the community and country can afford”
Components of primary health care:
• Education
• Promotion of food and nutrition
• Water and sanitation
• Maternal and child care
• Family planning
• Immunisations
• Prevention, control and
Treatment of local and common diseases
• Provision of essential drugs

11. Structural Adjustment in
Policies • Oil crisis of 70s and 80s
• Global economic recession
• Period of crisis, increased poverty and
debt for developing countries
• World Bank, International Monetary Fund
and US imposed restrictive policies
• Cuts in public spending and consumption
• Social services such as health and
education hit
• Privatisation and decentralisation
• Fee payments for health services

12. 1,146,000
The Global Fund | To fight AIDS,
Tuberculosis and Malaria, Claims
that by Jan 2007 had saved
Lives ( 3,000 a day )

13. First, Second & Third Worlds
First World
Industrialized countries
where businesses operate
independently of
governments North
America, Western
Europe, Japan and
Australia
Second world
Communist countries,
where governments plan
the economies. Russia,
Eastern Europe (e.g.,
Poland), China
Third world
Poor, less developed
countries, governments.
capitalist (e.g., Venezuela)
and communist (e.g.,
North Korea, Saudi
Arabia, Mali)

14. Health gap (2010)

15. World Ranking of health system
Shashwat awasthie

16. Very high human development

17. Low human development

18. The WHO South East Asia Region has 11 Member States

19. Human Development Index

20. Literacy Rate

21. Life Expectancy

22. Physicians /1,000 persons

23. Pvt Expenditure as % of Total Health Expenditure

24. Infant Mortality Rates
Crude Birth rate
•Rate at which children
are being born into the
population
•LDCs face a rate
around 24 per 1000
while MDCs are around
11 per 1,000

25. At Least a Third of Human Deaths
“some 18 (out of 57) million
per year or 50,000 daily —
are due to poverty-related
causes, in thousands” “diarrhea (2163) and
malnutrition (487)”
perinatal (3180) and
maternal conditions
(527),
childhood diseases
(847 — half
measles)
tuberculosis (1464),
meningitis (340),
hepatitis (159)
malaria (889)
and other
tropical diseases
(152),
respiratory infections
(4259 — mainly
pneumonia),
HIV/AIDS (2040),
sexually transmitted
diseases (128)

26. Key action areas for a global public health
Health as a global
public good
Health as a key
component of global
security
Practice and social
responsibility
Ethical principle of
health as global
citizenship.
Health as a key factor
of sound business
Strengthen global health
governance for
interdependence

27. Situation in the poor countries
● A falling life expectancy in many African countries
● A lack of access to even the most basic services
● An excess of personal expenditures for health of the
poorest;
● Health as a neglected arena of national and development
politics
● Health as a matter of survival.
● Predominant pattern is still infectious diseases
engendered by the natural environment (malaria,
tuberculosis and infant diarrhoea), as well as AIDS and
high rates of maternal deaths.
● Non communicable diseases are also beginning to plague
these regions

28. CREDITS: This presentation template was created by
Slidesgo, including icons by Flaticon, and infographics
& images by Freepik.
Some of the most important
problems in global health today
There are three broad cause
groups of health problems that,
collectively, constitute the
world's total disease burden.
• Group 1: communicable,
maternal, perinatal and
nutritional conditions;
• Group 2: non communicable
diseases;
• Group 3: injuries

29. Global Burden of Disease
01
The global burden of disease (GBD) is a
comprehensive regional and global
assessment of mortality and disability.
02 Developed in 1990 by the WHO
03
Provides information and projections
about disease burden on a global scale.
The GBD has three specific aims:

30. Why should we care ?
• Medical missionaries have been
on the forefront of health in
developing nations for 100’s of
years.
• We can enable others to live
more productive and fulfilling
lives.

31. How to Calculate GBD
● GBD = DALY + Mortality DALY = YLL + YLD
● The overall burden of disease is assessed using the disability-adjusted life year
(DALY), a time-based measure that combines years of life lost due to premature
mortality (YLLs) and years of life lost due to time lived in states of less than full
health, or years of healthy life lost due to disability (YLDs).
Comparison of the proportional distribution of deaths and YLL by region, 2004

32. Burden of disease by broad cause group and region, 2004

34. What is the leading cause of mortality

35. Chronic Disease
>80% of deaths occurred in low to middle income
countries (LMIC).
CDs responsible for 60% of all deaths in 2005
NCDs are killing more people in their prime adult years.
Surprising fact: – TB, HIV, and malaria only account for 10%
of the global deaths.

36. Mortality
Leading cause of mortality and
Burden of disease in world, 2004
DALY

37. Major causes of deaths,2004

38. • Cardiovascular diseases kill more people each year
than any other
Number 1 KILLER
• In 2004 – CHD killed 7.2 million people – Another 5.7
million died of stroke or another form of CVD

39. Adult mortality rates by major cause group and
region, 2004

40. Percent distribution of age at death by
region,2004

41. Distribution of deaths in the world by sex, 2004

42. Distribution of age at death and numbers of death,2004

43. Major Risk factors
Alcohol
Alcohol consumption
consumes your liver
really quickly
Cholesterol/ High Bp
Overweight and obesity
Tobacco use
Cigarette, chilam etc
cause cancer

44. Global Prediction for selected causes, 2004 to 2030

45. Millennium Goals
MDG1
Eradicating extreme
poverty and hunger
MDG3
Promoting gender
equality and empowering
women
Achieving universal
primary education
MDG2
MDG7 Ensuring environmental
sustainability
MDG5 Improving maternal
health
Combating
HIV/AIDS, malaria,
and other diseases
MDG6
MDG4
MDG8
Reducing child mortality rates
Developing a global partnership for the development
The Millennium Development Goals (MDGs) are eight international development goals to be achieved by
2015 addressing -

46. The Millennium Development Goals Report -Page 1
Most activities worldwide have targeted MDGs 4,
5, and 6, focusing on maternal and child health
(MCH) and communicable diseases, especially in the developing
countries, while fewer initiatives have focused on MDGs 1, 2, 3,
and 7, which are more difficult to influence
MDGs 4 and 5 have been considered most
important in the African region,
while MDGs 7 and 8 in the Western Pacific
Region
Arab countries have not considered MDGs among the top
priority for the policy makers, academia and social actors in
general mainly due to ethnic, religious, political and social
limitations

47. The Millennium Development Goals Report -Page 2
Low-income countries have attached high
relevance to MDG1 when compared to high-
income countries
The Hunger-reduction goal is on track; the target of
decreasing extreme poverty by half has been met, as
well as the goal of halving the proportion of people who
lack steady access to drinking water; conditions for
more than 200 million people living in favelas have
been improved; significant achievements have been
made in the fight against communicable diseases such
as malaria and tuberculosis and child and maternal
mortality have been reduced.

48. The Millennium Development Goals Report -Page 3
Primary school admission of girls has equalled that of
boys and developing countries experienced a reduced
debt burden and an improved climate for trade
Poverty reduction has been quite slow, or poverty has
even increased. Sub-Saharan Africa remains the most
underdeveloped region.
The goals of primary education and gender
equality also remain unfulfilled, with broad negative
consequences
MDG8 remains one of the most challenging even
if of primary importance for the achievement of
all MDGs

49. My Conclusions
The MDGs have focused world
attention on the needs of the poorest
and driven countries
Even if a major part of the MDGs has
been at least partially accomplished, a
POST-2015 slowdown must be
prevented at any cost
global health affects everyone
Global Health Care Is
Everyone’s Responsibility

50. Thank-you for your attention
Shashwat Awasthie 156A