Malaria, pneumonia, and advocacy for health

Sometimes I hate advocates. Anything which smacks of “my disease is more important than yours” is a great way for me to stop listening. Nicholas Kristoff’s blog post on pneumonia importantly highlights the large disease burden and the relatively scant public attention. However, the solution is not to have a world pneumonia day. Nor do we need to justify schistosomiasis control with tenuous evidence on its association with HIV prevalence. I understand what Hotez et al. are trying to accomplish since the latter is a hot issue, but I wonder whether we will be undermined by such messaging in the long run. As a friend of mine said, “Treat schisto to treat schisto.  Anything else is icing on the cake.”

We need to move beyond unilateral thinking and organize around broader public health platforms. Unfortunately, this is not as tangible as a single topic, and it doesn’t make a good bumper sticker.

How do we do it?

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3 Responses to “Malaria, pneumonia, and advocacy for health”


  1. 1 egbutter July 15, 2009 at 9:35 am

    We really do need to shift the emphasis back onto strengthening primary healthcare. Many of these developing countries have so many inadequacies in basic healthcare self-sufficiency, so vertical healthcare strategies like oncho and shisto programs are putting the cart before the horse. This is just like the Jeffrey Sachs versus Bill Easterly development argument.

    IMO if we can make *individuals* in these development agencies directly accountable for their programs and shift the power and money to the local administrators, there will be fewer of these “bumper sticker” programs (whether another UNAID shisto drug rollout or another MVP village) because the admin´s will know that if they make big promises and fail they will actually be held responsible for a change! This way, maybe we will finally see a capacity buildup at the level of the primary healthcare providers. Another problem, though, is making sure that the local leaders — all the healthcare workers with a SS education — are taught ethics and critical thinking (see a great speech by Pat Awuah http://www.ted.com/talks/patrick_awuah_on_educating_leaders.html), are well-compensated, and are held accountable for their actions. Another problem: what incentives can governments or citizens provide to facilitate these changes?

    • 2 naman July 15, 2009 at 12:19 pm

      Eric, these are indeed some key health systems questions people have been asking. I don’t think they have any easy answers but keep at it – and thanks for the link!

  2. 3 manish August 21, 2009 at 2:40 pm

    proper diet in pneumonia. pneumonia come after the malaria treatment what % of risk in this type.


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