Dec 03, 2014
Smartphones were pressed intobacteriological growth media.
“We didn’t have to wait long…”
University of Surrey, 2014.
Supertyphoon Haiyan
08 November 2013196 mph at landfall11 million affected
27,400 injured1,700 missing
6,000 dead
Things Not Digital in Global Public Health
Demographics
As of 2007, we’re more urban than rural for the first time in human history.
About a billion of us live in slums like this.
IslamabadImage: National Geographic
95% of the increase in population by 2050 will be in the cities of the developing world.
UN Habitat-2010
~9.31 Billionin 2050
Image: CDKN.org
William Gibson’s “uneven distribution”Caracas, Venezuela
MegacityGrowth
Doubling time:
0.2% = 350 years
0.6% = 116 years
1.5% = 47 years
2.5% = 28 years
4.0% = 18 years
5.0% = 14 years
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✔✔✔
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✔✔
✔
✔✔
✔
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✔= developing world
Infant mortalityper 1,000 live births
Best Worst
For reference, The US infant mortality
rate is 5.20.We rank 47th, between
Greece and New Caledoniahttps://www.cia.gov/library/publications/the-world-factbook/
But efforts like the Millennium Development Goals have shown what’s possible with infant mortality:
> = mortality dropped by roughly half
>>>>>>
>
= war variance
In the United States,stunning achievements in public healthand civicresponsibility
Disasters: Fast and Slow
Just over the past 48 months…
• Sendai earthquake and tsunami
• Fukushima nuclear disaster
• Christchurch earthquake
• Supertyphoon Haiyan
• US tornado swarms
• Russian wheat fires
• Russian heat wave
• Queensland floods
• Hurricane Sandy
• Pakistan floods
Nine Planetary Boundaries
Planetary boundaries: Exploring the safe operating space for humanity. Ecology and Society 14(2):32, 2009
About 25% of global agriculture is grown in water-stressed areas
World Resources Institute – May 2014
http://www.wri.org/applications/maps/agriculturemap/#x=142.03&y=12.23&l=2&v=home&d=gmia
About 15.4 millionall-causerefugees globally.
Just in syndromic surveillance alone, ISDS predicts in 2030 we’ll be about 4 million healthcare workers short.
Not like you. Like her.
Not such good news elsewhere…
• HIV• SARS• West Nile• Hantavirus• H5N1 Avian• H1N1 Swine• MERS• Lassa fever• Nipah• Ebola and Marburg• Legionnaires• Hendra• Enterovirus 71• Cyclosporiasis• Human Monkeypox
• Malaria (DR)• Diphtheria• Dengue• Tuberculosis (MDR, XDR, TDR)• Chikungunya• Cholera• Plague• Rift Valley Fever• Typhoid Fever• Resistance…
– MRSA– VRSA– NDM-1
• Zoonoses (75%...)• Agricultural and Livestock pathogens
Seem to be new Very different / Don’t belong
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Of more than 30 “new” infectious diseases since 1970, about 75% have been zoonotic
Turkana…refugees?Northern Kenya, 2012
• Language
• Culture
• Experience
• Cosmology
• Myth
Point of Care diagnostics?
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Bad water, food, medical care…persistent struggle.
Image: Crystal Davis, WRI
27
Dhaka, Bangladesh:On any given day 1/3 of the population is sick.
Grameen Kalyan, 2013
Image: InSTEDD
28
Hard-working, ambitious, and eager to learn
Image: Eric Rasmussen
But without a functioning State…
Janjaweed raid, Darfur, 2009Photo: Reuters
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Dadaab Refugee Camp, eastern Kenya, 2013
Natural disasters
Industrial disasters
Climate change
Conflict
Trafficking
Religious extremism
Economic recession
Post-colonial disintegration
Demographic migration
Poverty / Brain Drain
Emerging infections
Compound Crises
EnergySecurity
Ecosystem Services
Food Security
Humanitarian
Assistance and
Disaster Relief
National Recovery
and Reconstructi
on
WaterSecurity
Disaster Risk
Reduction
Political Stability
Infrastructure
Security
Hazard Preparedne
ss andResponse
Transportation Security
Job creation
Public Health
Communications
Security
CapacityBuilding
Emerging Disease
Detection
EconomicResilience
Human Security
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Data for
Decisions
Crowd-sourced data – open and free, to pretty rigorous standards
WWHGD.org
Data Preparedness for
Human Security
Image: MindTelANTz – Village health resources
Human Security Taxonomy ANTz
UN effort
Big Data. Huge.
For knee-of-the-curve warning of:
• Emerging infections• Developing famine• Economic disruption• Social unrest
11 May 2014
Food and Water
Aquaponics10% of the water.
8x yield / unit area / time.
Water
Fresh water reclamationseems a desirable goal
Photos by Lorenzo MosciaNational Geographic
Puralytics.com
Puralytics Shield
• 500 gallons per day
• 24 inches high, and 60 pounds
• LED-driven photocatalytic reactions
• Nanomembrane flow system
• 570 watts
• Replaceable cartridge
• Zero water waste
• Routine maintenance annually
First water production in the field 11 May 2014
Things we can’t do well yet in low-resource environments…
• Communicate between languages and cultures• Analyze water• Clean water• Diagnose viral diseases• Provide diagnostic tools to CHWs• Evaluate medication legitimacy• Predict zoonotic transmission risk• Provide power• Determine medication delivery• Manage cold-chains• Educate women
• Human security is a desirable goal.
• Health is one security component, driven by foundational needs.
• Exploring those mathematically inarguable needs is good business.
• It’s a market full of science, engineering, art and design.
• It’s also a market of systems: interesting, profitable, and fair.
Take-Home messages:
Eric Rasmussen, MD, MDM, FACP
RasmussenE @ ihs-i.com
360-621-3592