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Golden Lecture of Prevention. Building a Global Prevention Network to Share Knowledge and Wisdom. Hygeia In Greek mythology The goddess of health. Hygiene –The science that deals with the preservation & promotion of health. . September 19, 2003 Hippocrates Day.

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golden lecture of prevention

Golden Lecture of Prevention

Building a Global Prevention Network to Share Knowledge and Wisdom

slide2

Hygeia

In Greek mythology The goddess of health.

Hygiene –The science that deals with the preservation & promotion of health.

September 19, 2003

Hippocrates Day

This lecture is dedicated to a man who is currently recognized as the “father” of medicine. It’s because of his work, healers became doctors instead of sorcerers. Hippocratic oath is administered during the graduation ceremonies of all modern medical schools.

objectives
Objectives
  • To define prevention and highlight its importance in global health.

2. To discuss the importance of network in the context of the Supercourse and to begin to organize the internet based globalization for prevention

3. To distribute the golden lecture to 1 million faculty, students and professionals all over the world

definition of prevention
Definition of Prevention

“Actions aimed at eradicating, eliminating, or minimizing the impact of disease and disability. The concept of prevention is best defined in the context of levels, traditionally called primary, secondary, and tertiary prevention”

A Dictionary of Epidemiology, Fourth Edition

Edited by John M. Last

public health and sanitation
Public Health and Sanitation

Achievements of the 20th century:

  • Improvements in hygiene practices
  • Improvements in food handling (refrigeration)
  • Improvement in Water and sewage treatment
  • Vaccination practices
rising life expectancy
Rising Life Expectancy

Source: United Nations (U.N.) Population Division, Demographic Indicators, 1950-2050 (The 1996 Revision) (U.N., New York, 1996).

prevention and religion
Prevention and Religion

Washing Hands

  • Hands should be washed when one touches something polluted or unclean; likewise, before or after eating.
    • The Prophet, Peace Be Upon Him, said: “Whoever sleeps and his hands are not clean from fat and thereby gets harmed should blame no one but himself”
    • “The Prophet, Peace Be Upon Him, used to wash his hands before eating”
slide9

Death rate for Tuberculosis, 1860-1960, United States, Source: US Bureau of the Census, Historical Statictics of the United States; Colonial Times to 1970 (Washington, D.C.:Government Printing Office, 1975), Part 1 pp58,63.  Note: Data between 1860 and 1900 for Massachusetts only.

Koch

identified

tubercle

bacillus

Streptomycin

introduced

Vaccination

available

the sanitary revolution and the ascendancy of public health
The Sanitary Revolution and the Ascendancy of Public Health

The sanitary revolution produced the greatest transformation in the pattern of disease that the world had known since nomadic hunter-gatherers settled in permanent villages, and ultimately developed modern urban industrial communities

death rates for measles in children under age 15 england and wales 1850 1970
Death Rates for Measles in Children Under Age 15, England and Wales, 1850-1970

Source: Thomas McKeown, The Modern Rise of Population (Academic Press, San Francisco, 1976), pp. 93, 96.

example of successful prevention program in cuba vaccination program result
Example of successful prevention program in CubaVACCINATION PROGRAM RESULT

POLIO ELIMINATED SINCE 1962

DIPHTHERIA ELIMINATED SINCE 1969

NEWBORN TETANUS ELIMINATED SINCE 1972

CONGENITAL RUBELLA ELIMINATED SINCE 1989

MENINGITIS POST MUMPS ELIMINATED SINCE 1989

MEASLES ELIMINATED SINCE 1993

WHOOPING COUGHTRANSMISSION INTERRUPTED SINCE 1994

RUBELLATRANSMISSION INTERRUPTEDSINCE 1995

MUMPS TRANSMISSION INTERRUPTEDSINCE 1995

MORBIDITY

MENINGOCOCCICAL DISEASE REDUCTION 93%

TYFHOID FEVER REDUCTION 75%

B HEPATITIS REDUCTION 52%

introduction
Introduction
  • Cervical cancer is the 2nd most common cancer among women globally
  • Higher cervical cancer mortality in developing countries due to lack of effective screening programs
costs of malaria control
Costs of malaria control

Government-invests US $99,970/yr, protects 3.4 million people in transmission zone at $0.03 per head

  • Population blood surveys (surveillance) – 25%
  • Vector surveillance (strategic knowledge) – 12%
  • Case-management (disease-transmission control) -60%

Community

  • US$4.18 cost per illness-casesincur 83% of cost (=10 days income; 1/3rd for drugs, >1/3rd due to lost income).
  • Govt pays 17% of cost per illnessand creates treatment system and case-management standards
slide17

Death Rates for Coronary Heart Disease by Country Men Ages 35-74, 1970 and 1993 (Rate/100,000)

750

FIN

USA

AUST

SCOT

NZ

CAN

500

SING

USSR

250

ITY

SPN

FRAN

JPN

HK

CHN

0

slide18

Lifestyle Factors

“Genes load the gun.Lifestyle pulls the trigger”

Dr. Elliot Joslin

relation between chd events and ldl c in recent statin trials
Relation Between CHD Events and LDL-C in Recent Statin Trials

30

2° Prevention

25

20

% with

15

1° Prevention

CHD event

10

5

0

90

110

130

150

170

190

210

Mean LDL-C level at follow-up (mg/dL)

PI=placebo; Rx=treatment

.

slide22

Prevention and Internet: Internet “Epidemic”

Number of Internet users (millions)

Year

methods supercourse model

Teacher in Alexandria

Teacher in Cairo

Teacher in Pittsburgh

Teacher in Tanzania

Teacher in Paris

Teacher in Moscow

Methods: Supercourse model
slide24

Telepreventive Medicine

Inexpensive Low to High bandwidth systems designed to reach large numbers of healthy people to prevent disease.

Tele-Medicine

Expensive High bandwidth systems designed to reach small numbers of sick people to cure disease.

conclusions
Conclusions

Increased life expectancy in the past century was achieved through the improvement of sanitation and prevention

Successful prevention in the past and in the future needs to be rooted in the networking of health professionals around the world to share their knowledge

Internet based Information sharing is the key to prevention and a “golden” world

what is the future of prevention
What is the future of prevention?
  • Globalization of Prevention
  • Networking of people in prevention
  • Sharing of data, knowledge and wisdom

Please forward the Golden Lecture to faculty, students and health professionals in your country

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