Public Health Management & Prevention-Free-Samples for Students

Question: Identify the significance of globalization in terms of public health and the subsequent impact on public health management of Ebola. Answer: Introduction: The human civilization has been prone to many maladies over the course of time which have shaped the doctrines and frameworks of healthcare systems all over the world. Public health systems are primarily required to address contextual environments while dealing with outbreaks of communicable diseases. One of the prominent examples of such outbreak could be identified in the Ebola outbreak of West Africa. The following assessment is intended to identify the significance of globalization in terms of public health and the subsequent impact on public health management of Ebola and measures taken to address the condition. The particular highlights of the assessment would include a brief illustration of source of Ebola, its background and routes of transmission followed by its impact on humans. Another specific aspect of the assessment could be identified in the comparison of Ebola to other conditions such as Polio, chicken pox and the H1N1 avian flu virus which have vaccines from a socio- political perspective. This would be characterized by reflecting profoundly on the reasons for which Ebola does not have a vaccine. The final section of the assessment would be dedicated to evaluation of public health management and prevention strategies for Ebola with respect to the differences among wealthy and poor nations (Cushman et al., 2015). The discussion in the assessment could be used for deriving appropriate response to the question, How has globalization influenced the public health management and prevention of Ebola? Ebola background: The first known outbreaks of Ebola Virus Disease (EVD) can be traced back to 1976 in two different locations, Nzara in South Sudan and Yambuku in the Democratic Republic of Congo. The disease obtains its signature name from the Ebola River since the second outbreak was in a village in Yambuku which was near the river. However, the most prominent Ebola outbreak was in 2014-2016 in West Africa since the discovery of the virus. The severity of the outbreak was noticed in the considerably identified in the magnitude of cases and deaths alongside its transmission across borders. The outbreak spread to Liberia and Sierra Leone after originating in Guinea (Gemmell Harrison, 2017). The concerns of EVD are identified in the resultant fatal hemorrhagic fever which could be induced through infection by any Ebola virus strains. The commonly identified Ebola virus species amount to five among which one is responsible for causing the disease in non-human primates. The five species of Ebola virus are Zaire ebolavirus, Sudan ebolavirus, Bundibugyo ebolavirus, Tai Forest ebolavirus and the Reston ebolavirus that does not cause Ebola in humans. In order to ascertain the symptoms of EVD it is essential to identify the incubation period for the virus that can be defined as the period between infection and the first sighting of symptoms. In the case of Ebola virus, the incubation period ranges from 2 to 21 days. The first symptoms noted at the onset of the disease include fever, muscle pain, sore throat, fatigue and headache. The following conditions become complex with rashes, diarrhoea and symptoms of kidney and liver impairment as well as possibilities of internal and external bleeding in certain cases. These factors are clearly indicative of the impact of EVD on humans (Hobson, 2017). The transmission of the disease is also considered as an ambiguous aspect since there is no clear estimation of the source of the disease. However, the common assumption pertaining to its transmission is generally identified as a spill-over event when a human comes in contact with an infected animal followed by person to person transmission. The commonly identified sources of infection are fruit bats, porcupines, forest antelope and primates such as gorillas and chimpanzees (Rosen, 2015). The route of spill-over event is identified in contact with bodily fluids of infected animals while person to person transmission occurs through contact with bodily fluids of patients that have deceased or are sympathetic with respect to EVD. Person to person transmission of Ebola is facilitated through direct contact of mucous membranes or broken skin with infected body fluids, blood, infected animals and objects as well as sexual transmission. It is also imperative to note that Ebola is not transm itted through air or water and insects such as mosquitoes. The only animals that have been found to be vectors of EVD are few mammalian species largely referring to primates. After transmission between hosts, the virus enters the mucosal surface and inhibits the host immune response that provides the opportunity for viral replication in dendritic cells, monocytes and macrophages. In the following stages, the virus is transmitted to the spleen and liver through the bloodstream that lead to reduction in levels of Protein C, deregulation of the coagulation cascade, severe chemokine and cytokine responses and release of tissue factor from macrophages and monocytes (Macintyre et al., 2015). Ebola vaccine: The detrimental consequences of the Ebola outbreak can be compared to a catastrophic event that led to loss of over 11000 lives and infecting around 28000 people. Therefore, it is imperative to consider the implications of a lack of vaccine for Ebola in this scenario which could have otherwise prevented the numerous losses of lives. Hence it is imperative to consider the reasons for which Ebola does not have a vaccine while other diseases such as polio, H1N1 and small pox do have vaccines. The comparative review would suggest inferences from a socio political perspective reflecting primarily on the interests of globalization in the development of a vaccine. Globalization has been assumed as a profound instrument in changing social, economic, cultural and political frameworks all over the world. However, the primary objective of globalization is leveraged by multinational corporations and wealthy nations to realize their economic interests. It is imperative to consider that the vaccin es for diseases such as polio, small pox and H1N1 were developed on the urgency of these diseases being commonly observed in all countries. On the contrary, Ebola is specifically restricted to the developing countries in Africa with mortality rates in developed countries such as the US and Spain could be considered minimal. Therefore, the limited prospects of economic returns in the development of Ebola vaccine could be assumed as a prominent reason for the delay in creation of a vaccine for Ebola. The threats of Ebola virus have been profoundly observed since 1976 with over 26 outbreaks since that resulted in 1500 infections. However, there had been no steadfast progress in the research and development for an Ebola vaccine as a response to the severity of the condition. The understanding of the factors leading to the lack of a registered vaccine for Ebola as compared to other conditions which have a vaccine can be illustrated with references to practical examples for rejection of candidate vaccines. First of all, researchers who have developed functional vaccines for Ebola could not present it as a feasible business opportunity in order to obtain funding and license for the vaccine. The humongous cost associated with development and licensing of the Ebola vaccine is estimated in hundreds of millions of dollars (Panczyk et al., 2017). Furthermore, it is imperative to observe that socio-political perspectives had a major role in the promotion of initial efforts in the development of a vaccine. The research for developing an Ebola vaccine was initiated ten years before the West Africa outbreak which rendered promising results albeit at a slow pace. The most noticeable cause for the slow progress could be identified in the examples of development of proven vaccines which prevented Ebola infection in primates that were not permitted for human tests. While the primary rationale for development of a vaccine for Ebola would have to be aligned with the welfare of the people in Africa and prevent further outbreaks, it was observed that research was primarily guided on the basis of preventing bioterrorism attacks with Ebola virus. Since the initiation of research into development of an Ebola vaccine, many candidate vaccines have been subjected to clinical trials on primates. However, the social imperatives of testing unknown vaccines on humans led to the stalemate responsible for the lack of a registered vaccine for EVD. The complete dependence of the research and development activities in context of the vaccine on the pharmaceutical industry draws insights into the limitations over considering social interests at a specific period of time. Hence political precedents have to be considered in this case as wealthy countries should exercise their financial strength by investing in the research projects for development of Ebola vaccine. Since the primary interest for pharmaceutical companies is vested in financial returns, they would be less likely interested in production of a drug that could not facilitate productive economic dividends. Hence the commitment of wealthy countries to the cause would be a prolific measure for improving the prospects of a functional Ebola vaccine. The example of WHOs RD agreement that is intended to ensure collaboration of wealthy and poor countries for development of new, innovative and cost effective vaccines (Panczyk et al., 2017). Public health management and prevention: The Ebola outbreak in 2014-2016 was noted as a global phenomenon with prominent impacts noted in all corners of the world. However, the effectiveness of public health management and prevention strategies for the disease could be reviewed from the context of wealthy and poor nations. The origin of EVD was in West Africa that is primarily characterized by lower economic and educational status as compared to other countries such as the US which are comparatively higher in terms of education and economic status. Therefore, the public health management and prevention strategies would be characterized by drastic differences in the two different contexts (Gemmell Harrison, 2017). The public health management and prevention measures in areas such as Guinea, Liberia and Sierra Leone were primarily subject to mistrust from communities, social stigma for health workers and community resistance to medical intervention. The reason for these outcomes related to public health management of Ebola in poor countries could be identified in the lack of economic stability and a profound history of structural violence. The case of Sierra Leone could be considered as an example for illustrating the context of a poor country. The primary purpose of outsider visits to Sierra Leone was characterized by its reputation as a central port for the Atlantic slave trade followed by British colonialism for its mines. In the period of post colonialism the country was subjected to oppressive rule that led to limitations over the access of the population to basic healthcare services, employment and education. Furthermore, the ten year civil war from 1991-2002 was also responsible for indu cing economic instability as well as disruption of a social structure. Therefore, the context of poor countries such as Sierra Leone characterized by distrust in government officials and agencies alongside the perception of inequalities experienced by citizens could be considered as major setbacks for effective public health management and prevention of Ebola. The public health management and prevention for Ebola was initiated by national government as well as national and international NGOs supported by the WHO (Macintyre et al., 2015). The primary emphasis of the measures was aligned with aspects of community sensitization i.e. the make indigenous communities conform to the fact that native practices promote the spread of Ebola. This factor suggests the implications of the context of wealthy nations in which the cause of a disease is ascertained in the habits and practices of society and individuals. Despite the conflict in contexts, it can be observed that measures for addressing socio-cultural dimensions through consideration of community needs and limitations can provide feasible results in public health management and prevention of Ebola. The example of introducing safe burials which experienced resistance from native communities were associated with collaboration with local leaders and explaining the necessity of the intervention to the community thereby leading to adaptation of the measures for public health management and prevention of EVD. Conclusion: The assessment reflected clearly on the implications of globalization for public health management and prevention of Ebola. It can be clearly inferred from the review that social determinants of economic status and political interests are notably identified as influences on the framework for dealing with Ebola. The development of vaccines for Ebola is primarily inhibited due to the lack of commitment of wealthy nations and dependence of research and development on funding from pharmaceutical companies. With response to globalization, the public health management and prevention of Ebola can be addressed in varying contexts through tailoring the initiatives to suit community needs and practices. References Cushman, L. F., Delva, M., Franks, C. L., Jimenez-Bautista, A., Moon-Howard, J., Glover, J., Begg, M. D. (2015). Cultural competency training for public health students: Integrating self, social, and global awareness into a master of public health curriculum. 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