I went to a really good lecture at NIH today by Hans Rosling, creator of
Gapminder. I want to remember the link, so I thought putting it here in my blog would be an easy way to access it later.
Basically it's a tool to graph statistical informormation concerning global development indicators and allows non-statisticians to more easily understand trends. His software is actually named Trendalyzer and has been purchased by Google. I really appreciate the ability of these graphs to transform people's worldviews. Many still view the world according to the facts of 1950, when the world was divided into the West and the developing world; between small families with long lives and large families with short lives. But there has been massive change and transformation in the development of nations in the last 50 years, and especially in the last 10, including the rise of Asia. The sequence of progress for these former "developing world" countries has been very different from the West. In the West, wealth was developed first and then health. In emerging countries, health has developed first, which is now allowing wealth to grow astonishingly quickly. This caused a shift in Rosling's perspective, to now believe that disease causes poverty, not the reverse.
So instead of a polar world of West contrasted with developing world, we now live in a world defined by economic level. Rosling sees the world as collapsed/low/middle/high income. Collapsed are countries like Afghanistan -- very few fall into this category. Low income are countries receiving aid, which have less than $1K USD/capita -- about 2 billion people. Middle income are emerging economies, with between $1-10K USD/capita -- about 3 billion people. High income is the West + 20%, with greater than $10K USD/capita -- about 1 billion people. This breakout is not sustainable and won't be with one superpower. For example, China is now accumulating $1B per day! Compare that to Gates Foundation which distributes $3B in aid per year. When the US economy crashed and the government needed money, they couldn't get it from their own population. The countries with money now are Brazil, China, etc.
In terms of health, most of the world now fits into the old picture of the "West" -- small families with long lives. Because of these healthy populations, the middle income countries are having incredible ecomonic growth. In the meantime, these are highly educated people who can get a diagnosis, e.g. cancer, and know of the appropriate treatments but can't afford them. The low income countries do still need help with diseases like tuberculosis and malaria. However, as development continues, they will work themselves out of poverty. Development = school, health, infrastructure, information, freedom & rights, credit, market & employment, security, etc. So the global health goals are two-fold:
1) bring health research to bear on the problems of low income people, e.g. solve TB
2) use populations of the whole world with all genetic variations for studies