Clean water, cold vaccines, cell phones = a simple way to save lives

This post comes to us from Harvey Rubin MD, PhD. Professor of Medicine and Computer Science, University of Pennsylvania and Alice Conant, Harvey Mudd College.  The program they are working on, “Energy for Health” connects access to vaccines and clean water in developing countries with access to the fastest spreading technology in the world: cell phones.

According to the World Health Organization, 3 million people die each year from diseases spread by unclean water. These deaths are a direct result of the current water crisis in developing countries where more than 1 billion people have inadequate access to clean water and 2.6 billion people lack access to adequate sanitation. Together, unclean water and poor sanitation are the world’s second biggest killer of children.

Additionally, at least 2 million people die each year from vaccine preventable diseases. These deaths are not because there is a lack of vaccines and medications in the world, but because there is an inadequate cold chain — reliable refrigeration and storage units from the point of delivery of the vaccine or medicine in the country to the point of delivery to the patient in rural areas in developing countries.   Maintaining the cold chain is an almost overwhelming challenge in countries where resources are scarce.   The cold chain becomes increasingly unreliable as the distance between primary health centers and sub-health centers increases because of the lack of reliable power sources in the rural areas of developing countries.   This is where the cell phones come in.

A recent New York Times article, “Toilets and Cell phones,” informed the public that there are now more cell phones in India than toilets.  Cell phones are the fastest spreading technology in the world, and customers in developing countries account for two thirds of the universal mobile phones in use. Cell phones rely on cell towers, and each tower has its own supply of power. Our goal is to harness an adequate portion of this electrical energy to power refrigeration units and water filtration systems.  This synergy clearly benefits the cell phone service provider as well as the local population—more healthy people, more cell phone users, more cell phone users, more healthy people.  Couldn’t be a better arrangement.

This idea has received huge and enthusiastic support for its potentially transformative impact on world health and human security. By piggybacking access to viable vaccines, medications and clean water onto the fastest spreading industry in the world, we could solve a perplexing global health problem. According to the 2010 World Telecommunications/ICT Development Report, approximately 75% of the world’s rural inhabitants are covered by a mobile cellular signal, and it is estimated that close to 100% of the world will have mobile coverage by 2015.  In order to have mobile coverage you must be within the range of a cell tower (a matter of miles, depending on the territory), which means that if we can utilize the power from the towers to sustain cold chains and water filtration units, by 2015 close to 100% of the world could have access to viable vaccines, medication and clean water.

So far, our first-round calculations behind this technology suggest that it is completely doable. Cell phone towers run on alternating current (AC) power, have a backup energy generator in case the primary electrical supply goes down, and most units already have AC power outlets built into them!  Basic cold chain refrigeration units also run on AC power and consume approximately 200 Watts of power.

As we continue to expand on the research behind “Energy For Health”, we are exploring solutions to the following questions:

1) How does the cell tower distribution correspond with population distribution?

2) How will we monitor the security of the refrigeration and water filtration units?

3) What is a fair and equitable financial model for the installation and maintenance of the systems?

Excitement is growing in our team the University of Pennsylvania and with our partners as we continue to plan the pilot project of this technology and anticipate the enormous impact it will have on healthcare in developing countries. We welcome any ideas and suggestions.

Suicide declining since the 1980s

Suicide is a tragedy for individuals, their families and friends. But it can also reflect wider social problems, including depression and poor quality of life. For that reason, rates of suicide can offer insights into aspects of a society’s overall health.

There were an estimated  140,000 suicides in OECD countries in 2006, the most recent year for which internationally comparable data is available. Death rates were lowest in the southern European countries of Greece, Italy and Spain, as well as Mexico and the United Kingdom, at fewer than seven deaths per 100,000 people. They were highest in Korea, Hungary, Japan and Finland, at 18 or more deaths per 100 000 people.

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Health care rationing? NOT NICE

Photo courtesy of Jacques Bron

This week the Insights blog will be focusing on health care issues.

Today’s post comes from guest author Jonathan Wolff, Professor of philosophy and director of the Centre for Philosophy, Justice and Health, University College London.

It is amazing how a single word can distort a debate. Take the word ‘rationing’. What does that mean to you? To me, it conjures up a world of little cardboard booklets, which record whether or not you have been allocated your personal portion of eggs, butter, or flour. A world in which it makes sense to ask whether or not someone has had his or her ration.

In the US debate on health care reform, conservatives warned US citizens that, aside from the horrors of state control, universal health-care would inevitably lead to UK style health rationing. The debate about rationing largely focused on the question of whether it is a lesser evil than a system which, despite pouring much more money into health care per person than any other in the world, still left perhaps as many as 50 million people without health insurance.

I was completely bemused by this debate, and couldn’t understand why ‘progressives’ were prepared to let it be structured this way. For consider. Do we have rationing in the UK or elsewhere in Europe? Where do you keep your ration card? Has your NHS doctor ever refused to see you because you had used up your allocation of appointments? Has a hospital told you that you had already spent your share of nights on the ward?

What we have in England and Wales is the National Institute of Health and Clinical Excellence (NICE) with the job of deciding whether or not a new treatment or intervention is cost-effective. Sometimes, to the fury of patient groups and pharmaceutical companies, it decides that a drug is not worth the price asked for it, and recommends that it is not ‘refunded’ by the National Health Service.

Now, this is bound to cause dispute, and makes excellent news stories. It is easy to find someone who believes that their condition would be massively improved if an excluded drug was made available, and that NICE heartlessly puts a price on life. And indeed, we can argue that NICE may have erred in particular cases, or, more generally goes about its decision-making the wrong way. But it is hard to argue that considerations of cost are never relevant. If a drug cost ten thousand pounds and extended a life by an hour, it would be a difficult to argue that it should be made available at public expense. Sometimes we must put ‘a price on life’, somehow or other. (more…)