I was reading my public health journal when I came across a poignant interview with Laurie Garrett — who recently won a Pulitzer for her book. To be honest, I hadn’t heard of her or of the book until I read this interview. I was refreshingly impressed by the what she had to say, including her answer to the interviewer’s question of “do you think global public health efforts are winning?”
[What a dumb question! 100 million people are expected to be infected with HIV by 2010. We are certainly not winning anything other than job security.]
Regardless, her thoughtful response:
“Winning, to my mind, has on obvious goal post — life expectancy. And by that measure, we have a paradox. Since 1948 when the World Health Organization was created, average life expectancy for the people of planet Earth has risen by 40 percent. This has overwhelmingly been due to a combination of public health infrastructural interventions and rising personal wealth and education.
But, if you break that 40% down, remember that is an average, something very disturbing pops up. The long-lived societies are getting more long-lived, while the short-lived societies are either failing to improve, or thanks to wars and HIV, are going backward. So, today the life expectancy gap is the widest in human history with a disparity of five full decades. What this means is that a very long-lived society like Japan now offers, as a matter of statistical probability, a child born in 2007 the probability of living long enough to know his/her great-grandchildren. In contrast, very short-lived societies like Sierra Leone, Nepal or Zimbabwe now offer that same child only a remote possibility to live long enough to see his/her children reach adulthood. That is a crime.
The ‘win’ as far as I am concerned, would be closing that gap.”
Bravo! This sums up exactly why I love working in international public health.