-family:"Palatino Linotype"'>A Success Story: The Global Programme to Eliminate Lymphatic Filariasis (Ottesen, 2000)

            One prime example of success in the global health arena is the Global Programme to Eliminate Lymphatic Filariasis (GPELF).  Though not as well-known as diseases such as tuberculosis or HIV/AIDS, lymphatic filariasis (LF) affects nearly 50 million persons worldwide and is endemic in tropical regions of Asia, Africa, Central and South America.  The disease has disabling and stigmatizing symptoms such as elephantiasis (thickening of the skin and underlying tissues) and can cause extensive anguish for affected persons, but there have been successful interventions to interrupt transmission and halt disease progression in some regions such as Japan, Taiwan, and mainland China.  However, the disease burden of LF in many tropical areas, usually developing countries, is still immense today.

            The two factors that brought this global health initiative to fruition were the increase in the political commitment to address the health impact of LF and the technological refinement of treatment regimens by pharmaceutical companies.  In 1997 the WHO “called for countries to strengthen activities toward eliminating lymphatic filariasis as a public health problem and requested the Director General of WHO to mobilize support for global and national elimination activities” (Ottesen, 2000, p. 592).  Pharmaceutical breakthroughs included the enhancement of the drug into an annual, single-dose, which when given to an entire community over an approximately five-year period would effectively kill off the disease vector.  Additionally, a crucial step in establishing the GPELF came when SmithKline Beecham (now known as Glaxo Smith and Kline) agreed to work with the WHO and provide all the required drugs for free to see the elimination program through to its conclusion.  These technical and political halves merged to form the GPELF and worked together to develop a set of guidelines by which countries in the endemic region for LF could follow in order to address this widespread health problem.  In conjunction with the global partners in this initiative individual countries start out with a plan of action, which is ultimately agreed upon by all parties so that work on the ground can begin and the necessary drugs can enter the country in need.

            As of 2000, 29 of the 80 endemic countries in the world have entered into this elimination process, and at the end of 2000 over 25 million at-risk individuals have been treated for the disease.  The benefits of the GPELF extend beyond simply reducing disease burden from LF.  First, the widespread use of the elimination drugs also holds ancillary benefits for other endemic diseases such as hookworm and other intestinal parasite infections.  All of these health problems affect not only person well-being but also productivity of the population in general.  The nations who undertake this objective stand to benefit greatly and demonstrate in a cost-effective manner the value of this particular global health program.  As Ottesen (2000) summarizes:

The third, and perhaps most broadly important, consequence of the GPELF is its reinforcement of a new approach to the health problems of the developing world.  Good health is directly beneficial to all sectors of society.  While responsibility for health problems has generally fallen to the public sector, resources and skills to address these problems are increasingly found in the private sector.  Hence shared responsibility by the public and private sectors for the health problems of the world is extraordinarily important, and the network of partners that form the Global Alliance for the Elimination of Lymphatic Filariasis can become a model for approaching the health concerns of under-served populations worldwide.  (2000, p. 594).



             This chapter has provided a brief introduction into some of the major concepts and actors in the emerging field of global health.  The world is indeed a Global Village, with globalization and the emergence of new threats to the world population’s health requiring a paradigm shift from international health to global health.  Inherent in this global health paradigm is perspective writ large, necessitating an approach that addresses and accounts for global and local phenomena when considering health matters.  Globalizing forces are not new but have rather intensified in recent decades, and these global processes have indelibly changed the face of the world’s health.  The landscape of global health managers and policy makers has also shifted over time, bringing numerous new players into this arena.  This added complexity makes assessments of global health’s underlying mechanisms more difficult, but still necessary in order to make worthwhile gains in the struggle to improve the world’s health. 

Useful Resources

Global health reporting site - http://www.globalhealthreporting.org/
News site providing links to articles, conference proceedings, and conference annoucements concerning HIV/AIDS, tuberculosis, and malaria


Global Health Council - http://www.globalhealth.org/

The Council works to ensure that all who strive for improvement and equity in global health have the information and resources they need to succeed.


Global health facts site - http://www.globalhealthfacts.org/
Site provides current epidemiological data, both globally and by country, concerning HIV/AIDS, tuberculosis, malaria, and selected other infectious diseases.


Carter Center health programs - http://www.cartercenter.org/healthprograms/healthpgm.htm

Provides information about the Carter Center's work in Africa, Asia, and Latin America to :

GlobalHealth.gov - http://www.globalhealth.gov/

Site of the Office of Global Health Affairs, a section of  the U.S. Department of Health and Human Services.  Contains employment and funding opportunities as well as reports of the activities of the U.S. government in international health.


HHS Office of Global Health Affairs - http://www.hhs.gov/ogha/
Presents the mission and scope of activities of the Office of Global Health Affairs.  Not the same as GlobalHealth.gov, though the two are linked.


CDC Office of Global Health - http://www.cdc.gov/ogh/
Describes the efforts of the CDC and the ATSDR to recognize and respond to international influences on US health and to engage in global public health research and practice.


Globalization and Health journal - http://www.globalizationandhealth.com/
Peer-reviewed, open-access journal devoted to consideration of the effects of globalization on health



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