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Infectious Disease And Public Health Essay
Infectious diseases come with extremely tough challenges to mitigate them and then finally get them under control. Bringing any such infectious disease under control involves a lot of decisions and cooperation between various branches of government and the health services.Infectious Disease And Public Health Essay
Using the Internet, choose an infectious disease that was prevalent in the United States and had lasting consequences or select a disease from the following:
•West Nile Fever
Based on your research and understanding, create a 3 to 4-page report in a Microsoft Word document that includes the following:
•A brief description of your chosen infectious disease along with your reasons for choosing the disease.Infectious Disease And Public Health Essay
•Information on the work conducted by government departments to mitigate the impact of your chosen infectious disease.
•Investigations, research studies, and other surveillance data analyses regarding your chosen infectious disease.
•Instances of the emergence and re-emergence of your chosen disease.
•A brief summary of the government’s findings and investigations about your chosen disease.
•Past, current, and ongoing research pertaining to your chosen disease.
Support your writing with relevant facts or figures and indicate your current knowledge of the infectious disease.
Minimizing the transmission of infectious diseases is a core function of public health law. The
appropriate exercise of legal powers will vary according to the seriousness of the disease, the
means of transmission, and how easily the disease is transmitted.Infectious Disease And Public Health Essay
· Law can contribute to the prevention of infectious diseases by improving access to
vaccinations and contraceptives, and by facilitating screening, counselling and education of those
at risk of infection. Law also has a reactive role: supporting access to treatment, and authorizing
public health authorities to limit contact with infectious individuals and to exercise emergency
powers in response to disease outbreaks.
· Where public health laws authorize interferences with freedom of movement, the right to
control one’s health and body, privacy, and property rights, they should balance these private
rights with the public health interest in an ethical and transparent way. Public health powers
should be based on the principles of public health necessity, reasonable and effective means,
proportionality, distributive justice, and transparency.
· Immunization is a successful and cost-effective public health strategy that saves millions of
lives each year. Governments can support vaccination coverage by ensuring that vaccination is
free or affordable, by ensuring that all children are vaccinated (with limited exceptions for medical
or religious reasons), and that vaccinations are documented.
· Screening individuals to determine if they have been infected with or exposed to an infectious
disease is a core public health strategy. Early treatment has important public health benefits; for
example, people receiving treatment for tuberculosis and HIV infection are less likely to transmit
the infection to others. Routine, voluntary HIV testing benefits both affected individuals and their
intimate partners by facilitating early access to prevention, care and treatment services.
· Health laws can improve the success of voluntary screening programmes by including
counselling requirements, ensuring the confidentiality of test results, and protecting individuals
diagnosed with particular diseases from discrimination. Public health laws should protect the
confidentiality of a person’s HIV status, authorizing disclosure to third parties only in limited
circumstances where a third party is at significant risk of HIV transmission and where other
statutory preconditions are met.
· Governments should carefully consider the appropriate role of criminal law when amending
laws to prevent the transmission of infectious and communicable diseases. For example, criminal
penalties for transmission of HIV may create disincentives to individuals to come forward for HIV
testing and treatment, or may provide the pretext for harassment and violence against vulnerable
groups. Encouraging personal responsibility and self-protection is critical, especially in countries
where rates of HIV infection are high.Infectious Disease And Public Health Essay
· Public health laws should authorize compulsory treatment only in circumstances where an
individual is unable or unwilling to consent to treatment, and where their behaviour creates a
significant risk of transmission of a serious disease. Compulsory treatment orders should restrict
individual liberty only to the extent necessary to most effectively reduce risks to public health.
Advancing the right to health: the vital role of law Page | 151
· Public health laws may authorize the isolation of individuals and groups who may have been
exposed to an infectious disease, as well as the closure of businesses and premises and the
confiscation of property. The exercise of these powers must be based on public health
considerations, without discrimination on grounds of race, gender, tribal background, or other
inappropriate criteria. Public health laws should provide for the fair compensation of those who
have suffered economic loss due to a public health order affecting their property or facilities.
Minimizing the transmission of infectious diseases is a core function of public health law. Clearlydefined legal powers are needed to respond to outbreaks of contagious and serious diseases at
national level. The appropriate exercise of legal powers will vary according to the seriousness of the
disease, the means of transmission, and how easily the disease is transmitted. Some diseases are
entirely preventable by vaccination (e.g. measles and polio), or by access to improved sanitation and
clean drinking water (e.g. diarrhoeal and parasitic diseases). Others are treatable when detected in
a timely manner (e.g. tuberculosis and malaria). The epidemic of HIV can be substantially reduced
through laws supporting access to treatment, combined with measures to educate and support
individuals and communities to implement proven strategies for preventing transmission. As
discussed in Section 11.1, States Parties to the International Health Regulations (2005) have an
obligation to assess and notify WHO of all events occurring within their territories that may
constitute a public health emergency of international concern.1
The legal framework for responding
to public health emergencies is discussed further in Chapter 11.
In circumstances where a disease or infection is transmitted by sexual contact or other forms of
human behaviour that are private and difficult to monitor, the priority for governments is to create
an enabling legal environment that supports those behaviours that are most successful in preventing
further transmission. This is the challenge of HIV and the law. High rates of infection with HIV,
particularly in sub-Saharan Africa, combined with inadequate access to treatment, have resulted in a
heavy burden of disease from AIDS, dramatically reducing average life expectancy, productivity, and
creating major obstacles to the progressive realization of the right to health (see Section 3.2(a)).
These problems have been exacerbated by a lack of resources. In 2009, the Regional HIV Prevention
Experts Think Tank and Multisectoral Stakeholder meeting convened by the East African Community
recommended that Partner States commit at least 15% of their national budgets to health, and 15%
of the national health budget to HIV and AIDS interventions – beyond the 5% currently committed.Infectious Disease And Public Health Essay
They also recommended that Partner States scale up by at least 50% the allocation of the total HIV
and AIDS budget devoted to HIV prevention interventions.3
Page | 152 Advancing the right to health: the vital role of law
10.1 Building ethical principles into infectious
Public health laws can support the control of infectious diseases in two important ways. Firstly, law
has a proactive or preventive role: improving access to vaccinations and contraceptives, together
with screening, education, counselling and other strategies that aim to minimize exposure to
disease. Secondly, law has a reactive role: supporting access to treatment, and authorizing health
departments and health care providers to limit contact with infectious individuals and to exercise
emergency powers in response to disease outbreaks. Because infectious disease control and
prevention laws may involve interference with freedom of movement, the right to control one’s
health and body, and with privacy and property rights, public health laws should embody a decisionmaking process that balances these personal rights with the public’s health in an ethical and
transparent way. Table 10.1 identifies a set of ethical principles that are relevant and sets out what
they mean in terms of the exercise of coercive power over individuals, within a legal framework for
control of infectious diseases.4
Table 10.1: Building ethical principles into legislation that restricts personal rights and freedoms
Ethical principle Putting the principle into practice
Public health necessity Coercive powers should be exercised on the basis of a demonstrable threat
to public health. Mandatory physical examination, treatment or isolation
should require a reasonable suspicion that the person is contagious or could
pose harm to others.Infectious Disease And Public Health Essay
The specific measures adopted by governments must be appropriate to
prevent or reduce the threat. Governments should monitor the
effectiveness of public health interventions and ensure that they are based
on sound science.
Proportionality Governments must strive to ensure that there is a reasonable fit between
the coercive measures imposed on individuals, and the public health benefit
that they seek to achieve. Governments should adopt the least
burdensome measure from among the measures that are available and
reasonably appropriate to mitigate the risks in question. Restrictions that
are “gratuitously onerous or unfair” may “overstep ethical boundaries”.5
Distributive justice The risks, benefits and burdens of public health interventions should be
shared fairly. For example, vulnerable populations should not be targeted
with restrictive measures, nor excluded or given lower priority in the
allocation of treatment, vaccines, or other benefits.
Advancing the right to health: the vital role of law Page | 153
Trust and transparency The public should have an opportunity to participate in the formulation of
public health policies, and governments should give reasons for policies and
decisions that restrict individual freedoms. Openness and accountability
are essential to generating public trust, and are likely to improve public
health decision-making. Without public trust and voluntary cooperation,
governments will find it harder to achieve their goals and to act in the
10.2 Preventing the transmission of infectious
“Overwhelming evidence demonstrates the benefits of immunization as one of the most successful
and cost-effective health interventions known”.6
Immunization avoids about 2–3 million deaths
each year, as well as serious disability from vaccine-preventable diseases including Yellow fever,Infectious Disease And Public Health Essay
diphtheria, tetanus and pertussis, rubella, rotaviruses, polio, pneumococcal diseases, mumps,
measles, human papillomavirus, polio, hepatitis B, and Haemophilus influenzae type b.7
immunization coverage, national vaccination plans should provide for free or affordable
immunizations that are available from most health care providers, public education campaigns to
illustrate the importance and safety of vaccinations, monitoring of vaccination rates and their impact
on health outcomes, and limited exceptions for individuals who for medical or religious reasons wish
to avoid vaccinations.
Belize’s Public Health Act 2000 illustrates some important features of a national vaccination strategy:
all children are to be vaccinated, vaccinations are to be documented, any person (including any
adult) may be vaccinated free of charge, and public health officials may require any person to be
vaccinated or revaccinated if an outbreak occurs (Box 10.1). Governments may determine that
certain highly infectious diseases warrant compulsory vaccination, although such a requirement may
be subject to constitutional protections relating to the right to be free from non-consensual medical
treatment, or to freedom of religion.
Box 10.1: National requirements for child vaccination in Belize
Public Health Act8
Section 150. Child to be vaccinated within three months.
(1) Every parent of a child in Belize shall, within three months after the birth of the child, or within
three months after receiving into custody the child, take or cause the child to be taken to a public
vaccinator of the district in which such child is then resident, to be vaccinated according to this Act,
unless the child has been previously vaccinated by a [medical practitioner].Infectious Disease And Public Health Essay
Section 151. Inspection after vaccination.
Page | 154 Advancing the right to health: the vital role of law
(1) On the eighth day after the vaccination, the parent shall again take or cause the child to be taken
to the public vaccinator for inspection at such time and place as may have been appointed by him at
the time of vaccination.
(2) If on inspection it is ascertained that the vaccination has been unsuccessful, the parent shall, if
the vaccinator so directs, cause the child to be forthwith again vaccinated and afterwards inspected
as on the previous occasion.
(3) If the vaccination has been successful the public vaccinator or surgeon forthwith shall give to the
parent a certificate … and within seven days shall transmit a certified copy of the certificate to the
Registrar of the district within which the child’s birth was registered … or if the birth of the child has
not been registered, then he shall give it to the Registrar of the district where the child resides.
Section 152. Where child is unfit
(1) If any public vaccinator or surgeon is of opinion that the child is not in a fit and proper state to be
successfully vaccinated, he shall forthwith deliver to the parent a certificate under his hand
according to the form of the Sixth Schedule or to the like effect, that the child is then in a state unfit
for successful vaccination, which certificate shall remain in force for two months only but shall be
renewable for a like period from time to time, until a public vaccinator or surgeon thinks the child to
be in a fit state for successful vaccination, when the child shall with all reasonable dispatch be
vaccinated and a certificate of successful vaccination according to the form of the Fifth Schedule
duly given if warranted by the result and a certified copy sent to the Registrar of the district where
the child resides.Infectious Disease And Public Health Essay
S 154. Public Vaccination gratis.
(1) Any public vaccinator shall, on application, vaccinate or re-vaccinate without charge any person
at any time and place appointed for the attendance of such public vaccinator, and on the performing
of the same the public vaccinator shall appoint a time and direct such person to attend at the same
place, the time being as far as practicable the eighth day after vaccination.
National vaccination strategies should include contingency plans for outbreaks of highly contagious
or serious diseases (e.g. pandemic influenza). In these circumstances, shortages of vaccine may
occur. Priority of access to limited supplies of vaccine should occur in accordance with regulations
developed through a transparent process that provides the opportunity for meaningful public
discussion about the principles of fair allocation. In many cases, priority is likely to be given to health
care workers, emergency responders (e.g. fire and police personnel) and others responsible for
ensuring the continuation of key services and societal functions.Infectious Disease And Public Health Essay
Screening individuals to determine if they have been infected with or exposed to an infectious
disease is a core public health strategy. Screening enables health care providers to begin treatment
in a timely manner, to manage co-morbidities more effectively, to encourage patients to reduce
high-risk behaviour and, in certain cases, to identify the need for compulsory treatment. In addition
to reducing the severity of illness, early treatment may also reduce transmission rates. For example,
early treatment with antiretroviral drugs lowers the viral load of people with HIV and significantly
Advancing the right to health: the vital role of law Page | 155
reduces the risk of sexual transmission.10 WHO supports the expansion of HIV testing and
counselling in order to identify people with HIV early on in their infection and to “link them
successfully to prevention, care, and treatment services”.11
In addition to authorizing screening, including mandatory screening in appropriate circumstances,
public health laws can improve the success of screening programmes by including counselling
requirements, by ensuring the confidentiality of test results, and by protecting individuals diagnosed
with particular diseases (e.g. HIV) from discrimination. Laws drafted in accordance with human
rights principles increase the likelihood that individuals will voluntarily seek out testing and
Global strategies for controlling infectious diseases advise against placing heavy reliance on criminal
laws and penalties. For example, the Joint United Nations Program on HIV/AIDS has advised against
the criminalization of unintentional HIV transmission and non-disclosure of HIV infection to sexual
partners,13 and the HIV and AIDS Prevention and Management Bill, passed in 2012 by the East
African Legislative Assembly, integrates human rights principles into law in the region Infectious Disease And Public Health Essay
Global health encompasses multiple concepts, derived from public health concepts and international
health that were originally based in infectious disease control. However, the definition has evolved due
to such factors as global trade, travel, and relations. Additionally, the very inter-disciplinary nature of
global health within the context of social, political, environmental, and economic factors constantly
shapes the context in which health is attained, maintained, and lost in a world of differential resources,
approaches, and beliefs.
At its core, focusing on “health” global health operates under the premise that health (defined as
freedom from illness and the achievement of total physical and mental wellbeing) is a social good to be
enjoyed by all as a human right is based in the element of justice, above equity. This nuance recognizes
that, in order to participate fully in society, inputs to individuals/countries may not necessarily be equal,
as some individuals or countries may need more or different resources (see attached photo).
“Global” infers issues of global relevance and global benefit, and not necessarily that an issue must be
affecting multiple countries, or crossing boundaries at the time it is deemed a global health concern.
This global relevance implies a collaborative approach to solving public health issues where both/all
parties are invested in working together for shared public health good, especially when they contribute
unique resources… rather than a top-down, or charitable approach. Further, it also recognizes the
influential nature of how inter-related countries are… including the political and economic history that
define the pathology of disease and lack of well-being in particular settings in order to think about how
to achieve real, lasting, and just change with dignity and respect.Infectious Disease And Public Health Essay
Global Health is an ideal.
As a society we are no longer satisfied with isolated medical and scientific successes in one corner of the
globe, if they remain unattainable and inaccessible to the population at large. Global health tackles a
large spectrum of challenges, which preclude universal health and social wellbeing, through fostering an
academic environment for scholarship and research enabling better understanding of disease burden, so
as to generate effective preventive and treatment strategies.
The global in global health refers to the scope of the problems, not their location.
By this definition, global health issues can neither be confined to low and middle-income countries, or
underserved populations within the developed world, but rather focus on diseases that threaten
welfare, longevity and safety regardless of international boundaries.
Global health is derived from public health and international health. Global health shares the following
characteristics with public health and international health: priority on a population-based and
preventive focus; concentration on poorer, vulnerable, and underserved populations; multidisciplinary
and interdisciplinary approaches; emphasis on health as a public good and the importance of systems
and structures; and the participation of several stakeholders. But the definition of global health is not
only a rephrasing of a common definition of public health or a politically correct updating of
Global health emphasizes transnational health issues, determinants, and solutions, but the “global” in
global health refers to the scope of problems, not their location. Thus, global health can focus on
domestic health disparities as well as cross-border issues. Besides the infectious diseases and maternal
and child health, global health has to embrace the full breadth of important health threats including
chronic diseases, injuries, mental health, and the environment. Global health uses the resources,Infectious Disease And Public Health Essay
knowledge, and experience of diverse societies to address health challenges through- out the world.
Although global health places greater priority on prevention, it also embraces curative, rehabilitative,
and other aspects of clinical medicine and the study of basic sciences; it involves many disciplines within
and beyond the health sciences and promotes interdisciplinary collaboration and is a synthesis of
population based prevention with individual-level clinical care.Infectious Disease And Public Health Essay