The Future of Medicine

The Future of Medicine

• CRISPR: Genome editing tool that rewrites DNA and genome patterns.
• CRISPR operates using molecular "scissors" to cut DNA, enabling precise genome editing.
• Biological scissors can also be used to cut defective genes.
• Nanobot technology can achieve gene editing.
• Regenerative medicine aims to regenerate or replace human cells, tissues, or organs to restore normal bodily functions.

National Health and Medical Research Council (NHMRC)

• The NHMRC determines health priorities and goals for research and funding.
• Priorities include promoting wellness and health equity for Aboriginal and Torres Strait Islander populations.
• Promoting the use of AI in health and medicine is another research priority.
• Identifying emerging health threats like antimicrobial resistance (AMR) and environmental changes is crucial.
• Preventing long-term illnesses, chronic diseases, and improving the lives of individuals with long-term illnesses are key goals.

Milestones on the Long Road to Knowledge

• Identifying the most important medical milestones is crucial for understanding medical advancement.
• Medical milestones are identified through expert panels and analysis of historical achievements.
• What medicine is encompasses both patient experiences and doctor interpretations.
• Analyzing past milestones provides insights into the future of medicine.
• Examining medical advancements reveals how medicine progresses over time.
• The rise of evidence-based medicine is a key theme in medical milestones.
• Penicillin discovery, vaccines, oral rehydration therapy, and computers in medicine are examples of significant milestones.
• Public perception and voting influence the perceived importance of medical milestones.

21st Century Global Health Priorities (Charles and Martha Hitchcock, Christopher Murray)

• Increasing threats to health globally are an important focus.
• Life expectancy is showing a slower rate of progress globally.
• Factors reducing life expectancy include conflict and epidemics.
• Modeling future mortality and forecasting risk factors are important for planning.
• Drivers of health, including SDI (Summary Demographic Index) and risk factors, are forecasted.
• Population age-structure shifts, such as in sub-Saharan Africa, are monitored.
• Historic forecast samples dating back 40 years are referenced for analysis.
• Event rate, initial speed, detection probability, response delay, and effectiveness are considered.
• Future impacts on society are modeled.
• Climate change, conflicts, pandemics, habitability, fertility/migration, and physical environment are important factors.
• Diet obesity and physical inactivity show no indication of improvement.
• Antimicrobial Resistance (AMR) trends indicate an increase.
• The Sahel region in Africa faces particularly low rates of child nutrition and high child mortality.
• Social and fiscal strategies are needed to invert population pyramids.
• Accelerated innovation, global and regional cooperation are crucial strategies.
• Focus on high-risk locations and resilient health systems are essential for progress.

Health Care Delivery in the 21st Century

• Electronic health data is a modern tool.
• The aging population is growing rapidly, increasing demand for healthcare.
• Understanding the healthcare system from a consumer perspective is crucial.
• Educated systems are needed to keep people healthy.
• Healthcare is currently a privilege but should be a right.
• Rising median costs of drugs are unsustainable.
• Healthcare expenditures have decreased, creating fiscal oxygen.
• Medical cost pressures consistently increase.
• A system that incentivizes quality over quantity is needed.
• Increases in quality may lead to higher prices.
• Quality has varying definitions (survival vs. comfort).
• Innovation is better than implementation.
• Disease growth is primarily in chronic diseases.
• Important to determine if patients or patients' families are better suited to make health decisions.
• Primary care needs lowest price and easiest accessibility.
• Secondary care requires more expensive and professional solutions.
• Patients can decide between waiting for sophisticated care or undergoing standard procedures.
• Innovation in access to information, such as medical records, is important.
• Healthcare expenditures have steadily increased.
• It's important to create fiscal oxygen (saving money and expenditure).

Week 2: Global Action Plan on Antimicrobial Resistance (AMR)

• The 2015 World Health Assembly's is designed to combat antimicrobials.
• The action plan is in response to systematic misuse and overuse of antimicrobials putting every nation at risk.
• Without harmonized global action can lead to a post-antibiotic era where common infections can once again kill.

AMR 5 Main Objectives

• Improve understanding and awareness of AMR through communication, education, and training.
• Bolster knowledge and evidence through surveillance and research.
• Reducing infection incidence through sanitation, hygiene, and prevention measures.
• Optimizing the use of antimicrobial medicines in humans and animals.
• Develop a sustainable economic case for investment in diagnostics, vaccines, and other interventions.

WHO Action Plan

• Intends to provide high-quality, safe medicines that are accessible to all.
• Countries are expected to create their action plans on AMR, that are in line with this plan.

Scope

• Emphasizes collaboration across sectors (human health, animal health, agriculture)
• Urgency for multisectoral action as one should not use gaps in knowledge to impend progress.
• Outlines key actions for various actors in the fight against AMR over the next 5-10 years.

Challenge

• Focuses on the action plan rather than dwelling on descriptions of AMR.
• More awareness is needed regarding AMR impacts on society.

The Way Forward

• Monitoring and reporting needs to happen at the national, regional, and global levels.
• Inadequate recognition of the need for action is a barrier needing addressed.

The WHO States

• Country’s should have created action plans that align the global national plans.

Action Plan Principles

• It needs one-health approach.
• As AMR effects everyone, all sectors and disciplines should make it a priority to preserve antimicrobial medicines.
• Prioritizes good sanitation, hygiene
• Antimicrobials should be prioritized, and only by access.
• All countries should have a national action plan on antimicrobial resistance that includes an assessment on resource needs.
• surveillance, research, manpower, and regulatory capabilities need to be invested in.
• Political Commitment and international collaboration are needed

Technical and Financial Investments

• Incremental targets for implementation: Allow individual countries to determine priority actions to attain the 5 objectives to combat AMR.

Strategic Objectives

• Ensure long-term treatment for diseases by quality-assured medicines.

Objective 1

• Raise awareness on AMR and behaviors to target different sectors.
• Should be a core component of education and health sector training.

Objective 2

• Tackle AMR, benefit should outweigh costs.
• Knowledge gaps that need to be filled are
• Epidemiological information on pathogens and geographic patterns.
• Comprehending how resistance develops and spreads.
• Observe emerging resistance mechanisms.
• Understand social science and behavior.
• Research in treatments and prevention for common bacterial infections.
• Research of antimicrobials in agriculture.

Objective 3

• Better hygiene and sanitation.
• Improve food and water quality.
• Using vaccinations.
• Encourages sustainable animal husbandry.

Objective 4

• Wide spread use of antimicrobial medicines as a public good that is needed. Focus on being a product promotion.
• Low cost diagnostic tools that are easily accessible in healthcare.

Objective 5

• Invest in antimicrobial medicines and diagnostics.
• Capitalistic pharmaceutical perspective might meed Rethinking.
• Affordable diagnostics tools may inform health practices that are susceptible to pathogen.

Framework for Action

• The secretariat should implement and monitor national plans across countries.

AMR in the Western Pacific Region

• The World Health Organization provides a review of technical discussion to combat AMR.
• Three categories include: surveillance of AMR, monitoring use of antimicrobials and the health of the support system.

AMR Surveillance

• Allows for tracking microbial populations and early detection of resistant strains
• Assists in making therapy guidelines and containment of threats.
• Enhance capacities in lab testing of testing
• Establish who states that dont haves.
• Promote epidemic and antibiotic data
• Link AMR, clinical and pharmaceutical tata in order to make data systems for decision making
• Establish and coordinate regional AMR surveillance.

Quality assurance

• Strategies should address clinical quality and epidemic relevance with sample collections
• Biases are more difficult
• Data collection: central conformation for important phenotype strains.
• Tracks frequency and volumes for antimicrobials

WHO States

• Absence of research , lack of monitoring consumed by humans and animals

WHO Says

• Monitor with local, national and global communication.
• Countries have few developed plans comprehensive reports on monitoring

Why it faces challenges

• Lack of policies and not having capacity to track accurately.

WHO Monitoring Recommendations

• Derived from surveillance of antibiotic
• AMR global goods for health which should contribute.

Monitoring

• Support international, that can undertake valid surveillance
• Share data with the AMR surveillance systems.

Goal

• To develop and strengthen national systems to contain and collect.

WPHO Recommended

• Using system of chemicals

Surveillance Data

. Used to set benchmarks for efficient aid Challenges for monitoring antimicrobial: a lack of support and agreement in ways for data collection to track right

• Not as much human resources to work with
• State can’t validate methods
• Countries dont aggregate to meet requirements

Solutions

• Conduct analysis and capacity to assess and improve it.
• Common methods needed.
• Encourage resource mobilization.

Health System Response:

• Needed to eliminate misuse , and influenced by patient. With knowledge and encouragement.
• Urge action.
• China and Vietnam are high

Health

• Developing natural antibiotic policies can help
• Health doesn't always has supervision and can lead to high harm
• Educate people and is vital

Regulations

• Enforce Importation is difficult and rare

Strengthening and preventing control

• Maintain and manage
• Strengthen IPC and new development

Primary Objectives

• Is to determine the effectiveness of vaccines to combat and develop in bacterial pathogens to the AMR crisis
• Find how vaccines can reduce the antibiotic use
• Vaccines can reduce AMR emergence

Methods

• Uses literature to review research to create the models

Week 3: Social Determinants of Health

• Social determinants of health are factors aside from medical care that impact health via social policies.
• The World Health Organization defines SDH as conditions in which people are born, grow, live, work, and age and the fundamental drivers of these conditions.
• Social and economic factors greatly influence health, with complex pathways.

Evidence

• Significant evidence highlights the powerful role of social determinants in shaping health.
• The links between social factors and health can be controversial.
• There are limits of medical care.
• The impact on health of social factors is responsible for 10% -15% of preventable deaths.
• Half of deaths involve behavioral issues.
• US deaths are comparable, linking economic status to other major diseases.

Trends

• Associations exist between health indicators and income, education, etc.
• Socioeconomic gradient trends are seen mostly in non-Latino groups.
• Black-white disparity is highest among highly educated women.
• Discrimination can damage health.

Factors

• Poverty hurts health.
• Not everyone agrees on the effects.
• Education is a key determinant of overall health.
• Social economic factors can influence health greatly.
• Knowledge increased exponentially.
• Manifest issues in life and later in life.
• Social issues can occur throughout one’s life.

Challenges

• Complex causes are found.
• Health effects take a long time to manifest.
• Social factors are determinants of health.

Organizational culture

• Authors observe whether effects patient. Mortality rates.

• They used one study RSMR ; Risk, Mortality AMI; heart issues LSL Intervention designed by the authors.

• Behaviors that enable survival in an environment that changing

• 5 domains study

• That promotes enquiry

• Its safe to take risks with them

• Senior management support

• Time for improvement

• They used mixed methods

• Patients experienced culture shifts and had less rsmr.

Week 4: Public Health Defined

• Public health encompasses biological, technical, and medical knowledge.
• External factors like medical care and social also play a role.
• Public health involves protecting, promoting health and preventing illness, injury etc.
• Key factors are determining in it across a country. Definition of public health.
• Ensuring conditions in which people can be healthy.
• Organised community efforts for improving. Framework should involve structured organisations with voluntary.

Factors

• Economic, education.

Work

• Public health intelligence: Gather info.
• Developing, policy and settings goals.
• Infrastructure.

Services

• Preventing hazards.
• Behaviour
• Responding to disasters and disasters.

Status

• Investigate risks.
• Educate People
• Partnerships exist
• Inforce Safety

Key Principles

• Focus on prevention , quality and equity.

List

• Vaccinations
• Health hazard awareness/ etc

Week 5: Ebola

. Was first told in sierra Alot of cases Preventation

Study Is To

• Improve A case

Results

• The community was helpful
• It was safe to work on at a distance
• Support helped tracing
• Trust was used between all people

Prevention

• Lack of awareness is an issue