Describe the positive and negative impacts of globalization in the health problem of your
selected article or case study.
How was the problem addressed?
What are the successes and challenges related to the problem?
How could lessons learned from the problem be used to address the same health issue
—or a similar health issue—in another location?
According to the World Health Organization, tuberculosis bacillus is the third leading
cause of death and nearly 1/3 of the world’s population is infected with the disease burden. The
negative impact of globalization and the spread of TB were associated with financial hardship
and infrastructure for public health systems that were limited in services to detect and treat the
disease. TB is spread by inhaling infected bacteria in the air caused by active TB carriers. This
causes the disease to migrate rapidly worldwide. The positive impact of globalization was that
countries recognized a serious public health problem and governments all over the world
working to sustain TB control strategies and standardized treatment with assistance from the
World Bank and the WHO. The DOTS program was cost-effective, which rolled out rapidly in
countries.
In China, the Infectious and Endemic Disease Control (IEDC) program was established to
help control their TB epidemic. The DOTS program was approached for early detection in
patients and included a 6-month treatment, where they were directly observed with antibiotic
intake. China adopted the program with patients seeking examinations, standardized treatment,
and standardized reporting to develop evidence of the detected infectious TB cases and to cure
those detected.
The challenges to the DOTS program were insufficient financing and lack of dispensaries
in poor provinces of China. Inadequate referrals of suspected TB cases from hospitals to the TB
dispensaries was also a challenge as hospitals had no economic incentive to refer patients to
dispensaries. One of China’s major successes with the national TB program was by
implementing the cost-effective program, they were able to lower treatment failure rate with
rapid scale-up and increased development. Their strong political support from their government
and incentives provided to doctors and patients were essential to the success of the program.
This large-scale TB control program was shown as the highest cure rate in China, which proves
that it can be successfully implemented in other countries with a TB epidemic. The highest rates
of TB occur in sub-Saharan Africa and can significantly reduce the health burden of TB with this
program.
Levine R. Case Studies in Global Health: Millions Saved. Sudbury, MA: Jones and Bartlett
Publishers; 2007
