How Orphan Diseases Disproportionately Affect Emerging Nations

Global Health: The Multiple Challenges Involved in Treating Childhood Disorders

Discuss the relationship between health, development, poverty and equity.

There is an inextricable and intuitive relationship between health, development, poverty and equity. A vast body of scholarship confirms that people who enjoy an affluent lifestyle suffer from far fewer health-related concerns and live longer and healthier lives compared to their impoverished counterparts, thereby creating inequities that disproportionately affect the latter which are regarded as inherently unjust and unfair. For instance, according to the course materials, “It’s important to make a distinction between inequity and inequality. Inequity [refers to] differences in health that are not only unnecessary and unavoidable, but also unfair and unjust. Inequality describes differences in the distribution of health determinants between different groups” (Slide 12). Therefore, while inequalities in health care typically defy easy or cheap solutions, inequities are more amenable to resolution if the political wherewithal exists to do so.

Notwithstanding the foregoing constraints, the fundamental challenge in improving equitable access to high quality health care services is money. Lawmakers in developing nations may place a high priority on public health but may also lack the resources to effect the meaningful changes and improvements that are required. Nevertheless, the global standard of living has experienced gradual but sustained improvement in recent decades. Despite multiple hot spots around the world such as Haiti and Afghanistan that remain mired in a downward spiral of violence and poverty, people are living longer, healthier lives in general than ever before in history. These trends suggest that given enough time, even expensive-to-treat orphan diseases will be curable. This calculus, of course, ignores the harsh health care realities that are facing far too many impoverished nations today and these issues are discussed further below.

Consider Farmer’s ideas regarding the “socialization for scarcity.” Do you believe scarce resources should be spent on specialty pediatrics cancer care?

With respect to Farmer's idea regarding the “socialization for scarcity,” the argument is made that political and social issues are frequently more influential in the allocation of scarce resources than actual need. As a result, the “socialization of scarcity” translates into an unequal distribution of health care resources that adversely affect a population. In many ways, this argument makes a lot of sense given that the decision-making process concerning the allocation of scarce resources is often fraught with divergent opinions, flawed reasoning and individual, potentially biased preferences.

It is reasonable to suggest that the answer to whether scarce resources should be spent on specialty pediatrics cancer care depends on who is doing the asking and who is doing the answering. On the one hand, pundits eager to appear concerned over the plight of young people suffering from a potentially deadly disease may wring their hands and cluck that, “We want to help but there just isn’t enough money to go around.” On the other hand, the same question asked of the parents of these young victims will likely argue that far more resources need to be devoted to help these young people recover from their cancer and go on to lead normal, productive, meaningful lives. Indeed, most parents would insist that the entire national treasure should be invested to save their child’s life.

Clearly, the views concerning whether scarce resources should be spent on specialty pediatrics cancer care exist along a continuum ranging from absolutely no to absolutely yes, with multiple gradients of views between them. The view that all humankind has a fundamental right to equitable access to health care gained momentum during the late 20th century, and this notion has helped push the views about specialty pediatric cancer toward the “absolutely yes” extreme (Basilico et al., 2013). Moreover, a significant amount of progress has already been made in the treatment of pediatric cancer in developed nations which could serve to reduce the costs and improve the effectiveness of the treatments of this disease in emerging nations as well (Calligan et al., 2023).

Ideally, of course, every disease that currently afflicts young people should be thoroughly research and treatments and cures developed at the earliest opportunity possible. Early interventions for conditions such as pediatric cancer are far more effective and offer the best chance for these young victims to recover and live long and meaningful lives (Calligan et al., 2023). This optimal outcome, however, will never be possible unless unlimited resources become available to all humanity, a highly unlikely eventuality even given the progress being made on fusion energy. Consequently, the historical record confirms that humankind will always be confronted with a cost-benefit analysis concerning which diseases warrant a Manhattan Project-level intervention and which can be ignored, at least until the disorder starts affecting affluent children in developed nations as well.

At present, the best outcome that can be achieved in the allocation of scarce resources for specialty pediatrics care of any type would be to proportion the available resources according to the percentage of children who are affected by the disease. For instance, about 400,000 new cases of pediatric cancer are diagnosed each year (Childhood cancer, 2023). Other diseases such as malaria, pneumonia, diarrhea, tuberculosis and HIV kill millions of children each year (Childhood Diseases, 2023). Moreover, these disorders already have efficacious treatments available. As a result, funding for specialty pediatrics cancer care should be provided, but weighted according to the percentage of children who are afflicted by this disorder.