How to Stop the Spread of Disease

Garrett and Farmer

Laurie Garrett argues for continued global budgetary allocations for communicable disease programs and surveillance, emphasizing that investing in addressing non-communicable diseases at the expense of infectious disease control will have global repercussions if not addressed. She acknowledges that non-communicable diseases are a significant threat to public health, but she believes that communicable diseases should not be overlooked.

In contrast, Farmer et al. propose addressing both communicable and non-communicable diseases together in an integrated, diagonal fashion, arguing that efforts to reduce mortality and morbidity associated with either will be more effective if they are coordinated by building platforms to deliver both chronic and acute care.

While both arguments have merit, I find Farmer et al.'s proposal more compelling. First, addressing both communicable and non-communicable diseases in an integrated, diagonal fashion would strengthen health systems. Health systems that are primarily designed to address one type of disease may be ill-equipped to handle another type of disease. Therefore, addressing both communicable and non-communicable diseases together can help create a more holistic and comprehensive healthcare delivery system that is better equipped to address the full spectrum of health challenges that populations face.

Second, Farmer's proposal would more effectively combat health problems. This is because communicable and non-communicable diseases are often linked epidemiologically and etiologically. For example, people with compromised immune systems due to HIV/AIDS are more susceptible to non-communicable diseases such as cancer, cardiovascular disease, and diabetes. Therefore, addressing communicable diseases can help prevent non-communicable diseases and vice versa.

Moreover, the risk factors for many non-communicable diseases, such as poor nutrition and lack of physical activity, are also risk factors for communicable diseases. Therefore, addressing these risk factors can have a positive impact on both communicable and non-communicable diseases. Encouraging physical activity, promoting healthy eating habits, and improving access to nutritious foods can help prevent both types of diseases. Moreover, interventions that address these risk factors can have a ripple effect, preventing not only the targeted diseases but also related health problems. For example, promoting physical activity can reduce the risk of cardiovascular disease, diabetes, and certain types of cancer, as well as improve mental health.

Finally, coordinating efforts to address both types of diseases would lead to more efficient and effective healthcare delivery. By building platforms to deliver both chronic and acute care, health systems can better leverage their resources to address the full range of health challenges. This can lead to cost savings, increased efficiency, and ultimately better health outcomes for populations.

In conclusion, both communicable and non-communicable diseases are significant threats to global health, and addressing them in a coordinated and integrated way is critical. While Garrett emphasizes the importance of continued investment in communicable disease programs and surveillance, Farmer proposes a more comprehensive approach that would strengthen health systems and enable more efficient and effective healthcare delivery. I find Farmer’s argument to be the more convincing as it approaches the problem of health from a more holistic perspective, seeing how health problems are interrelated at various levels and in different ways. The key to addressing public health is not to do it piecemeal but rather to take it on holistically and as thoroughly as possible, with a view to the interrelatedness of diseases.