Christophe’s story

The improvements in peoples’ lives that could occur with the changes recommended in this report

Disease endemic countries (such as the country where Christophe lives and works) will have developed a research agenda that better matches their own needs. Money will have been invested in research for better drugs and diagnostics for diseases that have a high national disease burden – diseases such as sleeping sickness.

A new culture of public health innovation will have led to concerted efforts to develop new diagnostics and treatments. Through this, a new rapid diagnostic blood test will have been developed to detect the infection that causes sleeping sickness, and an effective, non-toxic, oral drug will be available to treat the late stage disease. A s a result of implementation research the best way of delivering these to relevant communities will have been developed. Local availability of these new tools will mean that diagnosis and treatment will be safer, more easily administered, less costly for the patient and more effective.

Adoption of One Health, One World will mean that various research disciplines and ministries (health, agriculture, science and technology) will be working together, in partnership with both human and animal health control programmes, sharing data and information and spearheading a more holistic approach to health. New geographical information system (GIS) and cellular telephone networks will be helping to assess disease risks and report health problems. They will also be used to deliver health messages to Christophe’s mining colleagues, who now receive treatment for trypanosomiasis under an integrated programme targeting sleeping sickness while deploying tsetse traps. Cost-effectiveness research will have led to the development of an integrated strategy of preventative chemotherapy for helminthic infections within a river blindness programme. New monitoring and surveillance techniques will also be proving beneficial to such programmes.

Because there will be a new infectious disease development index (and associated media interest and public pressure), stakeholders in international development (such as aid agencies) will be investing in such programmes. The index will have compelled policy-makers to develop new regulations that ensure that the formal health system monitors community health. T his will lead to improved data, which in turn will lead to resources being sent to where they are needed – such as to Christophe’s small mining community.

Finally, monitoring of resources and funding flows will have indicated a number of funding gaps – such as investment in research on the association between infectious diseases of poverty and mental health problems. Funds will have been directed to this area and research and policy-makers will be stimulated to recognize these as important issues. Christophe’s wife, a small trader at this point, will be able to use a newly adopted health insurance scheme resulting from research into health financing to cover costs of treatment. Christophe’s mother, now partially blind as a result of poorly managed trachoma, will be able to access new drugs and therapies that make her life easier as her health deteriorates. Despite these demands, the health insurance scheme will decrease out-of -pocket expenditure on health by Christophe and his family, so they can afford to send their daughter onto higher education. Eventually Christophe’s daughter will become a nurse, working at the local hospital that serves the miners.