Modern Medical Interventions: A Promising Status Quo From Heresy

I would rather let my monthly allowance be slashed off to half rather than let my health be degraded to half. As Buddha said, Without health life is not life; it is only a state of languor and suffering - an image of death. It is on that sense that I understand why different social health scholars are eager to determine the leading cause of the decline of mortality from decades ago until now to preserve life through health innovations in the context of the cause of the decline. Basically because an increase in mortality rate can be seen as a decrease in the health status and a decrease may mean a quality health of a certain population (Jane Ogden, Health Psychology; 4th edition, pg. 393). There are two possible factors that can be attributed to the fall of mortality along the time the famous assertion, the socioeconomic development (primarily in nutrition, good hygiene and environmental sanitation) and of course the considered modern heresy, the modern medical interventions (in the form of vaccines, medicines, as well as medical products and therapies). While I am convinced that the two should go hand in hand to combat the fatality of the known infectious diseases, I give more reasonable credit to modern medical interventions even if its not yet embraced by the many, especially through the introduction of vaccines, as the prime force that influences the decline of mortality by infectious diseases. I used logical reasoning and brought situations in futuristic approach to justify my stand. First, admitting without conceding that McKeown and his comrades were right on their study that the decline of mortality in England and Wales was largely attributable to the improvements in the environment (McKeown et al., 1955, 1962, 1975); they never concluded that it was solely attributed to it. Though medical measures were premature prior the 19th century, small pox vaccination even accounted considerable effects to the decline of mortality. How much more if we are going to talk about improved and developed vaccines in our modern times and assumingly apply it to England and Wales during those times? According to WHO data, pneumococcal disease and Hib are among the leading causes of vaccine-preventable deaths in children under five, which brings to fore the need for vaccination to mitigate their public-health impact and save childrens lives. Vaccination is the single most effective way of preventing infectious diseases. Second, in the absence of the benefits of modern medical measures, our predecessors had little to no defense against infectious disease such as smallpox, pneumonia, rotavirus, malaria, and measles. These infectious diseases had been tagging along with the length of history. Smallpox scarring can be found on Egyptian mummies more than 3,000 years ago (Science 1975; 187:5158). Even the Persian philosopher and physician Rhazes articulated the devastation of measles in the 10 century AD (Br J Ophthalmol 2008; 92:1324). If mere environmental improvement and diet modification were good enough, how come these prehistoric diseases remained a big problem prior to the introduction of vaccines and breakthrough medical innovations such as medicine? This only means that premature classical medical intervention also existed along with the development of the society. Even the idea of the destruction of the path of the spread of pathogens, claimed as the environmental modification, is technically a medical measure.

Third, medical interventions eliminate infectious diseases, not just confine. In the United States, infectious disease mortality declined 95 percent during the first 8 decades of the 20th century, from 797 deaths per 100,000 in 1900 to 36 deaths per 100,000 in 1980 (JAMA 1999; 281:61-6). The success of vaccination programs in the United States and Europe ushered in the 20th-century the concept of disease eradicationthe idea that a specific disease could be eliminated from the planet. In 1977, after a decade long campaign involving 33 nations, smallpox was eradicated worldwideapproximately ten years after it had been eradicated from the United States and the rest of the western Hemisphere (JAMA 1999; 282:1029-32). Finally, HIV as a modern infectious disease may add weight to the argument that modern medical intervention is the prime cause of the decline of mortality over the years. In 2004, HIV/AIDS was the sixth leading cause of death at the world level and the fourth leading cause in low-income countries, after lower respiratory infections, ischemic heart disease, and diarrheal diseases (WHO2008). You cant just merely modify your diet and the environment with this disease. It involves unpredictable human behavior and a virus that continually replacating. Once you have it, youll automatically be an expected candidate to the mortality counts of statisticians. Currently, victims are embracing the aid of anti-retroviral drugs to limit the lethalness of the diseases. As time advances, I won't be surprised that breakthroughs in medicine will arise and the elimination of this disease will be no more than a possibility just like how small pox said goodbye on the 3rd quarter of the 20th century. The initial decline in AIDS deaths starting around 2006 is partly related to the ongoing intensive global effort to provide Anti-Retroviral Therapy to increasing proportions of AIDS patients (Population Council, John Bongaarts et al., 2009). In fact, a new study found pills to be highly effective in preventing HIV transmission. Experts hail a pair of trials involving heterosexual couples in Africa as a breakthrough in AIDS prevention. The studies show that taking a pill containing one or two drugs each day can decrease transmission of HIV by as much as three-quarters (Thomas H. Maugh II, Los Angeles Times, July13, 2011). The bottom-line is, lives will be saved and will be reflected by the consistent decline of mortality. While socioeconomic development is a given, medical intervention is an active solution to an active problem for the volatile world of infectious diseases. Modern medical measures will then transcend from a mere heresy into a socially accepted fact called - status quo.

Axell Maramara Alterado, BSN, RN Master of Health Social Science Undergraduate (2012-2013)