Day 12: Globalization of Disease

Concept Notes:

Factors of globalization of infectious diseases

Global Communications and Travel

Human beings are the most efficient transmitters of diseases that have historically affected relatively small isolate parts of
the world. In the past, large proportions of populations were killed by plagues as people traveled to distant places. At
present, the speed of air transportation and communications have combined to rapidly spread infectious diseases and
information about them worldwide.

Trade

The rapid expansion of trade has exposed the world to many diseases. Example of which are trades of agricultural and
dairy products. Mad cow diseases, for instance, has become a contentious disease issue between the US and Japan.
Japanese people feared to be infected by imports of American beef.

Environmental Factors

Human activities have profoundly affected the natural environment. People have migrated to areas that bring them into
contact with animals and soils that play a role in the spread of infectious diseases. Furthermore, gradual increases in the
earth’s temperature are conducive to the global spread of diseases.

Ethnic Conflicts and Wars

Combatants are often more likely to die from infectious diseases than from actual fighting. It is estimated that more than
two-thirds of the roughly 600,000 deaths in the American civil war were caused by infectious diseases. When American
soldiers were transported on trains and troop ships, many perished.

Refugees and Migration

Conditions that influence people to leave one area to settle in another initiate the downward spiral leading to infectious
diseases. The deterioration of health services, the destruction of infrastructure, food shortages, and the lack of proper
sanitation make refugees susceptible to communicable diseases. For example, following the Gulf War in 1991, roughly
400,000 Kurdish refugees fled Iraq and ended up in squalid camps in adverse weather conditions. More than 70 percent
of the deaths were attributed to diarrhea and cholera.

Poverty

The poorest countries are generally more vulnerable to contracting infectious diseases. Overcrowding, malnutrition,
inadequate medical care, and unsanitary conditions facilitate the growth and transmission of infectious diseases.
Modern Medical Practices

A growing problem that assists the spread of infectious diseases is overuse and misuse of antibiotics. The increasing use
of antibiotics in agricultural products has contributed to a process of pathogenic natural selection, which promotes the
emergence of more virulent, resilient, resistant, and powerful disease strains.

Changing Social and Behavioral Patterns

Pervasive and instant communications, television programs, movies, and the Internet facilitate the global spread of
information about social practices that were once limited to smaller groups within societies. The global sex industry is an
example of how changing behavior contributes to the globalization of infectious diseases, such as HIV/AIDS. The spread
of infectious diseases has focused attention on human security.

Day 13: Globalization of Crime

Concept Notes:

Guided Practice: THE PORTUGUESE EXPERIMENT

According to Gil Kerlikowske, the former Director of the National Drug Control Policy, “85 percent of all drug treatment
research is conducted or funded in the United States,” but in 2012, he traveled to Portugal, Italy, Mexico, and Colombia to
talk with government and health officials about their respective addiction treatment programs. Kerlikowske noted that
Portugal’s unprecedented 2001 move of not arresting, trying, or imprisoning people with personal supplies of recreational
drugs has opened a large number of doors and ideas for new and innovative ways that governments can help their
addicted and at-risk citizens. Portugal’s experiment, now well over a decade old, has long been a topic of interest in the
public health umbrella of medicine and crime and punishment. TIME magazine reports of how the westernmost country of
mainland Europe became the first in the continent to “officially abolish all criminal penalties for personal possession of
drugs,” from marijuana and cocaine to heroin and methamphetamine.The program came about as a response to the
country’s debilitating drug problems in the late 20th century. Lisbon, the capital city, was a focal point for drug smuggling
and “a devastating heroin epidemic,” writes Medical Daily. As a result of the needle sharing, HIV and hepatitis spread
rapidly, and most of the 10.29 million people of Portugal knew, or knew of, someone addicted to heroin.

PORTUGAL'S HEROIN PROBLEM

The problem arose from the end of the dictatorship of the Second Republic, an authoritarian regime that ruled the country
with an iron fist from 1933 to 1974. The group was inspired by, based on, and enforced conservative and authoritarian
principles; when it fell, an entire generation of Portuguese people indulged themselves on freedoms that had long been
denied to them. Atop that list, says Medical Daily, were drugs. Soldiers returning from newly liberated, former African
colonies (Angola, Portuguese Guinea, and Mozambique) brought home cannabis, and black marketeers imported heroin
and cocaine. Dr. João Castel-Branco Goulão, one of the architects of Portugal’s drug policy, explained that his country
was “completely naive” about drugs. Under the rule of the Second Republic, Portugal had been closed off from the outside
world, with no social liberties for its people. When that government ended, drug and alcohol abuse was not only
commonplace, it was practically encouraged.

Unsurprisingly, when the party ended, the heroin was still there, and in a few short years, the country was suffering. Other
European nations had the time to discover what not to do with drugs, said Dr. Goulão, but Portugal was thrust into the
deep end of the learning curve. By the time authorities realized what had gone wrong, “we had a huge amount of people
who were addicted mainly to heroin.”
By the 1990s, almost 1 percent of Portugal’s citizens had a heroin addiction. The epidemic became the number one public
health issue in the country. In response, the government created a task force consisting of doctors, judges, and mental
and social healthcare workers. Dr. Goulão was one of the people tasked with saving his country. In 1998, he and his team
came up with a plan that no one saw coming: decriminalizing all drug use, and creating new policies and programs that
would treat addicts and prepare them for reintegration into Portuguese society.

CHANGING THE CONVERSATION

If addiction is a disease, argues Dr. Goulão, then why arrest sick people? The task force operated under the assumption
that the addiction epidemic was medical in nature, not an issue of law and order.
To that effect, Portuguese citizens who were apprehended with drugs were offered therapy instead of jail sentences. Fear
of prison is what makes addicts go underground, and incarceration costs taxpayers more than treatment. Dr. Goulão’s
team could logically make the argument that there was less to lose by providing drug addicts with health services that
would actually address their problems.

The Portuguese government agreed. Under the 2001 laws, citizens found guilty of possessing small amounts of drugs (no
more than a 10-day supply of the given substance) were sent to a panel made up of a psychologist, a social worker, and a
legal advisor, who would then devise an appropriate treatment plan. The citizen in question would be given the right to
refuse to accept the decision of the panel without criminal punishment. Jail would not be part of the arrangement.

RESPONSE AND RESULTS

Unsurprisingly, the new plans were not universally accepted at first. Portugal was a poor, socially conservative, and
majority Catholic country; the word on the street was that decriminalizing drug possession would do nothing but make
Portugal a haven for drug tourists and make the preexisting drug problem worse. Portugal was already home to the
highest levels of illegal and dangerous drug use across Europe; removing jail from the response paradigm seemed like
national suicide.

But in 2009, a report issued by Washington, DC’s Cato Institute revealed that five years after personal possession of
drugs was decriminalized in Portugal, the effects across the country far exceeded expectations:
- Illegal drug use by teenagers dropped.
- Rates of HIV infections by sharing contaminated needles dropped.
- The number of people seeking treatment for substance abuse more than doubled.

The Cato Institute’s research was conducted by Glenn Greenwald, a former lawyer, New York Times bestselling author,
and renowned journalist and political commentator. Greenwald told Salon magazine that an empirical evaluation of
Portugal’s decriminalization policy shows that the program “has been an unquestionable success” across the board. The
focus on treatment, and not punishment, has helped Portugal manage its drug problems and use “far better than most
Western nations,” which persist in treating consumption and addiction as problems of crime, not health.
Every metric, said Greenwald, showed that Portugal’s decriminalization has been wildly successful. The report by the
Cato Institute showed that compared to both the European Union and the United States, Portugal had the lowest rate of
lifetime cannabis consumption, both in Europe and America. More Americans have used cocaine than Portuguese have
smoked marijuana.

Every metric, said Greenwald, showed that Portugal’s decriminalization has been wildly successful. The report by the
Cato Institute showed that compared to both the European Union and the United States, Portugal had the lowest rate of
lifetime cannabis consumption, both in Europe and America. More Americans have used cocaine than Portuguese have
smoked marijuana.

Furthermore, between 2001 and 2006, the amount of lifetime use of heroin – the drug that was causing the most problems
for Portugal – fell by 2.5 percent to 1.8 percent among those 16-18 years old. Illegal drug use by children in grades 7-9
dropped from 14.1 percent to 10.6 percent. HIV infections and fatalities caused by heroin and other drugs declined by
more than 50 percent.

One of the most notable statistics to come out of Portugal’s decriminalization program was the number of people who
enrolled in methadone and buprenorphine treatment for drug addiction: from 6,040 before the policy to 14,887 afterwards.
The amount of money saved on law enforcement measures also funded drug-free treatment options.

Day 14: SUSTAINABLE DEVELOPMENT (UN) GOAL 1: END POVERTY IN ALL ITS FORMS EVERYWHERE
Concept Notes:

Goal 1 Targets:

 By 2030, eradicate extreme poverty for all people everywhere, currently measured as people living on
less than $1.25 a day
 By 2030, reduce at least by half the proportion of men, women and children of all ages living in poverty
in all its dimensions according to national definitions
 Implement nationally appropriate social protection systems and measures for all, including floors, and
by 2030 achieve substantial coverage of the poor and the vulnerable
 By 2030, ensure that all men and women, in particular the poor and the vulnerable, have equal rights to
economic resources, as well as access to basic services, ownership and control over land and other
forms of property, inheritance, natural resources, appropriate new technology and financial services,
including microfinance
 By 2030, build the resilience of the poor and those in vulnerable situations and reduce their exposure
and vulnerability to climate-related extreme events and other economic, social and environmental
shocks and disasters
 Ensure significant mobilization of resources from a variety of sources, including through enhanced
development cooperation, in order to provide adequate and predictable means for developing
countries, in particular least developed countries, to implement programmes and policies to end poverty
in all its dimensions
 Create sound policy frameworks at the national, regional and international levels, based on pro-poor
and gender-sensitive development strategies, to support accelerated investment in poverty eradication
actions

Day 15: SUSTAINABLE DEVELOPMENT: GOAL 2: END HUNGER, ACHIEVE FOOD SECURITY AND
IMPROVED NUTRITION AND PROMOTE SUSTAINABLE AGRICULTURE

Concept Notes:
 2017 FACTS AND FIGURES: HUNGER Globally, 1 in 9 people in the world today (795 million
people) are undernourished.

The vast majority of the world’s hungry people live in

developing countries, where 12.9% of the population is
underrated.
Breakdown of Hunger in 2015
Asia is the continent with the most hungry people – 2/3 of
1st - Asia: 511.7 million the total. The percentage in southern Asia has fallen in
2nd - Africa 232.5 million recent years but in Western Asia it has increased slightly.
3rd - Latin America: 34.3 million
4th - US and Europe: 14.7 million Southern Asia faces the greatest hunger burden, with about
5th - Oceania: 1.4 million 281 million undernourished people. In sub-Saharan Africa,
projections for the 2014 – 2016 period indicate a rate of
undernourishment of almost 23%

Poor nutrition causes nearly half (45%) of deaths under five

– 3.1 million children each year.

1 in 4 of the world’s children suffer stunted growth. In

developing countries, the proportion can rise to 1 in 3.

66 million primary school-age children attend classes hungry

across the developing world, with 23 million in Africa alone.

Goal 2 Targets:

 By 2030, end hunger and ensure access by all people, in particular the poor and people in vulnerable
situations, including infants, to safe, nutritious and sufficient food all year round
 By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets
on stunting and wasting in children under 5 years of age, and address the nutritional needs of
adolescent girls, pregnant and lactating women and older persons
 By 2030, double the agricultural productivity and incomes of small-scale food producers, in particular
women, indigenous peoples, family farmers, pastoralists and fishers, including through secure and
equal access to land, other productive resources and inputs, knowledge, financial services, markets
and opportunities for value addition and non-farm employment
 By 2030, ensure sustainable food production systems and implement resilient agricultural practices that
increase productivity and production, that help maintain ecosystems, that strengthen capacity for
adaptation to climate change, extreme weather, drought, flooding and other disasters and that
progressively improve land and soil quality
 By 2020, maintain the genetic diversity of seeds, cultivated plants and farmed and domesticated
animals and their related wild species, including through soundly managed and diversified seed and
plant banks at the national, regional and international levels, and promote access to and fair and
equitable sharing of benefits arising from the utilization of genetic resources and associated traditional
knowledge, as internationally agreed
 Increase investment, including through enhanced international cooperation, in rural infrastructure,
agricultural research and extension services, technology development and plant and livestock gene
 banks in order to enhance agricultural productive capacity in developing countries, in particular least
developed countries
 Correct and prevent trade restrictions and distortions in world agricultural markets, including through
the parallel elimination of all forms of agricultural export subsidies and all export measures with
equivalent effect, in accordance with the mandate of the Doha Development Round
 Adopt measures to ensure the proper functioning of food commodity markets and their derivatives and
facilitate timely access to market information, including on food reserves, in order to help limit extreme
food price volatility

Day 16: SUSTAINABLE DEVELOPMENT (UN) GOAL 3: ENSURE HEALTHY LIVES AND
PROMOTE WELL-BEING FOR ALL AT ALL AGES

Concept Notes:

FACTS AND FIGURES

 At the end of 2014, there were 13.6 million people accessing antiretroviral therapy
 New HIV infections in 2013 were estimated at 2.1 million, which was 38 per cent lower than in 2001
 At the end of 2013, there were an estimated 35 million people living with HIV
 At the end of 2013, 240 000 children were newly infected with HIV
 New HIV infections among children have declined by 58 per cent since 2001
 Globally, adolescent girls and young women face gender-based inequalities, exclusion, discrimination
and violence, which put them at increased risk of acquiring HIV
 HIV is the leading cause of death for women of reproductive age worldwide
 TB-related deaths in people living with HIV have fallen by 36% since 2004
 There were 250 000 new HIV infections among adolescents in 2013, two thirds of which were among
adolescent girls
 AIDS is now the leading cause of death among adolescents (aged 10–19) in Africa and the second
most common cause of death among adolescents globally
 In many settings, adolescent girls’ right to privacy and bodily autonomy is not respected, as many
report that their first sexual experience was forced
 As of 2013, 2.1 million adolescents were living with HIV

GOALS
 By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat
hepatitis, water-borne diseases and other communicable diseases
  By 2030, reduce by one third premature mortality from non-communicable diseases through prevention
and treatment and promote mental health and well-being
 Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and
harmful use of alcohol
 By 2030, ensure universal access to sexual and reproductive health-care services, including for family
planning, information and education, and the integration of reproductive health into national strategies
and programmes
 Achieve universal health coverage, including financial risk protection, access to quality essential health-
care services and access to safe, effective, quality and affordable essential medicines and vaccines for
all
 Support the research and development of vaccines and medicines for the communicable and
noncommunicable diseases that primarily affect developing countries, provide access to affordable
essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement
and Public Health, which affirms the right of developing countries to use to the full the provisions in the
Agreement on Trade Related Aspects of Intellectual Property Rights regarding flexibilities to protect
public health, and, in particular, provide access to medicines for all
 Substantially increase health financing and the recruitment, development, training and retention of the
health workforce in developing countries, especially in least developed countries and small island
developing States
 Strengthen the capacity of all countries, in particular developing countries, for early warning, risk
reduction and management of national and global health risks

Day 17: SUSTAINABLE DEVELOPMENT (UN) GOAL 4: ENSURE INCLUSIVE EDUCATION FOR ALL AND
PROMOTE LIFELONG LEARNING

Concept Notes:

GOALS

 By 2030, ensure that all girls and boys complete free, equitable and quality primary and secondary education
leading to relevant and Goal-4 effective learning outcomes
 By 2030, ensure that all girls and boys have access to quality early childhood development, care and preprimary
education so that they are ready for primary education
 By 2030, ensure equal access for all women and men to affordable and quality technical, vocational and tertiary
education, including university
 By 2030, substantially increase the number of youth and adults who have relevant skills, including technical and
vocational skills, for employment, decent jobs and entrepreneurship
 By 2030, eliminate gender disparities in education and ensure equal access to all levels of education and
vocational training for the vulnerable, including persons with disabilities, indigenous peoples and children in
vulnerable situations
 By 2030, ensure that all youth and a substantial proportion of adults, both men and women, achieve literacy and
numeracy
 By 2030, ensure that all learners acquire the knowledge and skills needed to promote sustainable development,
including, among others, through education for sustainable development and sustainable lifestyles, human rights,
gender equality, promotion of a culture of peace and non-violence, global citizenship and appreciation of cultural
diversity and of culture’s contribution to sustainable development
 Build and upgrade education facilities that are child, disability and gender sensitive and provide safe, nonviolent,
inclusive and effective learning environments for all
 By 2020, substantially expand globally the number of scholarships available to developing countries, in particular
least developed countries, small island developing States and African countries, for enrolment in higher
education, including vocational training and information and communications technology, technical, engineering
and scientific programmes, in developed countries and other developing countries
 By 2030, substantially increase the supply of qualified teachers, including through international cooperation for
teacher training in developing countries, especially least developed countries and small island developing states