A Tale of Two Cities

The health problems of millions of Americans are directly related to patients' failure to follow doctors’ orders. Community health workers are increasingly successful in New York and other American cities – not to substitute for doctors, but to help patients stick to their treatment plans.

Two columns on how Iran averted a major AIDS epidemic through needle exchange programs; a conservative theocracy is successfully treating drug abuse as if it were Amsterdam.

Tuberculosis is still a rampant problem in the developing world. Doctors are looking for even more advanced ways to test for TB beyond the GeneXpert tests.

One-pill-a-day generic AIDS drugs for poor countries are hard to make because each ingredient is patented by a different pharmaceutical company. The Patent Pool provides a way for companies to donate their intellectual property safely.

Twelve million people are blind in India, and are robbed of their livelihoods as a result. A hugely successful chain of cataract hospitals in India helped its business by treating half its patients for free.

Slow test results make it difficult to stop the spread of tuberculosis. Using faster diagnostic technology and driving vans to rural areas in Tanzania, GeneXpert is making progress in treating this curable disease.

According to the Centers for Disease Control and Prevention, drug overdoses are the leading cause of injury-related mortality. Naxolone, a drug used to revive overdose victims, is only available by prescription. However, private organizations have distributed Naxolone kits nationally, showing that the drug can save lives when it is more readily accessible.

Latin American women in San Francisco have suffered from post-partum depression, social isolation, and chronic stress at the time of their pregnancies. Run by midwives, the Centering Pregnancy program at the San Francisco General Hospital provides patient-centered care, an environment to speak in Spanish, and a nurturing community for women’s group appointments. The results boast fewer c-sections and pre-term births, and an improvement in emotional support and overall prenatal health.

Although patients go to hospitals to receive medical care, many Americans will acquire infections that did not already have them. The United States as a whole has made modest progress at reducing the rates of hospital-acquired infections. Spearheading the efforts, the Veterans Affairs Medical Centers have devised anti-MRSA strategies to keep patients safe.

For decades, AIDS has taken the lives of millions of people and infected millions more worldwide. The key to reducing the effect of AIDS, and even potentially curing it, involves treating patients as early as possible after being diagnosed with HIV, before the disease damages organs. San Francisco General Hospital developed the RAPID program for this purpose, with the goal of “Getting to Zero” the number of new infections and deaths.