How Iran Derailed a Health Crisis

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.

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.

The highest hospital costs come from preventable emergency room visits. A doctor in Camden developed a home visit program which gives better and cheaper care.

To educate and prepare new mothers, Centering Pregnancy and Centering Parenting sites in the United States offer community-based patient-centered care in low-income areas. Centering offers interactive learning, check-ups, and social support, so that women can take charge of their health.

Post-traumatic stress has dire consequences for U.S. veterans, including an increase in suicide, and not all therapeutic treatments for the disorder have succeeded. To treat and potentially cure the effects of PTSD, the Center for Mind-Body Awareness offers veterans Buddhist-inspired meditation, and mindfulness, as well as skills to develop creative expression.

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.

America’s system of health care is based on an old industrial-era model, without taking into account a decentralized, mobile, independent workforce that remains largely unprotected without health and unemployment insurance. The Freelancers Insurance Company, based in New York State, offers competitive premiums by having their executives receive salaries at low wages. The model keeps costs under control, which in turn makes health care more accessible to independent workers.

In a mountainous region of Lesotho, a man named Tsepo Kotelo visits 20 villages every week on his new motorcycle to provide health care to local villagers. The Elton John AIDS Foundation gifted the motorcycles to Kotelo and his colleagues, allowing them to increase the number of patients they visit by 600 percent. An organization called Riders for Health helps maintain the bikes, ensuring that remote villages will continue to receive medical care.

Physical illnesses trigger and exacerbate poverty because costs are too high to treat them. The Associação Saúde Criança in Rio de Janeiro counsels helps by assisting families with services such as food, medicine, vocational training, housing, and legal aid, which helps mothers achieve their personal goals.