Plagues and the Paradox of Progress: Why the World Is Getting Healthier in Worrisome Ways

MIT Press
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Why the news about the global decline of infectious diseases is not all good.

Plagues and parasites have played a central role in world affairs, shaping the evolution of the modern state, the growth of cities, and the disparate fortunes of national economies. This book tells that story, but it is not about the resurgence of pestilence. It is the story of its decline. For the first time in recorded history, virus, bacteria, and other infectious diseases are not the leading cause of death or disability in any region of the world. People are living longer, and fewer mothers are giving birth to many children in the hopes that some might survive. And yet, the news is not all good. Recent reductions in infectious disease have not been accompanied by the same improvements in income, job opportunities, and governance that occurred with these changes in wealthier countries decades ago. There have also been unintended consequences. In this book, Thomas Bollyky explores the paradox in our fight against infectious disease: the world is getting healthier in ways that should make us worry.

Bollyky interweaves a grand historical narrative about the rise and fall of plagues in human societies with contemporary case studies of the consequences. Bollyky visits Dhaka—one of the most densely populated places on the planet—to show how low-cost health tools helped enable the phenomenon of poor world megacities. He visits China and Kenya to illustrate how dramatic declines in plagues have affected national economies. Bollyky traces the role of infectious disease in the migrations from Ireland before the potato famine and to Europe from Africa and elsewhere today.

Historic health achievements are remaking a world that is both worrisome and full of opportunities. Whether the peril or promise of that progress prevails, Bollyky explains, depends on what we do next.

A Council on Foreign Relations Book

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About the author

Thomas J. Bollyky is the Director of the Global Health Program at the Council on Foreign Relations and an Adjunct Professor of Law at Georgetown University.

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Additional Information

Publisher
MIT Press
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Published on
Sep 21, 2018
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Pages
280
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ISBN
9780262348089
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Language
English
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Genres
Medical / Public Health
Political Science / International Relations / General
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Content Protection
This content is DRM protected.
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 In recent years, frugal and reverse innovation have gained attention as potential strategies for increasing the quality and accessibility of health care while slowing the growth in its costs. The notion that health technologies, services, and delivery processes developed for low-income customers in low-resource settings (known as "frugal innovations") might also prove useful in other countries and higher-income settings (a process some call "reverse innovation") is not new.  The demand for these types of innovation is increasing, however, as developed and developing countries alike strain to cope with the staggering economic and social costs of noncommunicable diseases (NCDs).

Increased attention on innovation is welcome—particularly when it is in service of improving the economic opportunities of the world's poorest and increasing their access to much-needed health-care products and services. The trick will be to ensure that the focus on reverse and frugal innovation goes beyond the latest buzzword and translates into real investments and results. With this goal in mind, this paper seeks to answer three practical questions regarding reverse and frugal innovation and NCDs: Are reverse and frugal innovations likely to be important for addressing the NCD challenges facing the poor in high- and low-income settings? Which pressing NCD challenges are reverse and frugal innovations best suited to help solve? What measures can donors, private companies, and nongovernmental organizations (NGOs) take to facilitate the use of reverse and frugal innovations to solve those problems?

The answers to these questions may contribute to the ongoing efforts of donors, investors, NGOs, and governments to move frugal and reverse innovation out of the realm of promising ideas and anecdotes and into broader practice to tackle the global challenge of NCDs.

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