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Welcome to Perspectives’ Community Space. Below are some of the comments we received as we were putting together July’s edition on “Best Buys in Global Health.” While some have been edited down for space reasons, we have taken pains not to alter the “voice” of the contributors. Click the comment button below to add your thoughts!”

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By contemporary standards, there is an incredible economic imbalance in the affordability of quality health between the high-income countries and the low-income ones. Access to medical care by people—especially in developing countries—has been further compounded by the process of globalization, economic and development programs that make social spending a luxury for poor nations, rampant political strife, the emergence of drug resistance microbes, the rapid spread of disease around the world, ever increasing cross-border travel and trade, as well as the HIV/AIDS pandemic. As it is now, staying alive in the developing countries is a monumental risk that has no alternative. Charles Ebere Department of Social Sciences University of The Gambia, West Africa

At 2.6 billion, half the developing world lacks a toilet and there are nearly as many without it today as there were in 1990. The result is massive and daily pollution of the environment with human faeces. Faeces—and drinking water and food contaminated by faeces—carry pathogens implicated in some 1.8 million deaths per year from diarrhoea, and 2 billion cases of parasitic worm infections. Before the vaccine was discovered in 1937, sanitation was the main measure to combat yellow fever, and today it is the only method of controlling dengue. The economic benefits from investing in toilets are difficult to calculate, but returns are thought to range from $3 per dollar investment to $34, which is large enough to rival other healthcare interventions. A sanitary toilet can be as basic as a pit in the ground, covered by a slab with a hole, and surrounded by a fence for privacy. In Bangladesh, some families are constructing their own toilets from scrap for under $5. Shahin Yaqub New York

Until recently, all expert diagnosis of x-rays in Mali had to take place in the capital, Bamako, or sometimes up to 1,000 kilometres from the regional hospital where the first analysis was made. A new tele-radiology project provides a solution for this problem by offering the possibility to send or receive x-ray scans and diagnoses over the Internet. This enables regional and local doctors to send patients’ x-rays to Bamako where trained radiologists and specialized doctors can make a quick diagnosis and suggest the best course of treatment. Instead of their knowledge and expertise remaining in the city, it is now being applied in remote places. See this link for more information. Anna Gerrard International Institute for Communication and Development The Netherlands

An accident victim, a young man, had to die because he could not make a deposit as demanded by the hospital authorities. A Good Samaritan volunteered to pay the initial deposit, but much blood was lost and the man died. In a government hospital in one of the states in the north, the medical director had to pay the bill of a dying patient for a blood transfusion before he was admitted. Thanks doctor! Rawlings Okorie Lagos, Nigeria

I believe the greatest health challenge the world is facing today are the pharmaceutical companies’ monopoly on medicine, especially HIV/AIDS treatments. I think health is a human right and, like water, governments and companies simply cannot deny, privatize, or charge people. The world should mobilize and purchase large quantities of generic medicine and distribute them to the people that need them. We have an obligation to uphold human rights, regardless of corporate control and the risk associated with going against it. To quote those who protested water privatization, and activists around our world: The People United, We’ll Never Be Defeated. Thank you. Andrew deSouza Burlington, Ontario, Canada Student

There is a huge unmet need for contraception in many parts of the world. Most women don’t know that they are “not fertile” for about 2/3 of their cycles. With this knowledge (Fertility Awareness) many women with no access to medical care or contraceptive technology could have much more control over when they become pregnant. Simplified versions of fertility awareness are available for women who are illiterate. (Note: FA is not the inaccurate Rhythm Method, but rather is a system of body observation.) Ilee Richaman Fertility Awareness Center New York

While heart disease, cancer, obesity, and smoking dominate health concerns in industrial countries, infectious diseases are the overriding health concern in developing countries. Many countries lacking the funds to invest in vaccines for childhood diseases today will pay a far higher price tomorrow. Ensuring access to a safe and reliable water supply for the estimated 1 billion people who lack it also is essential. For treating the symptoms of diarrheal disease (often caused by contaminated water), a UNICEF oral rehydration therapy campaign has made impressive gains, reducing deaths from diarrhea among children from 4.6 million in 1980 to 1.5 million in 1999. Few investments have saved so many lives at such a low cost. For more information on achieving better health for all, see this link. Lester R. Brown President, Earth Policy Institute Washington, DC

The best way to stay healthy diet-wise is to eliminate a completely flesh-eating diet, and replace it with the food originally designed for man—cereals, grains, nuts, vegetables and fruits—nature’s own storehouse of immunity against most of the world’s causes of ill health. One would expect that with numerous medical opinions on how increasingly dangerous it is for people to rely as much as they do on eating the flesh of animals, governments would massively support research on plant and vegetable substitutes. But instead, we are faced with contrasting opinion in support of disease-infested flesh-foods as diverse and contradictory as the selfish interests of the food companies and lobbyists they represent. Many more people die annually from diet-related heart and coronary diseases than any other. The secret to good health is therefore diet discipline. Dziedzorm Kwaku Segbefia Ghana Institute of Journalism Accra-Ghana, West Africa.

© Action Against Hunger-USA / Jim BulgatzTo provide effective healthcare in developing nations, an organization must create programs that take into account the needs, cultures, and resources of the recipients. For example, to improve infant nutrition, programs must utilize local foods and not introduce those that won’t be available once the organization leaves. By learning what beneficiaries need, want, and can provide for themselves, we can ensure that programs will be fully utilized and achieve the greatest good. Cathy Skoula Action Against Hunger New York

We need vitamins and minerals (micronutrients) in minute quantities for growth, brain development, and immunity against diseases. Deficiencies in vitamin A, iron, zinc and iodine have major negative effects on the health, development, and survival of children. Preventing micronutrient malnutrition saves lives and breaks cycles of poverty in developing countries, costing pennies per person, per year. Nobel laureate economists in the Copenhagen Consensus ranked investments in micronutrient programs second only to fighting HIV/AIDS. Zahra Popatia and Karen Luttrell Micronutrient Initiative Ottawa, Canada

Many businesses are involved in programs to improve global health. For example, the poorer sections of rural Indian households spend 12 percent of their income on healthcare, making its availability, affordability and quality a major national issue. In India, Royal Philips Electronics is using a custom-built tele-clinical van, complete with diagnostic equipment and dedicated doctors, to provide quality healthcare at an affordable price. Read more at this link. Danielle Carpenter World Business Council for Sustainable Development Geneva, Switzerland

** Questions? Responses? New ideas? Add your thoughts below!