Pneumonia vs. Malaria: Who gets the cash?

Today at IDI, the GHC fellows happened across a medical debate that we were privileged to attend, eat lunch, and chat with some potential funders.  Networking once again.

The debate raged between whether we should direct more funding towards pneumonia or malaria or we should evenly distribute funding between pneumonia, malaria and other common diseases that affect mortality rates of children under 5.  I was struck by a few interesting points from both sides:

  • One African child dies of malaria every 30 seconds
  • The Malaria disease burden (or mortality caused by the disease) is higher than that of pneumonia, but under 5 mortality rates are 4 times higher for patients with pneumonia/pneumonia and malaria concurrently, then just malaria
  • Malaria exposes children to pneumonia.
  • Pneumonia has a vaccine, and it works
  • Malaria doesn’t have a complete vaccine
  • Uganda’s under 5 mortality rate is 99 out of 1000

I know some of that might seem basic to readers who know anything about health, like most of the GHC fellows, but for me, this was all news.  Pretty serious stuff, you’d think. But as we laugh about adjusting the numbers of pneumonia mortality to include meningitis to increase the figures, Development Humor* strikes.  Development humor is a new phenomenon for me.  I noticed it first at DEN-L, when people would tell jokes about very serious subjects, like checkpoints and rape, that were really not that funny, and everyone would laugh and laugh.  I’d sit there wondering what was going on and thinking of the Eels song “That’s not really funny.” Health workers are the same way, only about infant mortality.  This time, I laughed too. After all, it would be funny if a doctor skewed the numbers to include children who died from meningitis since meningitis usually occurs in children with pneumonia, in order to make a more solid argument for an increase in funding of pneumonia care.  That’d be hilarious.

My Mind Wanders

To my apparent past time, counting.  I use to count the lights in church when I was bored, now I compulsively count people in workshops. 53 participants, 27 women, 26 men (good split), 15 muzungus (can I even say that?), 2 of whom are male, meaning 13 white women in this workshop, interesting, why are there so many foreign women working in health.  Roughly 16 IDI staff members on the sign in sheet.  A good turn out, all and all.

But my mind wanders somewhere else too. There’s a laptop and projector at the front of the room, 2 screens, 4 speakers (which for some reason we aren’t using) one in front, one in back (the room could be two rooms with a divider in the middle), a broken overhead ceiling contraption, 2 AC units that aren’t on and we’re using TurningTechnologies clickers to survey the audience.  And the whole thing was recorded.  Nice display of classroom technology.  Now how can we use all this for distance learning….?  Well, first the video is going online!

Results

I was impressed by the content of the discussion.  I learned a lot about malaria and pneumonia and I found the debate about funding interesting on a more philosophical level of life and what matters.  The group was asked what they would prefer (using the clicker’s, win for the nerd in me), funding focused on malaria, pneumonia, or an even split.  We agreed with 50% for the even split before the debate.  and 54% of for the even split after the debate.  Not much mind changing in this round, but it was a session preaching to the choir.  I voted with the majority both times.  It’s sort of the middle way.

*I haven’t found a “laughing at jokes that aren’t really funny” post on SEAWL but it should be there.

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