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  • Good morning, Hank.

  • It's Tuesday.

  • So a few weeks ago, I had to get a tetanus shot because I was trying to harvest some green beans and accidentally harvested part of my abdomen.

  • It was an easy trip to the doctor, but while I was there, I kept thinking about all the systems that had to be in place for me to get that tetanus shot like there had to be a system of roads and highways and bridges for me to get to the clinic and a system of gasoline distribution to fuel my car and electricity system was necessary to keep the lights on and refrigerate my tetanus vaccine.

  • A sewage treatment system, allows for sanitary hand washing them.

  • There's the system that trains and licenses health care workers and a system that manufactures and distributes the astonishing number of goods associated with my tetanus vaccine.

  • I don't just mean the needle and the syringe and the vaccine itself, but also a cotton ball and a band aid in an alcohol wipe and gloves for the health care worker.

  • In the dreary grind of daily life, most of us do not talk or think much about systems because you know they're boring, like medical breakthroughs are fascinating.

  • Improving supply chains so that medical breakthroughs that need to be refrigerated can stay refrigerated.

  • Not as fascinating.

  • Still, I would argue that healthy systems are kind of the key to a healthy and productive human lives.

  • They are so central and so interdependent that improving them can lead to this massive, virtuous cycle.

  • You can look at almost any country and see this, but let's consider, say, Thailand.

  • Between 1994 and 2014 Thailand's child mortality rate decreased by more than 55%.

  • So what got better?

  • Everything.

  • Everything got better transportation system's got better health care delivery systems got better.

  • Water treatment systems got better.

  • Agricultural efficiency got better, because better health means more people working.

  • Which means a bigger economy, which means more tax revenue to invest in things like still better health and also say better roads, better roads make health care and food delivery and everything else cheaper and faster.

  • Better agricultural yields and food delivery systems means better health, which means more people working, which grows the economy and so on.

  • So okay, let's just improve all the systems.

  • But yeah, of course, it's not that easy.

  • Like, let's look at Sierra Leone.

  • For instance, about 11% of Sierra Leone's total economy goes to spending on health care, which is similar percentage wise to like the UK, Australia or France.

  • But because Sierra Leone is a much poor country, 11% of their GDP is equal to $54 per person per year.

  • For health care.

  • I paid $75 just for that tetanus shot, which admittedly is extortion.

  • But still $54 per person per year is not enough to fund a robust health care system.

  • And Justus Healthy systems can create virtuous cycles.

  • Weak systems can create vicious ones.

  • If a country has very little tax revenue to build systems and lack the political and economic stability necessary to attract private enterprise systems can weaken, which means less political and economic stability.

  • Like Imagine, you're in the same situation.

  • I was in needing a tetanus shot.

  • But in a community with much weaker systems, you may have to travel on bad roads because the transportation system isn't strong.

  • The clinic might be understaffed because the health worker training and employment system isn't strong, and even if the clinic is adequately staffed and supplied.

  • Your tetanus shot might be ineffective because it wasn't adequately refrigerated because there wasn't electricity.

  • Investments that take a really narrow view of health care, like health care is only tetanus shots may not end up improving that situation much, and that's one of the reasons I admire partners in health so much which nerd Fight Area has been working with for a decade now.

  • Partners in health is systems focused.

  • They do not like, drop in with solutions they listen to and invest in communities.

  • And while learning about global health.

  • Over the last several years, I've seen again and again that these fragile systems can get better and that a focus on health in the largest sense of the word can improve every aspect of a community's life.

  • Of course, investing in fragile systems sometimes fails, and the progress is often not simple or linear.

  • But it is really so.

  • Let's stay excited about the breakthroughs and innovations that will improve human life, but let us not forget the humble systems that literally keep the lights on.

Good morning, Hank.


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    林宜悉 に公開 2021 年 01 月 14 日