The U.K.-based neurologist says that immunisation programmes are more effective than modern, high-tech diagnosis and treatment tools as well as procedures. In a chat with R. Madhavan Nair
Supply of safe drinking water and conventional mass immunisation programmes are the most cost-effective weapons in the battle against diseases in developing countries, said David Bates, a neurologist based in the United Kingdom who is on a short visit to Kozhikode.
Professor of Clinical Neurology at the University of Newcastle upon Tyne in the U.K., Dr. David Bates said immunisation campaigns such as the Pulse Polio programme now on in Kerala were of more value than modern high-tech diagnosis and treatment procedures for programmes aimed at providing large-scale effective healthcare.
"It is particularly true in developing countries," said Dr. Bates, who was here to speak on `Coma' at a continuing medical education (CME) programme on neuro-muscular diseases organised jointly by the Calicut Neurological Society and the Indian Medical Association's Academy of Medical Specialties.
Dr. Bates is trained in medicine at Downing College, Cambridge, and Middlesex Hospital in London and in neurology at the University of Newscastle upon Tyne and at Mayo Clinic, Rochester, Minnesota, in the U.S.
Dr. Bates said measures to provide good water supply and help to prevent infections through Pulse Polio and similar immunisation programmes formed a vital component of any successful and cost-effective healthcare system, as modern diagnostic and treatment methods were prohibitively expensive."
However, the new diagnostic tools that are now unaffordable to the poor would become cheaper over a period of time. He cited the case of X-Rays as an example, which, when devised by Wilhelm Rontgen were beyond the reach of the common man in terms of cost and availability, but were much more accessible now. "Similarly novel therapies would become the norm in the course of time," Dr. Bates said.
However, the new methods of diagnosis and treatment were advantageous in terms of the patient's safety and speed of treatment.
The neurologist said economics of healthcare would continue to play a critical role in healthcare programmes. This was in evidence in the United Kingdom when the National Health Service programme took up the healthcare of senior citizens, children below 16, the unemployed and the poor since 1948. There was no fee for the doctor or hospital facilities. Only a nominal fee had to be paid for the prescription. But such a situation was found to give rise to problems. These problems arose "since the people did not value the benefits they got free."
Human rights laws that were being raised by advocates of unlimited free medical care at Government expense were becoming dependent on economic factors even in the most egalitarian societies, he said. "Which is why cost effective conventional programmes like pulse polio are relevant in developing countries. Similar programmes are needed to prevent diseases resulting from hypertension, type - 2 diabetes and high cholestrol.
"We should try to prevent these diseases. We did that for small pox. It boils down to the old theory that prevention is better than treatment," says Dr Bates, whose current research involvement is predominantly in clinical trials of novel therapy in multiple sclerosis.
Supply of safe drinking water and conventional mass immunisation programmes are the most cost-effective weapons in the battle against diseases in developing countries, said David Bates, a neurologist based in the United Kingdom who is on a short visit to Kozhikode.
Professor of Clinical Neurology at the University of Newcastle upon Tyne in the U.K., Dr. David Bates said immunisation campaigns such as the Pulse Polio programme now on in Kerala were of more value than modern high-tech diagnosis and treatment procedures for programmes aimed at providing large-scale effective healthcare.
"It is particularly true in developing countries," said Dr. Bates, who was here to speak on `Coma' at a continuing medical education (CME) programme on neuro-muscular diseases organised jointly by the Calicut Neurological Society and the Indian Medical Association's Academy of Medical Specialties.
Dr. Bates is trained in medicine at Downing College, Cambridge, and Middlesex Hospital in London and in neurology at the University of Newscastle upon Tyne and at Mayo Clinic, Rochester, Minnesota, in the U.S.
Dr. Bates said measures to provide good water supply and help to prevent infections through Pulse Polio and similar immunisation programmes formed a vital component of any successful and cost-effective healthcare system, as modern diagnostic and treatment methods were prohibitively expensive."
However, the new diagnostic tools that are now unaffordable to the poor would become cheaper over a period of time. He cited the case of X-Rays as an example, which, when devised by Wilhelm Rontgen were beyond the reach of the common man in terms of cost and availability, but were much more accessible now. "Similarly novel therapies would become the norm in the course of time," Dr. Bates said.
However, the new methods of diagnosis and treatment were advantageous in terms of the patient's safety and speed of treatment.
The neurologist said economics of healthcare would continue to play a critical role in healthcare programmes. This was in evidence in the United Kingdom when the National Health Service programme took up the healthcare of senior citizens, children below 16, the unemployed and the poor since 1948. There was no fee for the doctor or hospital facilities. Only a nominal fee had to be paid for the prescription. But such a situation was found to give rise to problems. These problems arose "since the people did not value the benefits they got free."
Human rights laws that were being raised by advocates of unlimited free medical care at Government expense were becoming dependent on economic factors even in the most egalitarian societies, he said. "Which is why cost effective conventional programmes like pulse polio are relevant in developing countries. Similar programmes are needed to prevent diseases resulting from hypertension, type - 2 diabetes and high cholestrol.
"We should try to prevent these diseases. We did that for small pox. It boils down to the old theory that prevention is better than treatment," says Dr Bates, whose current research involvement is predominantly in clinical trials of novel therapy in multiple sclerosis.
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