Blue Marble Health Hotez.indb 1 6/22/16 11:02 AM Hotez.indb 2 6/22/16 11:02 AM Blue Marble Health An Innovative Plan to Fight Diseases of the Poor amid Wealth Peter J. Hotez, MD, PhD Baylor College of Medicine Johns Hopkins University Press Baltimore Hotez.indb 3 6/22/16 11:02 AM © 2016 Johns Hopkins University Press All rights reserved. Published 2016 Printed in the United States of America on acid-f ree paper 9 8 7 6 5 4 3 2 1 Johns Hopkins University Press 2715 North Charles Street Baltimore, Maryland 21218-4 363 www.press.jhu.edu Library of Congress Cataloging-i n-P ublication Data Names: Hotez, Peter J., author Title: Blue marble health : an innovative plan to fght diseases of the poor amid wealth / Peter J. Hotez ; with a foreword by Cher. Description: Baltimore : Johns Hopkins University Press, 2016. | Includes bibliographical references and index. Identifers: LCCN 2015046697| ISBN 9781421420462 (pbk. : alk. paper) | ISBN 1421420465 (pbk. : alk. paper) | ISBN 9781421420479 (electronic) | ISBN 1421420473 (electronic) Subjects: | MESH: Neglected Diseases —e conomics | Poverty Areas | Global Health—e conomics | Health Equity—economics | Tropical Medicine—e conomics Classifcation: LCC RA418.5.P6 | NLM W 74.1 | DDC 362.1086/942—dc23 LC record available at http://lccn.loc.gov/2015046697 A catalog record for this book is available from the British Library. The quotation from John Lennon on the facing page has been ascribed to Allen Saunders, who wrote in Reader’s Digest in the 1950s, “Life is what happens to us while we are making other plans” (http://www.hufngtonpost.com/claudia- gryvatz- copquin/gilda-r adner_b _2231040.html). Special discounts are available for bulk purchases of this book. For more information, please contact Special Sales at 410- 516-6 936 or To my champions and mentors in Texas: Mark Kline, MD, and Mark Wallace of Texas Children’s Hospital Paul Klotman, MD, President of Baylor College of Medicine Amb. Edward P. Djerejian, Director, James A. Baker III Institute for Public Policy, Rice University Philip K. Russell, MD, President Emeritus, Sabin Vaccine Institute And to my wife, Ann Hotez, and our four children, Matthew, Emily, Daniel, and our (now adult) special needs daughter, Rachel Hotez, who helps to keep me humble and reminds me daily of what John Lennon once wrote and sang: “Life is what happens while you are busy making other plans.” Hotez_FM.indd 5 6/28/16 12:22 PM This page intentionally left blank Hotez.indb 6 6/22/16 11:02 AM Contents Foreword, by Cher ix Preface xi Introduction 1 1 A Changing Landscape in Global Health 6 2 The “Other Diseases”: The Neglected Tropical Diseases 15 3 Introducing Blue Marble Health 32 4 East Asia: China, Indonesia, Japan, and South Korea 48 5 India 60 6 Sub-S aharan Africa: Nigeria and South Africa 73 7 Saudi Arabia and Neighboring Confict Zones of the Middle East and North African Region 85 8 The Americas: Argentina, Brazil, and Mexico 99 9 Australia, Canada, European Union, Russian Federation, and Turkey 113 10 United States of America 122 11 The G20: “A Theory of Justice” 141 12 A Framework for Science and Vaccine Diplomacy 154 13 Future Directions 164 Literature Cited 171 Index 199 Hotez.indb 7 6/22/16 11:02 AM This page intentionally left blank Hotez.indb 8 6/22/16 11:02 AM Foreword uring more than fve decades as an artist and performer on the world Dstage, I have been extremely blessed to visit dozens of nations and meet tens of thousands of amazing people of all religions and ethnic backgrounds. Connecting with people from all walks of life has been an energizing life force and an inspiration for my work. But I have also witnessed a dark side to our big and beautiful planet, namely, the dehumanizing efects of severe poverty. For me, there is nothing more devastating than seeing parents who cannot aford to care for or feed their children or seeing the desperate homeless. In response, I have tried to give back to those most in need. Trough our Cher Charitable Foundation, we have helped the poorest people living in Armenia as well as children with craniofacial deformities, head and neck diseases, and neglected diseases such as pediatric AIDS and cerebral malaria. Most recently, through our support of the Peace Village School in Shika- mana, Kenya, hundreds of orphans and other vulnerable children are get- ting a fresh start. We are beginning to make a diference. Aside from the challenges of being poor, it must also be especially dis- heartening to be poor and to live alongside great wealth. It’s a terrible thing to live as a “have not” next to a “have.” Yet in communities across America, more than one million families must survive on practically no money and barely scratch out an existence. Tese same destitute families usually live within a few miles or even a few blocks from those with enormous wealth and privilege. Now, with the latest fndings of Dr. Peter Hotez, we realize there’s a new dimension to extreme poverty. In the United States, or indeed anywhere Hotez.indb 9 6/22/16 11:02 AM