Key Formulas & Frameworks
Rโ = ฮฒ ร c ร D
ฮฒ = transmission probability, c = contact rate, D = infectious period. Rโ <1: disease dies out; Rโ >1: epidemic potential
CFR = (Deaths / Confirmed Cases) ร 100
Infection Fatality Rate (IFR) uses estimated total infections (including asymptomatic)
Core Concepts
Global Burden of Disease (GBD) study: 359 diseases, 286 causes of death, 87 risk factors. Leading causes globally: ischemic heart disease, stroke, COPD, lower respiratory infections, neonatal conditions. NCDs now cause 74% of deaths globally.
Marmot Commission (2008): health inequalities are driven by social gradients โ income, education, housing, employment, discrimination. "Causes of causes": poverty โ poor housing โ mold โ asthma. Closing the gap in a generation requires addressing these root causes.
Actors: WHO (normative), World Bank (funding), Gavi (vaccines), Global Fund (HIV/TB/malaria), MSF (emergency response), Rockefeller Foundation (capacity building). Power imbalances: funding countries set priorities; disease-specific funding distorts health systems.
Core Definitions
Worked Examples
Measles Rโ = 15: HIT = 1 โ 1/15 = 1 โ 0.067 = 93.3%. This is why measles requires 95%+ vaccination coverage. Polio Rโ = 6: HIT = 1 โ 1/6 = 83.3% โ achievable with high coverage.
A person disabled by stroke for 10 years (disability weight 0.4): YLD = 10 ร 0.4 = 4 DALYs. If they also die 20 years prematurely: YLL = 20. Total = 24 DALYs of healthy life lost.
Answer: HIT = 1 โ 1/4 = 75% of the population must be immune (through vaccination or prior infection) to stop transmission.
Answer: DALY (Disability-Adjusted Life Year): measures disease burden โ years of healthy life LOST. QALY (Quality-Adjusted Life Year): measures health benefit โ years of healthy life GAINED from an intervention. 1 DALY averted = 1 QALY gained.
Answer: The recognition that human health, animal health, and environmental health are interconnected and require collaborative approaches. 75% of emerging infectious diseases are zoonotic. Examples: COVID-19, Ebola, antimicrobial resistance, avian influenza.