|
The answer depends on the standpoint of the individual. Should he or she
contract a disease, then prevention is too late. The only thing left is,
hopefully, a cure. However, a minister of health may take a different view. In any country he will need to decide on the allocation of
his budget, and this in turn will depend on the priorities obtaining in that country. The main
priority may be prevention. This will require expenditure in fields other than medicine; these
are public works, nutrition and health education. Other ministries will therefore be involved.
In the long run there is little doubt that the prevention of disease is of higher priority than
finding cures.
This is particularly true in countries where people become the victims of epidemics, or
where certain diseases are endemic. In certain tropical countries, malaria is endemic. The effects
of it can be suppressed by drugs and its source, the anopheles mosquito, has long been known.
However without strict public health regulations, e.g. avoiding standing water, and using
mosquito nets in the wet season, malaria will persist, although the mosquito can be destroyed
by spraying. Meanwhile a course of drugs will build up the body's resistance. Suppression and
prevention will ultimately lead to a natural cure.
Discovery of the cause of any disease is crucial. Up to the 17th century England was
ravaged by a series of bubonic plagues which killed off people by the thousand, especially in
London. The old theory was that the plague was caused by the stench of rotting refuse. In fact,
it came from rat fleas, which infected humans. The prevention procedures was to destroy the
rats, which in turn meant providing London with proper drainage, and also to educate people
in public hygiene. The plague was eradicated by preventive methods, in a period when finding
an actual cure was medically impossible.
The most important preventive measure against disease is inoculation. The means is to
vaccinate with enough of the virus concerned to achieve immunity to the actual disease. Certain
diseases, some fatal, have now disappeared from the Western world as a result; immunity from
poliomyelitis, yellow fever, tetanus, typhoid fever and some forms of influenza can now be
achieved by injection. In the case of childish and non-fatal complaints, it is sometimes thought
best to accept them, because where a child's bodily health is generally good a natural immunity
results. In adults, jaundice and hepatitis are far more dangerous, although nowadays haematology saves many lives.
Other preventative measures include eliminating the cause of disease from the environment;
e.g. measures to prevent the inhalation of coal dust in the mining industry, and the rejection of
asbestos from the building trade. Where the quality of water is suspect, boiling achieves a general
level of safety. The strengthening of bodily defenses against disease is of strategic importance.
This necessitates a balanced diet, reasonable exercise, warmth in cold climates, good sleep, and
favorable housing and working conditions. When a disease has been caught,
measures to control it include the use of modern drugs, X-ray therapy in the case of cancer, and at times, surgery.
What is disease? It is the invasion of the body by outside agents, bacteria,
viruses, fungi, toxins or radiation. It can also result from changes in the body
and from physical malfunctioning, or from failure to adapt to environmental change. Changes in diet and the invasion of
microorganisms can also contribute. In general, people have a built-in immunity to these
invasions, though not always.
Unfortunately it seems that as fast as one disease is eliminated another seems to take its place.
This applies less to infectious and contagious disease than to contraction by individuals, though
not always. A greatly feared recent illness is AIDS, of which the origin is at present unknown,
though its means of spread has become clear. So far, this
scourge, which is becoming endemic
in certain parts of Africa, is incurable. It can be contained by prophylaxis and avoided altogether
by avoiding sexual promiscuity. The prevention of' its spread is essential. Its cure remains
uncertain.
Meanwhile there is no means of preventing or curing either the common cold or the various
kinds of rheumatic and arthritic complaints. All of them can be lived with if drug suppressants
are used, but the facts illustrate the patchy nature of medical advances. The same may be said
about cancer. There are treatments, but so far no cure. There are preventive measures, such as
not smoking, to avoid lung cancer, although the stated connection between smoking tobacco
and lung cancer is opinion and propaganda rather than demonstrable fact.
Certain addictions, including drug addiction, may be classified as disease. In no case is there
a cure for the condition. Prevention by abstention is all-important.
Dramatic advances in bodily organ replacement. e.g. heart, lung and kidney surgery, now
give new hope to many sufferers. Cure by skilled surgery may be the only option, since there
are no medical treatments. Neither are there any preventative measures.
These examples and others can be cited to prove the topic-statement either way, but if one
has to generalize for the long term, the balance may he on the side of prevention. However much
of the latter remains empirical while the actual causes of serious diseases remain unknown.
|
